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Thanks for visiting the Research and Supplemental Information page.  If you find any links that do not work, or if you have additional research you would like us to add, please send us an email to . Most of this research supports what is written in the book Tune In. You can purchase the entire e-book here.

Economics of Using Music Therapy in Healthcare and Education

  • Music Therapy reduces the cost per patient in hospice by $2,984.In this study, music therapy reduced costs per patient by almost three thousand dollars. The program itself costs $3615, resulting in a cost-benefit ratio of .83. When using cost-per-patient-day, the ratio improves to .95. This indicates that in a hospice setting, music therapy is a cost-effective way to improve patient experiences.
  • Music Therapy for procedural support slashes the cost of echocardiogram in children by $74.24 per procedure.By using a music therapist, children were able to complete echocardiograms without the need for medication and an RN, reducing costs by $74.24 per procedure.
  • Researchers estimate that a potential savings of $2.25 billion per year could be saved if music therapy was used throughout the United States during such procedures. DeLoach Walworth D. Procedural-support music therapy in the healthcare setting: A cost-effectiveness analysis. J Ped Nursing. 2005;20(4):276-84.
  • The cost savings when using music therapy showed a reduction of $567 per procedure. Wood B. CT scans and radiation exposure. AAP Grand Rounds. 2008;19:28-9.
  • Studies suggest health care dollars would be saved if music was used in the care of individuals. Cohen, Gene. “New theories and research findings on the positive influence of music and art on health with aging.” Arts and Health (March 2009): 48 – 62. A multi-state, two year study in the U.S., published in the journal Arts and Health in February 2009, monitored medication usage of two groups—one group that resided in long term care and one group that resided in long term care and participated in a regular group music program three times per week. The participants in the music program three times per week reported a higher overall rating of physical health, fewer doctor’s visits, less medication used, and fewer instances of falls compared to the control group. The author of the study suggests that if all persons who fall under what is classified as Medicare D (national health coverage for those aged sixty-five and older in the U.S.) participated in the music program with similar results as in the stud— then the savings would equal 6.3 billion dollars.
  • Long-term care workers find stress relief in Music; Landmark Study could save industry 1.46 Billion. American Music Conference 2007. The Recreational Music Making (RMM) program drastically reduced employee burnout and turnover.  The study revealed that the program decreased total mood disturbance by 46%.  This improvement could result in an 18.3 percent reduction in employee turnover, which would save the average 100-bed facility more than $89,000 a year—and the entire long-term care industry as much as $1.46 billion annually.  In the U.S. the employee turnover rate is typically 40-60% annually.

Music Therapy and Dementia – including Alzheimer’s Disease

  • This Cochrane review addressed the evidence that treatments based on music improve the emotional well-being and quality of life of people with dementia. It also addresses that Music therapists are specially qualified to work with individuals or groups of people, using music to try to help meet their physical, psychological and social needs. Other professionals may also be trained to provide similar treatments. Providing people with dementia who are in institutional care with at least five sessions of a music-based therapeutic intervention reduces depressive symptoms and improves overall behavioural problems at the end of treatment.
  • This review was not able to identify reliable empirical evidence on which to justify the use of music therapy as a treatment for dementia. However, the evidence available suggests that music therapy may be beneficial in treating or managing dementia symptoms, and the predominant conclusion of this review is the highlighting of the need for better-designed studies of the intervention.
  • Alzheimer’s disease is an irreversible, progressive brain disease that slowly destroys memory-thinking skills and eventually limits even the ability to carry out the simplest tasks. In most people with Alzheimer’s, symptoms first appear after age sixty. Estimates vary but experts suggest that as many as 5.1 million Americans may have Alzheimer’s disease.
  • A person’s ability to engage in music, such as drumming and singing, remains intact late into the disease process because these activities do not require cognitive functioning for feelings of achievement. “Alzheimer’s Foundation of America.” Alzheimer’s Foundation of America. Accessed March 31, 2015.
  • With dementia, repetition is even more important if Heath hopes to feel connected with Sarah and celebrate what they have had.  Hellen C., Padilla R. “Working with Elders Who Have Dementia and Alzheimer’s Disease.” New York : Psychology Press. 2011.

