Abstract
Most of us have experienced the physiological or emotional effects of listening to music. Today, research demonstrates that the simple act of listening to music has the power to improve our physical and mental health. In fact, a plethora of studies suggest that listening to music can calm patients' anxiety, relieve depression, improve markers of inflammation, improve memory and/or cognitive decline, enhance physical function, restore sleep, ease grief, optimize exercise performance, inspire, and heal—just to name a few. Perhaps as clinicians, we should become more proactive about understanding the power of music in order to optimize our patients' and our own health.
Music as Medicine
The treatment of listening to music is frequently offered as a part of well established formal music therapy programs. However, it can also be done independently, and according to some experts, the music does the work. Raglio et al. commented: “Simple music listening interventions do not require either a specifically trained therapist or a direct therapeutic relationship with the patient, being that beneficial effects are induced by the content of the musical stimuli and by the activity of listening itself. For these reasons, this practice is sometimes defined with the term ‘Music Medicine’ rather than ‘Music Therapy.” 1
Whether working with a music therapist or listening individually, listening to music may seem a simple task, and yet listening to music is a unique type of medicine that creates a complex response in both our body and our brain. Liu et al. commented: “It is not music to a listener until the sounds are associated with emotions and prior memories at the limbic system, which results in the individual differences in physical as well as psychological responses of listeners.”2 They added: “Pleasant music received by the right brain stimulates the release of endorphins from the pituitary gland, which decreases the concentration of adrenocorticotrophic hormone (ACTH) in the blood, indicating the reduction of stress.”2
Because of the complex way in which music is received by our brains, researchers continue to examine musical factors such as tempo and types of music and the effects on individuals' response. For example, in terms of the effects of different types of music, Holler et al. pointed out that “Some individuals may experience sad music as relaxing while other individuals prefer happy music.” 3 They added that many variances contribute to an individual's response to music, including prior musical experience, gender, age, and duration of exposure to music—all of which contribute to how music is received and processed. Other factors that may affect a person's response to music include whether the music is self-selected or based on preference.
Despite the complexities, growing evidence points to the many benefits of listening to music. As more people become aware of the power of listening to music, increasing numbers of opportunities and initiatives at research, community, and technological levels are appearing in order to engage people in platforms that support the use of music as a movement toward health and wellness.
Sound Health
One such initiative, Sound Health, was launched in 2016 in order to explore the important connections between music, health, and wellness. Sound Health is a partnership and initiative between the John F. Kennedy Center for the Performing Arts and the National Institutes of Health (NIH) and in association with the National Endowment for the Arts. Among the goals of the initiative are to understand further how the complex brain circuitry that is involved in listening, performing, and creating music can be harnessed for health, according to the NIH Website. 4 Emmeline Edwards, PhD, director of the Division of Extramural Research at the NIH National Center for Complementary and Integrative Health and speaking on behalf of Sound Health, commented in an interview: “Music has the remarkable ability to enhance child development, improve adult function and well-being, and optimize the quality of life during aging. Many studies have shown that music can also ameliorate the symptoms of a broad range of diseases and disorders that occur throughout the lifespan.”
Edwards added: “Recent scientific breakthroughs, including the development of new technologies, are providing the community with opportunities to understand the mechanisms through which music acts, and to develop new music interventions for a variety of human conditions.” To capitalize on these opportunities, Edwards said that a NIH Music and Health working group was formed to develop and implement a research agenda. She stated: “Through rigorous research, we will gain better understanding of the basic mechanisms through which music is processed by the brain and body; we will assess how music impacts health and physiology and facilitate rigorous music intervention studies to treat disease symptoms.”
