Music improves sleep quality in students

Ambient chemical and physical approaches for the modulation of sleep and wakefulness

Humans spend a third of their lives asleep. While the sleep-wake behaviors are primarily modulated by homeostasis and circadian rhythm, several ambient chemical and physical factors, including light, sound, odor, vibration, temperature, electromagnetic radiation, and ultrasound, also affect sleep and wakefulness. Light at different wavelengths has different effects on sleep and wakefulness. Sound not only promotes but also suppresses sleep; this effect is mediated by certain nuclei, including the pedunculopontine nucleus and inferior colliculus. Certain sleep-promoting odorants regulate sleep through the involvement of the olfactory bulb and olfactory tubercle. In addition, vibrations may induce sleep through the vestibular system. A modest increase in ambient temperature leads to an increase in sleep duration through the involvement of the preoptic area. Electromagnetic radiation has a dual effect on sleep-wake behaviors. The stimulation produced by the ambient chemical and physical factors activates the peripheral sensory system, which converts the chemical and physical stimuli into nerve impulses. This signal is then transmitted to the central nervous system, including several nuclei associated with the modulation of sleep-wake behaviors. This review summarizes the effects of ambient chemical and physical factors on the regulation of sleep and wakefulness, as well as the underlying neurobiological mechanisms.

Association of macronutrient intake, physical activity, anxiety, and depression with sleep quality among Iranian male adolescents

BACKGROUND

Adolescence is a unique stage of life accompanied by physiological and psychological modifications, along with stress, confusion, and depression.

MATERIALS AND METHODS

The present descriptive-analytical cross-sectional research was done on 267 male adolescents who studied at high schools in Zanjan, Iran. Demographic characteristics questionnaires, a 48-item food frequency questionnaire, a short version of the International Physical Activity Questionnaire (IPAQ), the Depression Anxiety Stress Scale (DASS-21), and the Pittsburgh Sleep Quality Index (PSQI) were used to collect data.

RESULTS

The mean ± standard deviation (SD) of age, weight, height, and sitting time was 15.94 ± 0.91 years, 68.53 ± 15.28 kg, 1.75 ± 0.06 m, and 449.25 ± 322.06 min, respectively. The study results showed that students with poor sleep quality showed a higher rate of depression than those with good sleep quality in the high and low physical activity groups (p < 0.05). The stress, depression, and anxiety scores significantly correlated with sleep quality in the physical activity groups (p < 0.05). The structural equation model analysis results showed that mental health directly affected sleep quality; this association was significant in the low physical activity group.

CONCLUSION

We found that sleep quality was independently related to mental health in young Iranian men. However, dietary intake was not a significant predictor of mental health or sleep quality. More studies are required to evaluate the association between dietary intake and sleep quality in adults.

Sleep-aiding music therapy for insomnia: Exploring EEG functional connectivity of sleep-related attentional bias

STUDY OBJECTIVES

This study aimed to investigate the relationship between sleep-aiding music and sleep-related attentional bias based on electroencephalography (EEG) functional connectivity (FC) in patients with insomnia disorder (ID), to evaluate the effectiveness of music in aiding sleep.

METHOD

This study included 30 participants, comprising 15 patients with ID and 15 healthy controls (HCs). Six types of music were selected for sleep aid, and a dot-probe task based on sleep-related attentional bias was utilized to collect behavioral and EEG data. Vigilance bias and disengagement bias were measured using reaction time and EEG FC. Differences in sleep-related attentional bias before and after the intervention of music were explored to evaluate the sleep-aiding effects and identify EEG biomarkers.

RESULTS

Compared with HCs, patients with ID showed decreased sleep-related attentional bias of EEG FC between occipital-central and temporal-frontal lobes. Among the six types of music, International Standard Sleep Aid and Lullaby had a greater impact on decreasing vigilance bias in the ID group. Additionally, the International Standard Sleep Aid and Nature Sound were more effective in decreasing disengagement bias in the ID group. This study also examined the resting-state EEG FC of patients with ID before and after the intervention of music. The results showed that the FC in the temporal, frontal, and occipital lobes significantly differed before and after the intervention of music, especially with the use of International Standard Sleep Aid, Lullaby, and Alpha Sound Wave. However, it is worth noting that these three types of music showed no similarities in EEG FC, in contrast to the result of sleep-related attentional bias of EEG FC.

CONCLUSION

This study found that the sleep-related attentional bias of EEG FC has more distinct characteristics when compared to resting-state EEG FC. The results suggest that the sleep-related attentional bias of EEG FC could be a potential biomarker for assessing the sleep-aiding effect of music interventions. International Standard Sleep Aid was the most effective for patients with ID among six types of sleep-aiding music. These findings could facilitate the development of personalized therapies for patients with ID.

CLINICAL TRIALS REGISTRATION

Chinese Clinical Trial Register, http://www.chictr.org.cn, ID: ChiCTR2400081608.

Bedtime music therapy for college students with insomnia: A randomized assessor-blinded controlled trial

BACKGROUND

Insomnia, a prevalent sleep disorder in contemporary society, frequently coexists with other mental health conditions such as depression, schizophrenia, and obsessive-compulsive disorder. Sleep disorders can compromise daytime functioning and overall quality of life. While music has been explored as an adjunct therapy for insomnia, its efficacy in improving insomnia among students remains unclear.

METHODS

Seventy-five students, aged between 18 and 30 years with an average age of 20.97 years (SD: 1.92), presenting sleep issues were randomly allocated to one of three groups: the classical music group, the jazz music group, and the control group, each with 25 participants. Participants in the classical and jazz music group were instructed to listen to classical or jazz music for a minimum of 30 min preceding bedtime. This was paired with deep breathing and relaxation techniques, practiced two consecutive nights per week from 23:00 to 01:00 over a five-week intervention period. Conversely, participants in the control group were only directed to follow the deep breathing and relaxation techniques before sleep on two consecutive nights weekly. Insomnia severity with the Insomnia Severity Index (ISI), sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), depressive symptoms with the Beck Depression Inventory-II (BDI- II), and anxiety symptoms with the Self-rating Anxiety Scale (SAS). Measurements were taken at baseline, after the second week of intervention, at the intervention's conclusion (five weeks), and two months post-intervention (follow-up).

RESULTS

1. The music groups showed a significant difference in insomnia severity compared with the control group after five weeks of intervention(p < .05). 2. music groups exhibited significant enhancements in sleep quality relative to the control group after a five-week intervention (p < .05). 3. Regarding mood enhancement, music groups showed significant improvements in depression and anxiety symptoms compared to the baseline after the five-week intervention. Notably, the control group also displayed improvements in these symptoms post-intervention.

CONCLUSION

1. Integrating music into a consistent bedtime routine ameliorates sleep quality and insomnia severity. However, no specific genre of music emerged as the superior choice for pre-sleep listening. 2. While music can considerably enhance mood indicators like depression and anxiety, techniques such as deep breathing and mindfulness also contribute positively. 3. Incorporating music before sleep tangibly elevates overall quality of life and daytime functioning.

TRIAL REGISTRATION

ChiCTR2300073953.

