The effectiveness of music listening for critically ill patients: A systematic review

Background: Music listening can be easily implemented as a safe, low-cost, and non-invasive intervention. Aims: We assessed the effectiveness of music listening on sleep quality, psychological outcomes, and physiological outcomes for critically ill patients in intensive care units (ICUs). Study design: It is a systematic review and meta-analysis. Twelve electronic databases were searched from inception to February 2022. Inclusion criteria were randomized and quasi-experimental trials that assessed the effect of music listening during ICUs, excluding those receiving music therapy. The outcome indicators were sleep quality, anxiety, depression, and physiological outcomes. We assessed the quality of the included studies using the Cochrane risk of bias tool, and performed a meta-analysis using RevMan 5.3 software. Standardized mean difference (SMD) or mean difference (MD) were used as measures of effect and the results were presented as SMD or MD with 95% confidence intervals (CIs). Results: A total of 1585 titles and abstracts were identified, in which 29 studies were included in the systematic review, which evaluated 2198 subjects, including 1106 in control groups and 1092 in intervention groups. Compared with control groups, music listening improved sleep quality (SMD: 0.93 [95% CI: 0.49–1.38]), anxiety (SMD: −1.12 [−1.55 to −0.69]), depression (SMD: −1.08 [−1.62 to −0.55]), and physiological parameters. Subgroup analysis revealed that music listening produced better results in improving sleep quality in studies of non-surgical patients, in studies in which researchers selected the type of music, in studies with longer intervention duration (>45 to ≤60 min), and in studies that used the Richards-Campbell sleep questionnaire. Bias risk was moderate in all of the included studies. Conclusions: Music listening can improve sleep quality, anxiety, and depression in critically ill patients. However, high-quality trials are still needed to determine the role of music listening in critical care in more depth. Relevance to clinical practice: Music listening is an inexpensive and easy-to-administer intervention that is unlikely to have adverse effects, in contrast to many sedative and analgestic drugs. It deserves widespread use in critically ill patients. Registration: The present study is registered with PROSPERO, number CRD42019147202.