Music Listening and Sleep in Rehabilitation of Adults with Acquired Brain Injury: A Pilot Study

Abstract.

BACKGROUND: Sleep is an important part of people’s life. Sleep is involved in many biological functions and sleep deprivation can be fatal. An acquired brain injury (ABI) may lead to impairment in various functional domains including sleep. Sleep disturbance is highly prevalent in ABI but is often neglected in treatment impacting recovery. Listening to relaxing music as a nonpharmacological intervention may lead to improvement in self-reported sleep quality for populations with insomnia, but research is lacking investigating the potential effect of music listening for sleep improvement in an ABI population. 

OBJECTIVE: The aim of this article-based master’s thesis is to investigate the acceptability and effectiveness of relaxing, self-selected music listening at bedtime on sleep improvement for patients with ABI and sleep disturbance undergoing inpatient rehabilitation.

METHOD: The study used a within-subjects crossover design with repeated measures for a total duration of 28 days. Included participants with poor sleep quality assessed with the Pittsburgh Sleep Quality Index (PSQI>5) were allocated by pairwise randomization to either a control condition or music condition first. The control condition consisted of standard care alone, and the music condition consisted of music listening at bedtime in combination with standard care. After the initial 14 days the participants switched conditions. PSQI measures was taken at baseline, day 14 and 28. Self-report and physiological sleep measures with wrist-worn actigraphy were taken daily in both conditions.

RESULTS: A total of four participants ended up being included in the final analysis. Data evaluating intervention acceptability suggests that listening to relaxing, self-selected music at bedtime may be suitable for sleep improvement in patients with ABI. Comparison of data showed no significant PSQI improvement during the music condition when compared to the control condition (p = .066, d = 1.41, BF₁₀ = 1.97). Non-significant condition x day interaction effects were found in analysis of all daily self-report and physiological sleep measures.

CONCLUSIONS: Preliminary intervention acceptability and PSQI results are promising and support the need for future trials investigating the effectiveness of music listening on sleep improvement in a larger ABI sample.