Sleep problems are found to be correlated with poor well-being and low quality of life. [1] Persistent sleeping disturbances can lead to fatigue, irritability, and various health issues. Numerous studies have examined the positive impact of music on sleep quality. As early as 2000 B.C., lullabies were designed to aid infant sleep. For adults with sleep-related disorders, music serves as a useful intervention in reducing stress. Approximately 25% of the population facing sleep difficulties regularly use music as a tool for relaxation. [2] This process can be either self-prescribed or under the guidance of a music therapist.
Music therapy is introduced into the medical field for treating sleeping disorders following scientific experimentations and observations. Compared to other pharmacological methods for improving sleep, music has no reported side effects [3] and is easy to administer. [4] In direct comparisons, music has improved sleep quality greater than audiobooks [5] [6] and has been comparable to sedative hypnotics. [7] In addition, music can be combined with relaxation techniques such as breathing exercises [8] and progressive muscle relaxation. [9] One review of non-pharmacological sleep aids identified music as the only sleep aid with adequate research. [10] The influence of music on sleep has been investigated across various contexts, exploring how music stimuli can influence different aspects of the sleeping experience. Implications of findings help in building up a more effective procedure of musical therapies to target sleep problems.
A number of companies such as Acoustic Sheep (producer of SleepPhones) and Snoozeband produce headbands that play music to make it easier and more comfortable to listen to music while trying to get to sleep.
Research suggests that music contributes to higher perceived sleep quality, greater sleep efficiency, longer sleep durations, less sleep disturbance, and less daytime dysfunction for older adults. [11] This was assessed through improved scores on the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Polysomnography investigations have found listening to slow-tempo music increased slow-wave sleep (deep sleep) and reduced rapid eye movement sleep (lighter sleep stage). [12] Music facilitates a large improvement in sleep quality for insomnia patients. [13] Interventions including music-assisted relaxation and listening to music effectively reduce sleep onset latency for people with insomnia. [14] However, several studies found music to have neither positive nor negative effects on subjective sleep quality for normal individuals. [15] [16]
Music can reduce sympathetic nervous system activity, decrease blood pressure and heart rate. [17] The decrease in Systolic Blood pressure, Diastolic Blood pressure, and heart rate signal a state of calmness, which is essential for having a good night sleep. Sedative music, which is characterized by a slow tempo, repetitive rhythm, gentle contours, and strings, is effective in generating anxiolytic responses to aid sleep. [18]
Electroencephalogram (EEG) studies give insights into how music alters brainwave activities during sleep. Gentle and soothing music can lead to increased delta wave activities which indicate deep sleep. [19] Several experiments have tested listening to preferred music significantly decreases cortisol levels and reduces the amount of stress experienced. [20] [21] Saliva melatonin, a hormone associated with sleep initiation, was found to be elevated among people using interactive music therapies. [22] These hormones work in attributing a more conducive environment for falling asleep and maintaining stable sleep stages.
Dickson & Schubert summarized and evaluated six researcher proposed reasons (RPR) by which music could potentially aid sleep: [23]
Dickson & Schubert proposed Habit Formation as an additional RPR under the Arts on Prescription model. Based on classical conditioning, repeated pairing of the music with the intention of sleep can generate a conditioned response. By forming this habit, music alone would be effective in triggering a relaxation response, which signals the body that it is time to sleep. This requires a minimum of three weeks for individuals suffering mild insomnia to become healthy sleepers and continues to improve sleep quality over three months. [24] Music improved sleep quality with increased exposure regardless of differences in the demographic, music genre, duration of treatment, and exposure frequency. Dickson suggests "listening to music that you find relaxing, at the same time, every night for at least three weeks".
Typical genres of music used for sleep (sedative music) include classical music, ethnic music, ambient music, meditation music and lullabies, although researchers have recognised a wide diversity of music genres aiding sleep. [6] The characteristics of music that have improved sleep quality in the music-sleep literature include slow tempo, small change of rhythm, and moderate pitch variation of melody. [16] The selection of music (self selected or researcher selected) does not appear to impact sleep quality. [25]
Instrumental music such as sitar or violin is recognized as more effective in inducing sleep than vocal music. [26] Although lyric gives depth and meaning to the music, it also stimulates cognitive processes, making it more difficult to fall asleep. Whereas instrumental music focuses on the melody and rhythm, it allows for relaxation without the distraction of lyrics. Research has given evidence for the use of instrumental music in improving sleep quality. [27]
Nature sounds like birdsong or rainfall can provoke a feeling of peacefulness and tranquillity to facilitate sleep. [28] Binaural beats work by presenting two different frequencies to each ear that synchronize brainwave activity. Those two methods can be combined to improve sleep quality by targeting both the sensory experience and brainwave alterations. [29]
While many studies have shown the significant influence of soft slow music on sleep, it is essential to acknowledge that this effect is not uniform across all individuals. Extensive research has revealed the variability in individual responses to musical stimuli, which can be due to their personal preference, cultural background, and susceptibility to different music types. [32] Some may find classical music entertaining, while others prefer ambient music for relaxation. Cultural background can also shape an individual's perception and response to music stimuli. The concept of music and sleep, although applicable to the general population, needs to take into account these differences to tailor each individual's taste. By customizing music choices, the overall effectiveness of music in improving sleep can be maximized, contributing to a better life quality for people. [33]
Hypnotic, or soporific drugs, commonly known as sleeping pills, are a class of psychoactive drugs whose primary function is to induce sleep and to treat insomnia (sleeplessness).