Stress Reduction – How Music Can Help

  • There is evidence to indicate that work stress causes 10% of all strokes.  Suadicani P1, Andersen LL, Holtermann A, Mortensen OS, Gyntelberg F. Perceived psychological pressure at work, social class, and risk of stroke: a 30-year follow-up in Copenhagen male study. J Occup Environ Med. 2011 Dec;53(12):1388-95.
  • 3 out of 4 doctor’s visits are for stress-related ailments. Schnall, Peter L. Unhealthy Work: Causes, Consequences, Cures. Amityville, N.Y.: Baywood Pub., 2009.
  • Music can boost productivity by reducing stress. “The Power of Music To Reduce Stress.” Psych Accessed March 31, 2015.
  • Music can focus us on a task by relaxing our mind and allowing our subconscious to manage some of the work. Cockerton, T., Moore, S., & Norman, D. (1997). “Cognitive test performance and background music.” Perceptual and Motor Skills 85 (1997): 1435 – 1438.
  • Allen K. et al. Normalization of hypertensive responses during ambulatory surgical stress by perioperative music. Psychosomatic Medicine, 63 (May/June 2001) 487 – 492. Print.
  • Waldon E. G. The effects of group music therapy on mood states and cohesiveness in adult oncology patients. Journal of Music Therapy 38 (Fall 2001) 212 – 238. Print. Collingwood, J. “The Power of Music To Reduce Stress.” Psych Central. 2007. Web. June 7, 2012. 
  • The research is clear that three deep breaths can reduce your fight or flight response. “Dr. Herbert Benson’s Relaxation Response.” Psychology Today. Accessed March 31, 2015.
  • Stress contributes to many human diseases. Carnegie Mellon University. “Stress Contributes To Range Of Chronic Diseases, Review Shows.” ScienceDaily Oct 9, 2007. Web. 3 Jun. 2012.
  • Studies show music can actually lower your heart rate and reduce stress for some people. Davis, W.B., & Thaut, M.H. “The influence of preferred relaxing music on measures of state anxiety, relaxation, and physiological responses.” Journal of Music Therapy 26 (1989): 168 – 187. Hyde IM, Scalapino W. The influence of music upon electro-cardiograms and blood pressure. Am J Physiol. 46 (1918): 35 – 38. Joseph CN, Porta C, Casucci G, Casiraghi N, Maffeis M, Rossi M, Bernardi L. Slow “Breathing improves arterial baroreflex sensitivity and decreases blood pressure in essential hypertension.” Hypertension. 46 (2005) 714 – 718. Bernardi P, Porta C, Sleight P. Cardiovascular, cerebrovascular and respiratory changes induced by different types of music in musicians and non-musicians: the importance of silence. Heart. 92 (2006) 445 – 452.
  • Music can: Relax the mind and lower stress levels. Collingwood, Jayne. “The Power of Music To Reduce Stress.” Psych Accessed April 1, 2015.
  • Nearly half of all workers suffer from moderate to severe stress while on the job, according to a recent survey. And 66 percent of employees report that they have difficulty focusing on tasks at work because of stress. Stress has been called the “health epidemic of the 21st century” by the World Health Organization and it costs American businesses up to $300 billion a year.
  • A survey of 2,500 employees by ComPsych, a provider of employee assistance programs (EAPs), highlights the problem. In addition to the challenges related to focus at work, employees also said that stress was responsible for errors and/or missed deadlines (21 percent), trouble getting along with co-workers/superiors (15.5 percent), missed days (14.9 percent) and lateness (14.4 percent). “Results By Industry.” March 29, 2012. Accessed April 1, 2015.
  • Slow, minor-key produce Alpha waves – these waves relax the brain, which can be useful and help your new. Millbower, L. (2000). Training with a beat: The teaching power of music. Sterling, VA: Stylus
  • Repetitive exposure to music can induce calmness. Another team of researchers out of Florida state under Dr. Kumar (a leading researcher in music for health took blood samples of 40 male seniors before 20 listening sessions and took another set of blood samples after the 20 sessions (4 weeks later).  The results were that 3 of the 4 main brain chemicals that affect our mental state including melatonin and epinephrine significantly rose – inducing a calmness.
  • Music can lower blood pressure. A study from the Journal of Hypertension to be published in 2010 found that daily sessions of voluntary music-guided slow breathing significantly reduced blood pressure. This is thought to occur by mood improvement and social ties. Modesti, P.A., et al., Psychological predictors of the antihypertensive effects of music-guided slow breathing. J Hypertens. 28(5): p. 1097-103.
  • Music Therapy benefits patients who suffer severe stress and anxiety associated with having and undergoing treatment for coronary heart disease – indicated by a decrease in blood pressure, heart rate, and levels of anxiety. Bradt J, Dileo C. Music for stress and anxiety reduction in coronary heart disease patients. Cochrane Database of Systematic Reviews, 2009, Issue 2. Art. No.: CD006577 DOI: 0.1002/14651858.CD006577.pub2

Child Development and Music

  • From as early as in our mother’s womb there is evidence that babies are aware of and respond to music and different sounds. Tan S., Pfordresher P., and Harre R. “Psychology of Music: From Sound of Significance.” New York: Psychology Press, 2010
  • There is evidence to say that our musical preferences start forming before the age of two. Fagen, J., Prigot, J., Carroll, M., Pioli, L., Stein, A., & Franco, A. (1997). Auditory context and memory retrieval in young infants. Child Development 68 (1997): 1057 – 1066. Rauscher, F. H., Shaw, G. L., Levine, L. J., Wright, E. L., Dennis, W. R., & Newcomb, R. L. Music training causes long-term enhancement of preschool children’s spatial-temporal reasoning. Neurological Research 19 (1997): 2 – 8. Viadero, D. “Music on the Mind”. Education Week, April 8, 1998. Wallace, W. T. (1994). “Memory for music: Effect of melody on recall of text.” Journal of Experimental Psychology: Learning, Memory & Cognition 20 (1994) 1471 – 1485.
  • There is great evidence around the connection of stimuli being received in early childhood and brain growth. Society For Neuroscience. “New Studies Show Factors Responsible For Enhanced Response To Music.” ScienceDaily, 13 Nov. 2003. Web. 6 Jun. 2012. 
  • The brain undergoes rapid neural development during the first years of life and new neural networks are formed more rapidly than at any other time. Casey B.J., Tottenham N., Liston C., Durston S. “Imaging the developing brain: what have we learned about cognitive development?” Trends in Cognitive Sciences 9.3 (March 2005): 104 – 110.
  • According to a study published by the American Psychological Association, playing an instrument as a child keeps the mind sharper as we age. “The Relation Between Instrumental Musical Activity and Cognitive Aging,” Brenda Hanna-Pladdy, PhD, and Alicia MacKay, PhD, University of Kansas Medical Center; Neuropsychology, Vol. 25, No. 3
  • In an analysis of U.S. Department of Education data on more than 25,000 secondary school students (NELS:88, National Education Longitudinal Survey), researchers found that students who report consistent high levels of involvement in instrumental music over the middle and high school years show “significantly higher levels of mathematics proficiency by grade 12.” This observation holds regardless of students’ socio-economic status, and differences in those who are involved with instrumental music vs. those who are not is more significant over time. Catterall, James S., Richard Chapleau, and John Iwanaga. “Involvement in the Arts and Human Development: General Involvement and Intensive Involvement in Music and Theater Arts.” Los Angeles, CA: The Imagination Project at UCLA Graduate School of Education and Information Studies, 1999.
  • Piano practice increases integrity of nerve fiber tracts. A 2005 study showed that practicing piano correlated with better organization of nerve fiber tracts. Especially in children, practicing the piano led to greater integrity of these tracts, even the pyramidal tract, which is a main tract that connects the brain with the spinal cord and is essential for movement.
    Bengtsson, S.L., et al., Extensive piano practicing has regionally specific effects on white matter development. Nat Neurosci, 2005. 8(9): p. 1148-50.
  • Music Therapy improves social interaction, non-verbal and verbal communicative skills, initiating behaviour, and social-emotional reciprocity in children with autism Geretsegger M, Elefant C, Mössler KA, Gold C. Music therapy for people with autism spectrum disorder. Cochrane Database of Systematic Reviews 2014, Issue 6. Art. No.: CD004381. DOI: 10.1002/14651858.CD004381.pub3
  • Music Therapy improves social adaptation, feelings of joy, and the quality of parent-child relationships. Geretsegger M, Elefant C, Mössler KA, Gold C. Music therapy for people with autism spectrum disorder. Cochrane Database of Systematic Reviews 2014, Issue 6. Art. No.: CD004381. DOI: 10.1002/14651858.CD004381.pub3

