Background: Music therapy, as a non-drug therapy, is widely used in patients with COPD. However, the effects of music therapy on dyspnea, anxiety, depression and other physiological parameters has not been elucidated. Therefore, we sought to investigate the effects of passive music therapy (listening to music) and mixed music (combination of listening and singing) in adults with COPD.

Methods: A systematic literature search was performed in PubMed, Cochrane, Embase, Web of Science, China National Knowledge Infrastructure, VIP, and Wanfang Data up to June 26, 2019. All randomized controlled trials that compared music with usual care or other non-musical types of intervention in subjects with COPD were included in the study. The risk of bias for randomized controlled trials was assessed with the Cochrane risk of bias tool. Outcomes included dyspnea, anxiety, depression, sleep quality, and quality of life, as well as physiological parameters (eg, blood pressure and breathing frequency).

Results: After initial screening of 216 potentially relevant records, 59 studies were eligible, and 12 studies with 812 participates met the inclusion criteria and were included in the final meta-analysis. Analysis showed that music therapy had a significant effect in relieving dyspnea (mean difference: -0.69, 95% CI -0.80 to -0.58, P < .001) and anxiety (standardized mean difference: -1.87, 95% CI -2.72 to -1.02, P < .001) in adults with COPD. Compared with the control group, music had no statistically significant effect on depression or St George Respiratory Questionnaire score. However, when it came to improving sleep quality, music reduced the total Pittsburgh Sleep Quality Index score (P < .001). In addition, the pooled results showed that there was a significant improvement in systolic blood pressure (mean difference: -7.45, 95% CI -10.95 to -3.96, P < .001) and diastolic blood pressure (mean difference: -4.07, 95% CI -7.03 to -1.12, P = .007) in the music group compared to the control.

Conclusions: Music therapy is effective in reducing dyspnea and anxiety in subjects with COPD. Additionally, music therapy may also improve sleep quality and physiological parameters of subjects with COPD. However, our conclusions need to be supported further by larger and longer well-designed trials.

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