I recently read a fascinating blog post by Nancy Andrews, Music in Medicine | Art and Science of Delirium. In fact, the videotaped lecture by Dr. Claudius Conrad above is taken from her post and it’s definitely thought-provoking. I encourage readers to visit Nancy’s website and her blog, Art and Science of Delirium. If you’re more interested in learning about the connection between music and delirium and sedation in the intensive care unit (ICU), you could fast forward to about 15 minutes through Dr. Conrad’s YouTube video. The reference to the portion of his talk about the relationship he and his group found between Mozart’s music and growth hormone and, in turn, the down-regulating effect on interleukin-6 is below.
I think it’s intriguing that most of the articles I skimmed through on PubMed about this issue are written by nurses. Wouldn’t it be wonderful if nurses and doctors and patients who have survived the experience of delirium in the ICU all collaborated to raise delirium research to a new level?
Conrad, C., H. Niess, et al. (2007). “Overture for growth hormone: requiem for interleukin-6?” Crit Care Med 35(12): 2709-2713.
BACKGROUND: Music has been used for therapeutic purposes since the beginning of cultural history. However, despite numerous descriptions of beneficial effects, the precise mechanisms by which music may improve human well-being remain unclear. METHODS: We conducted a randomized study in ten critically ill patients to identify mechanisms of music-induced relaxation using a special selection of slow movements of Mozart’s piano sonatas. These sonatas were analyzed for compositional elements of relaxation. We measured circulatory variables, brain electrical activity, serum levels of stress hormones and cytokines, requirements for sedative drugs, and level of sedation before and at the end of a 1-hr therapeutic session. RESULTS: Compared with controls, we found that music application significantly reduced the amount of sedative drugs needed to achieve a comparable degree of sedation. Simultaneously, among those receiving the music intervention, plasma concentrations of growth hormone increased, whereas those of interleukin-6 and epinephrine decreased. The reduction in systemic stress hormone levels was associated with a significantly lower blood pressure and heart rate. CONCLUSION: Based on the effects of slow movements of Mozart’s piano sonatas, we propose a neurohumoral pathway by which music might exert its sedative action. This model includes an interaction of the hypothalamic-pituitary axis with the adrenal medulla via mediators of the unspecific immune system
McCaffrey, R. and R. Locsin (2004). “The effect of music listening on acute confusion and delirium in elders undergoing elective hip and knee surgery.” Journal of Clinical Nursing 13: 91-96.
This study was undertaken to determine the effect of music on elders undergoing elective hip and knee surgery who experience acute confusion and delirium postoperatively. Postoperative confusion and delirium in elders often cause complications that negatively effect recovery. Music listening was introduced as an intervention to an experimental group. Nurses documented episodes of acute confusion and delirium experienced by elders postsurgically. Scores from a readiness-to-ambulate profile to determine if patients were cognitively ready for postoperative therapy were evaluated. There was a significant decrease in the number of episodes of postoperative confusion among those in the experimental group compared with those in the non-listening control group. In addition, the experimental group had significantly higher scores on the readiness-to-ambulate profile than the control group. These findings indicate that music listening is an effective nursing intervention that can be used to decrease acute postoperative confusion and delirium in elders undergoing elective hip and knee surgery.