A recent Sound Health workshop on Music and the Brain brought together basic neuroscientists, clinicians, and music therapy professionals to evaluate the state of basic and applied music research, according to Edwards. 5 Edwards said, “In this meeting, a diverse panel of experts discussed three overlapping periods of life (childhood, adulthood and aging) and made recommendations for enhancing research in each of these domains. The group developed a set of recommendations intended to highlight research opportunities and promote the rigor of future research.” 5
Edwards concluded: “Sound Health has generated tremendous excitement in the scientific community and the public at large. Numerous scientific symposia and meetings have taken place in the past two years. There are also public events that are designed to merge science and art and have had a profound impact on participants.” A recent community event featured musical performances, along with presentations from global experts in neuroscience and music, and included demonstrating how the simple act of listening to music affects brain function. To find out more about Sound Health, visit their Websites at
Research
The vast benefits of music therapy are extensive and reported in the literature. Specifically, research has shown that listening to music can help people in the presurgical setting, neonatal setting, during pregnancy, and many other settings. Below are just a few research examples of the power of listening to music.
Pregnant women may benefit from listening to music in a variety of ways, including improvement in anxiety and sleep disruption. One study looked at the effects of listening to music in women who were 18–34 weeks pregnant and reporting poor sleep quality. 2 In this study, 128 women were randomly assigned to listening to music or a control group. Sleep, anxiety, and stress were assessed before and after the intervention. The intervention in the music-listening group included listening to one of five prerecorded compact discs (classical music, nature sounds, lullabies, or children's songs) or music of preferred listening for 30 minutes at bedtime for two weeks. The authors stated that at bedtime, the participants rested or read while listening to their chosen music. Results of the study showed that compared to the control group, the active music-listening group experienced significantly less stress and anxiety along with improved sleep quality, according to the authors. Interestingly, the music intervention group preferred listening to lullabies. The authors concluded: “The findings further supported music therapy as an enjoyable and non-invasive therapeutic approach, capable of creating an environment that promotes the well-being of pregnant women.”2 They emphasized the importance of such findings, and commented that “pregnant women who reported alterations in sleep had more negative fetal health outcomes than women who did not report changes in sleep.”2
A Cochrane Review of 26 trials (including 2051 participants) explored the effects of listening to prerecorded music on preoperative anxiety and found that “music interventions may provide a viable alternative to sedatives and anti-anxiety drugs for reducing preoperative anxiety.” 6 The review authors stated: “None of the studies in this review included preoperative sedative drug intake as an outcome variable. However, the results of one study that compared a non-midazolam music listening group directly with a midazolam group found that music listening was more effective than midazolam for preoperative anxiety reduction.” 6 The authors also reported that most trials in the review used one session of 20–30 minutes of listening to music. However, two of the studies included in the review offered multiple music sessions, starting with the first session several days before surgery and then on the day of surgery. The authors commented on this and stated: “Compared to other studies, these two studies resulted in greater anxiety reduction … We would like to suggest that offering multiple music listening sessions allows for the patient to give feedback about the music, select different music if needed, and become more skilled in using music for relaxation purposes.” 6
In a study looking at the potential association of music listening for optimizing creativity or creative cognition, researchers randomly assigned 155 participants to complete various tasks while in a group that listened to classical music categorized as happy, calm, anxious, or sad music, or in a control silence group. 7 In the intervention group, music was played before and during tasks. No music was played in the silence group while completing tasks. Results showed that “listening to ‘happy music’ (i.e., classical music that elicits positive mood and is high on arousal), as compared to a silence control condition, is associated with an increase in divergent thinking.” 7 Divergent thinking, according to the study authors, pertains to the ability to generate new ideas and perspectives. The authors commented that this study supports the idea that creative thinking can be enhanced and stated: “Music listening can be easily integrated into daily life and may provide an innovative means to facilitate creative cognition in an inexpensive and efficient way in various scientific, educational and organizational settings when creative thinking is needed.” 7
Conclusion
While music therapy is a well established and scientifically supported field, there is still much to learn about how simple music listening can benefit our health and how that benefit actually occurs. Not to be taken lightly, a presenter at the Sound Health Music and Brain workshop commented on the benefits of music and stated: “There is a growing body of research showing that listening to or making music profoundly changes the brain by modulating cognition, emotion, multisensory, and motor networks.” 5 This seems reason enough for clinicians and practitioners to learn more about the power of music in health and healing.