The Power of Music Preferences and Good Quality Sound

Productivity and Motivation

  • When we respond positively to the music we are listening to we are more likely to improve our performance on certain tasks, our imagination is peaked, and our emotional state is altered. “The Psychology of Musical Preferences.” Psychology Today. Accessed March 30, 2015.
  • Research seems to support such a claim. For example, a trial where 75 out of 256 workers at a large retail company were issued with personal stereos to wear at work for four weeks showed a 10 percent increase in productivity for the headphone wearers. Other similar research conducted by researchers at the University of Illinois found a 6.3 percent increase when compared with the no music control group.
  • “Does Listening to Music While Working Make You Less Productive?” Ideas Does Listening to Music While Working Make You Less Productive Comments. Accessed March 31, 2015.
  • Music can stimulate creativity by increasing blood and oxygen flow to the brain – going from sleepy brain to teachable brain. University of Maryland Medical Center. “Joyful Music May Promote Heart Health.” ScienceDaily.  (accessed April 1, 2015).
  • However a summary of recent research from Taiwan shows while some background music can increase worker satisfaction and productivity, music with lyrics could have significant negative effects on concentration and attention. The study concluded that music without lyrics is preferable, as lyrics are likely to reduce worker attention and performance. Shih, YN. “Background Music: Effects on Attention Performance.” WORK 42, no. 4 (2012): 573-8.
  • For example, a trial where 75 out of 256 workers at a large retail company were issued with personal stereos to wear at work for four weeks showed a 10% increase in productivity for the headphone wearers. Other similar research conducted by researchers at the University of Illinois found a 6.3% increase when compared with the no music control group. Rosekind, Mark R., Kevin B. Gregory, Melissa M. Mallis, Summer L. Brandt, Brian Seal, and Debra Lerner. “The Cost Of Poor Sleep: Workplace Productivity Loss And Associated Costs.” Journal of Occupational and Environmental Medicine, 2010, 91-98.

Improving Quality of Life through Music

  • Terrance Hays and Victor Minichiello, have written extensively about the contribution of music to self-identity and quality of life. Hays T., Minichiello V. (2005). The meaning of music in the lives of older people: a qualitative study. Psychol. Music 33, 437–451

Music’s Capacity to Evoke Emotion

  • It would seem that music’s capacity to reflect and evoke emotions and memories, some deeply hidden, may have something to do with the choice to live without any music. Ernest Mas-Herrero, Robert J. Zatorre, Antoni Rodriguez-Fornells, Josep Marco-Pallarés. Dissociation between Musical and Monetary Reward Responses in Specific Musical Anhedonia. Current Biology, 06 March 2014
  • The ability to perceive emotion in music develops early in childhood, and changes throughout development. Dowling, W. J. (2002). “The development of music perception and cognition”. Foundations of Cognitive Psychology: Core Reading: 481–502.
  • Just as different people perceive events differently, based upon their past experiences, emotions elicited by listening to different types of music are affected due to personal, previous experiences. Ladinig, Olivia; Schellenberg, E. Glenn (1 January 2012). “Liking unfamiliar music: Effects of felt emotion and individual differences.”.Psychology of Aesthetics, Creativity, and the Arts 6 (2): 146–154.
  • In one study researchers presented excerpts of fast tempo, major mode music and slow tempo, and minor mode music to participants. These musical structures were chosen because they have been proven to convey happiness and sadness respectively. Hunter, P. G.; Schellenburg, E. G.; Schimmack, U. (2010). “Feelings and perceptions of happiness and sadness induced by music: Similarities, differences, and mixed emotions”. Psychology of Aesthetics, Creativity, and the Arts 4: 47–56.
  • People have different emotional reactions to the same music. A random sample of 540 Spanish consumers (aged fifteen to sixty-five), were played a series of radio advertisements for a fictitious mineral water. Vanessa Apaolaza-Ibáñez, Mark Zander, Patrick Hartmann. “Memory, emotions and rock ‘n’ roll: The influence of music in advertising, on brand and endorser perception.” African Journal of Business Management 4.17 (2010): 3805 – 3816.
  • Participants who listened to the music excerpts five times rated their emotions with higher intensity than the participants who listened to them only once. Ali, S. O.; Peynircioglu, Z. F. (2010). “Intensity of emotions conveyed and elicited by familiar and unfamiliar music”. Music Perception: An Interdisciplinary Journal 27: 177–182.
  • Music can change an individuals’s emotional stateChangizi, Mark. “Why Does Music Make Us Feel?” Scientific American Global RSS. September 15, 2009. Accessed April 1, 2015.


