Sound Verdict

Health

Music as an intervention: what the trials show

Music has more randomised trial evidence behind it than most things sold as wellness. The effects are real and specific.

Updated 2 min read 40 citations Evidence strength 4/5

Timecode control record sitting on a turntable platter with the tonearm lowered
Timecode vinyl lets a laptop follow the movement of a real record. Audiotecna · CC BY 2.0 · Wikimedia Commons

Sleep

A Cochrane review of music for insomnia in adults [5] is the strongest single piece of evidence here. Cochrane reviews are conservative by construction, so the existence of one addressing music at all reflects a real body of trials.

Music is not a treatment for chronic insomnia — that is CBT-I, covered on our sleep evidence site. It is a low-cost adjunct with a plausible mechanism through arousal reduction.

Music for insomnia

Exercise

The exercise literature is where effects are most consistent. Meta-analytic review of music in exercise and sport finds effects across performance and psychological outcomes, and specific trials have examined anaerobic performance and fast-tempo music. Music timing has been shown to differentiate fatigue perception, and personalised interactive music systems for physical activity have been meta-analysed.

The main mechanism is dissociation — attention redirected away from interoceptive discomfort — which lowers perceived exertion at a given workload. That is a genuine ergogenic effect achieved without changing physiology.

Where the evidence is strongest
ApplicationEvidenceEffect
Submaximal endurance exerciseGoodLower perceived exertion, longer time to exhaustion
High-intensity exerciseModerateSmaller effect; interoceptive signals dominate
Sleep onsetCochrane review [5]Modest improvement in sleep quality
Anxiety in clinical settingsMeta-analysed [4]Consistent modest reduction
Occupational burnoutSystematic review [3]Preliminary
Neurological rehabilitationSystematic review [2]Specific and promising

Clinical applications

Music interventions for psychological and physical outcomes have been meta-analysed broadly [4]. More specific applications include managing burnout in nurses [3] and rehabilitation for unilateral spatial neglect [2] — the latter being genuinely mechanistic rather than merely relaxing, using auditory attention to influence spatial attention. Musical neurofeedback is a developing area with its own review [1].

Choosing music for a purpose

  • For exercise: tempo matched to intended cadence, and music you actually like. Preference moderates the effect substantially.
  • For sleep: slow, predictable, low dynamic range. Anything that surprises you defeats the purpose.
  • For focus: familiar and without lyrics. Novelty and language both compete for the resources you are trying to allocate elsewhere.
  • For mood: matched then shifted. Starting where you are and moving works better than an abrupt contrast.

Common questions

Does music actually improve exercise performance?
Yes, principally by lowering perceived exertion at submaximal intensities. The effect is smaller at maximal effort.
What is the best tempo for running?
Roughly matching your intended cadence helps entrainment. Preference matters as much as tempo.
Can music help me sleep?
A Cochrane review addresses this [5], with modest effects. It is an adjunct, not a treatment for chronic insomnia.
Is there anything to binaural beats?
Far weaker evidence than ordinary music, and much stronger marketing.
Direct-drive turntable with platter, tonearm and an aftermarket record brush fitted
Miroslav Vajdic · CC BY-SA 2.0 · Wikimedia Commons
The evidence behind this page A stacked bar showing the composition of the 40 publications cited on this page by study type. 1030meta-analysis (10)randomised trial (30)
40 publications, 2008–2026. That is a mix with both trials and syntheses in it, which is the position from which a claim about cause is reasonable. Source: this page’s own citation list, below.

References

Every citation below links to the original peer-reviewed record on PubMed or via DOI. Nothing here is a substitute for medical advice.

