Meta-analysis2025Open access

Effect of music therapy on sleep quality in elderly: A systematic review and meta-analysis

Li C, Kumar AP, Wankhar D, Kuppusamy M, Govindasamy K

PloS one · 5 citations

How it was studied

Design
Meta-analysis (indexed by PubMed)
Studied in
People
Main outcome
Health markers and function

Who paid for it

Funding
Independent funding

Based on full-text disclosure statement.

Publication

Published
2025-11-04 · PLoS One · vol. 20 · issue 11 · p. e0334356
Publisher
Public Library of Science
Cited
6 citations · more than 82% of similar papers · 1.6× the field average
References
39 works
Access
Open access (journal) · CC-BY
Research areas
Music Therapy and Health · Sleep and related disorders · Intensive Care Unit Cognitive Disorders
Keywords
Intervention (counseling), Music therapy, MEDLINE, Clinical Practice, Certainty, Sleep (system call), Quality (philosophy), Sleep quality
MeSH
humans, music therapy, sleep, quality of life, aged, middle aged, randomized controlled trials as topic, sleep wake disorders, sleep quality

5 authors

From CN, BH, IN

  • Cheng Li · correspondingNingxia Normal University
  • Archana KumarArabian Gulf University
  • Dapkupar WankharAssam Down Town University
  • Maheshkumar KuppusamyCentral Council for Research in Yoga & Naturopathy
  • Karuppasamy GovindasamySymbiosis International University

Abstract

Background

Sleep disturbances are common among older adults, affecting up to 50% of this population and significantly impacting quality of life and health outcomes. Music therapy has been proposed as a non-pharmacological intervention to improve sleep quality in this population, but evidence regarding its effectiveness remains inconsistent across individual studies. Therefore, this systematic review and meta-analysis aims to synthesize available evidence on the effectiveness of music therapy interventions for improving sleep quality in elderly adults..

Methods

We conducted a systematic review and meta-analysis following PRISMA guidelines. Major databases were searched for studies evaluating music interventions for sleep quality in adults aged 50 + years. Randomized controlled trials (RCTs) and non-randomized controlled trials (non-RCTs) were included. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool for RCTs and the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool for non-RCTs. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using both common effect and random effects models. The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Results

The initial search retrieved 473 articles from electronic databases. After removing duplicates and screening, 10 studies (6 RCTs, 4 non-RCTs) published between 2010 and 2023 with 602 participants met inclusion criteria and were included in the meta-analysis. The random effects model showed significant improvement in sleep quality with music therapy (SMD: -0.79; 95% CI, -1.25 to -0.33; P < .001). Substantial heterogeneity was observed (I² = 79%; Q = 42.54; P < .001). Subgroup analysis revealed significant benefits in RCTs (SMD: -0.59; 95% CI, -1.11 to -0.07) but not in non-RCTs (SMD: -1.08; 95% CI, -2.36 to 0.19). Sensitivity analyses confirmed the robustness of findings, and no publication bias was detected. GRADE assessment indicated very low certainty of evidence for both RCTs and non-RCTs due to risk of bias concerns and substantial heterogeneity.

Conclusions

Music therapy demonstrates significant improvement in sleep quality among older adults; however, the very low certainty of evidence based on GRADE assessment suggests caution in clinical recommendations. Future research should address methodological limitations, particularly regarding bias in outcome measurement and intervention implementation, to provide more definitive evidence for clinical practice guidelines.

Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).

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