  • In the words of Arthur Hull: “The Community Drum Circle is a fun entry-level learning experience that is accessible to anyone who wants to participate. Drum Circle participants express themselves collectively by using a chorus of tuned drums, percussion, and vocals to create a song together while having a great time.
  • Group drumming alters neuroendocrine and immunologic measurements in the participants – this means a boost to your immune system. “Beating Stress — on the Drums.” WebMD. Accessed March 31, 2015.
  • Group drumming boosts cancer-killer cells in study. A study led by Barry Bittman found that one group drumming method increased Lymphokine-Activated Killer (LAK) which signaled a strengthening of the body’s immune system.  The advantage of drumming is that it’s inexpensive, portable and not time consuming.  It also enriches in other areas such as sociability, learning and mood improvement.

Music as a Drug

  • Listening to music was also found to be more effective than prescription drugs in reducing anxiety prior to surgery, a drug with little side effects. Chanda, Mona Lisa, and Daniel J. Levitin. “The Neurochemistry of Music.” Trends in Cognitive Sciences: 179-93.
  • When you listen to music that moves you your brain releases dopamine that makes you feel extra good and when we feel good it becomes easier to feel positive connections to others around us. “Why Music Makes You Happy : DNews.” DNews. Accessed March 31, 2015.
  • Dr. Daniel Levitin has proven that listening to music releases certain chemicals in the brain. Chanda, Mona Lisa, and Daniel J. Levitin. “The Neurochemistry of Music.” Trends in Cognitive Sciences: 179-93.
  • Making music in a group sees an increase in the human growth hormone. The Music Making and Wellness Project is an American study that looked at the benefits of senior’s participating in music programs.  They found that stress, depression and loneliness were greatly decreased in the individuals involved with the program and 90% showed an increase in the human growth hormone, which is something that typically decreases with age.

Music Connects People Together and Ignites Memories

Music and Brain Injury

  • Al-Janabi S, Nickels LA et al. Augmenting melodic intonation therapy with non–invasive brain stimulation to treat impaired left-hemisphere function: two case studies. Frontiers on Psychology doi: 10.3389/fpsyg.2014.00037 2014.00037/abstract_
  • Evidence-based Review of stroke –
  • Evidence based review of Moderate to Severe brain injury rehabilitation
  • Music Therapy helps to improve movement in stroke patients. Wiley-Blackwell. (2010, July 7). Rhythm of life: Music shows potential in stroke rehabilitation. ScienceDaily. Retrieved December 29, 2016 from

Music and the Brain

  • Research has demonstrated that music with a strong beat can stimulate brainwaves to resonate in sync with the beat. Certain tempos bring sharper concentration and more alert thinking, and other tempos bring a calm, meditative state. Music can relax the mind and lower stress levels – creating more neural pathways, opening doors to new learning and experiences.
  • The brain goes through many processes helping us interpret the music that we hear. Our ears become attuned to certain styles and textures which are specifically intriguing to us. Levitin, Daniel J. This is Your Brain on Music: The Science of a Human Obsession. New York: Dutton/Penguin, 2006.
  • There is a long held theory that the subconscious mind can recognize patterns within complex data and that we are hardwired to find simple patterns pleasurable. BioMed Central. “Creating simplicity: How music fools the ear.” ScienceDaily, 20. Jan. 2011 Web. 6 June 2012.

Speech Rehabilitation and Language Development with Music Therapy

Music Makes Us Smarter

  • While some studies indicate that music training is correlated with high music intelligence as well as higher IQ….Schellenberg, E. Glenn; Mankarious, Monika (1 January 2012). “Music training and emotion comprehension in childhood.”. Emotion 12 (5): 887–891….other studies refute the claim. Kratus, J. (1 January 1993). “A Developmental Study of Children’s Interpretation of Emotion in Music”. Psychology of Music 21 (1): 3–19. However what is worth noting is that exposure to music earlier in life seems to affect behavioral choices, schoolwork, and social interactions later in life.  “Impact of Music, Music Lyrics, and Music Videos on Children and Youth”.PEDIATRICS 124 (5): 1488–1494. 19 October 2009.

Music to Decrease Pain and Anxiety

  • A Neuroscientist was a patient at his own clinic being prepped for spinal surgery. Carr, Coeli. “Using music to ease patient stress during surgery.” 13 Oct. 2009. Web. June 1, 2012.
  • However, there is indication that surgeons are not asking others in the operating room for their preferences: one survey of anesthetists found that about a quarter felt that music “reduced their vigilance and impaired their communication with other staff,” and about half felt that music was distracting when they were dealing with a problem with the anesthesia.
  • Listening to music can reduce chronic pain by up to 21 per cent and depression by up to 25 per cent. It can also make people feel more in control of their pain and less disabled by their condition. Researchers carried out a controlled clinical trial with sixty people, dividing them into two music groups and a control group. They found that people who listened to music for an hour every day for a week reported improved physical and psychological symptoms compared to the control group.The participants, who had an average age of 50, were recruited from pain and chiropractic clinics in Ohio, USA. They had been suffering from a range of painful conditions, including osteoarthritis, disc problems and rheumatoid arthritis, for an average of six and a half years. Sandra L Siedlecki, Cleveland Clinic Foundation, Ohio, and Marion Good, Case Western University, Ohio. Journal of Advanced Nursing. Volume 54.5, pages 553 to 562.
  • Music has been found to block pain. Music therapy tries to synchronize the internal beats with external rhythms by using musical frequencies to and vibrations to slow down body rhythms.  The creates a number of physiological reactions such as lowering blood pressure, decreasing the levels of certain hormones in the body and forcing the brain to use both the left and right side simultaneously; all of which can promote healing.  Music has also been found to block pain using musical acupuncture where patients visualize musical notes hitting the body at the spot where the pain is coming from.

