慢性主观性头晕患者睡眠质量、疲劳严重度及日间嗜睡情况调查

目的对无前庭功能障碍的慢性头晕既慢性主观性头晕（CSD）患者睡眠质量、疲劳严重度、日间嗜睡以及焦虑抑郁情况进行调查。方法被调查者181例,其中CSD患者103例和对照者78例。所有参加者均完成了匹茨堡睡眠量表（PSQI）、疲劳严重度量表（FSS）、爱泼沃斯嗜睡量表（ESS）、抑郁自评量表（SDS）、焦虑自评量表（SAS）测评。同时进行了汉密尔顿抑郁量表（HAMD）及焦虑量表（HAMA）测定。采用非参数检验及χ2检验进行统计分析。运用Spearman相关分析和逻辑回归法对CSD与PSQI、ESS、FSS以及焦虑抑郁之间的关系进行研究。结果 CSD患者睡眠障碍、疲劳、日间过度嗜睡的患病率分别为90.3%（93/103）、70.9%（73/103）和46.6%（48/103）。46.6%~48.5%的CSD患者存在焦虑,51.5%~55.3%存在抑郁。CSD患者与对照组相比,睡眠质量、疲劳严重度、日间嗜睡及焦虑抑郁发生率明显高于对照组（均P〈0.05或〈0.01）。逻辑回归分析显示焦虑抑郁（P〈0.01,OR=35.732,95%CI=7.690~166.023）、睡眠质量（P〈0.01,OR=7.053,95%CI=2.675~18.595）和疲劳严重度（P〈0.05,OR=2.910,95%CI=1.186~7.140）与CSD之间有显著相关性。结论焦虑抑郁、睡眠质量差、疲劳与CSD相关。CSD患者睡眠质量下降,疲劳严重,存在日间过度嗜睡,焦虑抑郁情况突出。     

Suicidal ideation in outpatients with chronic musculoskeletal pain: an exploratory study of the role of sleep onset insomnia and pain intensity

OBJECTIVES: Sleep disturbance, depression, and heightened risk of suicide are among the most clinically significant sequelae of chronic pain. While sleep disturbance is associated with suicidality in patients with major depression and is a significant independent predictor of completed suicide in psychiatric patients, it is not known whether sleep disturbance is associated with suicidal behavior in chronic pain. This exploratory study evaluates the importance of insomnia in discriminating suicidal ideation in chronic pain relative to depression severity and other pain-related factors. METHODS: Fifty-one outpatients with non-cancer chronic pain were recruited. Subjects completed a pain and sleep survey, the Pittsburgh Sleep Quality Index, the Beck Depression Inventory, and the Multidimensional Pain Inventory. Subjects were classified as "suicidal ideators" or "non-ideators" based on their responses to BDI-Item 9 (Suicide). Bivariate analyses and multivariate discriminant function analyses were conducted. RESULTS: Twenty-four percent reported suicidal ideation (without intent). Suicidal ideators endorsed higher levels of: sleep onset insomnia, pain intensity, medication usage, pain-related interference, affective distress, and depressive symptoms (P < 0.03). These 6 variables were entered into stepwise discriminant function analyses. Two variables predicted group membership: Sleep Onset Insomnia Severity and Pain Intensity, respectively. The discriminant function correctly classified 84.3% of the cases (P < 0.0001). DISCUSSION: Chronic pain patients who self-reported severe and frequent initial insomnia with concomitant daytime dysfunction and high pain intensity were more likely to report passive suicidal ideation, independent from the effects of depression severity. Future research aimed at determining whether sleep disturbance is a modifiable risk factor for suicidal ideation in chronic pain is warranted.     

Sleep–wake activity rhythm and health‐related quality of life among patients with coronary artery disease and in a population‐based sample—An actigraphy and questionnaire study

The aim of this study was to explore whether there are gender differences in sleep and health‐related quality of life in patients with coronary artery disease (CAD) and a matched population‐based sample and to see how subjectively rated sleep is associated with actigraphy. Secondly, to explore whether factors that predict patients' sleep quality could be identified. Fifty‐seven patients with stable CAD and 47 participants from a population‐based sample were included. All participants completed the Uppsala Sleep Inventory (USI), the Epworth Sleepiness Scale and the SF‐36. Actigraphy recordings and a sleep diary were performed for seven 24‐h periods. Multiple stepwise regression analysis showed that sleep duration, sleep onset latency, nocturnal awakenings, vitality (SF‐36) and body mass index explained 60% of the sleep quality outcome (USI). Sleep duration, sleep efficiency and fragmentation index assessed with actigraphy and sleep diary accounted for 36% of the sleep quality outcome (diary). The result can form the basis for a non‐pharmacological, self‐care programme supported and led by nurses.     