The role of arts therapies in mitigating Sleep Initiation and Maintenance Disorders: a systematic review

Introduction

Arts therapies offer effective non-pharmacological intervention for Sleep Initiation and Maintenance Disorders (SIMDs), encompassing both passive and active modalities. This review assesses their effectiveness and ethical considerations, focusing on music therapy, meditation, and Tai Chi.

Methods

Following PRISMA guidelines, a detailed search across PubMed, the Cochrane Library, Web of Science, and CNKI identified 17 relevant RCTs. Utilizing the Joanna Briggs Institute (JBI) quality criteria and the PICO(S) framework for data extraction ensured methodological integrity.

Results

Analysis shows arts therapies significantly improve sleep quality. Music therapy and meditation yield immediate benefits, while Tai Chi and Qigong require longer commitment for significant outcomes.

Discussion

The link between SIMDs and mental health issues like anxiety, stress, and depression suggests arts therapies not only enhance sleep quality but also address underlying mental health conditions. The evidence supports a wider adoption of arts therapies in treating SIMDs due to their dual benefits.

Systematic review registration

PROSPERO, ID: CRD42024506393.

Effects of different interventions on insomnia in adults: Systematic review and network meta-analysis

OBJECTIVE

Insomnia is a common sleep disorder. There are many clinical-intervention methods for treating this condition, but thus far, the most effective method has not been determined.

METHODS

We conducted a network meta-analysis by including random evidence of insomnia improvement in people over 18 years old, without other physical diseases. From January 1, 1990 to June 15, 2022, we searched multiple electronic databases for randomized controlled trials of different insomnia-related, clinical-intervention methods. R software was used to analyze 10 indices, in order to evaluate the effect of sleep improvement. Primary outcomes comprised Pittsburgh sleep quality-index (PSQI) scores and insomnia severity-index (ISI) scores.

RESULTS

Finally, 122 randomized controlled trials were included in our study. For the PSQI scores, we found the sequence of intervention measures by effect to be as follows: electroacupuncture, acupuncture, repetitive transcranial magnetic stimulation (rTMS), essential oils, herbal medicine, traditional Western medicine, Tai Chi and Baduanjin, music, supplements, cognitive behavioral therapy for insomnia (CBT-I), and exercise. The results for ISI were similar to those for PSQI, but with slight differences.

CONCLUSION

Our research results indicate that various measures have a certain effect on improving sleep, among which the effect of instruments is more prominent. The curative effect of placebo groups was better than that of blank control groups. There is essentially no statistical difference in detailed classification within the same intervention category.

Effect of sleep ambient music on sleep quality and mental health in college students: a self-controlled study

To verify the effect of sleep ambient music intervention (SAMI) on sleep quality and mental status of college students, and to further explore the minimum effective duration of SAMI, this study was designed as a pre-and post-intervention self-controlled exploratory study. Participants were subjected to a one-week no-intervention test, then 4 weeks of music intervention followed. Subjective sleep quality data were collected using the Pittsburgh Sleep Quality Index (PSQI); objective sleep quality data were collected with Actigraphy; and mental status data were collected using the State-Trait Anxiety Inventory (STAI) and the Beck Depression Inventory-II (BDI-II). Data were analyzed and processed using mixed-effects models and repeated measures. The results showed that compared with the no-intervention week, college students' subjective sleep quality, objective sleep onset latency (SOL), trait anxiety, and depression symptom were reduced at week 1; week 2; week 3; week 4 under SAMI; state anxiety of college students at week 3 and week 4 under SAMI were also reduced. And there were differences in sleep quality among college students of different genders too. Compared with females, males had worse sleep efficiency (SE), shorter total sleep time (TST), and more awaking times (AT). In addition, 3 days was the minimum effective length for SAMI to shorten objective SOL, and 2 days was the minimum effective length to shorten the subjective SOL of college students. The findings of this study suggest that SAMI can improve subjective sleep quality, shorten objective SOL, and reduce anxiety and depression in college students. Interventions for more than 3 days had a significant effect on shortening SOL and long-term effects seemed to emerge after 3 weeks.

Effects of soothing images and soothing sounds on mood and well-being

OBJECTIVES

Mental health problems are increasing at an alarming rate, calling for the need for more cost-effective and easily accessible interventions. Visual images and sounds depicting nature have been found to have positive effects on individuals' mood and well-being; however, the combined effects of images and sounds have been scarcely investigated. This study therefore aimed to compare the mood effects of viewing nature-related soothing images versus listening to soothing sounds versus a combination of both.

METHODS

In this study, 149 participants aged 18-83 years old (M = 35.88, SD = 15.63; 72.5% female, male 26.8%, .7% transgender) were randomised into three intervention conditions: images only, sounds only or combined (images and sounds). Baseline depressive and anxiety symptoms were indexed, and four outcome variables (positive affect, negative affect, serenity affect and depressive mood states) were measured pre- and post-intervention.

RESULTS

Findings showed that all participants, regardless of group, reported a decrease in negative affect, positive affect and depressive mood as well as an increase in serenity affect (including feelings of soothe). However, there were no group differences. Exploratory analyses found that individuals with higher levels of depressive and anxiety symptoms at baseline experienced greater reduction in negative affect and depressive mood state, as well as a larger increase in serenity affect.

CONCLUSIONS

These findings therefore provide preliminary evidence that, upon further research and development, images and sounds depicting nature can potentially be developed for use as an effective tool to improve mood and well-being.

The audio features of sleep music: Universal and subgroup characteristics

Throughout history, lullabies have been used to help children sleep, and today, with the increasing accessibility of recorded music, many people report listening to music as a tool to improve sleep. Nevertheless, we know very little about this common human habit. In this study, we elucidated the characteristics of music associated with sleep by extracting audio features from a large number of tracks (N = 225,626) retrieved from sleep playlists at the global streaming platform Spotify. Compared to music in general, we found that sleep music was softer and slower; it was more often instrumental (i.e. without lyrics) and played on acoustic instruments. Yet, a large amount of variation was present in sleep music, which clustered into six distinct subgroups. Strikingly, three of the subgroups included popular tracks that were faster, louder, and more energetic than average sleep music. The findings reveal previously unknown aspects of the audio features of sleep music and highlight the individual variation in the choice of music used for sleep. By using digital traces, we were able to determine the universal and subgroup characteristics of sleep music in a unique, global dataset, advancing our understanding of how humans use music to regulate their behaviour in everyday life.

DEcrease STress through RESilience training for Students (DESTRESS) Study: Protocol for a randomized controlled trial nested in a longitudinal observational cohort study

INTRODUCTION

Chronic stress and burnout are highly prevalent among academically trained healthcare professionals, negatively affecting their well-being and capacity to engage in their work. Resilience to stress develops early in one's career path, hence offering resilience training to university students in these professions is one approach to fostering well-being and mental health. The aim of this study is to assess whether offering mindfulness-based resilience training to university students in healthcare professions reduces their perceived chronic stress.