Music Therapy and Mental Health

  • Working with two sample groups of 240 volunteers over 60 years old, where one group took part in weekly singing sessions over three months and the other didn’t, the research revealed an increase in the mental health component score on a validated health measure amongst the group of singers. It also revealed significantly reduced anxiety and depression scores. “Study into Benefits of Singing Proves Positive Impact on Health.” Study into Benefits of Singing Proves Positive Impact on Health. Accessed March 31, 2015
  • Music Therapy is associated with improvements in mood in persons with depression. Maratos A, Gold C, Wang X, Crawford M. Music therapy for depression. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD004517. DOI: 10.1002/14651858.CD004517.pub2

Music and Movement/Exercise

  • Group lessons can take your experience to a whole new level. to go on your daily run or attend your weekly spin class, you should change things up, says Jordan Metzl, a sports medicine physician at the Hospital for Special Surgery in New York. “Trying something new that shakes up your routine can really give you a fresh perspective and get you excited,” Dr. Metzl says. “Shake Things Up: Why You Should Try New Ways to Exercise.” WSJ. Accessed March 31, 2015.
  • Costas Karageorghis of Brunel University in London, one of the world’s leading experts on the psychology of exercise music, wrote that one could think of music as a legal performance-enhancing drug. In truth, it looks like music can boost your athletic performance by 15%. There’s more to it than distraction, music makes people less aware of their exertion. The music seems to propel them forward helping them get maximum benefit. Karageorghis, Costas I. “: Sport and Music for the Masses.” Sport in Society: 433-47.
  • The rhythm of your workout music stimulates the motor area of the brain aiding in your movements and keeping them steady. This leads to a sense of greater efficiency since keeping a steady pace is easier on our bodies than fluctuating through the workout. “Let’s Get Physical: The Psychology of Effective Workout Music.” Scientific American Global RSS. Accessed March 31, 2015.

Music and Immunity

  • Choir singing and listening to choral music have distinctly different effects of immunity. A 2004 study in the Journal of Behavioral Medicine reported the effects of choir singing versus listening on secretory IgA (S-IgA)-an antibody that protects the linings of many different organs in the body. They found that singing itself increases s-IgA and positive feeling states and decreases negative feeling states. Listening to choral music does exactly the opposite: s_IgA decreases and negative feeling states increase The next time you are at a concert or church you may want to sing along! Kreutz, G., et al., Effects of choir singing or listening on secretory immunoglobulin A, cortisol, and emotional state. J Behav Med, 2004. 27(6): p. 623-35.
  • Recreational music-making improves immunity. Studies have shown that making music for recreation improves mood states and immunity in younger and older adults [2]. Specifically, recreational music making increases many of the body’s fighter cells: number of lymphocytes, T cells, CD4+ T cells, memory T cells, and production of interferon-gamma and interleukin-6. These are all usually protective to the body. This study showed that these effects are especially true for older adults. Koyama, M., et al., Recreational music-making modulates immunological responses and mood states in older adults. J Med Dent Sci, 2009. 56(2): p. 79-90.

Music, Medicine and Parkinson’s

  • In 2009, researchers led by Lauren K. King of the Sun Life Financial Movement Disorders Research and Rehabilitation Centre at Wilfrid Laurier University, in Waterloo, Ontario, found that short-term use of vibroacoustic therapy with Parkinson’s disease patients led to improvements in symptoms, including less rigidity and better walking speed with bigger steps and reduced tremors (NeuroRehabilitation, December, 2009).

Music and Medical Settings

  • Music Therapy benefits patients who suffer severe stress and anxiety associated with having and undergoing treatment for coronary heart disease – indicated by a decrease in blood pressure, heart rate, and levels of anxiety. Bradt J, Dileo C. Music for stress and anxiety reduction in coronary heart disease patients. Cochrane Database of Systematic Reviews, 2009, Issue 2. Art. No.: CD006577 DOI: 0.1002/14651858.CD006577.pub2
  • Music Therapy alleviates cancer patients’ symptoms including anxiety, pain, fatigue. Joke Bradt, Cheryl Dileo, Lucanne Magill, Aaron Teague. Music interventions for improving psychological and physical outcomes in cancer patients. Cochrane Library, August 2016 DOI: 10.1002/14651858.CD006911.pub3

Music Therapy in ICU

  • Hetland B et al. Heart Lung. 2015. A narrative review of the influence of music during mechanical ventilation and weaning from mechanical ventilation. (3 databases, English only, 18 studies)
  • Umbrello M et al. Systematic Review 2019 “Music therapy reduces stress and anxiety in critically ill patients: a systematic review of randomized clinical trials  Minerva Anestesiologica  (6 databases, English, Italian, 11 studies for total of 959 patients)
  • Mofredj MD et al. Music Therapy, a review of the potential therapeutic benefits for the critically ill.  Journal of Critical Care 35 (2016) 195-199.
  • Bradt J, Dileo C.  Music interventions for mechanically ventilated patients.  Cochrane Database Syst Rev 2014;12:CD006902. (Epub 2014 Dec 9). (14 trials, English, French, German)
  • Authors’ conclusions: “This updated systematic review indicates that music listening may have a beneficial effect on anxiety in mechanically ventilated patients. These findings are consistent with the findings of three other Cochrane systematic reviews on the use of music interventions for anxiety reduction in medical patients. The review furthermore suggests that music listening consistently reduces respiratory rate and systolic blood pressure. Finally, results indicate a possible beneficial impact on the consumption of sedatives and analgesics. Therefore, we conclude that music interventions may provide a viable anxiety management option to mechanically ventilated patients.”
    • *indicates the larger N studies
    • note only 3 weaning studies
    • ICU music studies examined effects on weaning, pain or discomfort during ICU procedures, anxiety, relaxation, cost-effectiveness, sleep and nature sound effects on anxiety and agitation
    • Most studies used patient preferred relaxing, slow tempo 60-80BPM at a usual dose of 30 minutes delivered via headphones

