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.

 

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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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Mozart, Music, Babies & Health

January 24, 2010 by Robert Wascher  
Filed under Uncategorized

Welcome to Weekly Health Update



 

“A critical weekly review of important new research findings for health-conscious readers”

 

 

MOZART, MUSIC, BABIES & HEALTH

 

Wolfgang Amadeus Mozart, born in Salzburg on January 27, 1756, was a prolific and gifted composer, and is credited with over 600 original compositions prior to his death in 1791 at the age of 35.  A child prodigy, Mozart is said to have written his first composition by the age of 5.  Although Mozart composed music in a wide variety of styles, music scholars have noted that Mozart’s compositions tend to reflect a high degree of “periodicity,” involving extensive repetition of major melodic themes, when compared to the other enduring master classical music composers of Mozart’s era.  This aspect of Mozart’s music may be clinically important as, for example, clinical research studies in adults with epilepsy have compared Mozart’s music with that of Beethoven, Wagner, Bach, Chopin, Hayden, and Liszt, among others, and found that Mozart’s music was more effective in reducing seizure activity than that of the other titans of Classical music.  Thus, some experts in brain physiology have concluded that Mozart’s compositions may particularly resonate with the human brain’s circuitry, and may potentially affect brain function in clinically significant ways.

An entire commercial industry has emerged from a phenomenon that is often referred to as the “Mozart Effect.”  Clinical research in the early 1990s with infants suggested that listening to music by Mozart could at least temporarily improve spatial reasoning, or “spatial-temporal intelligence” in babies.  The rather narrowly focused findings of these studies have subsequently been grossly over-generalized, primarily by companies marketing Mozart recordings to hopeful new parents, as evidence that regularly listening to Mozart can enhance the IQ of infants and toddlers. 

Putting aside the debate over the potential impact of Mozart on the IQ of babies and toddlers, other recent research data has suggested that exposure to Mozart’s music might be associated with improved weight gain in underweight babies and children.  A newly published prospective clinical research study, which appears in the current issue of the journal Pediatrics, suggests a mechanism whereby underweight premature infants may be stimulated to gain weight following exposure to the music of Mozart. 

In this prospective, randomized study, 20 hospitalized premature infants receiving liquid nutrition through feeding tubes were randomly assigned to two different groups.  In the experimental group, the pre-term babies were exposed to a 30-minute period of Mozart’s music each day, for two consecutive days.   The control group of infants, however, was not exposed to any music on these two consecutive days.  This study included a crossover design, wherein all of these infants were then “crossed-over” into the opposite group, such that each baby participated in both the experimental group and the control group.  Measurements of these babies’ rate of energy metabolism were then performed during each 30-minute period of Mozart music exposure in the experimental group, and for equal 30-minute periods in the babies that were randomized to the control group.

Interestingly, the metabolic rates of the babies exposed to Mozart’s music decreased by 10 to 13 percent within 10 minutes of starting the Great Composer’s music (compared to the infants in the control group).  This innovative little study’s finding that the rate of energy metabolism in premature infants decreases following exposure to Mozart’s music is interesting, and may explain, at least in part, the findings of previous studies that underweight children gain weight after being exposed to recordings of Mozart’s music. 

Research studies such as this one raise the question of whether or not Mozart’s music, or that of other Classical composers, should be routinely used in hospital nurseries and neonatal intensive care units.  Meanwhile, if your baby or toddler is underweight, but otherwise healthy, a trial of “Mozart therapy” might just be in order.



In view of the extreme devastation and human misery brought about in Haiti by the recent earthquake, Weekly Health Update asks our tens of thousands of caring readers to give generously to established charities that are currently working in that country to assist the injured, the ill, and the homeless there.  There are many such legitimate charities, including the following two:

http://www.redcross.org/

http://www.imcworldwide.org/haiti



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, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author


For a somewhat lighter perspective on Dr. Wascher, please click on the following YouTube link: 

http://www.youtube.com/watch?v=7-Tdv7XW0qg

 

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