Effects of Patient-Directed Interactive Music Therapy on Sleep Quality and Melatonin Levels in Postoperative Elderly Patients: A Randomized Controlled Trial

Abstract

Purpose: 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). Patients and Methods: 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 minutes of interactive music sessions, including relaxation techniques. The PL group received only pre-selected relaxing music-listening for 30 minutes. 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. Results: 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. 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 significant difference between groups. Conclusion: Single IMT intervention improved subjectively assessed short-term sleep quality and elevated saliva melatonin levels in postoperative elderly patients. Trial Registration: The study was registered at ClinicalTrials.Gov (number NCT03156205).