Music intervention for insomnia: An exploratory pilot study

Abstract

Music-based intervention is a potential non-pharmacological approach for insomnia, but its physiological correlates and factors associated with symptom change remain uncertain. This single-arm pilot study explored changes in insomnia symptoms and potential response indicators. Twenty adults with insomnia completed five standardized music sessions. Assessments included the Athens Insomnia Scale (AIS), heart rate variability, mood, and self-reported sleep onset. Analyses included a Wilcoxon signed-rank test, generalized estimating equations, L1-regularized logistic regression, and a descriptive shallow decision tree. AIS scores were lower after the intervention period than at baseline (W=13.0, p<0.001). Mood differed by sleep-onset status in the unadjusted analysis (p=0.021), but no covariate was independently associated with sleep onset after adjustment. In a cohort-specific analysis, participants with baseline AIS >16 and an early LF/HF increase >0.077 met the study-defined responder criterion. AIS scores decreased after five music sessions, but the single-arm design does not permit causal attribution. The responder pattern was exploratory and requires confirmation in controlled studies with external validation.