Music Interventions for the Facilitation of Sleep in the Acute Geriatric Setting
试验速览
- 阶段
- 不适用
- 入组人数
- 50
- 试验地点
- 2
- 主要终点
- Sleep quality measured subjectively via the Insomnia Severity Index (ISI) questionnaire
研究概览
简要总结
Sleep disturbance is a common problem experienced by older patients, especially in the acute care setting, and has detrimental effects on patients' health and recovery. There is a keen focus on non-pharmacological interventions because of the high risk of side effects related to pharmacotherapy. Music is safe and cost-effective, and there is a growing body of evidence for its potential health benefits.
The purpose of our study is to examine the impact of music listening interventions on the facilitation of sleep for patients admitted to the geriatric assessment unit (GAU).
The investigators predict that a musical listening exercise will more effectively contribute to the facilitation of sleep compared to non-musical sounds and compared to standard of care on the GAU. The investigators plan to conduct this study as a feasibility study. It will be a 3-arm randomized controlled trial where participants will be randomized to either: (1) music listening intervention, (2) non-musical sounds involving nature sounds, or (3) standard of care on the GAU. The intervention will take place over 7 consecutive nights.
The primary outcome will be sleep quality, which will be measured objectively using sleep logs and subjectively through patients' own perspectives of their sleep through the Insomnia Severity Index. Secondary outcomes will include patients' sleep quality assessed by smart watches, which the investigators will evaluate to see if the data correlates to the sleep logs and patients' subjective view of their sleep. Other secondary outcomes will include patients' mood, level of pain, number medications used for sleep, duration of stay in hospital, patients' level of enjoyment of the music or non-musical sounds, and feasibility measures.
As this is a feasibility study, the goal is to show that it is possible to conduct a larger study with the same objectives and methodology. The ultimate goal is to create high-quality evidence to support (or refute) our hypothesis that music listening interventions are effective at facilitating sleep for patients admitted to the GAU. This would be a safe and cost-effective intervention to improve the health outcomes of this vulnerable population.
详细描述
Summary of background:
Sleep disturbance is a common problem experienced by older patients, especially in the acute care setting, and has detrimental effects on patients' health and recovery. There is a keen focus on non-pharmacological interventions because of the high risk of side effects related to pharmacotherapy. Music is safe and cost-effective, and there is a growing body of evidence for its potential health benefits.
Purpose:
The purpose of this study is to examine the impact of music listening interventions on the facilitation of sleep and the improvement of sleep quality for patients admitted to the geriatric assessment unit (GAU), as well as the feasibility of applying these interventions.
Hypothesis:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- None
入排标准
- 年龄范围
- 65 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •This study will include patients admitted to the GAU at St. Mary's hospital in Montréal over the six-month study period (March to August 2022). As many of the patients admitted to the GAU have major neurocognitive disorder (MNCD), the investigators will include them in our study (MNCD of any stage, including Alzheimer's disease). Furthermore, the investigators will include patients who take medications for sleep in our study, and they will be randomized into the 3 groups like all the other participants.
- •The patients' baseline characteristics will be noted upon entry into the study: admitting diagnosis, demographics (age, sex), whether they have MNCD, and their music sophistication. Patients' music sophistication will be evaluated using the General Musical Sophistication Subscale (GMSS) which is embedded within the Goldsmiths Musical Sophistication Index (Gold-MSI). Furthermore, as the investigators will be including patients who use medications for sleep in our study, the investigators will note what type of medication(s) the participants are taking. Specifically, the investigators will categorize the medications in the following categories: benzodiazepines, antidepressants, antipsychotics, melatonin or other; and the investigators will note if the indication is specifically for sleep or not.
排除标准
- •Patients who already listen to music or non-musical sounds as part of their sleep routine.
- •Patients with medical instability which limits their ability to participate in the study (determined by the patient's treating physician).
- •Patients who have a diagnosis of a sleep disorder including obstructive sleep apnea and REM sleep behaviour disorder.
- •Patients who are unable to communicate in English or French.
- •Patients with behavioural issues that limit their participation in the study; specifically, those that have agitation or hyperactivity that limits their compliance with the intervention as can be seen in cases of severe BPSD (Behavioural and Psychological Symptoms of Dementia) or hyperactive delirium.
- •Patients with severe hearing impairment, specifically those for whom their hearing impairment affects their ability to communicate their consent for this study and to listen to music.
结局指标
主要结局
Sleep quality measured subjectively via the Insomnia Severity Index (ISI) questionnaire
时间窗: 7 days
Sleep quality will also be measured subjectively through patients' own perspectives of their sleep with the Insomnia Severity Index (ISI) questionnaire which will be administered to the patients daily. The ISI is a questionnaire which has seven questions that pertain to participants' severity of insomnia symptoms. Participants are asked to answer each question on a scale of 0 to 4 (0 being asymptomatic and 4 being very symptomatic). The seven answers are added up to get a total score which ranges between 0 and 28. The higher the score, the more severe the insomnia is. The ISI questions will be slightly modified so that the questions focus on patients' latest night of sleep, not on their sleep over the past 2 weeks, as this questionnaire will be administered daily. The ISI has been shown to be a reliable and valid tool as an outcome measure in insomnia treatment and research in older patients.
Total sleep time measured objectively via sleep logs
时间窗: 7 days
Total sleep time will be measured objectively by sleep logs. This will be done by the overnight nurses who will complete a form in the morning where they will write down the following for each participant: * the time of sleep onset * the wake time in the morning * the number and duration of awakenings during the night (if there are any). The research assistants will pick up the form the next day to collect that data. With this information, the investigators will be able to calculate the total sleep time of each participant for each night in the study.
Number of awakenings during the night measured objectively via sleep logs
时间窗: 7 days
The number of awakenings will be measured objectively by sleep logs. This will be done by the overnight nurses who will complete a form in the morning where they will write down the number and duration of awakenings during the night (if there are any) for each participant as noted above. The research assistants will pick up the form the next day to collect that data.
次要结局
- Mood assessed via visual analog mood scale(7 days)
- Duration of stay in hospital(7 days)
- Enjoyment of intervention(7 days)
- Number of exclusions as a feasibility measure(6 months)
- Time needed to collect the data as a feasibility measure(6 months)
- Total sleep time assessed via smart watches(7 days)
- Medications used for sleep(7 days)
- Protocol adherence(7 days)
- Number of refusals as a feasibility measure(6 months)
- Number of eligible participants as a feasibility measure(6 months)
- Sleep onset latency assessed via smart watches(7 days)
- Sleep efficiency assessed via smart watches(7 days)
- Pain level assessed via a visual analog pain scale(7 days)
- Noise level(7 days)
- Cost of the study as a feasibility measure(6 months)
- Wake after sleep onset assessed via smart watches(7 days)
- Number of participations as a feasibility measure(6 months)
- Availability of the data as a feasibility measure(6 months)
研究者
Shek Fung
Principal Investigator
McGill University