Music Reduces Anxiety and Sedation in the ICU



A new study shows that music and noise-cancelling headphones significantly reduce anxiety and the need for sedation in critically ill patients.


 

MUSIC REDUCES ANXIETY AND SEDATION IN THE ICU

Critically ill patients who are hooked up to a mechanical breathing machine (ventilator) through a tube in their throat often experience significant anxiety and discomfort.  Such patients generally require deep sedation with intravenous sedatives and narcotics, which impairs their ability to actively participate in their care and recovery.

A new prospective, randomized clinical research study suggests that patient-initiated music therapy can significantly reduce anxiety and discomfort, and reduce the need for sedative medications.  This study appears in a forthcoming issue of theJournal of the American Medical Association.

In this innovative study, 373 patients admitted to 12 intensive care units (ICUs), at 5 different hospitals in Minnesota, were randomized into three separate groups.  All patients were connected to a mechanical ventilator.  In the first group, patients were able to self-initiate listening to music through headphones whenever they felt anxious or uncomfortable.  (The selection of music for each patient was tailored to their individual preference by a certified musical therapist.)  In the second group, patients were able to use noise-cancelling headphones, without music, whenever they felt anxious or uncomfortable.  (This second group was designed to control for the potentially beneficial noise-suppression effects of listening to music through headphones in the first group.)  Finally, the third group of patients served as the study’s “control” group, and this group of patients received standard ICU care, without music and without noise-cancelling headphones.

On average, the patients who listened to music through headphones experienced significantly lower levels of anxiety (based upon a validated anxiety assessment tool), when compared to patients who received only the usual ICU care.  In fact, by the fifth day of this study, anxiety levels in the music group were 37% lower than the anxiety levels in the “usual care” group of patients.  Patients in the noise-cancelling headphone group also appeared to benefit from a reduction in anxiety (due to the blocking of noise around them in the ICU).

A very important scientific aspect of this prospective, randomized clinical study was the monitoring and analysis of sedative medications administered to patients in each of the three study groups.  Compared with the “usual care” group of patients, the patients in the music group required significantly less sedative medication throughout each day of the study.  By the fifth day of this study, the patients in the music group required 38 percent less frequent administration of sedative medications, and the average intensity of their level of sedation was reduced by 36 percent (when compared to the “usual care” group of patients).  Patients in the noise-cancelling headphone group also benefitted in terms of the frequency of administration of sedative medication, and the intensity of sedation required to keep them comfortable, although patients in the music group experienced an even greater reduction in the frequency of sedative medication administration.

The findings of this important ICU study confirm the calming effects of music therapy.  The use of noise-cancelling headphones, to block out the often distressing sounds within the ICU environment, also appeared to provide a significant (but lesser) benefit to patients, when compared to standard ICU care.

While this study did not assess potential improvement in overall patient outcomes associated with music therapy or noise-cancelling headphones, such as time spent on the ventilator or time spent in the ICU, there is plenty of research data linking deeper levels of sedation with a prolonged need for mechanical ventilation and longer ICU stays, as well as other adverse patient outcomes.

Based upon the findings of this study, it would appear that music and noise-cancelling headphones should be considered as a new standard in the management of ICU patients who must be connected to a mechanical ventilator.

 

For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my bestselling book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!

Within one week of publication, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books. Within three months of publication, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.com Top 100 New Book Releases in Cancer” list.

 

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According to recent Bureau of Labor Statistics, the unemployment rate for veterans who served on active duty between September 2001 and December 2011 is more than 12 percent.  A new website, Veterans in Healthcare, seeks to connect veterans with potential employers.  If you are a veteran who works in the healthcare field, or if you are an employer who is looking for physicians, advanced practice professionals, nurses, corpsmen/medics, or other healthcare professionals, then please take a look at Veterans in Healthcare. As a retired veteran of the U.S. Army, I would also like to personally urge you to hire a veteran whenever possible.


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


 

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  Over the past 12 months, more than 3.1 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious readers.  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 


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Chronic Anxiety and Depression Significantly Increase the Risk of Early Death




 

A large new study suggests that chronic anxiety and depression are associated with a higher risk of premature death than was previously appreciated.