METHODS AND ANALYSIS

The study has a hybrid design combining a longitudinal observational cohort with a nested randomized controlled trial (RCT) with sequential multiple assignment and multistage adaptive interventions while taking participants' preferences into account. All students in healthcare related programmes at the Erasmus University Rotterdam are invited to participate. Within the observational cohort, students with a score of 14 or higher on the Perceived Stress Scale (PSS) are invited to take part in the RCT (n = 706). Eligible participants are randomized to control or active intervention in a ratio of 1:6. Those randomized to the control group and non-randomized participants in the cohort receive passive web-based psychoeducation about chronic stress and burnout through referral to specific websites. Participants randomized to the intervention group receive one of 8 active mindfulness-based interventions. They select a rank order of 4 preferred interventions and are randomized across these with equal probability. Non-response to the intervention is followed by sequential randomized assignment to another intervention, for a total maximum of 3 sequential interventions. All participants receive questionnaires at baseline, before and after each 8-week intervention period, and at 1- and 2-year follow-up. The primary outcome is perceived chronic stress measured with the PSS. Secondary outcomes include mental well-being, burnout, quality of life, healthcare utilization, drug use, bodyweight, mental and physical stress-related symptoms, resilience, and study progress.

ETHICS AND REGISTRATION

Approval from the Medical Ethics Review Committee was obtained under protocol number MEC-2018-1645. The trial is registered in the Netherlands National Trial Register by registration number NL7623, 22/03/2019, https://www.trialregister.nl/.

Listening to music for insomnia in adults

BACKGROUND

Insomnia is a common problem in modern society. It is associated with reduced quality of life and impairments in physical and mental health. Listening to music is widely used as a sleep aid, but it remains unclear if it can actually improve insomnia in adults. This Cochrane Review is an update of a review published in 2015.

OBJECTIVES

To assess the effects of listening to music on sleep in adults with insomnia and to assess the influence of specific variables that may moderate the effect.

SEARCH METHODS

For this update, we searched CENTRAL, MEDLINE, Embase, nine other databases and two trials registers up to December 2021. In addition, we handsearched reference lists of included studies, and contacted authors of published studies to identify additional studies eligible for inclusion, including any unpublished or ongoing trials.

SELECTION CRITERIA

Randomised controlled trials comparing the effects of listening to music with no treatment or treatment as usual (TAU) in adults complaining of sleep difficulties.

DATA COLLECTION AND ANALYSIS

Two review authors independently screened records for eligibility, selected studies for inclusion, extracted data and assessed risk of bias of the included studies. We assessed the certainty of the evidence using GRADE. The primary outcomes were sleep quality, insomnia severity, sleep-onset latency, total sleep time, sleep interruption, sleep efficiency and adverse events. Data on the predefined outcome measures were included in meta-analyses when consistently reported by at least two studies that were homogeneous in terms of participants, interventions and outcomes. We undertook meta-analyses using random-effects models.

MAIN RESULTS

We included 13 studies (eight studies new to this update) comprising 1007 participants. The studies examined the effect of listening to prerecorded music daily, for 25 to 60 minutes, for a period of three days to three months. The risk of bias within the studies varied, with all studies being at high risk of performance bias, because of limited possibilities to blind participants to the music intervention. Some studies were at high risk of detection bias or other bias. Four studies reported funding from national research councils, three studies reported financial support from university sources and one study reported a grant from a private foundation. Five studies did not report any financial support. At the end of the intervention, we found moderate-certainty evidence for improved sleep quality measured with the Pittsburgh Sleep Quality Index (PSQI) in themusic groups compared to no intervention or TAU (mean difference (MD) -2.79, 95% confidence interval (CI) -3.86 to -1.72; 10 studies, 708 participants). The PSQI scale ranges from 0 to 21 with higher scores indicating poorer sleep. The size of the effect indicates an increase in sleep quality of the size of about one standard deviation in favour of the intervention. We found no clear evidence of a difference in the effects of listening to music compared to no treatment or TAU on insomnia severity (MD -6.96, 95% CI -15.21 to 1.28; 2 studies, 63 participants; very low-certainty evidence). We found low-certainty evidence that, compared to no treatment or TAU, listening to music may reduce problems with sleep-onset latency (MD -0.60, 95% CI -0.83 to -0.37; 3 studies, 197 participants), total sleep time (MD -0.69, 95% CI -1.16 to -0.23; 3 studies, 197 participants) and sleep efficiency (MD -0.96, 95% CI -1.38 to -0.54; 3 studies, 197 participants), but may have no effect on perceived sleep interruption (MD -0.53, 95% CI -1.47 to 0.40; 3 studies, 197 participants). In addition, three studies (136 participants) included objective measures of sleep-onset latency, total sleep time, sleep efficiency and sleep interruption and showed that listening to music may not improve these outcomes compared to no treatment or TAU. None of the included studies reported any adverse events.

AUTHORS' CONCLUSIONS

The findings of this review provide evidence that music may be effective for improving subjective sleep quality in adults with symptoms of insomnia. More research is needed to establish the effect of listening to music on other aspects of sleep as well as the daytime consequences of insomnia.

The Effect of Classical Music on Heart Rate, Blood Pressure, and Mood

Anxiety and depression have deleterious effects on health. Numerous studies have demonstrated the negative impact of emotions such as stress and anxiety on heart rate (HR), blood pressure (BP), and heart disease. These mood states have been linked to stroke, heart failure, diabetes, heart disease, respiratory problems, and drug abuse. Negative emotions can affect the HR and BP through the link between the nervous system and the cardiovascular system. Our study demonstrates the positive effect of classical music on HR, BP parameters, and mood states.

Learning About Your Mental Health From Your Playlist? Investigating the Correlation Between Music Preference and Mental Health of College Students

The present study explored the correlation between music preference and mental health of college students to make an empirical contribution to research in this field. The self-reported music preference scale and positive mental health scale of college students were adopted to conduct a questionnaire survey in college students. Common method variance was conducted to test any serious common method bias problem. No serious common method bias problem was observed. The results showed that college students' preference for pop music, Western classical music, and Chinese traditional music has a significant and positive correlation with their mental health. Furthermore, college students' preference for heavy music has a significant and inverse correlation with their mental health. This research presents a correlational study; therefore, no causality can be inferred.

Study on the Intervention Effect of Music on Insomnia of College Students

In this study, we have analyzed the intervention effect of music on insomnia of college students. For this purpose, we have selected college students of grade 2019 facing insomnia in our school and randomly selected 96 of them as research objects after the informed consent of the students. 96 subjects were randomly divided into two groups, observation group and control group, 48 cases in each group. No music intervention was applied to the control group, while music intervention was applied to the observation group. After intervention, all college students in the observation group and the control group were given PSQI scale and filled it out. The score was collected on the spot and counted immediately to evaluate the intervention effect of music on college students' insomnia. After music intervention, the score of each dimension of PSQI showed that the observation group was significantly better than the control group in falling asleep time, quality of sleep, hypnotic drugs, sleep efficiency, sleep disorders, and daytime dysfunction, and the results were statistically significant (P < 0.05). There was a statistically significant difference in insomnia between the two groups (P < 0.05), and the intervention efficacy of insomnia in the observation group was better than that in the control group. The observation group had a higher satisfaction with the insomnia intervention effect, and the total satisfaction was 89.58%. The control group had low satisfaction with the intervention effect of insomnia, the total satisfaction was 52.08%, and the difference was statistically significant (P < 0.05). Through the application of the music intervention method, the sleep quality of college students had been improved, and the insomnia intervention effect was obvious; therefore, music intervention for college students' insomnia had a good intervention effect and had the value of promotion.

