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Music to calm patients who are ventilated and awake

JAMA 2013; doi:10.1001/jama.2013.5670 Critically ill adults who are mechanically ventilated while awake may be less anxious if they can listen to music of their own choice. In one trial from Minnesota in the US, awake patients who listened to music through headphones reported feeling significantly less anxious than controls who had usual care (19.5 points less anxious on a visual analogue scale running from 0 to 100). Patients didn’t listen to music for long each day, but they still had fewer sedative drugs than controls given usual care. Music through headphones worked better than noise cancelling headphones alone for some outcomes (one measure of sedation) but not others (self reported anxiety). This small trial wasn’t perfect, says a linked editorial (doi:10. 1001/jama.2013.5657), but it’s a good start. Music is unlikely to do any harm, unlike sedative drugs, and deserves further study. Anxiety during a spell in intensive care is a serious problem with enduring consequences. Researchers designing the next trial should consider using a validated measure of anxiety symptoms, rather than a simple visual analogue scale. Theymight also includemore deeply sedated adults. Few people on intensive units are awake enough and well enough to choose their own music and decide when to listen, even with help from a music therapist. These researchers had to screen more than 7000 patients to recruit the 373 who were randomised.