Insomnia, sleep quality, pain, and somatic symptoms: sex differences and shared genetic components

This study investigated the sex differences, and the shared genetic and environmental factors underlying the associations of sleep disturbances (insomnia and sleep quality) with pain and somatic symptoms in both adolescents and middle-aged adults. We recruited 259 adolescents (69 with current insomnia) and their parents (256 middle-aged adults, 78 with current insomnia). Insomnia severity and sleep quality were measured by the Insomnia Severity Inventory (ISI) and Pittsburgh Sleep Quality Index (PSQI), respectively. Pain and somatic symptoms were measured by the Somatic Symptom Inventory and Visual Analogue Scale for overall pain. Subjects with insomnia scored higher on all measures of pain and somatic symptoms than non-insomnia patients, in both adolescents and adults (P<.001). Both pain and somatic measures were associated with ISI and PSQI scores after controlling for age, sex, depressive and anxiety symptoms. There was an interaction effect between insomnia and female sex on pain and somatic symptoms (P<.05), especially in adults. Pain and somatic symptoms ran in family with moderate heritability (range h(2)=0.15-0.42). The phenotypic associations of ISI and PSQI with pain and somatic measures were both contributed by genetic (range p(G)=0.41-0.96) and environmental (range p(E)=0.27-0.40) factors with a major genetic contribution. In summary, insomnia and poor sleep quality are closely associated with pain and somatic symptoms. Insomnia seems to modulate the sex differences in pain and somatic symptoms, especially in the adult population. A shared genetic predisposition might underlie the associations of insomnia and sleep quality with pain and somatic symptoms.     

Insomnia,Sleepiness, and Depression in Adolescents Living in Residential Care Facilities

The main objective of this study was to document sleep patterns and disturbances reported by youths temporarily living in residential care facilities. A secondary objective was to examine the relationships between sleep disturbances and mood and daytime sleepiness. A self-reported questionnaire on sleep patterns and habits assessing duration, frequency, and consequences of sleep difficulties, the Beck Depression Inventory-2, and the Epworth Sleepiness Scale were administered to a sample of 66 adolescents. Results suggest a high rate of sleep disturbances in this sample, with 41% reporting insomnia symptoms and 21% meeting diagnostic criteria for an insomnia syndrome. Those with more severe insomnia syndrome showed more severe depressive symptoms and daytime consequences.     

Gender differences in the relationships between sleep disturbances and academic performance among nursing students: A cross-sectional study

BackgroundSleep disturbances, such as insomnia, excessive daytime sleepiness, and poor-quality sleep, are common among nursing students and are closely linked with academic performance.ObjectivesTo examine the prevalence of sleep disturbances and academic performances in male and female nursing students and to determine gender-specific effects on the relationship between sleep disturbances and academic performance.DesignA cross-sectional study design was adopted.SettingsThis study was conducted in a school of nursing in Indonesia.ParticipantsA total of 492 undergraduate students (103 males and 389 females) were included.MethodsData pertaining to the biosociodemographic characteristics, Pittsburgh Sleep Quality Index, Insomnia Severity Index, Epworth Sleepiness Scale, Morningness-Eveningness Questionnaire, and Beck Depression Inventory were collected from July 1, 2018 to September 30, 2018. Academic performance was measured using grade point average of the academic year 2017–2018. A multivariate logistic regression model was used for data analyses.ResultsThe prevalence of poor sleep quality, insomnia, and daytime sleepiness was 66.0%, 45.6%, and 24.3%, respectively, in male nursing students and 71.5%, 52.4%, and 28.8%, respectively, in female nursing students. For circadian rhythm preferences, 66% male and 51.7% female nursing students were categorized as intermediate- and morning-type people, respectively. Insomnia was the only variable among sleep disturbances that significantly correlated with the risk of poor academic performance in female nursing students even after adjustment of covariates.ConclusionsSleep disturbances were highly prevalent among female and male nursing students, and insomnia was substantially associated with poor academic performance in female nursing students. Identifying sleep disturbances among nursing students and designing effective interventions to specifically target them are required to improve academic performance of female nursing students.     

