I can hear music
My wife loves music. Most any music will do – she pops right up and starts dancing. And, boy, is she a great dancer. I love watching her, and I love dancing with her, although I look ridiculous next to her. Imagine playing golf with Tiger Woods. You can’t but help feel inadequate.
My wife plays music all the time. She tells me, “Music is medicine. Get into it, feel it, experience it, and let it do its magic.”
In fact, my wife insisted we play music for my friend who was in the ICU for months. (Fit for life: A personal story.) Even though my friend was unconscious for long periods of time, my wife insisted he could hear the music and that it would make him feel calmer and reduce his fear quotient. She was convinced. Of course, I said nothing at the time, but I was skeptical. Anyway, I liked listening. It helped pass the time.
This got me wondering if there was any credible research showing that music can be used for healing. When I began to dig into the research literature, past and present, I was surprised. I think you may be too.
Music’s influence
As I learned, using music for healing is one of the oldest branches in the field of medicine. Early records from ancient Egyptian, Babylonian, Ayurvedic, and classical Chinese documents show health practitioners incorporated music with medicine in what was termed “musical healing.”
The ancient Greeks valued the relationship between music and medicine as expressed in the god Apollo, whose gifts included both the musical and healing arts. The first use of the term “musical medicine” began with Pythagoras, the fifth-century philosopher-mathematician. The Romans are said to have used musicians in their battlefield hospitals as a form of anesthesia.
Neuroscientific studies show music therapy to be capable of influencing complex neurobiological brain processes that potentially can play an important role in various medical treatments. Also, clinical studies provide supportive evidence that music therapy can be effective for a wide range of medical issues, including the following:
- Depression
- Autism
- Dementia
- Alzheimer’s disease
- During surgery
- Post-surgical recovery
- General pain
- Oncologic pain relief
- Post-operative caesarean delivery
- Coronary disease-induced stress and anxiety
- Frequent urination
- General anxiety
- Disorders of consciousness
- Infant development
- Sleep disorders
- Blood pressure and heart-rate disorders
- Schizophrenia
- Substance misuse
Post-operative recovery
The most extensive research on music’s role in medicine has focused on post-operative recovery. Most people undergo a surgical procedure at some point in their lives – doctors perform more than 51 million operative procedures in the U.S. every year. In England, more than 4-6 million hospital admissions per year lead to surgical care. Patients who have undergone a surgical procedure, with or without anesthesia, know the post-operative period can be difficult. It is often prolonged and painful as well.
Music to improve patients’ post-op experience has a long history in western medicine, including being used by Florence Nightingale, as described in her influential 1859 nursing book.
The first report of using music in the medical literature appeared in the Journal of the American Medical Association in 1914. Today, a search of the literature reveals more than 4,000 titles and abstracts of studies, including many randomized controlled trials, where different interventions were compared to differing choices of music (by patient and/or researcher), post-operative.
Analyses of many of these studies suggest that music played in the peri-operative (pre-operative, intra-operative, and post-operative) setting can reduce post-operative pain, anxiety, and analgesia needs, and improve patient satisfaction. However, no differences were reported regarding length of hospital stay, infections, wound healing rates, or costs, although a few studies measured these variables. No side effects of music therapy were identified.
Apparently, cognitive activities such as listening to music can affect perceived intensity and unpleasantness of pain, enabling a patient’s sensation of pain to be reduced. Another potential mechanism to explain music’s positive effects could be music’s ability to reduce autonomic nervous system activity, such as reduced pulse and respiration rate and decreased blood pressure.
For patients undergoing general anesthesia, some evidence suggests that parts of the brain involved in hearing can sometimes be perceptive during general anesthesia. For about one in 1,000 people undergoing general anesthesia, unwanted intra-operative awareness while anesthetized is a risk factor for post-operative, post-traumatic stress. Perhaps intra-operative music might prevent this effect by reducing fear or changing the patient’s unconscious focus? Whether other distracting stimuli (videos or talking books) might have a similar effect to music is unclear.
Autism
People who have Autism Spectrum Disorder, Asperger’s Syndrome, childhood disintegrative disorders, or pervasive developmental disorders often show a heightened interest and response to music. This has been shown to aid in the teaching of verbal and nonverbal communication skills and in establishing normal developmental processes.
