Music for Sleep After Stroke

Mindful Music-listening to as a Tool to Improve Sleep Post-stroke: A Single Case Experimental Design Study

Sleep difficulties are common following stroke yet effective evidence-based interventions for improving sleep in this population are lacking. A small number of studies have investigated the use of music listening as a way to improve sleep in adults with insomnia.

This study aims to examine whether a mindful music-listening intervention can reduce subjective and objective insomnia symptoms and improve mood and fatigue post-stroke.

Six adults with a clinical diagnosis of stroke presenting with an insomnia disorder will be recruited from stroke services within NHS Greater Glasgow and Clyde. A multiple baseline single case experimental design will be employed. Participants will be randomly allocated to a baseline phase of 7, 11 or 15 days, followed by a five-week mindful music-listening intervention incorporating sleep hygiene. Changes in subjective and objective sleep will be measured using questionnaires and actigraphy, respectively. Mood and fatigue will also be measured. The data will be analysed using visual inspection, Tau-U and multi-level modelling.

Inclusion Criteria:

• aged 18+ (no upper age limit);
• clinically and/or radiologically confirmed diagnosis of stroke
• score of ≤16 on the Sleep Condition Indicator (SCI; (Espie et al, 2018))
• at least 3-months post-stroke

Exclusion Criteria:

• Transient Ischemic Attack
• subarachnoid hemorrhage
• sleep medication commenced within the last 2 weeks (stable medication accepted)
• significant receptive aphasia or major psychiatric/substance abuse problem preventing engagement in the intervention
• deafness or severe hearing impairment preventing engagement in the intervention (use of hearing aids does not lead to exclusion where these support sufficient level of hearing for engagement)
• unable to give informed consent.
• participation in another intervention study with risk of contamination of study outcomes (determined on a case-by-case basis)