Psychological Interventions to Improve Sleep in Young Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials

INTRODUCTION

The effects of impaired sleep on the wellbeing of young adults are profound, and the adverse outcomes for mental health are well documented in the research literature.

OBJECTIVE

This systematic review and meta-analysis aimed to identify, summarize, and synthesize the available evidence from randomized-controlled trials (RCTs) investigating psychological interventions aimed at improving sleep and related secondary outcomes such as anxiety and depression in healthy young adults.

METHOD

Nine electronic databases (Cochrane Central Registry of Controlled Trials [CENTRAL], PubMed, Scopus, PsycNET, CINHAL, INFORMIT, Web of Science [Science and Social Citation Index], OpenSigle and EMBASE) were searched, returning 54 full-text papers for assessment, with 13 studies meeting inclusion criteria for the meta-analysis.

RESULTS

A random effects meta-analysis showed that the combined effect of all interventions was moderate (ES = -0.53, 95% CIs [- 0.69, -0.36], p < .01), reflecting the efficacy of psychological interventions at improving sleep scores at post-intervention. Subgroup analyses of individual interventions showed that cognitive-behavioral interventions improved sleep (ES = -0.67, 95% CIs [-0.77, -0.57], p < .01) and secondary outcomes for anxiety (ES = -0.35, 95% CIs [-0.56, -0.15], p < .01) and depression (ES = -0.41, 95% CIs [-0.70, -0.13], p < .01) at post-intervention.

CONCLUSION

The results of the current review support the implementation of cognitive and behavioral interventions for sleep among young adults experiencing both sleep and comorbid mental health problems.

Music in Quarantine: Connections Between Changes in Lifestyle, Psychological States, and Musical Behaviors During COVID-19 Pandemic

Music is not only the art of organized sound but also a compound of social interaction among people, built upon social and environmental foundations. Since the beginning of the COVID-19 outbreak, containment measures such as shelter-in-place, lockdown, social distancing, and self-quarantine have severely impacted the foundation of human society, resulting in a drastic change in our everyday experience. In this paper, the relationships between musical behavior, lifestyle, and psychological states during the shelter-in-place period of the COVID-19 pandemic are investigated. An online survey on musical experience, lifestyle changes, stress level, musical behaviors, media usage, and environmental sound perception was conducted. The survey was conducted in early June 2020. Responses from 620 people in 24 countries were collected, with the large proportion of the responses coming from the U.S. (55.5%) and India (21.4%). Structural equation modeling (SEM) analysis revealed causal relationships between lifestyle, stress, and music behaviors. Elements such as stress-level change, work risk, and staying home contribute to changes in musical experiences, such as moderating emotion with music, feeling emotional with music, and being more attentive to music. Stress-level change was correlated with work risk and income change, and people who started living with others due to the outbreak, especially with their children, indicated less change in stress level. People with more stress-level change tended to use music more purposefully for their mental well-being, such as to moderate emotions, to influence mood, and to relax. In addition, people with more stress-level change tend to be more annoyed by neighbors' noise. Housing type was not directly associated with annoyance; however, attention to environmental sounds decreased when the housing type was smaller. Attention to environmental and musical sounds and the emotional responses to them are highly inter-correlated. Multi-group SEM based on musicians showed that the causal relationship structure for professional musicians differs from that of less-experienced musicians. For professional musicians, staying at home was the only component that caused all musical behavior changes; stress did not cause musical behavior changes. Regarding Internet use, listening to music via YouTube and streaming was preferred over TV and radio, especially among less-experienced musicians, while participation in the online music community was preferred by more advanced musicians. This work suggests that social, environmental, and personal factors and limitations influence the changes in our musical behavior, perception of sonic experience, and emotional recognition, and that people actively accommodated the unusual pandemic situations using music and Internet technologies.

Sound sleep: Lullabies as a test case for the neurobiological effects of music

Music is part of the cultural practice and, at the same time, is interwoven with biology through its effects on the brain and its likely evolutionary origin. Studies on music, however, are traditionally based on the humanities and often carried out in a purely historical context, without much input from neuroscience and biology. Here, we argue that lullabies are a particularly suited test case to study the biological versus cultural aspects of music.

Parents matter: barriers and solutions when implementing behavioural sleep interventions for infant sleep problems

Behavioural sleep interventions (eg, extinction-based methods) are among the most efficacious evidence-based techniques in the treatment of infant sleep problems. However, behavioural sleep interventions can be challenging for families to successfully implement. This review aims to summarise current research surrounding the potential barriers that arise when clinicians attempt to implement extinction-based methods with parents of infants. We provide a model that summarises 3 types of contextual-barriers; socio-cultural barriers, parent barriers, and infant barriers. Based on the current evidence, we propose that adopting a stepped care approach, planning ahead, increasing support, motivational interviewing, and/or emotional regulation may serve as useful tools for parents when implementing extinction-based methods. By considering these techniques, more families may receive the benefits of improved infant sleep.

Towards Effective Music Therapy for Mental Health Care Using Machine Learning Tools: Human Affective Reasoning and Music Genres

Music has the ability to evoke different emotions in people, which is reflected in their physiological signals. Advances in affective computing have introduced computational methods to analyse these signals and understand the relationship between music and emotion in greater detail. We analyse Electrodermal Activity (EDA), Blood Volume Pulse (BVP), Skin Temperature (ST) and Pupil Dilation (PD) collected from 24 participants while they listen to 12 pieces from 3 different genres of music. A set of 34 features were extracted from each signal and 6 different feature selection methods were applied to identify useful features. Empirical analysis shows that a neural network (NN) with a set of features extracted from the physiological signals can achieve 99.2% accuracy in differentiating among the 3 music genres. The model also reaches 98.5% accuracy in classification based on participants’ subjective rating of emotion. The paper also identifies some useful features to improve accuracy of the classification models. Furthermore, we introduce a new technique called ’Gingerbread Animation’ to visualise the physiological signals we record as a video, and to make these signals more comprehensible to the human eye, and also appropriate for computer vision techniques such as Convolutional Neural Networks (CNNs). Our results overall provide a strong motivation to investigate the relationship between physiological signals and music, which can lead to improvements in music therapy for mental health care and musicogenic epilepsy reduction (our long term goal).

Effects of music therapy on depression: A meta-analysis of randomized controlled trials

Background

We aimed to determine and compare the effects of music therapy and music medicine on depression, and explore the potential factors associated with the effect.

Methods

PubMed (MEDLINE), Ovid-Embase, the Cochrane Central Register of Controlled Trials, EMBASE, Web of Science, and Clinical Evidence were searched to identify studies evaluating the effectiveness of music-based intervention on depression from inception to May 2020. Standardized mean differences (SMDs) were estimated with random-effect model and fixed-effect model.

