Evidence Based Research

This research paper explores the effectiveness of music therapy in improving sleep patterns for patients with depression. The PICOT format was used to develop the research question. Medline was the main database used for the research study. Two primary research articles were used in the study. The results indicate that music therapy is an effective non-pharmacological intervention for promoting sleep patterns among patients with depression.

Running head: EVIDENCE BASED RESEARCH
Evidence based research
Name of the student:
Name of the university:
Author note:

1
EVIDENCE BASED RESEARCH
Table of Contents
Introduction:...............................................................................................................................2
Methods:.....................................................................................................................................3
Results- search stages & number of items found:......................................................................4
Discussion:.................................................................................................................................5
References:.................................................................................................................................8

2
EVIDENCE BASED RESEARCH
Introduction:
In the target population of patient with depression, can the use of music therapy as an
intervention as compared to standard care improve the sleep patterns within the
timeframe of 6 to 12 months?
This research question had been developed using the PICOT format which is one of
the most useful and systematic format that has been used in the evidence based research. The
PICOT format stands for five interconnected elements relevant to an evidence based research,
population, intervention, comparison, outcome, and timeframe. In this question, the
population selected is the patients with depression, and the intervention selected is music
therapy, the comparison selected in standard treatment regimen, the desired outcome is
improved sleep patterns, and the selected time frame is six to twelve months. Hence, it can be
easily concluded that the question fits the PICOT format perfectly (Saimbert, Pierce &
Hargwood, 2016).
Depression is a very common mental health issues and it is prevalent in a variety of
different age groups (Petrovsky, Cacchione & George, 2015). Among the various other
symptoms that are associated with diagnosis of depression, the complaint of inability to fall
asleep is all too common. According to the recent statistical reports, the percentage of
Australians living with depression is close to three million, and almost 50% of them present
with a co-occurring disorder of insomnia, which further worsens the depression symptoms
(Beyondblue.org.au, 2018). The impact of sleep deprivation is extreme on depression, the
negative thoughts, anxiety and restlessness which is associated with depression symptoms act
as significant challenges in obtaining a peaceful sleep (Tai, Wang & Yang, 2015). This in
turn further deteriorates the negative thought pattern of a depression, aggravating the
hopelessness, helplessness, and can even provoke suicidality among the patients. Hence,

3
EVIDENCE BASED RESEARCH
discovering a non-pharmacological and nontoxic intervention for promoting sleep patterns
among the patients with depression is the key topic area which I have selected for this
research paper (Tsai et al., 2014).
This PICO questions had been developed by a number of different trial and error
methods. I had to rephrase the question and the elements or phrases chosen a couple of times
to avail the best available research hits. For instance, I had to change the time frame selected
a couple of times from 3 months to 6 months and ultimately to 12 months to be able to get
optimal results in the research, especially to ensure getting finding primary evidence and
systematic reviews in the study. Ultimately, my peers have helped me as well in modifying
and improvising and I am extremely grateful for their support and assistance.
Methods:
A number of different databases have been used in the research study in order to avail
the most relevant primary research evidences. However, the main database from which the
article have been chosen and used in the research paper had been Medline. There are various
contributing factors that has propelled the choice of Medline as the chosen database for the
research paper. First and foremost, it has to be mentioned that Medline is an excellent
resource for medical or clinical research studies as it provides the access to peer-reviewed
and complete research articles along with the articles being authorative evidences (McGowan
& Murray, 2016). Along with that, Medline is the only database that contains more than 12
million references to scientific literature. Along with that, the Medline is the only database
which can provide the access to most extensive research articles, hence it has been chosen for
this study as the main database.
However, there have been other databases used for the research as well which helped
us to sort out the articles to be used the study and for collecting a few key supporting articles

