Music & Stress

Appl Psychophysiol Biofeedback. 2007 Dec;32(3-4):163-8

• Labbé E, Schmidt N, Babin J, Pharr M.
• Department of Psychology, University of South Alabama, Mobile, AL 36688, USA

Listening to classical and self-selected relaxing music after exposure to a stressor should result in significant reductions in anxiety, anger, and sympathetic nervous system arousal, and increased relaxation compared to those who sit in silence or listen to heavy metal music. Fifty-six college students, 15 males and 41 females, were exposed to different types of music genres after experiencing a stressful test. Several 4 x 2 mixed design analyses of variance were conducted to determine the effects of music and silence conditions (heavy metal, classical, or self-selected music and silence) and time (pre-post music) on emotional state and physiological arousal. Results indicate listening to self-select or classical music, after exposure to a stressor, significantly reduces negative emotional states and physiological arousal compared to listening to heavy metal music or sitting in silence.

J Dev Behav Pediatr. 2007 Oct;28(5):399-403

• Caprilli S, Anastasi F, Grotto RP, Abeti MS, Messeri A.
• Pain Service and Palliative Care, Department of Oncoemathology, A. Meyer Children's Hospital, and Department of Psychology, University of Florence, Florence, Italy

OBJECTIVE: The experience of venipuncture is seen by children as one of the most fearful experiences during hospitalization. Children experience anxiety both before and during the procedure. Therefore, any intervention aiming to prevent or reduce distress should focus on the entire experience of the procedure, including waiting, actual preparation, and conclusion. This study was designed to determine whether the presence of musicians, who had attended specific training to work in medical settings, could reduce distress and pain in children undergoing blood tests. METHODS: Our sample population was composed of 108 unpremedicated children (4-13 years of age) undergoing blood tests. They were randomly assigned to a music group (n=54), in which the child underwent the procedure while interacting with the musicians in the presence of a parent or to a control group (n=54), in which only the parent provided support to the child during the procedure. The distress experienced by the child before, during and after the blood test was assessed with the Amended Form of the Observation Scale of Behavioral Distress, and pain experience with FACES scale (Wong Baker Scale) only after the venipuncture. RESULTS: Our results show that distress and pain intensity was significantly lower (p<.001; p<.05) in the music group compared with the control group before, during, and after blood sampling. CONCLUSIONS: This controlled study demonstrates that songs and music, performed by "professional" musicians, have a beneficial effect in reducing distress before, during, and after blood tests. This study shows, moreover, that the presence of musicians has a minor, but yet significant, effect on pain due to needle insertion.

Appl Psychophysiol Biofeedback. 2007 Dec;32(3-4):163-8

• Labbé E, Schmidt N, Babin J, Pharr M.
• Department of Psychology, University of South Alabama, Mobile, AL 36688, USA

Listening to classical and self-selected relaxing music after exposure to a stressor should result in significant reductions in anxiety, anger, and sympathetic nervous system arousal, and increased relaxation compared to those who sit in silence or listen to heavy metal music. Fifty-six college students, 15 males and 41 females, were exposed to different types of music genres after experiencing a stressful test. Several 4 x 2 mixed design analyses of variance were conducted to determine the effects of music and silence conditions (heavy metal, classical, or self-selected music and silence) and time (pre-post music) on emotional state and physiological arousal. Results indicate listening to self-select or classical music, after exposure to a stressor, significantly reduces negative emotional states and physiological arousal compared to listening to heavy metal music or sitting in silence.

Br J Surg. 2007 Aug;94(8):943-7

• Leardi S, Pietroletti R, Angeloni G, Necozione S, Ranalletta G, Del Gusto B.
• Geriatric Surgery, Department of Surgical Science, L'Aquila University, L'Aquila, Italy