Results

A total of 55 RCTs were included in our meta-analysis. Music therapy exhibited a significant reduction in depressive symptom (SMD = −0.66; 95% CI = -0.86 to -0.46; P<0.001) compared with the control group; while, music medicine exhibited a stronger effect in reducing depressive symptom (SMD = −1.33; 95% CI = -1.96 to -0.70; P<0.001). Among the specific music therapy methods, recreative music therapy (SMD = -1.41; 95% CI = -2.63 to -0.20; P<0.001), guided imagery and music (SMD = -1.08; 95% CI = -1.72 to -0.43; P<0.001), music-assisted relaxation (SMD = -0.81; 95% CI = -1.24 to -0.38; P<0.001), music and imagery (SMD = -0.38; 95% CI = -0.81 to 0.06; P = 0.312), improvisational music therapy (SMD = -0.27; 95% CI = -0.49 to -0.05; P = 0.001), music and discuss (SMD = -0.26; 95% CI = -1.12 to 0.60; P = 0.225) exhibited a different effect respectively. Music therapy and music medicine both exhibited a stronger effects of short and medium length compared with long intervention periods.

Conclusions

A different effect of music therapy and music medicine on depression was observed in our present meta-analysis, and the effect might be affected by the therapy process.

Music on Prescription to Aid Sleep Quality: A Literature Review

Research on the efficacy of music for improving sleep quality has produced mixed results. We investigated whether the number of music dosages could be a reason for the lack of clarity. Six longitudinal music sleep studies using the Pittsburgh Sleep Quality Index (PSQI) over 3 weeks were identified. Music when compared to active (audiobooks or medication) or passive controls significantly improved (improvement is reflected by a lower score) PSQI within the first or second week of prescription. The improvement was an average mean difference of −1.15 (SD = 0.53) for each week. Music dosages continued to be associated with improved PSQI over a study that had a 3-month music intervention. One study with a low initial PSQI score resulted in poor sleepers (PSQI > 5) achieving healthy sleep (PSQI < 5) within 3 weeks of regular music intervention. For future studies, “prescribing” music beyond 3 weeks may lead to more instances of healthy sleep, particularly for those who have mild sleep problems. To explain the findings, we proposed that the relationship between weeks of music listening and improved PSQI are attributed to the truncation of poor bedtime habits linked to ruminative tendencies and consequent hyperarousal prior to the music intervention. Music listening at bedtime replaces those bad habits, we argue, by forming a new psychological link between bedtime and sleep through evaluative conditioning. The findings of the present study provide disarming evidence of the potential for prescription of music for treating mild sleep disorder.

Closed-loop Electroencephalogram-based modulated audio to fall and deepen sleep faster

The transition from wake to sleep is a continuum that is well characterized by the electroencephalogram (EEG) power spectral ratio (ρ) between the beta (15 to 30 Hz) and theta (4 to 8 Hz) bands. From wake to sleep, the value of ρ gradually decreases.We have designed and implemented a single EEG-signal based closed-loop system that leverages ρ to modulate the volume of a pink-noise type of audio such that the volume becomes gradually softer as sleep initiates. A proof-of-concept trial was conducted with this system and it was found that using this concept resulted in a reduction of sleep latency and latency to deep sleep.

The Effects of Presleep Slow Breathing and Music Listening on Polysomnographic Sleep Measures - a pilot trial

Knowledge on efficient ways to reduce presleep arousal and, therefore, improve sleep, is scanty. We explored the effects of presleep slow breathing and music listening conditions on sleep quality and EEG power spectral density in young adults in a randomized, controlled trial with a crossover design. Participants’ (N = 20, 50% females) sleep was measured on two consecutive nights with polysomnography (40 nights), the other night serving as the control condition. The intervention condition was either a 30-minute slow breathing exercise or music listening (music by Max Richter: Sleep). The intervention and control conditions were placed in a random order. We measured heart rate variability prior to, during and after the intervention condition, and found that both interventions increased immediate heart rate variability. Music listening resulted in decreased N2 sleep, increased frontal beta1 power spectral density, and a trend towards increased N3 sleep was detected. In the slow breathing condition higher central delta power during N3 was observed. While some indices pointed to improved sleep quality in both intervention groups, neither condition had robust effects on sleep quality. These explorative findings warrant further replication in different populations.

Classical music, educational learning, and slow wave sleep: A targeted memory reactivation experiment

Poor sleep in college students compromises the memory consolidation processes necessary to retain course materials. A solution may lie in targeting reactivation of memories during sleep (TMR). Fifty undergraduate students completed a college-level microeconomics lecture (mathematics-based) while listening to distinctive classical music (Chopin, Beethoven, and Vivaldi). After they fell asleep, we re-played the classical music songs (TMR) or a control noise during slow wave sleep. Relative to the control condition, the TMR condition showed an 18% improvement for knowledge transfer items that measured concept integration (d = 0.63), increasing the probability of "passing" the test with a grade of 70 or above (OR = 4.68, 95%CI: 1.21, 18.04). The benefits of TMR did not extend to a 9-month follow-up test when performance dropped to floor levels, demonstrating that long-term-forgetting curves are largely resistant to experimentally-consolidated memories. Spectral analyses revealed greater frontal theta activity during slow wave sleep in the TMR condition than the control condition (d = 0.87), and greater frontal theta activity across conditions was associated with protection against long-term-forgetting at the next-day and 9-month follow-up tests (rs = 0.42), at least in female students. Thus, students can leverage instrumental music-which they already commonly pair with studying-to help prepare for academic tests, an approach that may promote course success and persistence.

Effect of music of specific frequency upon the sleep architecture and electroencephalographic pattern of individuals with delayed sleep latency: A daytime nap study

Introduction:

Sleep is normal human behaviour. However, the stress in daily life leads to altered sleep behaviour like insomnia, parasomnia, etc. Owing to possible side effects, mind–body interventions like music, yoga and meditation could be a better alternative intervention to pharmacological interventions for the condition. It is known that 432 Hz music to have some effect on the overall sleep quality though some knowledge gap does exist. The present study aims to find the effects of 432 Hz on sleep quality and sleep latency in a daytime nap among subjects with history of delayed sleep latency.

Material and Method:

Fifteen healthy male volunteers aged 18 to 40 years with history of delayed sleep latency were recruited for the study from a cohort of working staff and students at the institute, after due ethical clearance following the inclusion and exclusion criteria. All the subjects were subjected to sleep study with and without music intervention at the gap of 1 week. Sleep parameters recorded include sleep stages, electroencephalogram (EEG), electrocardiogram (ECG), electromyography (EMG), nasal airflow, thoracic movement, nasal saturation etc.

Result:

Outcome of the study shows some decrease in the mean sleep latency (P > 0.05) with significant increase in the energy of alpha waves (P < 0.01) at the sleep onset.

Conclusion:

It was concluded that 432 Hz music has some significant calming effect as reflected by increased alpha activities without any significant effect upon the sleep latency in the daytime naps.