A nightmare, also known as a bad dream, is an unpleasant dream that can cause a strong emotional response from the mind, typically fear but also despair, anxiety, disgust or sadness. The dream may contain situations of discomfort, psychological or physical terror, or panic. After a nightmare, a person will often awaken in a state of distress and may be unable to return to sleep for a short period of time. Recurrent nightmares may require medical help, as they can interfere with sleeping patterns and cause insomnia.
A sleep disorder, or somnipathy, is a medical disorder of an individual's sleep patterns. Some sleep disorders are severe enough to interfere with normal physical, mental, social and emotional functioning. Sleep disorders are frequent and can have serious consequences on patients' health and quality of life. Polysomnography and actigraphy are tests commonly ordered for diagnosing sleep disorders.
Insomnia, also known as sleeplessness, is a sleep disorder where people have trouble sleeping. They may have difficulty falling asleep, or staying asleep for as long as desired. Insomnia is typically followed by daytime sleepiness, low energy, irritability, and a depressed mood. It may result in an increased risk of accidents of all kinds as well as problems focusing and learning. Insomnia can be short term, lasting for days or weeks, or long term, lasting more than a month. The concept of the word insomnia has two possibilities: insomnia disorder (ID) and insomnia symptoms, and many abstracts of randomized controlled trials and systematic reviews often underreport on which of these two possibilities the word insomnia refers to.
Stress management consists of a wide spectrum of techniques and psychotherapies aimed at controlling a person's level of stress, especially chronic stress, usually for the purpose of improving everyday functioning. Stress produces numerous physical and mental symptoms which vary according to each individual's situational factors. These can include a decline in physical health, such as headaches, chest pain, fatigue, and sleep problems, as well as depression. The process of stress management is named as one of the keys to a happy and successful life in modern society. Life often delivers numerous demands that can be difficult to handle, but stress management provides a number of ways to manage anxiety and maintain overall well-being.
Fibromyalgia is a medical syndrome which causes chronic widespread pain, accompanied by fatigue, waking unrefreshed, and cognitive symptoms. Other symptoms can include headaches, lower abdominal pain or cramps, and depression. People with fibromyalgia can also experience insomnia and a general hypersensitivity. The cause of fibromyalgia is unknown, but is believed to involve a combination of genetic and environmental factors. Environmental factors may include psychological stress, trauma, and certain infections. Since the pain appears to result from processes in the central nervous system, the condition is referred to as a "central sensitization syndrome".
Autogenic training is a relaxation technique first published by the German psychiatrist Johannes Heinrich Schultz in 1932. The technique involves repetitions of a set of visualisations accompanied by vocal suggestions that induce a state of relaxation and is based on passive concentration of bodily perceptions like heaviness and warmth of limbs, which are facilitated by self-suggestions. Autogenic training is used to alleviate many stress-induced psychosomatic disorders.
Nightmare disorder is a sleep disorder characterized by repeated intense nightmares that most often center on threats to physical safety and security. The nightmares usually occur during the REM stage of sleep, and the person who experiences the nightmares typically remembers them well upon waking. More specifically, nightmare disorder is a type of parasomnia, a subset of sleep disorders categorized by abnormal movement or behavior or verbal actions during sleep or shortly before or after. Other parasomnias include sleepwalking, sleep terrors, bedwetting, and sleep paralysis.
Sleep hygiene is a behavioral and environmental practice developed in the late 1970s as a method to help people with mild to moderate insomnia. Clinicians assess the sleep hygiene of people with insomnia and other conditions, such as depression, and offer recommendations based on the assessment. Sleep hygiene recommendations include: establishing a regular sleep schedule; using naps with care; not exercising physically or mentally too close to bedtime; limiting worry; limiting exposure to light in the hours before sleep; getting out of bed if sleep does not come; not using bed for anything but sleep and sex; avoiding alcohol as well as nicotine, caffeine, and other stimulants in the hours before bedtime; and having a peaceful, comfortable and dark sleep environment. However, as of 2021, the empirical evidence for the effectiveness of sleep hygiene is "limited and inconclusive" for the general population and for the treatment of insomnia, despite being the oldest treatment for insomnia. A systematic review by the AASM concluded that clinicians should not prescribe sleep hygiene for insomnia due to the evidence of absence of its efficacy and potential delaying of adequate treatment, recommending instead that effective therapies such as CBT-i should be preferred.