  1. Personalized Interactive Music Systems for Physical Activity and Exercise: Exploratory Systematic Review and Meta-Analysis Danso A, Kekäläinen T, Koehler F, et al. · JMIR human factors · 2025 · Meta-analysis DOIPubMed 40921008Full text
  2. Musical Neurofeedback Advancements, Feedback Modalities, and Applications: A Systematic Review Bhavsar P, Shah P, Sinha S, et al. · Applied psychophysiology and biofeedback · 2024 · Systematic review DOIPubMed 38837017
  3. A systematic review and meta-analysis of music interventions to improve sleep in adults with mental health problems Zhao N, Lund HN, Jespersen KV · European psychiatry : the journal of the Association of European Psychiatrists · 2024 · Meta-analysis DOIPubMed 39373544Full text
  4. Music-based interventions for unilateral spatial neglect: A systematic review Long J, Zhang Y, Liu X, et al. · Neuropsychological rehabilitation · 2023 · Systematic review DOIPubMed 35980394
  5. Association of Music Interventions With Health-Related Quality of Life: A Systematic Review and Meta-analysis McCrary JM, Altenmüller E, Kretschmer C, et al. · JAMA network open · 2022 · Meta-analysis DOIPubMed 35315920Full text
  6. The Use of Music to Manage Burnout in Nurses: A Systematic Review Finnerty R, Zhang K, Tabuchi RA, et al. · American journal of health promotion : AJHP · 2022 · Systematic review DOIPubMed 35633074Full text
  7. Effects of music in exercise and sport: A meta-analytic review Terry PC, Karageorghis CI, Curran ML, et al. · Psychological bulletin · 2020 · Meta-analysis DOIPubMed 31804098
  8. Effect of Listening to Music on Wingate Anaerobic Test Performance. A Systematic Review and Meta-Analysis Castañeda-Babarro A, Marqués-Jiménez D, Calleja-González J, et al. · International journal of environmental research and public health · 2020 · Meta-analysis DOIPubMed 32599941Full text
  9. Music interventions for improving psychological and physical outcomes in cancer patients Bradt J, Dileo C, Magill L, et al. · The Cochrane database of systematic reviews · 2016 · Meta-analysis DOIPubMed 27524661
  10. Music for insomnia in adults Jespersen KV, Koenig J, Jennum P, et al. · The Cochrane database of systematic reviews · 2015 · Meta-analysis DOIPubMed 26270746Full text
  11. Active music therapy reduces depressive symptoms and enhances sleep and daily-life autonomy in older adults Migliore S, Spinoso R, De Federicis LS, et al. · Clinical gerontologist · 2026 · Randomised controlled trial DOIPubMed 41423713
  12. Combined effects of low-dose caffeine and warm-up music enhance male athletes' performance in simulated Taekwondo combat: a double-blind, randomized crossover trial Delleli S, Ouergui I, Messaoudi H, et al. · Psychopharmacology · 2025 · Randomised controlled trial DOIPubMed 40064697
  13. Recovery effects of slow-tempo preferred music on brain activity, physiological and psychological responses following high-intensity interval exercise in healthy male adults Sreepetch S, Ramyarangsi P, Mukda S, et al. · Acta psychologica · 2025 · Randomised controlled trial DOIPubMed 40845778
  14. Effects of mindfulness breathing meditation on stress and cognitive functions: a heart rate variability and eye-tracking study Hooi LY, Chen PL, Tan KW, et al. · Scientific reports · 2025 · Randomised controlled trial DOIPubMed 41136540Full text
  15. Neurologic dance training and home exercise improve motor-cognitive dual-task function similarly, but through potentially different mechanisms, among breast cancer survivors with chemotherapy-induced neuropathy: Initial results of a randomized, controlled clinical trial Worthen-Chaudhari LC, Crasta JE, Schnell PM, et al. · Journal of Alzheimer's disease : JAD · 2025 · Randomised controlled trial DOIPubMed 39584292Full text
  16. Effects of personalized music listening on post-stroke cognitive impairment: A randomized controlled trial Fan LP, Quijano-Ruiz A, Wang C, et al. · Complementary therapies in clinical practice · 2024 · Randomised controlled trial DOIPubMed 39098085
  17. A Personalized Music Intervention in Nursing Home Residents Living With Dementia: Findings From a Randomized Study Inoue M, Ihara ES, Layman S, et al. · Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2024 · Randomised controlled trial DOIPubMed 38867708
  18. Music Timing Differentiates Fatigue Perception and Performance during Isometric Strength Exercises: A Crossover Randomised Trial Poon ET, Kwan WL, Chow CC, et al. · Journal of sports science & medicine · 2024 · Randomised controlled trial DOIPubMed 38455446Full text
  19. Feasibility of therapeutic music listening in fibromyalgia: a randomised controlled pilot study Raglio A, Bettaglio R, Manera MR, et al. · Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2023 · Randomised controlled trial DOIPubMed 36334181
  20. Listening to Fast-Tempo Music Improves Physical Performance in Recreational Swimmers Aburto-Corona JA, Romero-Torres JA, Montero-Herrera B, et al. · Research quarterly for exercise and sport · 2023 · Randomised controlled trial DOIPubMed 35426762