Possible Effect of Binaural Beat Combined With Autonomous Sensory Meridian Response for Inducing Sleep

Sleep is important to maintain physical and cognitive functions in everyday life. However, the prevalence of sleep disorders is on the rise. One existing solution to this problem is to induce sleep using an auditory stimulus. When we listen to acoustic beats of two tones in each ear simultaneously, a binaural beat is generated which induces brain signals at a specific desired frequency. However, this auditory stimulus is uncomfortable for users to listen to induce sleep. To overcome this difficulty, we can exploit the feelings of calmness and relaxation that are induced by the perceptual phenomenon of autonomous sensory meridian response (ASMR). In this study, we proposed a novel auditory stimulus for inducing sleep. Specifically, we used a 6 Hz binaural beat corresponding to the center of the theta band (4-8 Hz), which is the frequency at which brain activity is entrained during non-rapid eye movement (NREM) in sleep stage 1. In addition, the "ASMR triggers" that cause ASMR were presented from natural sound as the sensory stimuli. In session 1, we combined two auditory stimuli (the 6 Hz binaural beat and ASMR triggers) at three-decibel ratios to find the optimal combination ratio. As a result, we determined that the combination of a 30:60 dB ratio of binaural beat to ASMR trigger is most effective for inducing theta power and psychological stability. In session 2, the effects of these combined stimuli (CS) were compared with an only binaural beat, only the ASMR trigger, or a sham condition. The combination stimulus retained the advantages of the binaural beat and resolved its shortcomings with the ASMR triggers, including psychological self-reports. Our findings indicate that the proposed auditory stimulus could induce the brain signals required for sleep, while simultaneously keeping the user in a psychologically comfortable state. This technology provides an important opportunity to develop a novel method for increasing the quality of sleep.

Effects of Relaxing Music on Healthy Sleep

Sleep is vital for human health and wellbeing, and sleep disturbances are comorbid to many mental and physiological disorders. Music consistently improves subjective sleep quality, whereas results for objective sleep parameters diverge. These inconsistencies might be due to inter-individual differences. Here, 27 female subjects listened to either music or a control text before a 90 minutes nap in a within-subjects design. We show that music improved subjective sleep quality as compared to the text condition. In all participants, music resulted in a reduced amount of sleep stage N1 during the nap. In addition, music significantly increased the amount of slow-wave sleep (SWS) and increased the low/high frequency power ratio. However, these effects occurred only in participants with a low suggestibility index. We conclude that listening to music before a nap can improve subjective and objective sleep parameters in some participants.

How does music aid sleep? literature review

With the growth of interest in using music to treat insomnia, there is a need to collect and evaluate the literature. This paper reviews disparate literature and assesses the various kinds of assertions and hypotheses made by researchers about music's efficacy in assisting sleep. Six main researcher proposed reasons (RPR) for how music aids sleep were identified in the literature: (1) relaxation, where music encourages physiological or psychological relaxation; (2) distraction, where music acts as a focal point to distract from inner stressful thoughts; (3) entrainment, synchronization of biological rhythms to beat structures in music; (4) masking, obscuring noxious background noise with music; (5) enjoyment, listening to preferred, emotionally relatable or pleasant music; and (6) expectation, individuals cultural beliefs around music. We evaluated each RPR in terms of the evidence available in the extant literature. Masking RPR was identified as having support for improving sleep. Relaxation, distraction and enjoyment RPR had mixed levels of support. Expectation RPR had possible support. Entrainment had mixed possible support. The paper discusses interactions between RPRs, and a call is made to turn research attention to sequencing the RPRs and possible RPR mediators, with relaxation being a likely mediator of several RPRs.

The Effect of Mind-Body Therapies on Insomnia: A Systematic Review and Meta-Analysis

BACKGROUND/PURPOSE

Sleep plays an important role in individuals' health. The functions of the brain, the cardiovascular system, the immune system, and the metabolic system are closely associated with sleep. As a prevalent sleep disorder, insomnia has been closely concerned, and it is necessary to find effective therapies. In recent years, a growing body of studies has shown that mind-body therapies (MBTs) can improve sleep quality and ameliorate insomnia severity. However, a comprehensive and overall systematic review has not been conducted. In order to examine the effect of MBTs on insomnia, we conducted a systematic review and meta-analysis evaluating the effects of MBTs on sleep quality in healthy adults and clinical populations.

METHODS

PubMed, EMBASE, the Cochrane Library, and review of references were searched up to July 2018. English language studies of all designs evaluating the effect of MBTs on sleep outcomes in adults with or without diseases were examined. To calculate the SMDs and 95% CIs, we used a fixed effect model when heterogeneity was negligible and a random effect model when heterogeneity was significant.

RESULTS

49 studies covering 4506 participants published between 2004 and 2018 were identified. Interventions included meditation, tai chi, qigong, and yoga which lasted 4 to 24 weeks. The MBTs resulted in statistically significant improvement in sleep quality and reduction on insomnia severity but no significant effects on sleep quantity indices, which were measured by sleep diary or objective measures. We analyzed the effects of tai chi and qigong separately as two different MBTs for the first time and found that qigong had a slight advantage over tai chi in the improvement of sleep quality. Subgroup analyses revealed that the effect of MBTs on sleep quality in healthy individuals was larger than clinical populations. The effect of MBTs might be influenced by the intervention duration but not the frequency.

CONCLUSIONS

MBTs can be effective in treating insomnia and improving sleep quality for healthy individuals and clinical patients. More high-quality and well-controlled RCTs are needed to make a better conclusion in further study.

A randomized controlled trial of bedtime music for insomnia disorder

Music is often used as a self-help tool to alleviate insomnia. To evaluate the effect of bedtime music listening as a strategy for improving insomnia, we conducted an assessor-blinded randomized controlled trial. Fifty-seven persons with insomnia disorder were included and randomized to music intervention (n = 19), audiobook control (n = 19) or a waitlist control group (n = 19). The primary outcome measure was the Insomnia Severity Index. In addition, we used polysomnography and actigraphy to evaluate objective measures of sleep, and assessed sleep quality and quality of life. The results showed no clear effect of music on insomnia symptoms as the group × time interaction only approached significance (effect size = 0.71, p = .06), though there was a significant improvement in insomnia severity within the music group. With regard to the secondary outcomes, we found a significant effect of the music intervention on perceived sleep improvement and quality of life, but no changes in the objective measures of sleep. In conclusion, music listening at bedtime appears to have a positive impact on sleep perception and quality of life, but no clear effect on insomnia severity. Music is safe and easy to administer, but further research is needed to assess the effect of music on different insomnia subtypes, and as an adjunctive or preventive intervention.

