Music to improve sleep quality in adults with depression-related insomnia (MUSTAFI): randomized controlled trial

Abstract

Background

Insomnia in depression is common and difficult to resolve. Unresolved depression-related sleep disturbances increase risk of relapse at high costs for individuals and society. Trials have suggested music for insomnia in various populations, but there is little research on the effectiveness of music for depression-related insomnia.

Methods

We examined the efficacy of a music intervention on insomnia, depression symptoms and quality of life in adults with depression-related insomnia. A two-armed randomized controlled trial was conducted, including depression outpatients with insomnia (n = 112) in a 1:1 ratio to music intervention and waitlist control group. The intervention group listened to music at bedtime for 4 weeks. Participants received treatment as usual during 8 weeks with assessments at baseline, at 4 and 8 weeks. The primary outcome measure was Pittsburgh Sleep Quality Index (PSQI), secondary outcomes comprised Actigraphy, the Hamilton Depression Rating Scale (HAMD-17) and World Health Organisation well-being questionnaires (WHO-5, WHOQOL-BREF).

Results

The music intervention group experienced significant improvements in sleep quality and well-being at 4 weeks according to global PSQI scores (effect size = −2.1, 95%CI −3.3; −0.9) and WHO-5 scores (effect size 8.4, 95%CI 2.7;14.0). At 8 weeks, i.e. 4 weeks after termination of the music intervention, the improvement in global PSQI scores had decreased (effect size = −0.1, 95%CI −1.3; 1.1). Actigraphy sleep assessments showed no changes and there was no detection of change in depression symptoms.

Conclusions

Music intervention is suggested as a safe and moderately effective sleep aid in depression-related insomnia. Trial registration: Clinicaltrials.gov. ID NCT03676491

Keywords:

• Music
• depression
• insomnia
• sleep quality
• non-pharmacological

Disclosure statement

The authors Lund and Bertelsen declare conflicting interests due to ownership and sales of the MusicStar app. Other co-authors have no conflicting interests.

Data availability statement

The data sets are available from the corresponding author upon reasonable request.

Additional information

Funding

This work was supported by Clinic South, Aalborg University Hospital – Psychiatry, The Obel Family Foundation, Aase & Ejnar Danielsen Foundation, and The Danish North Region Health Research Foundation. Sound pillows were delivered by Fønix Musik Aps. We are thankful for the vital financial support. The funding bodies had no role or authorities over the research or related publications.

Notes on contributors

Helle Nystrup Lund

Helle Nystrup Lund is Music Therapist, Ph.D. at Aalborg University Hospital, Psychiatry, Aalborg, DK. (Corresponding author).

Inge Nygaard Pedersen

Inge Nygaard Pedersen is Ass. Prof. Emeritus, Ph.D. at Aalborg University, DK.

Agnieszka M. Heymann-Szlachcinska

Agnieszka M. Heymann-Szlachcinska is MD, Ph.D. in Unit for Anxiety and Obsession, Aalborg University Hospital, Psychiatry, DK.

Maryla Tuszewska

Maryla Tuszewska is MD, Ph.D. in Department for Child and Adolescent Psychiatry, Aalborg University Hospital, DK.

Gustav Bizik

Gustav Bizik is MD, Ph.D. in Unit for Depression, Aalborg University Hospital, Psychiatry, DK.

Jens Ivar Larsen

Jens Ivar Larsen is MD, Ph.D. in Unit for Depression, Aalborg University Hospital, Psychiatry, DK.

Antonio Drago

Antonio Drago is MD, Ph.D. in Unit for Depression, Aalborg University Hospital, Psychiatry DK.

Eszter Kulhay

Eszter Kulhay is MD, Ph.D. in Unit for Depression, Aalborg University Hospital, Psychiatry, DK.

Anelia Larsen

Anelia Larsen is Head of unit for mood disorders. Clinical psychologist, Ph.D., Aalborg University Hospital, Psychiatry, DK.

Helle Østermark Sørensen

Helle Østermark Sørensen is Project nurse, Unit for Psychiatric Research, Aalborg University Hospital, DK.

Bettina Grønbech

Bettina Grønbech is Project nurse, Unit for Psychiatric Research, Aalborg University Hospital, DK.

Lars Rye Bertelsen

Lars Rye Bertelsen is Music Therapist, Ph.D. Student, Music Therapy Clinic, Aalborg University Hospital, Psychiatry, DK.

Jan Brink Valentin

Jan Brink Valentin is Senior Statistician, Danish Center for Clinical Health Services Research, Aalborg University.

Jan Mainz

Jan Mainz is Professor, MD, Psychiatry Management, Aalborg University Hospital, and Danish Center for Clinical Health Services Research, Aalborg University, DK.

Søren Paaske Johnsen

Søren Paaske Johnsen is Clinical Professor, MD, at The Faculty of Medicine, Aalborg University and Danish Center for Clinical Health Services Research, Aalborg University, DK.