4
EVIDENCE BASED RESEARCH
that has been used in this assignment. The three article databases used in this article had been
devoid of any available pre-set filters, as a result these databases helped in only obtaining
article for the preliminary research for the study and obtain supporting paper for the articles.
The databases used had been Google scholar, Cochrane library, and PubMed database. Each
of the database has helped us arrive at a list of apt supportive literature based on which the
final search will be performed using Medline database. In this case the search strategy has
used Boolean operators and different delimiters such as abstract, peer reviewed and only
2014 onwards to ensure that the research articles chosen for the final paper are relevant,
accurate and recent. The subject headings for the final search had been different
combinations of the research phrases selected for the paper. The search phrases used for the
assignment had been ‘depression’, ‘sleeping patterns’, ‘insomnia’, ‘music therapy’, ‘standard
treatment’, ‘intervention’, ‘sleep cycle’.
Results- search stages & number of items found:
First and foremost, I had used the three pre-set filter databases, Google scholar,
Cochrane library and PubMed, to gather preliminary research evidence to start the paper on
the topic area. After which the research question was crafted using the PICOT format
(McGowan & Murray, 2016). After which the Medline database was accessed through the
MYSCU library and preliminary research was carried out using three of the search phrases
and Boolean operator ‘OR’. The first search had been successful with overwhelming results
of 99000 hits. In order to narrow down the evidence list and enhance the relevance and
accuracy of the research, I applied the limiter of full text, which narrowed down the results to
3099 results. After which I added one more limiter of English language to further narrow
down the research, which narrowed the result hits to 3068 articles. After which I had to apply
a third limiter of abstract available to reduce the evidence size further, which brought the total
result to 2900 hits. Then I had to limit the study to only Australia based researches and peer

5
EVIDENCE BASED RESEARCH
reviewed which helped narrow down the research to 98 article and then I had limited to age
group as the older adults which narrowed the results further to 98 results. The last limiter
applied had been depression as a major heading which helped narrow down the result
obtained to 19 articles, out of which I selected five most relevant articles for the paper on the
basis of my best understanding.
Table of search stages & number of items found:
Discussion:
Two primary research articles which had been used in the research study as the main
articles for the assignment had been a pilot project and a systematic review. It has to be
mentioned in this context that both of these articles which had been used for this academic
research study had been based on the effectiveness of the music therapy in the context of
improving sleep quality and duration for the elderly patients with depression which had been
the target population chosen for the research paper. Elaborating on the first research article,

6
EVIDENCE BASED RESEARCH
by Lund and Pederson (2016), the primary aim of the article had been to determine the
effectiveness of sound pillows to improve the sleep quality for the elderly patients with
depression and bipolar disorders. Undoubtedly, this research study had focused on the a novel
product, a sound pillow which had been infused with a customized designed playlists,
especially calm music for the target patients to use for 30 days straight. The data was
collected in the form of short semi structured interviews four times throughout the listening
period with respect to the follow up data collection. The result of this primary evidence
described that music listening is extremely helpful in facilitating better sleep quality in the
patients that are struggling with depression. The research study had been a pilot project which
had been clear and succinct in providing key information regarding the chosen topic area and
has helped in determining the best possible data in the most easy to understand format. This
research article has also been the only article to focus on only older adults as the target
population al;igning with the criteria of this research study effectively, hence, it had been
chosen for this research paper.
The second systematic review which is used had been by Feng et al. (2017), which
also focussed on the effectiveness of music therapy to improve the sleep patterns in the older
adults struggling with insomnia due to mental illnesses. The meta analysis design utilized all
available literature, especially relevant clinical trials, and the database information has been
identified from PubMed, Embase, the Cochrane Library. The results indicated that the
insomnia issues of the older adults are effectively managed by the use of music therapy as a
standalone intervention. Along with that, the authors have also concluded that music
associated relaxation is the best possible intervention method to help the older adults
struggling with insomnia and associated mental illnesses such as depression. The clear and
succinct design and thorough and extensive meta-analysis had been the key reason for
selecting this article as the second choice of systematic review.

7
EVIDENCE BASED RESEARCH
A few other articles had been rejected due to relevancy and authenticity issues in the
research study including the study by Huang, Chang, Hsieh and Lai (2017), which had been a
RCT judging the effect of music video intervention in adults with sleep disturbance due to the
small sample size and partial irrelevance. The study by Zhao, Bai, Bo and Chi (2016) on
effectiveness of music therapy for older adults with depression was rejected for lack of focus
on sleep improvement. The article by Shum, Taylor, Thayala and Chan (2014) had been
rejected due to irrelevance as well as it had not focussed on depression. The last study
rejected had been by Gaewlai et al. (2018) which had a very small sample size limiting the
transferability of the study.