The music that helps people sleep and the reasons they believe it works: A mixed methods analysis of online survey reports

Sleep loss is a widespread problem with serious physical and economic consequences. Music can impact upon physical, psychological and emotional states, which may explain anecdotal reports of its success as an everyday sleep aid. However, there is a lack of systematic data on how widely it is used, why people opt for music as a sleep aid, or what music works; hence the underlying drivers to music-sleep effects remain unclear. We investigated music as a sleep aid within the general public via a mixed methods data online survey (n = 651) that scored musicality, sleep habits, and open text responses on what music helps sleep and why. In total, 62% of respondents stated that they used music to help them sleep. They reported fourteen musical genres comprising 545 artists. Linear modelling found stress, age, and music use as significant predictors of sleep quality (PSQI) scores. Regression tree modelling revealed that younger people with higher musical engagement were significantly more likely to use music to aid sleep. Thematic analysis of the open text responses generated four themes that described why people believe music helps sleep: music offers unique properties that stimulate sleep (Provide), music is part of a normal sleep routine (Habit), music induces a physical or mental state conducive to sleep (State), and music blocks an internal or external stimulus that would otherwise disrupt sleep (Distract). This survey provides new evidence into the relationship between music and sleep in a population that ranged widely in age, musicality, sleep habits and stress levels. In particular, the results highlight the varied pathways of effect between music and sleep. Diversity was observed both in music choices, which reflected idiosyncratic preferences rather than any consistent musical structure, and in the reasons why music supports good sleep, which went far beyond simple physical/mental relaxation.

The Benefit of Directed Forgetting Persists After a Daytime Nap: The Role of Spindles and Rapid Eye Movement Sleep in the Consolidation of Relevant Memories

Study Objectives

We aimed to investigate the effect of directed forgetting instruction on memory retention after a 2-hour delay involving a daytime nap or an equivalent amount of time spent awake. We examined the associations between sleep-specific oscillations and the retention of relevant and irrelevant study materials.

Methods

We applied a list-method directed forgetting paradigm manipulating the perceived relevance of previously encoded lists of words. Participants were randomly assigned to either a nap or an awake group, and to a remember or a forget subgroup. The remember and the forget subgroups were both instructed to study two consecutive lists of words, although, the forget subgroup was manipulated to forget the first list and memorize only the second one. Participants were 112 healthy individuals (44 men; Mage = 21.4 years, SD = 2.4).

Results

A significant directed forgetting effect emerged after a 2-hour delay both in the awake and sleep conditions; however, the effect was more pronounced within the sleep group. The benefit of directed forgetting, that is, relatively enhanced recall of relevant words in the forget group, was evidenced only in those participants that reached rapid eye movement (REM) phase. Non-rapid eye movement (NREM) sigma power was correlated with memory performance for the relevant (second) list, and sleep spindle amplitude was associated with the retention of both lists. These associations, however, were detected only within the forget subgroup. REM duration correlated with recall performance for the relevant (second) list within the forget subgroup, and with recall performance for the first list within the remember subgroup.

Conclusions

A directed forgetting effect persists after a 2-hour delay spent awake or asleep. Spindle-related activity and subsequent REM sleep might selectively facilitate the processing of memories that are considered to be relevant for the future.

Reviewing the Effectiveness of Music Interventions in Treating Depression

Depression is a very common mood disorder, resulting in a loss of social function, reduced quality of life and increased mortality. Music interventions have been shown to be a potential alternative for depression therapy but the number of up-to-date research literature is quite limited. We present a review of original research trials which utilize music or music therapy as intervention to treat participants with depressive symptoms. Our goal was to differentiate the impact of certain therapeutic uses of music used in the various experiments. Randomized controlled study designs were preferred but also longitudinal studies were chosen to be included. 28 studies with a total number of 1,810 participants met our inclusion criteria and were finally selected. We distinguished between passive listening to music (record from a CD or live music) (79%), and active singing, playing, or improvising with instruments (46%). Within certain boundaries of variance an analysis of similar studies was attempted. Critical parameters were for example length of trial, number of sessions, participants' age, kind of music, active or passive participation and single- or group setting. In 26 studies, a statistically significant reduction in depression levels was found over time in the experimental (music intervention) group compared to a control (n = 25) or comparison group (n = 2). In particular, elderly participants showed impressive improvements when they listened to music or participated in music therapy projects. Researchers used group settings more often than individual sessions and our results indicated a slightly better outcome for those cases. Additional questionnaires about participants confidence, self-esteem or motivation, confirmed further improvements after music treatment. Consequently, the present review offers an extensive set of comparable data, observations about the range of treatment options these papers addressed, and thus might represent a valuable aid for future projects for the use of music-based interventions to improve symptoms of depression.

Exploring the effect of sound and music on health in hospital settings: A narrative review

BACKGROUND

Sound in hospital space has traditionally been considered in negative terms as both intrusive and unwanted, and based mainly on sound levels. However, sound level is only one aspect of the soundscape. There is strong evidence that exploring the positive aspect of sound in a hospital context can evoke positive feelings in both patients and nurses. Music psychology studies have also shown that music intervention in health care can have a positive effect on patient's emotions and recuperating processes. In this way, hospital spaces have the potential to reduce anxiety and stress, and make patients feel comfortable and secure. This paper describes a review of the literature exploring sound perception and its effect on health care.

DATA SOURCES AND REVIEW METHODS

This review sorted the literature and main issues into themes concerning sound in health care spaces; sound, stress and health; positive soundscape; psychological perspective of music and emotion; music as a complementary medicine for improving health care; contradicting arguments concerning the use of music in health care; and implications for clinical practice. Using Web of Science, PubMed, Scopus, ProQuest Central, MEDLINE, and Google, a literature search on sound levels, sound sources and the impression of a soundscape was conducted. The review focused on the role and use of music on health care in clinical environments. In addition, other pertinent related materials in shaping the understanding of the field were retrieved, scanned and added into this review.

RESULTS

The result indicated that not all noises give a negative impression within healthcare soundscapes. Listening to soothing music was shown to reduce stress, blood pressure and post-operative trauma when compared to silence. Much of the sound conveys meaningful information that is positive for both patients and nurses, in terms of soft wind, bird twitter, and ocean sounds.

CONCLUSIONS

Music perception was demonstrated to bring about positive change in patient-reported outcomes such as eliciting positive emotion, and decreasing the levels of stressful conditions. Whilst sound holds both negative and positive aspects of the hospital ecosystem and may be stressful, it also possesses a soothing quality that induces positive feelings in patients. Conceptualizing the nature of sound in the hospital context as a soundscape, rather than merely noise can permit a subtler and socially useful understanding of the role of sound and music in the hospital setting, thereby creating a means for improving the hospital experience for patients and nurses.

Prevalence of Sleep Disorders Among Children 4 - 6 Years Old in Tehran Province, Iran

BACKGROUND

Sleep patterns may change over a person's lifetime; however, the quantity and quality of sleep always depend on individual factors such as age, sex, and psychological and environmental factors. In children, sleep is as important as development. Quantitative sleep problems related to sleep onset and qualitative sleep disorders such as frequent awakenings may lead to insufficient sleep.

OBJECTIVES

This study aimed to assess the prevalence of sleep disorders among children 4 - 6 years old attending the health centers of Shahid Beheshti University of Medical Sciences, Tehran, Iran, in 2013.

PATIENTS AND METHODS

This was a cross-sectional study on 400 children selected using a multistage sampling method. Data were collected by interviews. The questionnaire included two sections: a demographic section with questions about the demographic characteristics of the children and parents and a children's sleep habit questionnaire (CSHQ). Data were analyzed by SPSS 16 and different statistical tests were used (P < 0.05).