长时程透析对血液透析患者睡眠质量的影响

目的 调查长时间血液透析对血液透析患者睡眠质量的影响. 方法 通过问卷调查和收集临床资料相结合的方法,选取首都医科大学附属北京友谊医院血液净化中心40例维持性血液透析患者进行研究,应用AIS量表、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)量表爱泼沃斯嗜睡、(Epworth Sleepiness Scale,ESS)量表调查患者的睡眠质量,根据睡眠质量情况将患者配对分组为普通透析组(Hemodialysis HD)20人和长程透析组)6个月的临床试验.结果 LSHD组患者Kt/V明显高于HD组患者,P值＜0.05,2组患者在PSQI量表、ESS量表评分差异存在显著性,LSHD组患者睡眠质量明显高于HD组,P值＜0.05. 结论 维持性血液透析的患者多存在睡眠质量下降的问题,增加透析剂量可以改善睡眠质量.     

Excessive daytime sleepiness in adults with brain injuries.

OBJECTIVES: To determine the prevalence, demographics, and causes of excessive daytime sleepiness in adults with brain injuries after the acute phase of their injury and to investigate the relations between self-report and objective measures of hypersomnolence. DESIGN: A case series of patients enrolled consecutively into a residential rehabilitation program. SETTING: University sleep laboratory, live-in rehabilitation center. PATIENTS: Adults with brain injuries (n = 71); mean time +/- standard deviation from injury to study, 38 +/- 60 months. INTERVENTIONS: A polysomnogram and Multiple Sleep Latency Test (MSLT) were performed in each subject. Each subject also completed the Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) questionnaires. MAIN OUTCOME MEASURES: Sleep patterns, by polysomnogram. Daytime hypersomnolence, diagnosed by mean sleep latency on the MSLT 相似文献   

Self-reported changes to nighttime sleep after traumatic brain injury

OBJECTIVES: To explore subjective sleep reports from people in the chronic stages of traumatic brain injury (TBI) and to examine the extent and nature of sleep complaints in this population. DESIGN: Survey. SETTING: All participants were community based at the time of data collection. PARTICIPANTS: Sixty-three subjects with TBI consecutively recruited after discharge from rehabilitation and 63 age- and sex-matched controls from the general community. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: A 7-day self-reported sleep-wake diary assessing sleep and wake times, sleep onset latency, frequency, and duration of nocturnal awakenings and daytime naps; a general sleep questionnaire used to evaluate sleep changes and quality; and the Epworth Sleepiness Scale to measure daytime sleepiness. RESULTS: Group-wise comparisons showed a significantly higher frequency of reported sleep changes after TBI (80%) relative to the control group (23%), supporting previous findings. The TBI group reported more nighttime awakenings and longer sleep onset latency; these changes were more frequently reported by participants with TBI with milder injuries. Increased levels of anxiety and depression were associated with increased reporting of sleep changes. CONCLUSIONS: These findings confirm the experience of changes to sleep after TBI and may at least in part account for the reported increased daytime sleepiness in this population. Sleep disturbance should be addressed during rehabilitation. Treatments need to focus on correcting the underlying cause of the sleep problem and to address patients' subjective experiences of their sleep, possibly through education and mood stabilization.     

Analysis of sleep characteristics and clinical outcomes of 139 adult patients with infective endocarditis after surgery

BACKGROUNDLittle is known about the postoperative sleep quality of infective endocarditis patients during hospitalization and after discharge. AIMTo investigate the sleep characteristics of infective endocarditis patients and to identify potential risk factors for disturbed sleep quality after surgery. METHODSThe Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale were used to assess patient sleep quality. Logistic regression was used to explore the potential risk factors. RESULTSThe study population (n = 139) had an average age of 43.40 ± 14.56 years, and 67.6% were men (n = 94). Disturbed sleep quality was observed in 86 patients (61.9%) during hospitalization and remained in 46 patients (33.1%) at 6 mo after surgery. However, both PSQI and Epworth Sleepiness Scale scores showed significant improvements at 6 mo (P < 0.001 and P = 0.001, respectively). Multivariable logistic regression analysis showed that the potential risk factors were age (odds ratio = 1.125, 95% confidence interval: 1.068-1.186) and PSQI assessed during hospitalization (odds ratio = 1.759, 95% confidence interval: 1.436-2.155). The same analysis in patients with PSQI ≥ 8 during hospitalization suggested that not using sleep medication (odds ratio = 15.893, 95% confidence interval: 2.385-105.889) may be another risk factor. CONCLUSIONThe incidence of disturbed sleep after infective endocarditis surgery is high. However, the situation improves significantly over time. Age and early postoperative high PSQI score are risk factors for disturbed sleep quality at 6 mo after surgery.     