  21. The effects of tempo and loudness variations during warm-up with music on perceived exertion, physical enjoyment and specific performances in male and female taekwondo athletes Ouergui I, Jebabli A, Messaoudi H, et al. · PloS one · 2023 · Randomised controlled trial DOIPubMed 37104494Full text
  22. Effects of caffeine consumption combined with listening to music during warm-up on taekwondo physical performance, perceived exertion and psychological aspects Delleli S, Ouergui I, Messaoudi H, et al. · PloS one · 2023 · Randomised controlled trial DOIPubMed 37871019Full text
  23. A multiple mediation analysis of the association between asynchronous use of music and running performance Kawabata M, Chua KL · Journal of sports sciences · 2021 · Randomised controlled trial DOIPubMed 32809899
  24. Self-Selected Motivational Music on the Performance and Perceived Exertion of Runners Clark JC, Baghurst T, Redus BS · Journal of strength and conditioning research · 2021 · Randomised controlled trial DOIPubMed 30550400
  25. Vocal music enhances memory and language recovery after stroke: pooled results from two RCTs Sihvonen AJ, Leo V, Ripollés P, et al. · Annals of clinical and translational neurology · 2020 · Randomised controlled trial DOIPubMed 33022148Full text
  26. Daily music listening to reduce work-related stress: a randomized controlled pilot trial Raglio A, Bellandi D, Gianotti M, et al. · Journal of public health (Oxford, England) · 2020 · Randomised controlled trial DOIPubMed 30942385
  27. Measuring the effects of listening for leisure on outcome after stroke (MELLO): A pilot randomized controlled trial of mindful music listening Baylan S, Haig C, MacDonald M, et al. · International journal of stroke : official journal of the International Stroke Society · 2020 · Randomised controlled trial DOIPubMed 30940047Full text
  28. The effect of music on anaerobic exercise performance and muscular endurance Cutrufello PT, Benson BA, Landram MJ · The Journal of sports medicine and physical fitness · 2020 · Randomised controlled trial DOIPubMed 31818058
  29. Bench press performance during an intermittent hypoxic resistance training to muscle failure Martínez-Guardado I, Sánchez-Ureña B, Olcina G, et al. · The Journal of sports medicine and physical fitness · 2019 · Randomised controlled trial DOIPubMed 30293408
  30. Watching television or listening to music while exercising failed to affect post-exercise food intake or energy expenditure in male adolescents Livock H, Barnes JD, Pouliot C, et al. · Appetite · 2018 · Randomised controlled trial DOIPubMed 29772291
  31. The Impact of Listening to Music During a High-Intensity Exercise Endurance Test in People With COPD Lee AL, Dolmage TE, Rhim M, et al. · Chest · 2018 · Randomised controlled trial DOIPubMed 29253555
  32. Randomized Trial of a Group Music and Imagery Method (GrpMI) for Women with Fibromyalgia Torres E, Pedersen IN, Pérez-Fernández JI · Journal of music therapy · 2018 · Randomised controlled trial DOIPubMed 29788133
  33. Effects of Meditation and Music-Listening on Blood Biomarkers of Cellular Aging and Alzheimer's Disease in Adults with Subjective Cognitive Decline: An Exploratory Randomized Clinical Trial Innes KE, Selfe TK, Brundage K, et al. · Journal of Alzheimer's disease : JAD · 2018 · Randomised controlled trial DOIPubMed 30320574Full text
  34. Group Music Therapy as a Preventive Intervention for Young People at Risk: Cluster-Randomized Trial Gold C, Saarikallio S, Crooke AHD, et al. · Journal of music therapy · 2017 · Randomised controlled trial DOIPubMed 28340118
  35. Older Adults' Music Listening Preferences to Support Physical Activity Following Cardiac Rehabilitation Clark IN, Baker FA, Taylor NF · Journal of music therapy · 2016 · Randomised controlled trial DOIPubMed 27591761
  36. Attentional distraction during exercise in overweight and normal-weight boys Deforche B, De Bourdeaudhuij I · International journal of environmental research and public health · 2015 · Randomised controlled trial DOIPubMed 25782065Full text
  37. Pre-task music improves swimming performance Smirmaul BP, Dos Santos RV, Da Silva Neto LV · The Journal of sports medicine and physical fitness · 2015 · Randomised controlled trial PubMed 25303170
  38. Cognitive, emotional, and social benefits of regular musical activities in early dementia: randomized controlled study Särkämö T, Tervaniemi M, Laitinen S, et al. · The Gerontologist · 2014 · Randomised controlled trial DOIPubMed 24009169
  39. Music listening enhances cognitive recovery and mood after middle cerebral artery stroke Särkämö T, Tervaniemi M, Laitinen S, et al. · Brain : a journal of neurology · 2008 · Randomised controlled trial DOIPubMed 18287122
  40. Effects of Preferred vs. Nonpreferred Music on Resistance Exercise Performance Ballmann CG, McCullum MJ, Rogers RR, et al. · Journal of strength and conditioning research · 2021 · Clinical trial DOIPubMed 30531416