Dementia, Alzheimer’s disease
In older adults with Alzheimer’s, dementia, and other mental disorders, music therapy has been found to reduce aggressive or agitated behavior, reduce symptoms of dementia, improve mood, and improve cooperation with daily tasks, such as bathing. Music therapy also may decrease risk of heart or brain diseases in elderly dementia patients.
In his book Musicophilia(Knopf, 2007), Oliver Sacks describes how music can animate people with Parkinson’s disease who cannot otherwise move, give words to stroke patients who cannot otherwise speak, and calm and organize people whose memories are ravaged by Alzheimer’s or amnesia.
Mental illness, depression
There is evidence that music therapy may increase responsiveness to antidepressant medications. In elderly depressed adults, a home-based program of music therapy may have long-lasting effects. In depressed adult women, music therapy may lead to reductions in heart rate, respiratory rate, blood pressure, and depressed mood. Music therapy also may be beneficial in depression following total knee replacement surgery or in patients undergoing hemodialysis.
Infant development
In addition, there is evidence that music played to the womb during late pregnancy may lead to children being more responsive to music after birth. Soothing music also may help relax agitated newborns. Pre-term newborns exposed to music may have increased feeding rates, reduced days to discharge, increased weight gain, and increased tolerance of stimulation. They also may have reduced heart rates and a deeper sleep after therapy.
Sleep quality
In older adults, music may result in significantly better sleep quality as well as longer sleep duration, greater sleep efficiency, shorter time needed to fall asleep, less sleep disturbance, and less daytime dysfunction. Evidence of sleep benefits for elementary-age children or stable pre-term infants also exists. Music therapy also may be as effective as chloral hydrate in inducing sleep or sedation in children undergoing EEG testing.
Oncologic pain relief
In several studies, music and poetry were both successful to ameliorate pain and depression related to oncologic pain, with music more successful for pain modulation.
Neonatal
There are more than 4,800 research citations, including about 20 random controlled studies with 1,128 participants receiving recorded or live music interventions in neonatal ICU units between 24-40 weeks of gestational age. Recorded music improved heart rate, respiratory rate, better feeding and sucking outcomes, and material anxiety compared to no music conditions.
Stress and anxiety reduction in coronary heart disease patients
Individuals with coronary heart disease (CHD) often suffer from severe distress due to diagnosis, hospitalization, surgical procedures, uncertainty of outcome, fear of dying, doubts about progress in recovery, helplessness, and loss of control. Such adverse effects put the cardiac patient at greater risk for complications, including sudden cardiac death. Music interventions have been used to reduce anxiety and distress and improve physiological functioning in medical patients with CHD.
In a recent study with 1,369 participants, music intervention had a small, beneficial effect on psychological distress. Listening to music had a moderate effect on anxiety in people with CHD and in people with myocardial infarction. Studies that used patient-selected music resulted in greater anxiety-reducing effects, reduced heart rate, respiratory rate, and systolic blood pressure. Studies that included two or more music sessions led to a small and consistent pain-reducing effect. Results also suggest that listening to music may improve patients’ quality of sleep following a cardiac procedure. A small number of studies pointed to a possible beneficial effect of music on reducing pain medication intake after cardiac procedures or surgery.
Conclusions
So it would seem my dancing wife is on to something: Music is medicine.We still have much to learn about why and how music can be used in different medical and health situations, but there seems little doubt, based on research evidence, that music can play a vital role to Health Yourself.
Have you experienced music’s healing benefits? Tell us in the comments section below.
References:
- Allen, K., and Blascovitch, J. 1994. “Effects of music on cardiovascular reactivity among surgeons.” JAMA;272:882.
- Arruda, M.A. 2016. “Evaluation of the effects of music and poetry in oncologic pain relief: A randomized clinical trial.” Journal of Palliative Medicine; 19(9):943.
- Bechtold, M.L., et al. 2009. “Effect of music on patients undergoing colonoscopy: A meta-analysis of randomized controlled trials.” Digestive Diseases and Sciences; 54:19.
- Bieleninik Ł. 2016.”Music therapy for preterm infants and their parents: A meta-analysis.” Pediatrics; 138(3). pii: e20160971. doi: 10.1542/peds.2016-0971.