Major depression and insomnia in chronic pain

OBJECTIVES: Insomnia and depression are common problems for people with chronic pain, and previous research has found that each is correlated with measures of pain and disability. The goal of this study was to examine the combined impact of major depression and insomnia on individuals with chronic pain. METHODS: The participants were patients with chronic musculoskeletal pain who underwent evaluation at an interdisciplinary treatment center. On the basis of semistructured interviews, participants were classified in three groups depending on whether they: (1) met criteria for major depression with insomnia (n = 38); (2) had insomnia without major depression (n = 58); or (3) had neither insomnia nor major depression (n = 47). The groups were then compared on self-report measures that included the McGill Pain Questionnaire, the Beck Depression Inventory, and the Multidimensional Pain Inventory. RESULTS: Participants with major depression and insomnia reported the most difficulty on measures of affective distress, life control, interference, and pain severity, although the insomniac patients without major depression also had elevated scores on some measures. In regression analyses, insomnia severity ratings did not contribute uniquely to the prediction of psychosocial problems when depression was controlled, but they did contribute to the prediction of pain severity. CONCLUSIONS: These results suggest that patients with chronic pain and concurrent major depression and insomnia report the highest levels of pain-related impairment, but insomnia in the absence of major depression is also associated with increased pain and distress.     

The mediating and moderating effects of sleep hygiene practice on anxiety and insomnia in hospital nurses

This study aimed to test the mediating and moderating effects of sleep hygiene practice on the relationship between anxiety and insomnia severity in hospital nurses. A cross‐sectional survey was employed, and a convenience sample was recruited from one regional hospital in Taiwan. Participants completed the following self‐report questionnaires over a 3‐month period in 2009: the Insomnia Severity Index, the Beck Anxiety Inventory, and Sleep Hygiene Awareness and Practice Scale. The results indicated that nurses with more anxiety tended to have higher insomnia severity. Further, nurses with poor sleep hygiene practice had more insomnia. Sleep hygiene practice partially mediated the effects of anxiety on insomnia severity. Also, sleep hygiene practice was a moderator in the relationship between anxiety and insomnia severity with age and work units as covariates. Sleep hygiene practice mediated and moderated the relationship between anxiety and insomnia severity after controlling the variables of age and work units. Continuing to learn and train sleep hygiene practice might promote nurses' sleep hygiene, and thereby ameliorate anxiety and reduce the risk of insomnia.     

Cognitive behavioral therapy for insomnia associated with traumatic brain injury: a single-case study

OBJECTIVE: To test the efficacy of a cognitive behavioral therapy (CBT) for insomnia with a patient with traumatic brain injury (TBI). DESIGN: Single-case study. SETTING: Outpatient rehabilitation center. PARTICIPANT: A man in his late thirties who sustained a moderate TBI in a motor vehicle crash and who developed insomnia. He complained of difficulties falling asleep and staying asleep, despite pharmacotherapy with zopiclone. INTERVENTIONS: Eight weekly individual CBT sessions. Treatment included stimulus control, sleep restriction, cognitive therapy, and sleep hygiene education. MAIN OUTCOME MEASURES: Sleep diary and polysomnography data. RESULTS: Sleep onset decreased from 47 to 18 minutes, and nocturnal awakenings dropped from 85 to 28 minutes on average at posttreatment. Sleep efficiency also increased substantially (58% to 83%). Polysomnography evaluations corroborated the diary data by showing a decrease in total time awake (63.2 to 26.3 min) and in the number of awakenings (21 to 7.5). The majority of gains were well maintained at 1- and 3-month follow-up assessments. CONCLUSIONS: These preliminary results suggest that sleep disturbances after TBI can be alleviated with a nonpharmacologic intervention. CBT for post-TBI insomnia is a promising therapeutic avenue deserving more scientific and clinical attention.     

How is sleep quality affected by the psychological and symptom distress of advanced cancer patients?