BACKGROUND: Music therapy could reduce stress and the stress response. The aim of this study was to investigate the role of music therapy in alleviating stress during day surgery. METHODS: Sixty patients undergoing day surgery were randomized to one of three groups, each containing 20 patients. Before and during surgery, patients in group 1 listened to new age music and those in group 2 listened to a choice of music from one of four styles. Patients in group 3 (control group) heard the normal sounds of the operating theatre. Plasma levels of cortisol and subpopulations of lymphocytes were evaluated before, during and after operation. RESULTS: Plasma cortisol levels decreased during operation in both groups of patients who listened to music, but increased in the control group. Postoperative cortisol levels were significantly higher in group 1 than in group 2 (mean(s.d.) 14.21(6.96) versus 8.63(2.72) ng/dl respectively; P < 0.050). Levels of natural killer lymphocytes decreased during surgery in groups 1 and 2, but increased in controls. Intraoperative levels of natural killer cells were significantly lower in group 1 than in group 3 (mean(s.d.) 212.2(89.3) versus 329.1(167.8) cells/microl; P < 0.050). CONCLUSION: Perioperative music therapy changed the neurohormonal and immune stress response to day surgery, especially when the type of music was selected by the patient. Copyright (c) 2007 British Journal of Surgery Society Ltd.

Appl Psychophysiol Biofeedback. 2007 Mar;32(1):31-50

• Sokhadze EM.
• Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, 500 Preston Street, Bldg. A., Suite 210, Louisville, KY 40292, USA

The purpose of this study was to compare the effects of music and white noise on the recovery of physiological measures after stressful visual stimulation. Twenty-nine participants took part in the experiment. Visual stimulation with slides eliciting disgust was followed by subjectively pleasant music, sad music, and white noise in three consecutive sessions. The spectral power of the frontal and temporal EEG, skin conductance, heart rate, heart period variability, facial capillary blood flow, and respiration rate were recorded and analyzed. Aversive visual stimulation evoked heart rate deceleration, increased high frequency component of heart period variability, increased skin conductance level and skin conductance response frequency, decreased facial blood flow and velocity, decreased temporal slow alpha and increased frontal fast beta power in all three sessions. Both subjectively pleasant and sad music led to the restoration of baseline levels on most parameters; while white noise did not enhance the recovery process. The effects of pleasant music on post-stress recovery, when compared to white noise, were significantly different on heart rate, respiration rate, and peripheral blood flow. Both positive and negative music exerted positive modulatory effects on cardiovascular and respiratory activity, namely increased heart rate, balanced heart period variability, increased vascular blood flow and respiration rate during the post-stress recovery. Data only partially supported the "undoing" hypothesis, which states that positive emotions may facilitate the process of physiological recovery following negative emotions.

Eur J Anaesthesiol. 2005 Feb;22(2):96-102

• Nilsson U, Unosson M, Rawal N.
• Orebro University Hospital, Department of Anaesthesiology and Intensive Care, Orebro, Sweden

BACKGROUND AND OBJECTIVES: This randomized controlled trial was designed to evaluate, first, whether intra- or postoperative music therapy could influence stress and immune response during and after general anaesthesia and second, if there was a different response between patients exposed to music intra- or postoperatively. METHOD: Seventy-five patients undergoing open hernia repair as day care surgery were randomly allocated to three groups: intraoperative music, postoperative music and silence (control group). Anaesthesia and postoperative analgesia were standardized and the same surgeon performed all the operations. Stress response was assessed during and after surgery by determining the plasma cortisol and blood glucose levels. Immune function was evaluated by studying immunoglobulin A (IgA) levels. Patients' postoperative pain, anxiety, blood pressure (BP), heart rate (HR) and oxygen saturation were also studied as stress markers. RESULTS: There was a significantly greater decrease in the level of cortisol in the postoperative music group vs. the control group (206 and 72 mmol L(-1) decreases, respectively) after 2 h in the post anaesthesia care unit. The postoperative music group had less anxiety and pain and required less morphine after 1 h compared with the control group. In the postoperative music group the total requirement of morphine was significantly lower than in the control group. The intraoperative music group reported less pain after 1 h in the post anaesthesia care unit. There was no difference in IgA, blood glucose, BP, HR and oxygen saturation between the groups. CONCLUSION: This study suggests that intraoperative music may decrease postoperative pain, and that postoperative music therapy may reduce anxiety, pain and morphine consumption.

J Music Ther. 2004 Fall;41(3):192-214

• Pelletier CL.
• The Florida State University, USA

A meta-analytic review of research articles using music to decrease arousal due to stress was conducted on 22 quantitative studies. Results demonstrated that music alone and music assisted relaxation techniques significantly decreased arousal (d = +.67). Further analysis of each study revealed that the amount of stress reduction was significantly different when considering age, type of stress, music assisted relaxation technique, musical preference, previous music experience, and type of intervention. Implications and suggestions for future research are discussed.