A relaxation technique is any method, process, procedure, or activity that helps a person to relax; attain a state of increased calmness; or otherwise reduce levels of pain, anxiety, stress or anger. Relaxation techniques are often employed as one element of a wider stress management program and can decrease muscle tension, lower blood pressure, and slow heart and breath rates, among other health benefits.
Shift work sleep disorder (SWSD) is a circadian rhythm sleep disorder characterized by insomnia, excessive sleepiness, or both affecting people whose work hours overlap with the typical sleep period. Insomnia can be the difficulty to fall asleep or to wake up before the individual has slept enough. About 20% of the working population participates in shift work. SWSD commonly goes undiagnosed, so it's estimated that 10–40% of shift workers have SWSD. The excessive sleepiness appears when the individual has to be productive, awake and alert. Both symptoms are predominant in SWSD. There are numerous shift work schedules, and they may be permanent, intermittent, or rotating; consequently, the manifestations of SWSD are quite variable. Most people with different schedules than the ordinary one might have these symptoms but the difference is that SWSD is continual, long-term, and starts to interfere with the individual's life.
Progressive muscle relaxation (PMR) is a method of deep muscle relaxation that does not involve any medications, meaning it is a non-pharmacological intervention. The idea behind progressive muscle relaxation is that there is a relationship between a person's mind and body. The body responds to its environment by creating certain mind or body states such as anxiety, stress, and fear. When the body is in these states, the muscles tense up. Progressive muscle relaxation aims to reverse these body states back to more neutral, relaxed states.
The psychological and physiological effects of meditation have been studied. In recent years, studies of meditation have increasingly involved the use of modern instruments, such as fMRI and EEG, which are able to observe brain physiology and neural activity in living subjects, either during the act of meditation itself or before and after meditation. Correlations can thus be established between meditative practices and brain structure or function.
Sleep deprivation, also known as sleep insufficiency or sleeplessness, is the condition of not having adequate duration and/or quality of sleep to support decent alertness, performance, and health. It can be either chronic or acute and may vary widely in severity. All known animals sleep or exhibit some form of sleep behavior, and the importance of sleep is self-evident for humans, as nearly a third of a person's life is spent sleeping.
In psychology, relaxation is the emotional state of low tension, in which there is an absence of arousal, particularly from negative sources such as anger, anxiety, or fear.
Cognitive behavioral therapy for insomnia (CBT-I) is a technique for treating insomnia without medications. Insomnia is a common problem involving trouble falling asleep, staying asleep, or getting quality sleep. CBT-I aims to improve sleep habits and behaviors by identifying and changing the thoughts and the behaviors that affect the ability of a person to sleep or sleep well.
PTSD or post-traumatic stress disorder, is a psychiatric disorder characterised by intrusive thoughts and memories, dreams or flashbacks of the event; avoidance of people, places and activities that remind the individual of the event; ongoing negative beliefs about oneself or the world, mood changes and persistent feelings of anger, guilt or fear; alterations in arousal such as increased irritability, angry outbursts, being hypervigilant, or having difficulty with concentration and sleep.
An orexin receptor antagonist, or orexin antagonist, is a drug that inhibits the effect of orexin by acting as a receptor antagonist of one (selective orexin receptor antagonist or SORA) or both (dual orexin receptor antagonis or DORA) of the orexin receptors, OX1 and OX2. Medical applications include treatment of sleep disorders such as insomnia.
MDMA-assisted psychotherapy is the use of prescribed doses of MDMA as an adjunct to psychotherapy sessions. Research suggests that MDMA-assisted psychotherapy for post-traumatic stress disorder (PTSD), including Complex PTSD, might improve treatment effectiveness. In 2017, a Phase II clinical trial led to "breakthrough therapy" designation by the US Food and Drug Administration (FDA) for potential use as a treatment for PTSD.
Behavioral sleep medicine (BSM) is a field within sleep medicine that encompasses scientific inquiry and clinical treatment of sleep-related disorders, with a focus on the psychological, physiological, behavioral, cognitive, social, and cultural factors that affect sleep, as well as the impact of sleep on those factors. The clinical practice of BSM is an evidence-based behavioral health discipline that uses primarily non-pharmacological treatments. BSM interventions are typically problem-focused and oriented towards specific sleep complaints, but can be integrated with other medical or mental health treatments. The primary techniques used in BSM interventions involve education and systematic changes to the behaviors, thoughts, and environmental factors that initiate and maintain sleep-related difficulties.