Scolaris Content Display Scolaris Content Display

Study flow diagram
Figures and Tables -
Figure 1

Study flow diagram

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included trials
Figures and Tables -
Figure 2

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included trials

Risk of bias summary: review authors' judgements about each risk of bias item for each included trial
Figures and Tables -
Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included trial

Forest plot of comparison: 1 Sleep quality: listening to music versus control ‐ Pittsburgh Sleep Quality Index (PSQI) ‐ global score, outcome: 1.1 Sleep quality: Pittsburgh Sleep Quality Index (PSQI) ‐ immediately post‐treatment.
Figures and Tables -
Figure 4

Forest plot of comparison: 1 Sleep quality: listening to music versus control ‐ Pittsburgh Sleep Quality Index (PSQI) ‐ global score, outcome: 1.1 Sleep quality: Pittsburgh Sleep Quality Index (PSQI) ‐ immediately post‐treatment.

Forest plot of comparison: 1 Sleep quality: listening to music versus control ‐ Pittsburgh Sleep Quality Index (PSQI) ‐ global score, outcome: 1.2 Subgroup (PSQI) by music selection ‐ immediately post‐treatment.
Figures and Tables -
Figure 5

Forest plot of comparison: 1 Sleep quality: listening to music versus control ‐ Pittsburgh Sleep Quality Index (PSQI) ‐ global score, outcome: 1.2 Subgroup (PSQI) by music selection ‐ immediately post‐treatment.

Forest plot of comparison: 1 Sleep quality: listening to music versus control ‐ Pittsburgh Sleep Quality Index (PSQI) ‐ global score, outcome: 1.3 Subgroup (PSQI) by relaxation instructions ‐ immediately post‐treatment.
Figures and Tables -
Figure 6

Forest plot of comparison: 1 Sleep quality: listening to music versus control ‐ Pittsburgh Sleep Quality Index (PSQI) ‐ global score, outcome: 1.3 Subgroup (PSQI) by relaxation instructions ‐ immediately post‐treatment.

Comparison 1 Sleep quality: listening to music versus control ‐ Pittsburgh Sleep Quality Index (PSQI) ‐ global score, Outcome 1 Sleep quality: Pittsburgh Sleep Quality Index (PSQI) ‐ immediately post‐treatment.
Figures and Tables -
Analysis 1.1

Comparison 1 Sleep quality: listening to music versus control ‐ Pittsburgh Sleep Quality Index (PSQI) ‐ global score, Outcome 1 Sleep quality: Pittsburgh Sleep Quality Index (PSQI) ‐ immediately post‐treatment.

Comparison 1 Sleep quality: listening to music versus control ‐ Pittsburgh Sleep Quality Index (PSQI) ‐ global score, Outcome 2 Subgroup (PSQI) by music selection ‐ immediatly post‐treatment.
Figures and Tables -
Analysis 1.2

Comparison 1 Sleep quality: listening to music versus control ‐ Pittsburgh Sleep Quality Index (PSQI) ‐ global score, Outcome 2 Subgroup (PSQI) by music selection ‐ immediatly post‐treatment.

Comparison 1 Sleep quality: listening to music versus control ‐ Pittsburgh Sleep Quality Index (PSQI) ‐ global score, Outcome 3 Subgroup (PSQI) by relaxation instructions ‐ immediately post‐treatment.
Figures and Tables -
Analysis 1.3

Comparison 1 Sleep quality: listening to music versus control ‐ Pittsburgh Sleep Quality Index (PSQI) ‐ global score, Outcome 3 Subgroup (PSQI) by relaxation instructions ‐ immediately post‐treatment.

Summary of findings for the main comparison. Listening to music compared to no treatment or treatment‐as‐usual (TAU) for adults with insomnia

Listening to music compared to no treatment or treatment‐as‐usual (TAU) for adults with insomnia

Patient or population: adults with insomnia
Settings: home, sleep lab or rehabilitation centre
Intervention: listening to music
Comparison: no treatment or TAU

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

Number of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

No treatment or TAU

Listening to music

Sleep quality ‐ immediately post‐treatment
PSQI1. Scale from: 0 to 21

Follow‐up: 21 to 35 days

The mean score in the intervention groups was
2.8 lower
(3.42 lower to 2.17 lower)

264
(5 studies)

⊕⊕⊕⊝
moderate2,3

A lower score indicates better sleep quality (i.e. fewer sleep problems).

