Summary: Listening to music helps improve mood and decreases anxiety, regardless of the genre. Researchers found listening to music elicits similar autonomic nervous system activation patterns people experience as a result of exercise. Findings reveal clinically significant improvements in well-being and health-related quality of life associated with music engagement.
Source: University of New South Wales
What’s your favorite genre of music? Do you prefer Bach over Metallica? Or perhaps David Bowie is more your jam than Ed Sheeran?
When it comes to the most impactful music in terms of health and well-being, does genre matter? Not really, according to current research. There is clear evidence that listening to the music you like can help improve your mood and decrease anxiety, for example.
Dr. Matt McCrary from UNSW Medicine & Health says engaging with music—which includes listening to music, playing an instrument or singing—elicits an emotional response, which also has a physiologic component.
“The specific ‘hows’ and ‘whys’ regarding music’s ability to elicit this emotional response is still the topic of much debate but it appears to be related to the creation of an emotional connection between musicians, who create sound with an emotional intention, and listeners, who receive this emotional information,” explains Dr. McCrary, who is an Adjunct Lecturer at the Prince of Wales Clinical School, UNSW Sydney.
Dr. McCrary says the physiologic implications of this emotional response are a broad activation of many brain regions and autonomic nervous system activation—specifically, of the “fight or flight” (sympathetic) response during most music engagement, followed by increased “rest and digest” (parasympathetic) activity after the music stops.
“My working hypothesis is that repeatedly engaging with music and eliciting these autonomic nervous system activation patterns increases our ability to respond effectively to stress, which in turn improves our overall health and well-being.”
And coming back to whether you prefer contemporary pop, heavy metal or classical music, there is currently no evidence to support whether a particular genre is better than another, just as long as it’s music you enjoy.
“The most impactful music on health and well-being appears to be the music that you like the most, as playing and listening to it corresponds to the strongest emotional and physiologic response. For some, this may be classical music, and for others, it may be heavy metal,” says Dr. McCrary.
Interestingly, engaging with music elicits similar autonomic nervous system activation patterns that we experience when participating in exercise. However, Dr. McCrary says the magnitude of these responses to music is of a lower amplitude when compared to exercise.
In a recent paper published in JAMA Network Open, Dr. McCrary and his colleagues revealed that repeatedly engaging with music—which could be listening to music, playing an instrument, or singing—has a real, tangible positive impact on our overall health. This tangible positive impact of music appears to be about half the impact of the positive health effects of regular exercise.
“This study provides the first quantitative evidence of clinically significant improvements in well-being and health-related quality of life associated with music engagement. Additionally, by focusing on studies that used the SF-36—the most widely used short-form health survey—this analysis enabled the magnitude of the impacts of music interventions to be compared and contextualized for the first time against established interventions such as exercise and weight loss.”
Based on the findings of the study, Dr. McCrary says he was pleasantly surprised to find the impact of music interventions is, on average, tangible, quantifiable, and statistically and clinically significant.
“The most exciting thing about these results is the insights they provide into the potential impact of music on our overall health. For example, exercise is associated with the prevention of 1.6 million annual deaths. If music can have half this impact, we’re looking at the prevention of 800,000 annual avoidable deaths. So, the potential here is exciting if we can figure out how to target and maximize music’s effects,” explains Dr. McCrary.
“Previous systematic reviews used narrative methods to synthesize the broad range of, often conflicting, results regarding music’s health impact. This is to say, this study aimed to be very direct and quantitative, taking a ‘cold,’ impartial approach to music’s effects, and I wasn’t sure that the impact of music on health-related quality of life (HRQOL) would be quantifiably significant.”
The researchers acknowledge that the individual variation in results is broad, meaning the impact of engaging with music at an individual level is still unclear. The analysis also couldn’t provide any insights into how to optimize music “prescriptions,” for example how long or often to engage with music.
“The practical implication of these limitations is that, while we now have a better sense of the average impact of music interventions, much more work needs to be done to enable music to be reliably prescribed for maximum health benefits in a given individual.”
Dr. McCrary says the next big step to realizing music’s health potential is the creation of a framework to enable music’s health effects to be reliably prescribed across individuals.
“This framework has been developed theoretically, adapting key insights from the development of reliable exercise prescriptions. The immediate next step is to empirically test this prescription framework and see if it can consistently produce positive health outcomes in various real-world settings, for example clinical rehabilitation and public health programs. The aim is to begin doing it by the end of this year.”
In the words of the great Swedish supergroup ABBA, thank you for the music.
Association of Music Interventions With Health-Related Quality of Life
Increasing evidence supports the ability of music to broadly promote well-being and health-related quality of life (HRQOL). However, the magnitude of music’s positive association with HRQOL is still unclear, particularly relative to established interventions, limiting inclusion of music interventions in health policy and care.
To synthesize results of studies investigating outcomes of music interventions in terms of HRQOL, as assessed by the 36- and 12-Item Health Survey Short Forms (SF-36 and SF-12).
MEDLINE, Embase, Web of Science, PsycINFO, ClinicalTrials.gov, and International Clinical Trials Registry Platform (searched July 30, 2021, with no restrictions).
Inclusion criteria were randomized and single-group studies of music interventions reporting SF-36 data at time points before and after the intervention. Observational studies were excluded. Studies were reviewed independently by 2 authors.
Data Extraction and Synthesis
Data were independently extracted and appraised using GRADE criteria (Grading of Recommendations, Assessment, Development, and Evaluations) by multiple authors. Inverse-variance random-effects meta-analyses quantified changes in SF-36 mental and physical component summary (respectively, MCS and PCS) scores from preintervention to postintervention and vs common control groups.
Main Outcomes and Measures
SF-36 or SF-12 MCS and PCS scores, defined a priori.
Analyses included 779 participants from 26 studies (mean [SD] age, 60  years). Music interventions (music listening, 10 studies; music therapy, 7 studies; singing, 8 studies; gospel music, 1 study) were associated with significant improvements in MCS scores (total mean difference, 2.95 points; 95% CI, 1.39-4.51 points; P < .001) and PCS scores (total mean difference, 1.09 points; 95% CI, 0.15-2.03 points; P = .02). In subgroup analysis (8 studies), the addition of music to standard treatment for a range of conditions was associated with significant improvements in MCS scores vs standard treatment alone (mean difference, 3.72 points; 95% CI, 0.40-7.05 points; P = .03). Effect sizes did not vary between music intervention types or doses; no evidence of small study or publication biases was present in any analysis. Mean difference in MCS scores met SF-36 minimum important difference thresholds (mean difference 3 or greater).
Conclusions and Relevance
In this systematic review and meta-analysis, music interventions were associated with clinically meaningful improvements in HRQOL; however, substantial individual variation in intervention outcomes precluded conclusions regarding optimal music interventions and doses for distinct clinical and public health scenarios.