Kim Jeongmin, Choi Dain, Yeo Myung Sun, Yoo Ga Eul, Kim Soo Ji, Na Sungwon
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Music Therapy, Graduate School, Ewha Womans University, Seoul, Republic of Korea.
Nat Sci Sleep. 2020 Oct 21;12:791-800. doi: 10.2147/NSS.S286375. eCollection 2020.
This study aimed to investigate the effects of patient-directed interactive music on saliva melatonin levels and sleep quality among postoperative elderly patients in the intensive care unit (ICU).
A total of 133 elderly patients were randomized into three groups: interactive music therapy (IMT), passive listening (PL), and the control group. The control group (n = 45) received routine medical care, while IMT and PL groups received music therapy on ICU day 1. The IMT group received up to 20 mins of interactive music sessions, including relaxation techniques. The PL group received only pre-selected relaxing music-listening for 30 mins. Saliva melatonin and cortisol levels were measured three times at 11 p.m. (preoperative, operation day, and postoperative day [POD] 1). The Richards-Campbell Sleep Questionnaire (RCSQ) and Quality of Recovery-40 questionnaire (QoR40) were administered on the preoperative day, as well as PODs 1 and 2.
The RCSQ showed a significant improvement in the IMT group compared to the control group on POD2 (71.50 vs 56.89, p=0.012), but the QoR40 did not show any difference between groups. The quality control of the saliva sample was not available due to the immediate postoperative patient's condition, resulting in a higher dropout rate. Saliva melatonin levels on POD 1 were elevated in the IMT group compared to the control group (1.45 vs 0.04, p=0.0068). The cortisol level did not show a significant difference between groups.
Single IMT intervention improved subjectively assessed short-term sleep quality in postoperative elderly patients. It is difficult to conclude whether music therapy intervention affects the level of melatonin and cortisol.
The study was registered at ClinicalTrials.Gov (number NCT03156205).
本研究旨在探讨患者主导的互动音乐对重症监护病房（ICU）术后老年患者唾液褪黑素水平和睡眠质量的影响。
总共133例老年患者被随机分为三组：互动音乐疗法（IMT）组、被动聆听（PL）组和对照组。对照组（n = 45）接受常规医疗护理，而IMT组和PL组在ICU第1天接受音乐疗法。IMT组接受长达20分钟的互动音乐疗程，包括放松技巧。PL组仅接受预先选择的放松音乐聆听30分钟。在晚上11点测量唾液褪黑素和皮质醇水平三次（术前、手术日和术后第1天[POD]）。术前、POD 1和POD 2使用理查兹 - 坎贝尔睡眠问卷（RCSQ）和恢复质量 - 40问卷（QoR40）。
RCSQ显示，与对照组相比，IMT组在POD2时有显著改善（71.50对56.89，p = 0.012），但QoR40在组间未显示任何差异。由于术后患者的即时状况，唾液样本的质量控制不可用，导致较高的失访率。与对照组相比，IMT组在POD 1时唾液褪黑素水平升高（1.45对0.04，p = 0.0068）。皮质醇水平在组间未显示显著差异。
单次IMT干预改善了术后老年患者主观评估的短期睡眠质量。难以得出音乐疗法干预是否影响褪黑素和皮质醇水平的结论。
该研究在ClinicalTrials.Gov注册（编号NCT03156205）。
