International Journal of Innovative Studies in Medical Sciences (IJISMS)

ISSN 2457-063X (Online) www.ijisms.com Volume: 3 Issue: 1 | 2019

Effectiveness of Music Therapy on Quality of Sleep among Elderly

People in Selected Old Age Homes at Kanpur
Anuj Kumar1, S. Merridith 2, Vinil Upendrababu3
1
Lecturer, Yashraj College of Nursing, Chaubeypur, Kanpur, Uttar Pradhesh, India
2
Assistant Professor, faculty of Nursing, Rama College of Nursing, Rama University, Mandhana, Kanpur. Uttar Pradhesh,
India
3
Research Scholar, Department of Nursing, Shri Venkateshwara University , Gajraula, Amroha, Uttar Pradesh, India

Abstract: Sleep is essential for a person’s health and sleep at right time can help to protect your mental
wellbeing. Sleep plays a vital role in maintaining good health, physical health, quality of life and safety. In
health and well being throughout a person’s life. contrast studies States that sleep deficiency affects
However, most of the patients are suffering from sleep activity in some parts of brain. If you are sleep
related disorders when they are either diseased or deficient, you may have trouble in making decision,
hospitalized. A number of nursing measures as well as solving problems, controlling your emotions and
relaxing techniques has been improving the sleep pattern behavior with change.[2]
of the patient as per the research evidences. Hence in this
Sleep helps your brain to work properly. While you're
study the investigator tried to provide music therapy for
sleeping, your brain is preparing for the next day. It's
the patients in purpose of reducing the disturbed
forming new pathways to help you learn and
sleeping pattern and improving the quality of life. The
remember information. The damage from sleep
main objective of this study were to assess the
deficiency can occur in an instant (such as a car crash),
effectiveness of music therapy on the quality of sleep in
or it can harm you over time. For example, ongoing
experimental group by comparing with the control
sleep deficiency can raise your risk for some chronic
group and to find out the association of the results of the
health problems. It also can affect how well you think,
study with selected demographic variable. A non
react, work, learn, and get along with others.[3]
randomized quasi experimental control group research
design was used for this study and the selected sampling Studies show that a good night's sleep improves
technique for this study were a non probability purposive learning. Whether you're learning math, how to play
sampling. With this same technique the investigator has the piano, how to perfect your golf swing, or how to
selected 30 samples in each experimental group and drive a car, sleep helps to enhance your learning and
control group. A modified Pittsburgh sleep quality index problem-solving skills. Sleep also helps you pay
was used to collect data. Results of the study shows that attention, make decisions, and be creative. Sleep
73.33% elderly people are not having any significant deficiency alters activity in some parts of the brain.
insomnia followed by the intervention of musical Sleep deficiency also has been linked to depression,
therapy. However, there was no significant difference in suicide, and risk-taking behavior. Sleep is one of the
pre test and post test sleep score value in control group. strangest things we do each day. The average adult will
Hypothesis testing revealed that highly significant spend 36 percent of his or her life asleep.[4]
(p˂0.05) difference was found between post test sleep
Music is one of the alternative form of therapeutic
score and pre test sleep score among elderly people in
treatment for sleep disorders. It helps in achieving
experimental group.
relaxation by soothing the central nervous system
Keywords: Music therapy. Quality of sleep, elderly and attaining peace and stillness of mind. Studies
people, Old age homes recommend that the music therapy for geriatric
helps to reduce the individual perception of
1. INTRODUCTION tranquilizing medication, reduces the use of
Sleep is a naturally recurring state of mind hypnotics on the hospital ward and helps in overall
characterized by altered consciousness relatively rehabilitation.[5]
inhibited sensory activity, inhibition of nearly all Music therapy uses music to promote good cognitive
voluntary muscles and reduced interactions with functioning of the brain. Through music therapy,
surroundings. It is distinguished from wakefulness by a elderly adults can express emotions, improve their
decreased ability to react to stimuli but is more easily listening, comprehension, promote good memory and
reversed than the state of hibernation or being improve their verbal and social skills. Listening to
comatose.[1] music is a big part of music therapy. During music
Sleep plays a vital role in maintaining good health and therapy, elderly adults are encouraged to sing, play
well being throughout your life. Getting enough quality