- Bradt, J. 2013. “Music for stress and anxiety reduction in coronary heart disease patients.” The Cochrane Database of Systematic Reviews; (12):CD006577.
- Brandt, J., et al. 2013. “Music interventions for pre-operative anxiety. Cochrane Database of Systematic Reviews; CD006908.
- Ceped, M.S., et al. 2010. “Music for pain relief.” Cochrane Database of Systematic Reviews; (8) CD004843.
- Croom, A,M. 2012. “Music, neuroscience, and the psychology of wellbeing.” Frontiers in Psychology; 2:1.
- Dobek, C.E., et al. 2014. “Music modulation of pain perception and pain-related activity in the brain, brain stem, and spinal cord: A functional magnetic resonance imaging study.” The Journal of Pain;1 5:1057.
- Economidou, E., et al. 2012. “Does music reduce post-operative pain? A review.” Health Science; 6:365.
- Egbert, L.D., et al. 1964. “Reduction of post-operative pain by encouragement and instruction of patients.” New England Journal of Medicine; 207:825.
- Engwall, M., and Sorenson-Duppils, G. 2009. “Music as a nursing intervention for postoperative pain: A systematic review.” Journal of Perianesthesia Nursing; 24:370.
- Hole, J., et al. 2015. “Music as an aid for post-operative recovery in adults: A systematic review and meta-analysis.” The Lancet; 386(10004):1659.
- Kane, E. 1914. “The phonograph in the operating room.” Journal of the American Medical Association; 62:1829.
- Magee, W.L. 2016. “Editorial: Music and disorders of consciousness: Emerging research, practice, and theory.” Frontiers in Psychology; 7:1273.
- McCaffrey, R., and Good, M. 2000. “The lived experience of listening to music while recovering from surgery.” Journal of Holistic Nursing; 18:378.
- McCaffrey, R., and Locsin, R. 2002. “Using music listening in nursing: A symphony of practice.” Holistic Nursing Practice;16:231.
- Moris, D.N., and Linos, D. 2013. “Music meets surgery: Two sides to the art of ‘healing.’” Surgical Endoscopy; 27:719.
- Nightingale, F. 1859. “Notes on nursing: What it is, and what it is not,” Harrison, London.
- Nilsson, U., et al. 2008. “The anxiety and pain reducing effects of music interventions: a systematic review.” Journal of the Association of periOperative Nurses; 87:780.
- Salimpoor, V.N., et al. 2011. “Anatomically distinct dopamine release during anticipation and experience of peak emotion to music.” Nature Neuroscience; 14:257.
- Ullmann, Y., et al. 2008. “The sounds of music in the operating room.” Injury; 39:592.
- van der Heijden, MJ. 2016. “Do hospitalized premature infants benefit from music interventions? A systematic review of randomized controlled trials. PLoS One; 8;11(9):e0161848. doi: 10.1371.
- Way, T.J., et al. 2013. “Effect of noise on auditory processing in the operating room.”Journal of the American College of Surgeons; 216:933.
- White, J.M. 1999. “Effects of relaxing music on cardiac autonomic balance and anxiety after acute myocardial infarction.” American Journal of Critical Care; 8:220.
- www.cdc.gov/nchs/fastats/inpatient-surgery.htm.
- Zarghi, A., et al. 2014. “Assessment of brain function in music therapy.” American Journal of Applied Psychology; 2:66.
Karen Markey
In an NPR interview, Barbra Streisand underlines the power of music when relaying a story about her late mother who had Alzheimer’s disease, “Toward the end of her life, I don’t think she knew who I was. But she would remember the melodies of her youth and so we would hum together in her kitchen. It just shows you the power of music …” (Quoted from http://www.npr.org/templates/story/story.php?storyId=1457570)
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Elaine Sims - 1964
Thank you for your article drawing attention to the important role of the arts in health, healing and wellness. The U-M Health System has been a leader in the field of arts in healthcare bringing the arts to the delivery and experience of care since 1986. Please visit the Gifts of Art website for a listing of the many programs offered to patients at UM Hospitals including live music at the bedside, weekly public concerts and the Life Sciences Orchestra. http://www.med.umich.edu/goa
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