The aim of this study was to assess the relationship between sleep quality, pain, psychological distress, cognitive status and post-traumatic experience in advanced cancer patients. Participants were 82 advanced cancer patients referred to a palliative care unit for control of pain and other symptoms. A variety of assessment tools were used to examine the prevalence of sleep disturbance, the severity of pain and depression, hopelessness, cognitive function and quality of life. Using the Pittsburgh Sleep Quality Index (PSQI) 96% of patients were 'poor sleepers'. Statistically significant associations were found between PSQI and the SF-12 (Short Form-12) Quality of Life Instrument (MCS, P < 0.0005, PCS, P < 0.0005), depression (Greek Depression Inventory) (P < 0.0005) and hopelessness (Beck Hopelessness Scale) (P = 0.003). Strong associations were also found between PSQI and IES-R (Impact of Event Scale-Revised) (P = 0.004). The strongest predictors of poor sleep quality in this model were MCS (P < 0.0005), PCS (P < 0.0005) and IES-R (P = 0.010). Post-traumatic experience and quality of life seemed to be the strongest predictors of sleep quality in a sample of advanced cancer patients referred for palliative care.     

Association of sleep and co-occurring psychological conditions at 1 year after traumatic brain injury

Fogelberg DJ, Hoffman JM, Dikmen S, Temkin NR, Bell KR. Association of sleep and co-occurring psychological conditions at 1 year after traumatic brain injury.ObjectivesTo compare individuals' sleep 1 year after traumatic brain injury (TBI) with that of a healthy comparison group, and examine the relationship between sleep, co-occurring conditions, and functional status in those with TBI.DesignLongitudinal assessment of a prospectively studied sample of individuals with moderate to severe TBI. Assessment of sleep occurred at 1 year after TBI.SettingInpatient acute rehabilitation for TBI and community follow-up at 1 year postinjury.ParticipantsIndividuals with TBI (N=174) were recruited from consecutive admissions to an inpatient rehabilitation unit and enrolled into the TBI Model Systems study. Participant mean age was 38, and mean Glasgow Coma Scale score on admission was 9.3. Seventy-eight percent of the sample were men.InterventionsNone.Main Outcome MeasuresSleep was assessed with the Pittsburgh Sleep Quality Index (PSQI). Depression, anxiety, and pain were measured with the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7 Scale, and an analog pain rating scale, respectively.ResultsParticipants with TBI reported significantly greater sleep difficulties than the healthy comparison group. Forty-four percent of participants with TBI reported significant sleep problems (PSQI>5). Participants with 1 or more co-occurring conditions (depression, pain, or anxiety) had significantly worse sleep than those without such a condition. The highest level of sleep problems was reported by participants with multiple co-occurring conditions. Sleep problems were also associated with poor functional status.ConclusionsSleep difficulties are a frequent problem at 1 year after TBI, and often co-occur with depression, anxiety, and pain. Assessment and treatment of sleep difficulties should be included in clinical practice. Future research on the potential causal relationship among co-occurring conditions may assist in additional intervention planning.     

足底按摩结合护理干预对失眠症患者睡眠质量的影响

目的观察足底按摩结合护理干预对失眠症患者睡眠质量的影响。方法将86例失眠症患者随机分为治疗组（n=46）和对照组（n=40）。治疗组用手法刺激与失眠有关的足底部脏腑器官的相应反射区，并针对其影响睡眠质量的因素给予相应的护理干预。对照组予常规药物治疗及常规护理，两组治疗前后同时进行匹兹堡睡眠质量指数（PSQI）、焦虑自评量表（SAS）及抑郁自评量表（SDS）评定。结果治疗组治疗前后的PSQI各因子评分和总分及SAS、SDS评分均有非常显著性差异（P〈0．01）；两组治疗前后差值间的比较，PSQI各因子评分和总分及SAS、SDS评分有显著性或非常显著性差异（P〈0．05或P〈0．01）。结论足底按摩结合护理干预能有效地改善失眠症患者的睡眠质量。     

Hypnotizability,Sleepiness, and Subjective Experience

The relationships between hypnotizability, sleepiness, and the subjective experience of hypnotic suggestions were investigated in 90 participants. Scores from the Harvard Group Scale of Hypnotic Susceptibility Form A (HGSHS:A), the Karolinska Sleepiness Scale (KSS), the Epworth Sleepiness Scale (ESS), the Pittsburgh Sleep Quality Index (PSQI), and our self-developed Questionnaire on Subjective Hypnotic Experiences (QSHE) were analyzed. Findings show that hypnotizability correlates with both habitual daytime sleepiness and instantaneous sleepiness after the hypnotic procedure. Results also indicate that subjective self-evaluation of responses to hypnotic suggestions may be a useful tool in some cases when comparing with other subjectively rated scales, such as those concerning sleepiness.     