Br J Health Psychol. 2004 Sep;9(Pt 3):393-403

• Chafin S, Roy M, Gerin W, Christenfeld N.
• Department of Psychology, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0109, USA

OBJECTIVES: Interventions that reduce the magnitude of cardiovascular responses to stress are justified, at least in part, by the notion that exaggerated responses to stress can damage the cardiovascular system. Recent data suggest that it is worthwhile to explore, in addition to the magnitude of the cardiovascular responses during stress (reactivity), the factors that affect the return to baseline levels after the stressor has ended (recovery). This experiment examined the effect of listening to music on cardiovascular recovery. DESIGN AND METHOD: Participants (N = 75) performed a challenging three-minute mental arithmetic task and then were assigned randomly to sit in silence or to listen to one of several styles of music: classical, jazz or pop. RESULTS: Participants who listened to classical music had significantly lower post-task systolic blood pressure levels (M = 2.1 mmHg above pre-stress baseline) than did participants who heard no music (M = 10.8 mmHg). Other musical styles did not produce significantly better recovery than silence. CONCLUSIONS: The data suggest that listening to music may serve to improve cardiovascular recovery from stress, although not all music selections are effective.

Dtsch Med Wochenschr. 2003 Dec 19;128(51-52):2712-6

• Vollert JO, Störk T, Rose M, Möckel M.
• Medizinische Klinik mit Schwerpunkt Kardiologie, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum

BACKGROUND: In a study with coronary patients it was estimated that music is able to lower stress and fear and contributing to relaxation in spite of physical exercise. PATIENTS AND METHODS: 15 patients (13 male, two female, mean age 62,2 +/- 7,6 years) of a coronary sport unit were listening to an especially composed relaxation music while training their common heart-frequency adapted exercises. Before the exercises and after listening to music blood pressures were measured and blood was collected for determination of beta-endorphin. Simultaneous to blood collection the participants had to perform two psychometric test: the perceived stress experience questionnaire (PSQ) of Levenstein to measure the graduation of subjective perceived stress and the state-anxiety inquiry (STAI) of Spielberger as an indicator of coping. To practice the trial ("test trial"), the whole protocol was performed one week prior to the mean trial, but without listening to music and without blood collections and blood pressure measurements. RESULTS: In the test trial without music there were no significant changes in PSQ-data. In the mean trial, under the influence of music, values in the section "worries" decreased as a sign of lower worries (26.6 versus 27.6; p = 0.039). STAI-values were significantly lower as a sign of reduced fear after listening to music (31 versus 34; p = 0.045). beta-endorphin concentration (10.91 microg/l versus 15.96 microg/l, p = 0.044) and systolic blood pressure (130 mmHg versus 140 mmHg; p = 0.007) decreased significantly after listening to music. CONCLUSIONS: Regarding worries and fear, patients seemed to benefit by the intervention of music. beta-endorphin was lowered significantly after music despite physical activity.

Ann N Y Acad Sci. 2003 Nov;999:374-6

• Khalfa S, Bella SD, Roy M, Peretz I, Lupien SJ.
• INSERM EMI-U 9926, Université de la Méditerranée, Faculté de Médecine Timone, 13385 Marseille cedex 05, France

The goal of the present study was to determine whether relaxing music (as compared to silence) might facilitate recovery from a psychologically stressful task. To this aim, changes in salivary cortisol levels were regularly monitored in 24 students before and after the Trier Social Stress Test. The data show that in the presence of music, the salivary cortisol level ceased to increase after the stressor, whereas in silence it continued to increase for 30 minutes.

J Music Ther. 2003 Fall;40(3):189-211

• Hirokawa E, Ohira H.
• Gifu Prefectural Music Therapy and Research Center, Japan

The purpose of this study was to examine the effects of listening to high-uplifting or low-uplifting music after a stressful task on (a) immune functions, (b) neuroendocrine responses, and (c) emotional states in college students. Musical selections that were evaluated as high-uplifting or low-uplifting by Japanese college students were used as musical stimuli. Eighteen Japanese subjects performed stressful tasks before they experienced each of these experimental conditions: (a) high-uplifting music, (b) low-uplifting music, and (c) silence. Subjects' emotional states, the Secretory IgA (S-IgA) level, active natural killer (NK) cell level, the numbers of T lymphocyte CD4+, CD8+, CD16+, dopamine, norepinephrine, and epinephrine levels were measured before and after each experimental condition. Results indicated low-uplifting music had a trend of increasing a sense of well-being. High-uplifting music showed trends of increasing the norepinephrine level, liveliness, and decreasing depression. Active NK cells were decreased after 20 min of silence. Results of the study were inconclusive, but high-uplifting and low-uplifting music had different effects on immune, neuroendocrine, and psychological responses. Classification of music is important to research that examines the effects of music on these responses. Recommendations for future research are discussed.

