Effects of culturally adapted music listening on anxiety and sleep quality among elderly patients following coronary artery bypass surgery

Elderly individuals who are post-operative coronary artery bypass graft (CABG) surgery patients often suffer from anxiety and sleep disturbance. These can affect the health of the person and also hinder recovery. This study investigated the effects of a culture-specific music intervention on the anxiety and sleep quality of elderly heart patients. The research employed a longitudinal design with 31 participants aged 65 to 75 who had recently undergone CABG. Although an initial sample of 120 was projected, recruitment was limited during the COVID-19 pandemic; therefore, the findings should be regarded as preliminary. Participants listened to 30 min of Turkish classical music designed in the Uşşak makam, a melodic mode associated with calmness, every day for 12 weeks. We measured anxiety using the State-Trait Anxiety Inventory (STAI-I and STAI-II). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). This assessment was done at baseline, 2 weeks, 1 month, and 3 months. Statistical evaluation through Linear Mixed-Effects Models (LMMs) showed a significant decrease in state anxiety and trait anxiety throughout the intervention (p < 0.001). The quality of sleep also significantly improved (p < 0.001). The analysis showed that the time passed was essential to greater anxiety relief and sleep. The sleep outcomes of study participants were affected by chronic conditions such as diabetes and depression, which also affect anxiety. Subsequent mediation analysis showed that decreasing anxiety partially mediated sleep improvement, as statistically significant bootstrapped indirect effects indicated. According to the findings, the results suggest that using culturally meaningful music postoperatively effectively reduces psychological distress, promoting better sleep in elderly CABG patients. The key driver of sleep quality in highly anxious individuals seems to be anxiety reduction. Listening to music, a non-intrusive, inexpensive, and culturally sensitive strategy, is potentially beneficial in the holistic rehabilitation of geriatric cardiac care. These findings are preliminary and require validation in larger randomised controlled trials. Further validation through randomized controlled trials is essential to support and advance these early findings.