Effects of traditional Chinese medicine nursing techniques combined with music-based interventions on sleep in older adults: a systematic review and meta-analysis

OBJECTIVE: The aims of this study were to systematically evaluate the effects of traditional Chinese medicine nursing techniques combined with music-based interventions on sleep quality in older adults and to explore their effects on anxiety and pain. METHODS: Randomized controlled trials (RCTs) published up to 9 May 2026 were systematically searched in China National Knowledge Infrastructure, Wanfang Data, VIP Database, China Biomedical Literature Database, PubMed, Web of Science, the Cochrane Library, and Embase. Meta-analysis was performed using RevMan 5.4 and Stata 15.0. The primary outcome was the Pittsburgh Sleep Quality Index (PSQI), and the secondary outcomes were the Self-Rating Anxiety Scale (SAS) and the Visual Analogue Scale (VAS). Fixed- or random-effects models were selected according to the degree of heterogeneity, and subgroup analyses were performed. RESULTS: A total of 11 RCTs involving 838 older adults were included. The pooled results showed that the combined intervention significantly improved sleep quality [PSQI: mean difference (MD) = -2.28, 95% confidence interval (CI): -3.07 to -1.48]. Compared with the control group, the combined intervention was also associated with greater reductions in anxiety (SAS: MD = -9.95, 95% CI: -14.31 to -5.59) and pain (VAS: MD = -1.06, 95% CI: -1.57 to -0.54). Subgroup analyses showed that auricular acupressure, Baduanjin, and traditional Chinese medicine massage combined with music-based interventions all improved PSQI scores. Among these, auricular acupressure combined with music-based interventions showed the most stable effect (MD = -1.89, 95% CI: -2.55 to -1.23). Interventions lasting 15 days or longer were associated with lower heterogeneity and more stable effects. CONCLUSION: Traditional Chinese medicine nursing techniques combined with music-based interventions may improve sleep quality in older adults and may also help reduce anxiety and pain. Different combined approaches showed favorable effects, with auricular acupressure combined with music-based interventions demonstrating the most stable results. Interventions lasting 15 days or longer may be more likely to produce stable benefits. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD420261308801.