RESULTS

The mean age of the children was 64.27 ± 9.3 months. The prevalence of sleep disorders was 36.25%. Sleep disorders were significantly associated with age, height, body mass index, residence of children, father's occupation, mother's diseases, father's drug abuse, and parents' marital status (P < 0.05).

CONCLUSIONS

Sleep disorders in children threaten growth and development, and are dangerous for their health. Sleep disorders should be considered in the differential diagnosis of children's learning and behavioral problems.

Reduction in time-to-sleep through EEG based brain state detection and audio stimulation

We developed an EEG- and audio-based sleep sensing and enhancing system, called iSleep (interactive Sleep enhancement apparatus). The system adopts a closed-loop approach which optimizes the audio recording selection based on user's sleep status detected through our online EEG computing algorithm. The iSleep prototype comprises two major parts: 1) a sleeping mask integrated with a single channel EEG electrode and amplifier, a pair of stereo earphones and a microcontroller with wireless circuit for control and data streaming; 2) a mobile app to receive EEG signals for online sleep monitoring and audio playback control. In this study we attempt to validate our hypothesis that appropriate audio stimulation in relation to brain state can induce faster onset of sleep and improve the quality of a nap. We conduct experiments on 28 healthy subjects, each undergoing two nap sessions - one with a quiet background and one with our audio-stimulation. We compare the time-to-sleep in both sessions between two groups of subjects, e.g., fast and slow sleep onset groups. The p-value obtained from Wilcoxon Signed Rank Test is 1.22e-04 for slow onset group, which demonstrates that iSleep can significantly reduce the time-to-sleep for people with difficulty in falling sleep.

Automatic sleep onset detection using single EEG sensor

Sleep has been shown to be imperative for the health and well-being of an individual. To design intelligent sleep management tools, such as the music-induce sleep-aid device, automatic detection of sleep onset is critical. In this work, we propose a simple yet accurate method for sleep onset prediction, which merely relies on Electroencephalogram (EEG) signal acquired from a single frontal electrode in a wireless headband. The proposed method first extracts energy power ratio of theta (4-8Hz) and alpha (8-12Hz) bands along a 3-second shifting window, then calculates the slow wave of each frequency band along the time domain. The resulting slow waves are then fed to a rule-based engine for sleep onset detection. To evaluate the effectiveness of the approach, polysomnographic (PSG) and headband EEG signals were obtained from 20 healthy adults, each of which underwent 2 sessions of sleep events. In total, data from 40 sleep events were collected. Each recording was then analyzed offline by a PSG technologist via visual observation of PSG waveforms, who annotated sleep stages N1 and N2 by using the American Academy of Sleep Medicine (AASM) scoring rules. Using this as the gold standard, our approach achieved a 87.5% accuracy for sleep onset detection. The result is better or at least comparable to the other state of the art methods which use either multi-or single- channel based data. The approach has laid down the foundations for our future work on developing intelligent sleep aid devices.

Digital media use in the 2 h before bedtime is associated with sleep variables in university students

Digital media use is widespread in University students, and use of digital media near bedtime has a broadly negative effect on sleep outcomes. Adequate and good quality sleep is important for physical and mental health, but few studies have rigorously measured both sleep and digital media use. In this study, we investigated whether self-reported sleep patterns were associated with digital media use in a first-year University student (N = 254, 48% male) population. Students tracked their sleep through daily online diaries and provided digital media use data in 15-min blocks for 2 h prior to bedtime on nine occasions. A longer duration of digital media use was associated with reduced total sleep time and later bedtime, while greater diversity of digital media use was associated with increased total sleep time and earlier bedtime. Analysis of activities in the last hour before bedtime indicated that activity type plays a role in digital media's effect on sleep, with computer work, surfing the Internet, and listening to music showing the strongest relationship to multiple sleep variables. These findings have implications for physical and mental health of University students and can inform design of devices to minimize negative effects of digital media on sleep.

Music for insomnia in adults

BACKGROUND

Insomnia is a common sleep disorder in modern society. It causes reduced quality of life and is associated with impairments in physical and mental health. Listening to music is widely used as a sleep aid, but it remains unclear if it can actually improve insomnia in adults.

OBJECTIVES

To assess the effects of listening to music on insomnia in adults and to assess the influence of specific variables that may moderate the effect.

SEARCH METHODS

We searched CENTRAL, PubMed, Embase, nine other databases and two trials registers in May 2015. In addition, we handsearched specific music therapy journals, reference lists of included studies, and contacted authors of published studies to identify additional studies eligible for inclusion, including any unpublished or ongoing trials.

SELECTION CRITERIA

Randomised controlled trials and quasi-randomised controlled trials that compared the effects of listening to music with no treatment or treatment-as-usual on sleep improvement in adults with insomnia.

DATA COLLECTION AND ANALYSIS

Two authors independently screened abstracts, selected studies, assessed risk of bias, and extracted data from all studies eligible for inclusion. Data on pre-defined outcome measures were subjected to meta-analyses when consistently reported by at least two studies. We undertook meta-analyses using both fixed-effect and random-effects models. Heterogeneity across included studies was assessed using the I² statistic.

MAIN RESULTS

We included six studies comprising a total of 314 participants. The studies examined the effect of listening to pre-recorded music daily, for 25 to 60 minutes, for a period of three days to five weeks.Based on the Grades of Recommendations, Assessment, Development and Evaluation (GRADE) approach, we judged the evidence from five studies that measured the effect of music listening on sleep quality to be of moderate quality. We judged the evidence from one study that examined other aspects of sleep (see below) to be of low quality. We downgraded the quality of the evidence mainly because of limitations in design or being the only published study. As regards risk of bias, most studies were at high risk of bias on at least one domain: one study was at high risk of selection bias and one was judged to be at unclear risk; six studies were at high risk of performance bias; three studies were at high risk of detection bias; one study was at high risk of attrition bias and was study was judged to be at unclear risk; two studies were judged to be at unclear risk of reporting bias; and four studies were at high risk of other bias.Five studies (N = 264) reporting on sleep quality as assessed by the Pittsburgh Sleep Quality Index (PSQI) were included in the meta-analysis. The results of a random-effects meta-analysis revealed an effect in favour of music listening (mean difference (MD) -2.80; 95% confidence interval (CI) -3.42 to -2.17; Z = 8.77, P < 0.00001; moderate-quality evidence). The size of the effect indicates an increase in sleep quality of the size of about one standard deviation in favour of the intervention compared to no treatment or treatment-as-usual.Only one study (N = 50; low-quality evidence) reported data on sleep onset latency, total sleep time, sleep interruption, and sleep efficiency. However, It found no evidence to suggest that the intervention benefited these outcomes. None of the included studies reported any adverse events.

AUTHORS' CONCLUSIONS

The findings of this review provide evidence that music may be effective for improving subjective sleep quality in adults with insomnia symptoms. The intervention is safe and easy to administer. More research is needed to establish the effect of listening to music on other aspects of sleep as well as the daytime consequences of insomnia.