Music Therapy & Sleep

By Ray Leone, MMT, MT-BC, head of A Place To Be’s medical music therapy program at Inova.

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We all know how important sleep is in healing, recovery and wellness. Good sleep is one of the most important ways to reset, refocus and rebound. With sleep being so important in every aspect of good health and healing, why is it so hard to get good sleep in a hospital? The noise of the monitors, various hospital staff interrupting good sleep (although, for good reasons) and just being out of sorts from the environment all lead to interrupted sleep. Sleep is essential, yet when we most need it, while in the hospital, it can be very difficult. As a music therapist working in a medical setting, when I can help patients sleep, that seems to be a great thing and this is an area where Music Therapy can be very effective. Recently, throughout the course of one day I was able to help 4 patients move into a sleep state…with music (and some relaxation techniques).

First there was the gentleman, in his early 50s, who had been in the hospital for almost 2 weeks as a result of complications with various medication abuse. When I met him, he was pleasant and open to music therapy. He also looked exhausted and told me that he was very anxious about where he would go from here (both figuratively and literally). After a brief chat he said, “I’m so tired. I’ve never felt this tired. I just need some sleep.” Through improvised music and focus, he fell asleep during our session.

Next there was the woman, in her 40s, with throat cancer. She was dealing with significant pain and some issues with confusion, seemingly from powerful medications. She was aware of my presence when I greeted her and was able to tell me that she was in “constant pain”; the kind that you probably can’t imagine unless you experience it. She also looked exhausted and very weak. I suggested she close her eyes and focus on the sound of the guitar. As I played I occasionally coached her on some deeper breathing. After about 30 minutes…she was soundly sleeping.

There was the woman, in her 30s, in the oncology unit. Her nurse asked me to visit because of anxiety and pain (she could not give more meds for a while). This patient also has cerebral palsy and has very limited movement capacity, which may exacerbate her pain. When I entered her room, her face told the entire story…pain, in her abdomen area as a result of surgery the previous day. Again, “Focus on the music… Let the music take you away for a bit… Breathe…” It took her awhile to settle but soon - she was sleeping.

And finally, the gentleman, in his 50s, also dealing with pain as a result of advanced stomach cancer. He and his wife were both very pleasant and welcoming but both looked exhausted, especially him. In conversation there appeared to be a real fear of the unknown (for both). Again, “Let the music take you away and give you a break…” I incorporated some guided imagery for him; “Think of a place in your mind where you feel very comfortable and at ease. A beach? The mountains? Someplace at home? Focus… Go there in your mind…” (all supported with improvised music on the guitar). He seemed to fall asleep for a bit, his affect softened considerably…comfort. He and his wife were holding hands and his relief seemed to help her. As the music concluded, after a few moments he slowly opened his eyes. A slight smile, “I felt like I was in a big open field. It was warm. It was open. Everything was open.” Then… “Will you be able to come back tomorrow?”

The constant here was the music. Live, improvised music that I was providing on the guitar. I don’t believe that any of these patients would have moved towards a sleep state with recorded music. This is Music Therapy. The music was purposeful and different for each patient even though we were working on the same goals and outcomes - relaxation…pain reduction…sleep. The music took them and went with them on their own personal journeys. There was some purposeful tension incorporated into the music to start, with dissonance and minor modes, then slowly moving to release, moving towards more harmony and soothing sounds and tones. Tempos fluctuated as needed, following the patient…following their breathing rhythms. The music was leading and the music was following, in the moment. The music was dynamic and the music was fluid. And yes, there was some occasional verbal guidance, but…the driving force was the music, presented live, individualized and in the moment. This is why Music Therapy, as a medium, can help relax, can help relieve, …sleep.

The healing power of music…

(*the stories presented in this blog are based on accounts and experiences and are not actual accounts and experiences)