Music intervention studies investigating Weaning from Mechanical Ventilation

  • Hunter BC et al.  Music Therapy as an Adjunctive Treatment in the Management of Stress for Patients Being Weaned From Mechanical Ventilation. J Music Ther 2010: 47(3):198-219.
    • In this pilot study, the practicality and efficacy of using Music therapy (MT) to assist 61 adult difficult-to-wean patients off of mechanical ventilation was assessed.   The authors compared the effects of 45-60 minute live MT sessions 3x/week during weaning trials on vital signs before and after MT sessions, patient and nurse satisfaction, and nursing perceptions of patient anxiety.  They found positive physiological effects on heart rate and respiratory rate from the beginning to the end of the MT sessions, high patient and nurse satisfaction and improved patient as well as nursing stress with less need perceived for medical intervention.  This suggests that live music therapy is feasible and helpful for weaning patients from mechanical ventilation by reducing stress and anxiety.
  • Twiss et al. The effect of music listening on older adults undergoing cardiovascular surgery. Nurs in Crit Care. 2006; 11(5):224-231.
    • This study of 62 adults undergoing cardiovascular surgery tested the use of continuous music listening throughout surgery and post-operative care versus usual care on anxiety as measured on the Spielberger State Trait Anxiety inventory, and on intubation time.  Patients chose music from a selection of 6 pre-recorded CDs of relaxing music provided by the researcher.  They found the music group had significantly lower anxiety scores and fewer minutes of intubation post-operatively.  This suggests that music listening during and after surgery reduces anxiety and hastens time to removal of breathing tubes after surgery.
  • Jaber S et al. Effects of music therapy in intensive care unit without sedation in weaning patients versus non ventilated patients. Ann Fr Anesth Reanim 2007;26:30-8 French language – English Abstract only assessed
    • This randomized crossover study of 30 critically ill patients (15 intubated and 15 non-intubated) evaluated the effect of 20 minutes of music listening versus rest, on vital signs, the Richmond-Agitation-Sedation-Scale (RASS), bispectral index score (BIS) and the Numerical rating scale (NRS) for pain. The authors found that a single music intervention session was effective for decreasing anxiety, pain, and promoting relaxation, as indicated by decreases in heart rate, blood pressure, BIS respiratory rate and NRS in intubated patients during weaning.

Music Intervention studies investigating Discomfort or Pain during procedures

  • Aktas YY et al. The effects of music therapy in endotracheal suctioning of mechanically ventilated patients. Nurs Crit Care 2016;21:44-52.
    • This study of 66 mechanically ventilated cardiovascular surgery ICU patients tested the effect of researcher chosen instrumental slow tempo flute music compared with usual care on pain, sedation and vital signs during endotracheal suctioning.  The music group received 20 minutes of music listening before and 20 minutes after the procedure.  The authors found that pain scores were significantly reduced in the music group during endotracheal suctioning.  This suggests that music listening can be used to improve pain management during painful ICU procedures. 
  • Cooke et al.  The effect of music on discomfort experienced by intensive care unit patients during turning: a randomized crossover study. Int J Nurs Pract 2010; 16:125-31.
    • This study of 17 post-operative ICU patients aimed to test the effect of patient-preferred music on discomfort and anxiety experienced during the turning procedure as measured on a numerical rating scale and faces anxiety scale.  Music intervention began 15 minutes before and continued throughout the turning procedure and was compared to headphones with no music in the control group.   They found no difference in the two groups in discomfort and anxiety in the turning procedure.  Some limits to the study were the low baseline ratings of discomfort and anxiety in both groups.  This suggests that further research is warranted to determine if music is effective at alleviating moderate to high levels of discomfort and anxiety during turning in critically ill patients.

Music intervention studies investigating effects on anxiety and stress in critically ill patients.