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 International Journal of Innovative Studies in Medical Sciences (IJISMS)
ISSN 2457-063X (Online) www.ijisms.com Volume: 3 Issue: 1 | 2019

instruments, write songs, and even learn how to play H3- There is a significant association between the level
new instruments.[6] of quality of sleep after post test among elderly people
in control group with their selected demographic
Globally, the proportion of people aged 60 years
variables.
and over is growing faster than any other age
group. By the year 2025, people in this age group 2. MATERIAL AND METHODS
will reach a total of 1.2 billion and this will rise to 2
billion in the year 2050 with 80 % of them living in 2.1 RESEARCH DESIGN:
developing country.[7] The research approach adopted for this study was
Surveys have estimated that more than 50% of evaluative approach and the design will be quasi-
community living people aged 65 or older experimental one experimental and control group.
experience sleep disturbance. Sleep disorder can Setting of the study: The study was conducted in
result due to tiredness, depression, greater anxiety, Swaraj vridhrashram near panki power house, Kanpur.
irritability, pain sensitivity, muscle tremors and lack
of day time alertness. The main goal of music 2.2 VARIABLES:
therapy is to reduce psycho- physiological stress, Independent Variable
pain and anxiety.[8]
In this study Music therapy is the independent variable.
Music therapy also provides avenues for
communication that can be helpful to those who find it Dependent Variable
difficult to express themselves in words. Research in In this study dependent variables refers to the quality
music therapy supports its effectiveness in many areas of sleep of elderly people.
such as: overall physical rehabilitation and facilitating
movement, increasing people's motivation to become Demographic Variables
engaged in their treatment, providing emotional Age, Gender, Education Status, Occupation, Years of
support for clients and their families, and providing an institutionalization, Family history of disease, alcohol
outlet for expression of feelings.[9] and tobacco.
1.1STATEMENTS OF PROBLEM: 2.3 POPULATION:
“A study to Assess the Effectiveness of Music therapy The population for the study were elderly residents in
on the Quality of sleep among Elderly people in swaraj Vridhrashram near panki power house, Kanpur.
selected old age homes at Kanpur”.
2.4 SAMPLE:
1.2 OBJECTIVES OF THE STUDY:
The sample of the study were 60 elderly of Swaraj
1. To assess the quality of sleep among elderly people Vridhashram who fulfilled the sampling criteria.
before music therapy in experimental group.
2.5 SAMPLING TECHNIQUE:
2. To Assess the quality of sleep among elderly
people before music therapy in control group. With the help of purposive sampling technique, 60
elderly people were selected as sample for the study.
3. Assess the effectiveness of music therapy on
the quality of sleep in experimental group by 2.6 DEVELOPMENT AND DESCRIPTION OF THE
comparing with the control group. TOOL USED IN THE STUDY:

4. To find out the association of quality of sleep The tool to assess the quality of sleep was developed by
among experimental and control group after post test the investigator with the modification of Pittsburgh
with selected demographic variables. sleep quality index. Validity and reliability of tool was
checked. The tool consists of 2 sections. The tool used
HYPOTHESIS: for the study include:
H0- There is no significant differences in the level of SECTION A:
quality of sleep before and after music therapy among
elderly people in control group in old age homes. Baseline proforma which include the socio-
demographic data like Age, Gender, Sex, years of
H1- There is a significant differences in the level of institutionalization, Educational Qualification, type of
quality of sleep before and after music therapy among occupation, socio-economic status.
elderly people in experimental group in old age homes.
SECTION B:
H2-- There is a significant association between the level
of quality of sleep after post test among elderly people A modified pitssburgh sleep quality index for the
in experimental group with their selected demographic assessment of sleep was prepared and utilized as a tool
variables. to collect the data from elderly peoples. This Modified
Pittsburgh sleep quality index consist of 34 questions.