 

 

CHRONIC ANXIETY AND DEPRESSION SIGNIFICANTLY INCREASE THE RISK OF EARLY DEATH

As I discuss in my bestselling book, A Cancer Prevention Guide for the Human Race, most previous research studies have suggested only rather weak links between chronic stress and cancer risk, although there is some data linking chronic depression with breast cancer risk.  However, in view of the increasing number of people around the world who are currently experiencing chronic anxiety and depression during these economically and geopolitically troubled times, the findings of a new public health study that psychological distress significantly increases the risk of premature death from serious illnesses, including cancer, is concerning.  This new study appears in the current issue of the British Medical Journal.

Altogether, 68,222 adults in Great Britain were followed for an average of more than 8 years within the prospectively conducted Health Survey for England study.  All of these study participants were clinically free of serious physical illness when they first joined this very large public health study.  All of the participants in this study were assessed for psychological stress using a validated assessment questionnaire, which was administered in their homes by research staff.  Subsequently, the incidence of serious physical illnesses during the course of this study was then correlated with the degree of measured psychological distress.  The rather dramatic findings of this large prospective public health study illustrate the magnitude of the impact of chronic, severe stress on our bodies, including the risk of premature death due to stress-associated physical illnesses.

After adjusting for preexisting serious physical illnesses, lifestyle-associated risk factors for serious illnesses, and socioeconomic factors known to be linked to chronic, serious illnesses, this study still identified a highly significant increase in the risk of premature death associated with the extent of psychological distress among volunteers in this very large study.  When the “psychological distress score” was compared with death rates, having a score of 1 to 3 (compared to a score of “0,” which reflects no evidence of psychological distress) was associated with a 20 percent increase in the risk of premature death.  A psychological stress score of 4 to 6 was associated with a 43 percent increase in the risk of early death, while a distress score of 7 to 12 was associated with a whopping 94 percent increase in the risk of premature death when compared to study volunteers who were without evidence of any significant psychological distress!

Upon further analysis, death due to cardiovascular disease and other non-cancer causes increased significantly, and proportionally, with each increase in the psychological distress score.  Cancer-associated deaths also increased with rising psychological distress scores, although this association was only observed among volunteers with significantly elevated distress scores.  However, for non-cancer causes of death, the risk of premature death was significantly elevated with evenmild increases in psychological distress.

The potential impact of this study’s findings are highly significant, as they not only reveal a “dose-dependent” relationship between stress levels and the risk of premature death from serious physical illnesses, but the sheer magnitude of the impact of high levels of chronic anxiety and depression on the risk of premature death is much higher, potentially, than has been observed in previous and much smaller studies.

Although this study was not designed to identify the biological mechanisms whereby prolonged periods of increased psychological distress lead to early death, numerous prior studies have shown that chronic depression and anxiety can directly activate an inflammatory response in humans which, in turn, is known to increase the risk of cardiovascular disease, infection, and cancer, as well as other chronic, serious illnesses.  It is also well known that chronic anxiety and chronic depression increase the likelihood of unhealthy behaviors that have also been linked to serious, chronic illnesses, including smoking, excess alcohol or other drug intake, unhealthy diets, and lack of exercise, in addition to other unhealthy behaviors.  What is especially unique about this new study (other than its sheer size), however, is that the researchers were able to identify and adjust for preexisting unhealthy behaviors among the study’s volunteers when they analyzed the study’s data, which increases the likelihood that the adverse effects of chronic anxiety and depression on the risk of premature death observed in this research study are actually a direct result of psychological distress rather than unhealthy lifestyle choices.

If you are experiencing high levels of chronic stress, and if you are frequently anxious or depressed, then please seek help from your personal physician or a mental health professional.  If you are thinking of harming yourself, or someone else, then please seek immediate help.  These are very trying times for many people, and the ongoing worldwide challenges that have provoked such high levels of stress do not appear likely to disappear any time soon.  Knowing that so many other people around the world are also feeling worried and chronically stressed can make each of us feel less alone in our distress.  However, sometimes the awareness that others are experiencing similar levels of distress is, by itself, not enough to ease our anxiety or depression.  So, if you are struggling with anxiety or depression, and especially if you are feeling alone and isolated at the same time, then please seek the help and support of others.  In the vast majority of cases, feelings of hopelessness or helplessness will eventually pass when you get help and support during dark times in your life.


 

For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my bestselling book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!

Within one week of publication, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books. Within three months of publication, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list.




Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


 

Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


 

I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!)  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 




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