8
EVIDENCE BASED RESEARCH
References:
Beyondblue.org.au (2018). Statistics and references. Retrieved from
https://www.beyondblue.org.au/about-us/research-projects/statistics-and-references
[Accessed on 10th Nov]
Feng, F., Zhang, Y., Hou, J., Cai, J., Jiang, Q., Li, X., ... & Li, B. A. (2017). Can music
improve sleep quality in adults with primary insomnia? A systematic review and
network meta-analysis. International journal of nursing studies. Doi:
10.1016/j.ijnurstu.2017.10.011
Gaewlai, P., Vallibhakara, S. A. O., Perkins, K. M., Chantra, M., Sephu, S., Wisajun, P., &
Awirutworakul, T. (2018). Comparative Effectiveness of Active Group Music
Therapy in Major Depressive Disorder Compared to Standard Group Psychotherapy:
A Randomized Controlled Trial. JOURNAL OF THE MEDICAL ASSOCIATION OF
THAILAND, 101(4), 529. Retrieved from
http://www.jmatonline.com/index.php/jmat/article/view/8902
Huang, C. Y., Chang, E. T., Hsieh, Y. M., & Lai, H. L. (2017). Effects of music and music
video interventions on sleep quality: A randomized controlled trial in adults with
sleep disturbances. Complementary therapies in medicine, 34, 116-122. Doi:
10.1016/j.ctim.2017.08.015
Lund, H. N., & Pedersen, I. N. (2016). Pilot Project: Sound pillow treatment to improve sleep
quality for patients with depression or bipolar diagnosis with sleeping
problems. European Psychiatry, 33, S80. Doi: 10.1016/j.eurpsy.2016.01.026

9
EVIDENCE BASED RESEARCH
McGowan, J. E., & Murray, K. (2016). Exploring resilience in nursing and midwifery
students: a literature review. Journal of advanced nursing, 72(10), 2272-2283. Doi:
10.5195/jmla.2018.345
Petrovsky, D., Cacchione, P. Z., & George, M. (2015). Review of the effect of music
interventions on symptoms of anxiety and depression in older adults with mild
dementia. International psychogeriatrics, 27(10), 1661-1670. Retrieved from
https://www.cambridge.org/core/journals/international-psychogeriatrics/article/
review-of-the-effect-of-music-interventions-on-symptoms-of-anxiety-and-depression-
in-older-adults-with-mild-dementia/DE257F0A0B088D33695A8AE9DE676C75
Saimbert, M., Pierce, J., & Hargwood, P. (2016). Developing Clinical Questions for
Systematic Review. Comprehensive Systematic Review for Advanced Practice
Nursing, 79. Retrieved from https://books.google.co.in/books?
hl=en&lr=&id=2SsODAAAQBAJ&oi=fnd&pg=PA79&dq=pico+framework+mcgow
an&ots=IPmybxVYJJ&sig=LTbKkzO4-
jFEfNxdndoqmr4JKvg#v=onepage&q&f=false
Shum, A., Taylor, B. J., Thayala, J., & Chan, M. F. (2014). The effects of sedative music on
sleep quality of older community-dwelling adults in Singapore. Complementary
therapies in medicine, 22(1), 49-56. Doi: 10.1016/j.ctim.2013.11.003
Tai, S. Y., Wang, L. C., & Yang, Y. H. (2015). Effect of music intervention on the cognitive
and depression status of senior apartment residents in Taiwan. Neuropsychiatric
disease and treatment, 11, 1449. Doi: 10.2147/NDT.S82572
Tsai, H. F., Chen, Y. R., Chung, M. H., Liao, Y. M., Chi, M. J., Chang, C. C., & Chou, K. R.
(2014). Effectiveness of music intervention in ameliorating cancer patients’ anxiety,
depression, pain, and fatigue: A meta-analysis. Cancer nursing, 37(6), E35-E50.

10
EVIDENCE BASED RESEARCH
Retrieved from
https://journals.lww.com/cancernursingonline/Abstract/2014/11000/Effectiveness_of_
Music_Intervention_in.14.aspx
Zhao, K., Bai, Z. G., Bo, A., & Chi, I. (2016). A systematic review and meta‐analysis of
music therapy for the older adults with depression. International journal of geriatric
psychiatry, 31(11), 1188-1198. Doi: 10.1002/gps.4494