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 International Journal of Innovative Studies in Medical Sciences (IJISMS)
ISSN 2457-063X (Online) www.ijisms.com Volume: 3 Issue: 1 | 2019

The elderly people has to pick out one statement in 6. Alcohol Consumption and tobacco chewing : As per
each group that best describes the way he /she have the findings majority of the selected samples were not
been feeling the past months including the day of consuming either any alcohol products or tobacco
inventory. In all cases, a score of “0” indicates no products in both group .
difficulty . While a score of “3” indicates severe
3.2 ASSESSMENT OF LEVEL OF QUALITY OF SLEEP
difficulty. The “global” score, with a range of 0-102
AMONG ELDERLY PEOPLE BEFORE
points.
IMPLEMENTATION OF MUSIC THERAPY IN
The tool was prepared by the investigator under the CONTROL AND EXPERIMENTAL GROUP
guidance of experts from the field of nursing and
Table 3.1. Distribution of elderly people according to
medicine.
quality of sleep before implementation of music therapy
2.7. DATA COLLECTION PROCEDURE:
Level of quality of Experimental Control Group
The main study was planned for a period of 4 weeks in sleep Group
the Month of july 10th to August 7th 2017. Sixty NO. % NO. %
samples were collected through purposive sampling No clinical 00 00 12 40
technique. After taking the consent from the concerned significant
samples the data were collected from the samples. Insomnia
Phase I: Sub threshold 10 33.34 11 36.66
Insomnia
With prior informed consent, pretest was conducted Clinical 18 60 5 17
through modified Pittsburgh sleep quality index to insomnia(moderate
assess the sleep quality. Clinical
severity) 2 6.66 2 6.66
Phase II: insomnia(Severe)

The investigator administered instrumental music 3.3 ASSESSMENT OF LEVEL OF QUALITY OF SLEEP
therapy as intervention. AMONG ELDERLY PEOPLE AFTER
IMPLEMENTATION OF MUSIC THERAPY AMONG
Phase III: ELDERLY PEOPLE IN CONTROL AND
After 28 days post test was conducted to the same EXPERIMENTAL GROUP
elderly people by using the same modified Pittsburgh Table 3.2. Distribution of elderly people according to
sleep quality index. quality of sleep after the implementation of music
3. RESULT therapy
Level of quality of Experimental Control Group
The data thus obtained were analyzed and presented
sleep Group
under the following sections. No. % No. %
3.1. DESCRIPTION OF DEMOGRAPHIC VARIABLES No clinical 22 73.33 5 16.66
significant
1. Age : Among the total sample the highest percentage Insomnia
of samples were belongs to the category of 60-65 years Sub threshold 8 26.67 14 46.68
both in the control group as well as in the experimental Insomnia
group 46.67 and 33.3% respectively. Clinical 00 00 5 16.66
insomnia(moderate
2. Sex: Majority of the samples were male in the Clinical
severity) 00 00 6 20
experimental group(60%), but it is the other way insomnia(Severe)
round in contol group where the prominent sex was
3.4 EFFECTIVENESS OF MUSIC THERAPY ON
female(63%).
QUALITY OF SLEEP
3. Level of education: In both control and experimental
Table 3.3 Comparison of post test level of quality of
group majority of the samples were completed their
sleep among elderly people
lower and upper primary education, 46.7% and 33%
respectively. Aspect EXPERIMENTAL CONTROL GROUP
GROUP
4. Type of occupation : As per the type of occupation, Level of quality of
most of the samples were self employers (40% in each) sleep No Mea SD Mean N Mea SD Mean
in both groups. . n % o n %
No clinical
5. Years of institutionalization: In both groups the 22 14.7 5.4 43.32 3.76 7.74 12.53
significant
highest percentage 12(40%) and 14(46.7%) Insomnia 3 9 % 5 %
respectively were living from 2 to 5 years.
Sub threshold 8 9.5 13. 27.94 17.1 13.9 50.29
9 % 14 6 %

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 International Journal of Innovative Studies in Medical Sciences (IJISMS)
ISSN 2457-063X (Online) www.ijisms.com Volume: 3 Issue: 1 | 2019