The change is about the size of one standard deviation which is considered a clinically relevant change.

The studies included participants with a complaint of poor sleep (PSQI > 5)¹.

Sleep onset latency ‐ immediately post‐treatment
PSG and morning questionnaire

Follow‐up: 3 days

See comment

See comment

50
(1 study)

⊕⊕⊝⊝
low4,5

The one trial reporting this outcome found no evidence of an effect of the intervention.

The data were not available for analysis.

The study included participants that had reported poor sleep for at least one month (PSQI > 5)¹.

Total sleep time ‐ immediately post‐treatment
PSG and morning questionnaire
Follow‐up: 3 days

See comment

See comment

50
(1 study)

⊕⊕⊝⊝
low4,5

The one study reporting this outcome found no evidence of an effect of the intervention.

The data were not available for analysis.

The study included participants that had reported poor sleep for at least one month (PSQI > 5)¹.

Sleep interruption ‐ immediately post‐treatment
PSG and morning questionnaire
Follow‐up: 3 days

See comment

See comment

50
(1 study)

⊕⊕⊝⊝
low4,5

The one study reporting this outcome found no evidence of an effect of the intervention.

The data are not available for analysis.

The study included participants that had reported poor sleep for at least one month (PSQI > 5)¹.

Sleep efficiency ‐ immediately post‐treatment
PSG
Follow‐up: 3 days

See comment

See comment

50
(1 study)

⊕⊕⊝⊝
low4,5

The one study reporting this outcome found no evidence of an effect of the intervention.

The data were not available for analysis.

The study included participants that had reported poor sleep for at least one month (PSQI > 5)¹.

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI)
CI: confidence interval; PSG: polysomnography; PSQI: Pittsburgh Sleep Quality Index

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 Pittsburgh Sleep Quality Index. 0 indicates good sleep quality and 21 indicates severe sleep problems. Clinical cut off > 5 (Buysse 1989).
2 Limitations in the design such as inadequate allocation concealment procedures and lack of blinding.
3 The estimated effect is about one standard deviation and can be considered large.
4 Limitations in the design such as lack of blinding.
5 Only one trial measured this outcome.

Figures and Tables -
Summary of findings for the main comparison. Listening to music compared to no treatment or treatment‐as‐usual (TAU) for adults with insomnia
Comparison 1. Sleep quality: listening to music versus control ‐ Pittsburgh Sleep Quality Index (PSQI) ‐ global score

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Sleep quality: Pittsburgh Sleep Quality Index (PSQI) ‐ immediately post‐treatment Show forest plot

5

264

Mean Difference (IV, Random, 95% CI)

‐2.80 [‐3.42, ‐2.17]

2 Subgroup (PSQI) by music selection ‐ immediatly post‐treatment Show forest plot

5

Mean Difference (IV, Random, 95% CI)

Subtotals only

2.1 Researcher‐selected music

3

144

Mean Difference (IV, Random, 95% CI)

‐2.42 [‐3.24, ‐1.60]

2.2 Participant‐selected music (choice among researcher pre‐selected music)

2

130

Mean Difference (IV, Random, 95% CI)

‐3.35 [‐4.28, ‐2.42]

3 Subgroup (PSQI) by relaxation instructions ‐ immediately post‐treatment Show forest plot

5

Mean Difference (IV, Random, 95% CI)

Subtotals only

3.1 Music listening alone

3

149

Mean Difference (IV, Random, 95% CI)

‐2.85 [‐3.92, ‐1.78]

3.2 Music listening and relaxation instructions

2

125

Mean Difference (IV, Random, 95% CI)

‐2.64 [‐3.74, ‐1.54]

Figures and Tables -
Comparison 1. Sleep quality: listening to music versus control ‐ Pittsburgh Sleep Quality Index (PSQI) ‐ global score