Music

What it is

Music here means recorded music people play for themselves; in the sleep trials, usually 25 to 60 minutes of prerecorded music before bedtime, at home or in hospital [1]. Music therapy is a related approach led by a trained therapist, often used for stress and anxiety in medical settings [2].

What the research says

Sleep: a 2022 Cochrane review of 13 randomised trials (1,007 adults with insomnia symptoms) found moderate-certainty evidence that listening to music at bedtime improved sleep-quality scores, by 2.79 points on the 0-to-21 Pittsburgh Sleep Quality Index (10 trials, 708 people) [1]. Improvements in time to fall asleep, total sleep time and sleep efficiency were smaller and rated low certainty, and sleep-lab measures did not improve [1]. Meta-analyses in older adults [3][4], hospital patients (10 trials, 726 people) [5] and pregnant women (4 trials, 348 women) [6] found similar sleep-quality gains. A four-week randomised trial in 112 adults with depression-related insomnia improved sleep-quality scores by about 2 points, with the benefit fading after listening stopped and no change on actigraphy [7].

Stress and anxiety: a meta-analysis of 47 studies (2,747 participants) found a medium-to-large effect of music therapy on stress-related outcomes [2]. A meta-analysis of 32 randomised trials (1,924 people) found anxiety improved during treatment (SMD -0.36) but the effect was no longer clear at follow-up [8].

Doses used in studies

Sleep trials typically used 25 to 60 minutes of prerecorded music daily, for three days to three months [1]. Older adults improved most with slow, sedative music and at least four weeks of listening [3]. The college trial used at least 30 minutes of classical or jazz before bed, two nights a week for five weeks [9].

Safety and interactions

None of the trials in the Cochrane sleep review reported any adverse events [1]. Music has no medicine interactions and no upper dose. The main risk is volume: in one meta-analysis about 24% of 12- to 34-year-olds exposed themselves to unsafe listening levels through personal devices, and heavy headphone use is linked to hearing changes at high frequencies [10][11]. Trials in pregnant women reported no harms [12][6]. We found no breastfeeding-specific data. People with hearing loss or ringing in the ears may want to check with a doctor before using headphones at night.

Caveats and open questions

Music trials cannot be blinded — listeners know they are listening — so some of the benefit may come from expectation, and the Cochrane reviewers rated every included trial at high risk of performance bias [1]. In adults without a sleep disorder, pooled results showed no clear improvement overall, although programmes of at least three weeks helped [13]. The largest older-adult review rated its evidence very low certainty because of bias and heterogeneity [4].