Insomnia 5. DISCUSSION
The first objective of the study was to assess the
Clinical quality of sleep among elderly people before music
insomnia(modera 00 00 00 00 5 10.6 21.8 31.26
3 7 % therapy in experimental group. As per the data
te severity)
Clinical insomnia collected from the samples it is evident that 34% of
(Severe) 00 00 00 00 6 15.2 25.0 44.70 elderly people had sub threshold insomnia, 60%
1 % elderly people had clinical insomnia (moderate
severity) where as 2 elderly people had severe clinical
n=60 insomnia (severe) in experimental group. Similarly it is
3.4.1 Significance of difference between pre-test the same way round in the case of control group too.
and post test sleep score The results of this study is supported by the study
conducted by Fadıloğlu et al. (2006) . In his study also
H1--There is a significant differences in the level of he has found out that 63% of the elderly patients slept
quality of sleep before and after music therapy among between 22:00 and 23:00, 23% had difficulty falling
elderly people in experimental group in old age homes. sleep, 38% woke up between 06:00 and 07:00 in the
Table. 4. Significance of differences between pre-test morning, and 47% frequently woke up after falling
and post-test sleep scores. sleep[10]. Similarly in another study which is
conducted by Mr. Babacan Gümüş et al. (2009) in a
Experimental Group Control Group
nursing home reported that 47.8% of the samples (
Pre-test Post-test “t” Pre-test Post-test “t”
elderly people) had difficulties falling sleep, and 58.3%
of them woke up after falling sleep[11].
Me SD Me SD 17. Mean SD 1.
an an 37 79 The second main objective of the study was to
12 24 8. 37. 19. 47 20. assess the effectiveness of music therapy on the quality
55 .8 05 16 43 .2 55 of sleep in experimental group by comparing with the
(df 29), (table value = 2.045) control group. After the intervention of music therapy
P< 0.05
in the experimental group most of the elderly people
22(73.33%) were not having any sleep . This reveals
The above mention table revealed paired‘t’ test, which that the music therapy was effective for the
was calculated to assess the significant difference experimental group of elderly people.Distribution of
between pre and post test sleep scores value, among overall mean ,SD and mean percentage of post test
experimental group shows highly significant difference quality of sleep score of control and experimental
.The calculated “t” value (26.370) is more than the table group elderly people shows that among control group
value at 0.05 level of significance. Hence the hypothesis the highest mean of sleep score was 17.1±13.96 which
(H1) is accepted. is 54.5% for sub threshold insomnia and the lowest
The paired‘t’ test of control group show no significance mean of sleep score was 15.2±25.01 which is 12.53 for
difference between pre test and post test sleep score no clinical significant insomnia. Similarly in
value. The calculated “t” value (1.79) is less than the experimental group the highest mean quality of sleep
table value at 0.05 level of significance. Hence the score was 14.73± 5.49 which is 43.32% for no clinical
hypothesis (H0) is accepted. significant insomnia and the lowest mean of sleep score
was 9.5±13.9 which is 27.94 % for sub threshold
4. ASSOCIATION BETWEEN POST TEST SLEEP insomnia. However the overall mean score was 27±
SCORE AND SOCIO DEMOGRAPHIC 5.62 and 55 ±12.8 for both group respectively. This
VARIABLES result is supported by a pilot study conducted in United
States on the effectiveness of music for sleep
Among the selected demographic variables : Age, Sex, disturbance in 25 elderly people shows that 24(96%)
Status, Occupation, Years of institutionalization, Family of the participant reported improved sleep after
history of disease, Alcohol and Tobacco, Only education listening to the music. These result demonstrated that
status and type of occupation has shown an association music therapy procedure is effective in sleep
with post test sleep score of samples in experimental disturbance.
group.
6. CONCLUSION
However among the selected demographic variables
like Age, Sex, Status, Occupation, Years of Based on the findings of the study it is quite evident
institutionalization, Family history of disease, Alcohol that music therapy is effective to improve the sleep
and Tobacco, nothing has shown an association with quality of elderly people. Also, the investigator is
the post test sleep score of control group samples. recommended to provide music therapy to all patients
especially to the elderly who are suffering from sleep
disorders.

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 International Journal of Innovative Studies in Medical Sciences (IJISMS)
ISSN 2457-063X (Online) www.ijisms.com Volume: 3 Issue: 1 | 2019

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