J Music Ther. 2001 Winter;38(4):254-72

• Knight WE, Rickard PhD NS.
• Monash University, Victoria, Australia

Previous research suggests that while subjective anxiety is reduced by relaxing music, the effect of music on physiological stress indices is less consistent. In the current study, the effect of relaxing music on participants' subjective and physiological response to stress was explored, with attention paid to methodological factors and mediating variables that might have contributed to inconsistencies in previous studies. Undergraduate students (43 females & 44 males) were exposed to a cognitive stressor task involving preparation for an oral presentation either in the presence of Pachelbel's Canon in D major, or in silence. Measures of subjective anxiety, heart rate, blood pressure, cortisol, and salivary IgA were obtained during rest and after presentation of the stressor. The stressor caused significant increases in subjective anxiety, heart rate, and systolic blood pressure in male and female controls. These stress-induced increases were each prevented by exposure to music, and this effect was independent of gender. Music also enhanced baseline salivary IgA levels in the absence of any stress-induced effects. These findings provide experimental support for claims that music is an effective anxiolytic treatment, the robustness of which is demonstrated by retention of the effect in the presence of a range of potentially mediating variables.

Neuroradiology. 2001 Jun;43(6):472-6

• Schneider N, Schedlowski M, Schürmeyer TH, Becker H.
• Department of Neuroradiology, Hannover Medical School, Germany

We studied the influence of music on stress reaction of patients during cerebral angiography. We randomised 30 patients to a music or a control group. We measured stress hormones, blood pressure, heart rate and psychological parameters. Patients examined without music showed rising levels of cortisol in plasma, indicating high stress levels, while cortisol in patients examined with music remained stable. Systolic blood pressure was significantly lower listening to music. Patients with a high level of fear did appear to benefit particularly from the music.

J Post Anesth Nurs. 1994 Dec;9(6):340-3

• Winter MJ, Paskin S, Baker T.

Many patients in the Surgical Holding Area become stressed and anxious. In a hospital setting music reduces patients' anxiety. This study determined that music can reduce the anxiety and stress of patients in the Surgical Holding Area. In this study, one group of subjects listed to music while a second group did not. Subjects who listened to music while in the Surgical Holding Area had significantly less stress and anxiety than did those who did not listen to music. Both groups spent similar lengths of time in the Surgical Holding Area. The results strongly suggest that if music were available to all patients in the Surgical Holding Area, most would select this option, and they would experience less anxiety.

J Music Ther. 1991 Winter;28(4):180-92

• Caine J.
• Florida State Hospital, Chattahoochee

The purpose of this study was to examine the effects of music on selected stress behaviors, weight, caloric and formula intake, and length of hospital stay. Subjects were 52 preterm and low birth weight newborns in a newborn intensive care unit (NBICU) who were in stable condition and restricted to isolettes. Subjects in the experimental and control groups were matched for equivalency based on sex, birth weight, and diagnostic criticality. Eleven males and 15 females were assigned to the control group and received routine auditory stimulation. The experimental group of 11 males and 15 females received music stimulation, which consisted of approximately 60 minutes of tape recorded vocal music, including lullabies and children's music, and routine auditory stimulation. Thirty-minute segments of the recording were played alternatively with 30 minutes of routine auditory stimulation three times daily. Exposure to music stimulation occurred only during the infants' stay in the NBICU. Results suggest music stimulation may have significantly reduced initial weight loss, increased daily average weight, increased formula and caloric intake, significantly reduced length of the NBICU and total hospital stays, and significantly reduced the daily group mean of stress behaviors for the experimental group. Data analyses suggest the length of hospital stay may be correlated with the amount of stress experienced by the neonate and not with weight gains. Theoretical and practical aspects of these results are discussed.