Abstract: Background Sleep-wake disorders are most likely to occur in patients after cerebral hemorrhage，which can delay the recovery process.But long-term pharmaceutical treatment can cause low response.Tomatis listening therapy can stimulate and improve the interconnections between human ears and the nervous system，thereby regulating the sleep structure via listening to the music consisting of sounds with the sudden transition from low-to-high frequencies and vice versa.Objective To explore the effect of Tomatis listening therapy on sleep structure in patients with acute cerebral hemorrhage.
Methods: 138 patients with sleep disorders after acute cerebral hemorrhage were recruited from Neurosurgery Department，North China University of Science and Technology Affiliated Hospital，from July 2017 to July 2018.By use of a table of random numbers，they were equally divided into control group，music therapy group，and listening therapy group，receiving conventional nursing，conventional nursing and common music therapy，conventional nursing in combination with Tomatis listening therapy （listening to the music consisting of sounds with the sudden transition from low-to-high frequencies and vice versa），respectively.The intervention lasted for consecutive 14 days for all participants.Sleep quality data were collected by overnight PSG monitoring.Sleep structure was compared between the groups before and after intervention.
Results: There were significant differences in non-REM latency，REM latency，ratios of non-REM latency to total sleep time， stage 3 non-REM sleep time to total sleep time，stage 4 non-REM sleep time to total sleep time，and REM sleep time to total sleep time after intervention among three groups （P<0.05）．Self-controlled comparisons showed that，compared with baseline，after intervention，sleep quality changed insignificantly in the control group （P>0.05）；ratio of stage 4 non-REM sleep time to total sleep time increased in music therapy group （P<0.05）；ratios of total sleep time to total recording time，stage 3 non-REM sleep time to total sleep time，stage 4 non-REM sleep time to total sleep time，and REM sleep time to total sleep time increased while non-REM latency，and ratios of non-REM latency to total sleep time decreased in listening therapy group （P<0.05）．Intergroup comparisons found that three groups showed significant differences in post-intervention ratios of non-REM latency to total sleep time，and REM latency to total sleep time，non-REM sleep time to total sleep time，stage 3 non-REM sleep time to total sleep time，stage 4 non-REM sleep time to total sleep time，and REM sleep time to total sleep time （P<0.05）．Moreover，pre- and post-intervention differences in ratios of non-REM latency to total sleep time，and non-REM sleep time to total sleep time，“slow wave” （stages 3 and 4 non-REM） sleep time to total sleep time，and REM sleep time to total sleep time differed significantly between the groups （P<0.05）．To be specific，music therapy group had a greater pre- and post-intervention difference in ratio of stage 4 non-REM sleep time to total sleep time than the control group ，compared with listening therapy group，pre- and post-intervention differences in ratios of non-REM sleep time to total sleep time，“slow wave” sleep time to total sleep time，and REM sleep time to total sleep time，and pre- and post-intervention difference in non-REM latency were all less in the control group，and they were also less in music therapy group except the latter aspect （P<0.017）．
Conclusion: Tomatis listening therapy in combination with conventional nursing can effectively improve the sleep structure and sleep quality in patients with acute cerebral hemorrhage.
