music and medicine
Human brain recording information with headphones.

The role of music in health has been studied since ancient times. Music was utilized in Asia, Egypt, Romania, Africa and America to improve spirits, alleviate diseases and provide a calming effect to the patients. Music therapy improved communication, health and quality of life (QOL). Music is a non-verbal means of emotional expression. The body, mind and spirit as being interconnected, music touches every aspect of our being and have positive effect on QOL.

It regulates pain, mood and anxiety levels. Music therapy has been proven to work in psychiatric hospitals, drug & alcohol programs, rehabilitation centers, acute care hospitals and nursing facilities. The scientific basis of music therapy is explained by its effect on certain brain activities. Psychological and behavioral changes induced by music have beneficial effect on cardiovascular system as well. In patient with high blood pressure music reduces both systolic and diastolic blood pressure. Listening to pleasant music promotes emotional self-regulation by increasing dopaminergic activity in the ventral striatum and ventral tegmental area of the brain and by decreasing the reactivity of the hypothalamic-pituitary-adrenal axis. In turn, these changes decrease serum cortisol (stress hormone) levels, increase the synthesis and release of central and peripheral endocannabinoids such as anandamide (positive thoughts and happiness) and endorphins, and increase the predominance of parasympathetic heart modulation (reduce heart rate, BP).

Research on music therapy has grown exponentially over 20 years. Randomized controlled trials (RCTs) have shown anxiolytic (anti-anxiety) effects of music therapy in surgery, cardiology and oncology. The clinical studies have shown that music listening decrease depression, agitation and anxiety. In fact, music therapy is recommended by National guidelines to control behavioral outcomes. Music therapy is goal directed approach in which music is used to improve, sustain and restore a state of well being in individuals. Music therapy encourages patients with brain injuries and neurological diseases to participate in exercises and activities. The benefits of music therapy have been found in patients with stroke and dementia.  

The role of music in end of life (palliative) care is well established. It facilitates the feeling of meaning and a psycho-spiritual integration of life expression. Patients with terminal illnesses like cancer have immensely benefitted by music therapy. Canadian music therapist Susan Munro was pioneer in systemically describing her work in palliative patients on physical, psychological, social and spiritual level.

Music therapy has shown to enhance spirituality and lowering of salivary cortisol level (a marker of stress). Even family members reported the positive outcome of music on overall well being of patients.

Music in Surgery:

Patient planned for surgery has tremendous anxiety and stress before the procedure. Generally sedatives or anxiolytics are used prior to anesthesia to control anxiety in such patients. Music therapy is increasingly being used to reduce preoperative anxiety. In a meta-analysis of 26 clinical studies involving 2051 patients, it was found that listening to music significantly reduces anxiety as compared to routine care. The benefits of music therapy have been shown in patients undergoing knee, hip and gynecological surgeries. Music played during caesarian section has shown to reduce the anxiety and stress of mother particularly those with history of multiple caesarian deliveries. 

Music in Neonatal ICU:

Music therapy has shown significant benefits in mother with preterm infants admitted in ICU. The major effect is observed in alleviation of anxiety and depression in mothers. It was further shown that listening familiar songs selected by mothers themselves has better effect. Familiar songs can help control anxiety, improve concentration, recover memory, provide a sense of security and motivation, and stimulate social interaction, simultaneously giving opportunities to recognize and improve their emotions.        

Music and sleep:

Thomas Dekker said, “Sleep is that golden chain that ties health and our bodies together”. Sleep loss has been linked to a range of physical and mental health issues, with short-term effects evident even after a single night of poor sleep. Short-term memory may be impaired and participants report lower levels of happiness and more feelings of depression. Work-related and driving accident rates are also thought to increase as a result of reduced cognition and efficiency. The drugs prescribed for sleep loss (sedatives or anxiolytics) are known to produce several side effects. The long term use of these drugs cause nausea, dizziness, dependency and withdrawal, amnesia (forgetfulness), seizures, and even an increase in mortality. Given the prevalence of sleep disturbance, cost, and potentially harmful side effects of these drugs, low cost, non-pharmaceutical alternatives become a priority. Music has been found to provide a low cost option for populations suffering from sleep difficulties. It was also noted that self selected music has more analgesic and anti-anxiety effect that prerecorded music.

Music and Autism:

Autism is a lifelong condition with a median age of diagnosis >4 years. Families of such children face significant challenges during developmental transitions. School-age children in particular often remain unengaged in social settings, reducing opportunities for socio-communicative development. The randomized controlled trials (RCTs) of music interventions for autism have reported positive effects of music on emotional engagement, social interaction, communication and parent–child relationships, suggesting that musical activities in a therapeutic context can promote measurable behavioral changes in children with autism. A study has shown that 8–12 weeks of music intervention (relative to non-music behavioral intervention) can improve parent-reported social communication, QOL and intrinsic brain connectivity in school-age children, thus supporting the use of music as a therapeutic tool in such children.

Music & Dementia:

People suffering from dementia who are in institutional care found benefitted with at least five sessions of a music-based therapeutic intervention. Music reduced depressive symptoms and improved overall behavioral problems at the end of treatment. It may also improve emotional well-being and quality of life and reduce anxiety.  

Leonardo Da Vinci rightly stated on music “Do you know that our soul is composed of harmony?” The most fascinating aspect of music is its transmodality. Recent psychological and neuroscientific evidences suggest that music is unique in the coupling of perception, cognition, action and emotion. This explains why music has been since time immemorial and should continue to be a part of the healing process.