  • Chlan L et al. Effects of patient directed music intervention on anxiety and sedative exposure in critically ill patients receiving ventilatory support. JAMA 2013; 309(22): 2335-2344
    • In this multi-center study of 373 critically ill patients the authors evaluated whether listening to patient preferred and initiated music reduces anxiety and the use of sedatives during ventilator support.  They found a reduction in daily anxiety as measured by visual analog scale scores compared with usual care and reductions in doses of sedatives by the 5th study day.  This suggests that patient directed and preferred music reduces anxiety and the use of sedative drugs in mechanically ventilated patients.
  • Chlan et al. Economic Evaluation of a Patient-Directed Music Intervention for ICU Patients Receiving Mechanical Ventilatory Support  Crit Care Med. 2018 Sep; 46(9): 1430–1435. DOI: 10.1097/CCM.0000000000003199
    • This study is a secondary analysis of the randomized controlled study of 373 mechanically ventilated patients testing the effects of patient directed and initiated music listening on anxiety and sedative exposure compared with noise-cancelling headphones or usual care.  The authors found that the music group had a decreased length of ICU stay and the music is a cost-effective intervention to reduce anxiety.
  • Han et al. Effects of music intervention on physiological stress response and anxiety level of mechanically ventilated patients in China: A randomized controlled trial. J Clin Nurs 2010;19 (7-8) 978-987.
    • This 3 group randomized controlled study of 137 mechanically ventilated patients tested the effects of a single session of 30 minutes of patient preferred relaxing music compared with headphones with no music or quiet rest groups.  Standardized anxiety scores on the Spielberger State-trait anxiety scale were measured before and after the intervention and vitals signs were measured before, throughout and after the intervention in all 3 groups.  They found improved heart rate, blood pressure, and respiratory rates in the music group while vital signs worsened over time in the quiet rest control group.  Reduced anxiety scores occurred in the music and headphones groups.  This suggests that preferred music listening improves physiological stress measures and anxiety in mechanically ventilated Chinese patients.  Noise and the soundscape in ICU in general may be contributing to stress and may be improved with noise cancelling headphones.
  • Lee CH et al. Effects of Music Intervention on State Anxiety and Physiological Indices in patients undergoing Mechanical Ventilation in the Intensive Care Unit.  Biol Res Nurs 2017;19:137-44.
    • This randomized study of 85 mechanically ventilated patients evaluated the effect of 30 minutes of relaxing patient preferred music vs. headphones with no music on two standardized measures of anxiety, heart rate, blood pressure and serum cortisol levels.  They found the music group had statistically significant better values in all post intervention measures except diastolic blood pressure.  This suggests that relaxing preferred music improves anxiety in mechanically ventilated patients.
  • Almerud S and Petersson K.  Music Therapy–A Complementary Treatment for Mechanically Ventilated Intensive Care Patients.  Intensive Crit Care Nurs 2003: 19(1) 21-30.
    • In this study of 20 consecutive ICU patients on mechanical ventilation, the authors tested the effects of 30 minutes classical music applied with headphones during night sleep on blood pressure and heart rate when compared with a control group resting under similar circumstances.  There was a statistically significant drop in blood pressure during the intervention, and trend towards a drop in heart rate. None of the subjects recalled listening to music while ventilated.  This suggests that during the time the music intervention was applied it had a relaxing effect on patients being mechanically ventilated.
  • Beaulieu-Boire, et al. Music and biological stress dampening in mechanically ventilated patients at the intensive care ward – a prospective interventional randomized crossover trial.  J Crit Care 2013; 28(4):442-450.
    • In this randomized crossover study of 49 mechanically ventilated patients the authors evaluated the impact of slow tempo music listening for one hour 2x/day on vital signs, sedative drug consumption and blood stress biomarkers compared to a control condition of rest and headphones with no music.  The patients acted as their own control group. They found a trend towards a decrease in fentanyl use, and that blood cortisol and prolactin levels decreased in the intervention group.  There was no significant change in vital signs observed.  This suggests that slow tempo music quickly reduces stress hormone levels and may reduce narcotic use in mechanically ventilated patients in ICU.
  • Chlan LL. Psychophysiologic Responses of Mechanically Ventilated Patients to Music: A Pilot Study. Am J Crit Care 1995 May;4(3):233-8.
    • In this randomised study of 20 mechanically ventilated patients divided into 2 groups, the author tested the effect of classical music listening with noise-cancelling headphones for 30 minutes vs. rest with noise-cancelling headphones and no music on heart rate (HR), respiratory rate (RR), blood pressure (BP) and anxiety measured on standard scoring using the Profile of Mood States (POMS).  There were decreases in HR, BP and RR found in the music intervention group and improved POM scores.  This suggests that music listening improves physiological and subjective patient reports of anxiety and stress.
  • Chlan L.  Effectiveness of a music therapy intervention on relaxation and anxiety for patients receiving ventilator assistance.  Heart Lung. 1998; 27 (3):169176.
    • This multi-center study of 54 alert non-sedated mechanically ventilated patients examined the effect of a single session of non-lyrical relaxing music – 60-80 beats per minute, 30 minute dose – compared with rest with no headphones for 30 minutes on heart rate, respiratory rate and a standardized anxiety measure, the Spielberger State Anxiety inventory.   The author found a decrease in HR and RR over time in the music group as well as an improvement in anxiety scores.  This suggests that a single music session improves physiological stress and patient reported anxiety during mechanical ventilation.
  • Chlan L et al. Influence of Music on the Stress Response in Patients Receiving Mechanical Ventilatory Support: A Pilot Study. Am J Crit Care 2007 Mar;16(2):141-5.
    • This study of 10 mechanically ventilated patients tested the effect of patient selected music listening for 60 minutes compared to rest for 60 minutes with no headphones on biochemical stress markers in the blood over time, and heart rate.  No significant differences were found in levels of biomarkers between groups, but levels of corticotrophin and cortisol decreased over time in the music listening group.  The trend to decreased levels was not statistically significant.  This suggests that a further study is needed in larger numbers of patients with controlled conditions to determine if the trend of a reduction in biochemical stress markers is actually significant.
  • Chlan L et al.  Does Music Influence Stress in Mechanically Ventilated Patients?  Inten Crit Care Nurs 2012 Jun;29(3):121-7
    • This randomized controlled study of 65 mechanically ventilated patients examined the effects of patient directed and preferred music tailored by a music therapist compared with patient initiated use of noise cancelling headphones or usual care (3 groups) on 24 hour urinary free cortisol (UFC) collected daily.  The authors did not find a significant difference in UFC between the 3 groups and there was high variability in levels at entry to the study.   There were limitations to the study that may have impacted results such as medication effects on UFC or other medical conditions that were not controlled for.
  • Chlan L et al. Feasibility of a music intervention protocol for patients receiving mechanical ventilatory support.  Altern Ther. 2001; 7(6):80-83.
    • This study of 5 alert mechanically ventilated patients tested the feasibility of patients requesting and choosing preferred relaxing music over a 3 day period and explored barriers to the protocol for patients and nursing staff.  The authors found that patients were able to independently request music and listened for over 1 hour on average, at a time.  Nurses were also cooperative in offering the intervention.  This suggests that patient initiated music interventions are feasible in the ICU setting for mechanically ventilated patients.
  • Conrad et al. Overture for growth hormone: Requiem for interleukin-6.  Crit Care Med 2007; 35(12):2709-2713.
    • This randomized controlled study of 10 post-operative critically ill patients tested the effects of one hour of Mozart piano sonatas versus rest with headphones and no music on vital signs, brain electrical activity, serum levels of stress biomarkers, level of sedation and use of sedative drugs.  They found the music intervention reduced the amount of sedative drugs needed to achieve a comparable level of sedation, lower blood pressure and heart rate, increased growth hormone and reduced stress biomarkers such as epinephrine and inflammatory cytokine levels.  This suggests music may exert its relaxing effects through the brain via hormone release and immune system changes.
  • Dijkstra, et al.  The effects of music on physiological responses and sedation scores in sedated mechanically ventilated patients.  J Clin Nurs 2010; 19 (7-8):1030-1039.
    • This randomized controlled study of 20 sedated mechanically ventilated patients evaluated the effects of 3 doses of 30 minutes of a choice of classical or easy listening music vs. same dose rest periods on vital signs, and sedation scores measured on the Ramsay Sedation Scale.  They found no difference in vital signs between groups but subjects in the music group had higher sedations scores. This suggests that music leads to a deeper level of sedation.
  • Korhan et al.  The effect of music therapy on physiological signs of anxiety in patients receiving ventilatory support.  J Clin Nurs. 2011; 20(7-8):1026-1034.
    • This randomized study of 60 mechanically ventilated patients evaluated the effect of 60 minutes of classical music listening on vital signs before, during and after the intervention.  They found the music group had significantly lower mean respiratory rates and blood pressures than the control group and that these measures progressively improved at 30, 60 and 90 minutes.  This suggests music listening is beneficial for reducing physiological measures of anxiety and that there is a cumulative dose effect: 60 minutes showed more benefit than 30 minutes of music listening.
  • Lee et al. Music and its effect on the physiological responses and anxiety levels of patients receiving mechanical ventilation: A pilot study.  J Clin Nurs 2005 May; 14(5):609-20. doi: 10.1111/j.1365-2702.2004.01103.x.
    • This randomized study of 64 mechanically ventilated patients tested the effects of 30 minutes of relaxing music listening versus headphones with no music on vital signs, observed behaviors, anxiety measured on a standardized scale, and patient satisfaction.  They found significant improvements in heart rate, respiratory rate, and blood pressure in the music group, and an increase in observed comfortable behavior.  This suggests music can provide a simple, safe and effective method of reducing potentially harmful physiological anxiety responses in mechanically ventilated patients.
  • Stubbs et al.  Experiences and perceptions of music therapy in critical illness. Nurs Times. 2005; 101(45): 34-36.
    • This qualitative study of 5 critically ill patients and 4 nurses assessed their perceptions of benefit of 2 sessions of 30 minutes of relaxing music listening with unstructured interviews.  They found the nurses reported there were no disadvantages to the music intervention, and felt it was a positive experience for patients.  Patients did not recall listening to music in the ICU, but recognized the songs when cued and reported pain perception being altered, sleep relaxation and music dreams.  This study suggests that nurses perceive music intervention has positive benefits in critical illness without adverse effects.
  • Wong et al.  Effects of music therapy on anxiety in ventilator-dependent patient. Heart Lung. 2001; 30(5): 376-386.
    • This study of 20 ventilator dependent patients in ICU tested 30 minutes of a choice of relaxing Chinese or Western music delivered via headphones compared with 30 minutes of uninterrupted rest on vital signs, and a standardized measure of anxiety.  They found music listening was more effective than rest in decreasing anxiety on the Spielberger State Trait Anxiety Inventory and improving blood pressure and respiratory rates by the end of the intervention.  This suggests that relaxing music improves physiological and subjective measures of anxiety in mechanically ventilated patients.
  • Chan MF et al. Investigating physiological responses of patients listening to music in the intensive care unit.  J Clin Nurs 2009:18:1250-7.
    • This quasi-experimental study of 101 alert critically ill ICU patients assessed the effects of 30 minutes of relaxing music delivered via headphones on vital signs to determine if there was a patient profile for high responders to the music intervention.  Researchers provided 4 choices of low pitch 60-80BPM tempo relaxing familiar music to patients.  They found that female, older age and those on ventilators were more likely to respond positively with larger effects on heart rate, respiratory rate and blood pressure measures.  This suggests that music should be offered to patients if they accept it for relaxation in ICU and music should be based on patient preference.