Psychosocial factors in chronic spinal cord injury pain.

Chronic pain is a problem among patients with spinal cord injuries, but the psychosocial factors associated with spinal cord injury (SCI) pain are not well understood. To understand SCI pain further, 54 patients (19 with quadriplegia and 35 with paraplegia) completed the Beck Depression Inventory, State-Trait Anxiety Inventory, Profile of Mood States, Acceptance of Disability Scale and SCI Interference Scale. Forty-two patients stated they had SCI pain and completed the Multidimensional Pain Inventory and the Pain Experience Scale. Results revealed that anger and negative cognitions were associated with greater pain severity. Patients who reported pain in response to a general prompt experienced more severe pain than patients who reported pain only when directly questioned about the presence of pain, but these different reporting groups did not differ on emotional variables. Those who were less accepting of their disability reported greater pain severity. Additionally, patients who perceived a significant other expressing punishing responses (e.g., expressing anger at the patients or ignoring the patients) to their pain behaviors reported more severe pain. Level of lesion, completeness of injury, surgical fusion and/or instrumentation and veteran status were not associated with pain severity. Finally, pain was associated with emotional distress over and above the distress associated with the SCI itself. Overall, psychosocial factors, not physiological factors, were most closely associated with the experience of pain. Multidimensional aspects of pain are used to explain these findings and suggest that treatment should be directed at the emotional and cognitive sequelae of chronic SCI pain.     

单中心维持性血液透析患者睡眠质量的随访调查

目的 通过对单中心患者睡眠质量进行纵向分析,以探讨维持性血液透析(Maintenance haemodialysis,MHD)患者睡眠障碍的动态变化规律及其影响因素. 方法 以本中心稳定透析大于3个月的忠者为研究对象,采用匹兹堡睡眠指数(Pittsburgh sleep quality index,PSQI)量表及爱泼沃斯嗜睡量表(Epworth sleepiness scale,ESS)间隔15个月前后对本组病例的睡眠情况进行2次评估,并记录当月的血液生化相关指标以进行统计学分析. 结果 ①第1次评估中有60例患者完成调查,其存在睡眠障碍者占60％(PSQI＞5),日间嗜睡发生率为58.3％(ESS＞ 6);②第2次评估60例患者中有55例完成调查,其存在睡眠障碍者占89％,日 间嗜睡发生率为87.3％.本组病例15个月前后的比较,随着PSQI和ESS得分数值的升高,与其甲状旁腺激素(iPTH)、钙磷乘积,C反应蛋白(CRP)、血红蛋白(Hb)存在相关性,且具有统计学意义(P＜0.05). 结论 ①随着透析龄的增加睡眠障碍存在恶化的趋势.②睡眠障碍的恶化与 iPTH、钙磷乘积,CRP、Hb存在相关性.     

Music improves sleep quality in older adults

AIM: The aim of this paper is to report an investigation of the effects of soft music on sleep quality in older community-dwelling men and women in Taiwan. BACKGROUND: Sleep is a complex rhythmic state that may be affected by the ageing process. Few studies have focused on the effects of music, a non-pharmacological method of improving the quality of sleep in older adults. METHOD: A randomized controlled trial was used with a two-group repeated measures design. Sixty people aged 60-83 years with difficulty in sleeping were recruited through community leaders and screened using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale. Those reporting depression, cognitive impairment, medical or environmental problems that might interfere with sleep; and those who used sleeping medications, meditation, or caffeine at bedtime were excluded. Participants listened to their choice among six 45-minute sedative music tapes at bedtime for 3 weeks. There were five types of Western and one of Chinese music. Sleep quality was measured with the PSQI before the study and at three weekly post-tests. Groups were comparable on demographic variables, anxiety, depressive symptoms, physical activity, bedtime routine, herbal tea use, napping, pain, and pretest overall sleep quality. RESULTS: Music resulted in significantly better sleep quality in the experimental group, as well as significantly better components of sleep quality: better perceived sleep quality, longer sleep duration, greater sleep efficiency, shorter sleep latency, less sleep disturbance and less daytime dysfunction (P = 0.04-0.001). Sleep improved weekly, indicating a cumulative dose effect. CONCLUSION: The findings provide evidence for the use of soothing music as an empirically-based intervention for sleep in older people.