Music intervention studies investigating effects on sleep in critically ill patients.

  • Su CP et al.  A randomized controlled trial of the effects of listening to non-commercial music on quality of nocturnal sleep and relaxation indices in patients in medical intensive care unit. J Adv Nurs 2013;69:1377-89.
    • This study of 28 medical intensive care patients (APACHE II score <=25) tested the effects of 45 minutes of non-commercial sedating piano music vs. headphones with no music on vital signs, subjective and objective sleep parameters at nocturnal sleep time.  They found the music group had improved subjective sleep quality and objective sleep profiles as well as lower heart rate, blood pressure and respiratory rates, and the music dose was cumulative.  This suggests that 30 minutes or more of soothing music improves sleep quality and relaxation in medical ICU patients.

Nature Sound intervention studies investigating the effects on anxiety in mechanically ventilated patients

  • Saadatmand et al.  Effect of nature-based sounds intervention on agitation, anxiety, and stress in patients under mechanical ventilator support: A randomized controlled trial.  Int J Nurs Stud. 2013: 50 (7): 895-904.
    • This study of 60 adult mechanically ventilated patients evaluated the effect of 30-90 minutes of listening to nature-based sounds vs. 30 minutes of rest with headphones and no music on standardized measures of anxiety and agitation as well as vital signs.  They found the nature sounds group had significantly lower blood pressures, anxiety and agitation levels than the control group as measured by the FACES anxiety and Richmond Agitation scales after the intervention. They also found the improvements progressed over time.  This suggests listening to nature sounds improves anxiety, and agitation in mechanically ventilated patients and longer listening sessions have even more benefit.

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