Related Experiment Video
Updated: Apr 9, 2026
Assessing the Effects of Music Listening on Psychobiological Stress in Daily Life
Published on: February 2, 2017
Influence of Music on Cortisol Levels in Mechanically Ventilated Critically Ill Patients: A Systematic Review
Carmen Fernández-Álvarez1, David Zuazua-Rico1,2, M Pilar Mosteiro-Díaz2
1Hospital Universitario Central de Asturias, Oviedo, Spain.
Background:
Music has been proposed as a simple, non-invasive intervention to modulate stress responses in patients undergoing invasive mechanical ventilation (IMV). Its potential impact on cortisol levels represents a promising approach to mitigating physiological stress in intensive care.
Aim:
To examine the effectiveness of music interventions in reducing cortisol levels and, consequently, modulating the stress response in mechanically ventilated patients in intensive care units (ICUs).
Study Design:
A systematic review was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD42023409196). Five electronic databases were searched without date restrictions. Eligible studies were randomised controlled trials (RCTs) assessing music interventions in adult patients receiving IMV, with serum cortisol as the primary outcome. Risk of bias was assessed using the Cochrane RoB 2 tool. Owing to substantial heterogeneity, findings were synthesised narratively.
Results:
Five RCTs (n = 208) met the inclusion criteria. Three reported significant reductions in cortisol following music interventions, while two found no differences. Variability in music type, intervention duration, sedation status and measurement timing contributed to inconsistent results. Risk of bias was low in two studies, whereas three were rated as raising some concerns.
Conclusions:
Current evidence on the effect of music on cortisol in mechanically ventilated patients is limited and inconsistent. Findings remain contradictory, preventing firm conclusions about efficacy. Future multicentre trials with standardised protocols and rigorous control of confounders are required.
Relevance To Clinical Practice:
This review highlights a major gap in evidence regarding the biological impact of music in IMV patients. Results from five small, heterogeneous RCTs are inconclusive, and some of them are limited by methodological concerns. Thus, current evidence is insufficient to support changes in clinical practice. While music remains a low-risk intervention of interest, its actual effect on physiological stress has yet to be demonstrated. Large-scale, high-quality studies are needed before clinical recommendations can be made.
Systematic Review Registration:
PROSPERO ID: CRD42023409196.
Related Concept Videos
01:20Assessment of Ventilation I: Respiratory Rate
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
01:30Acute Respiratory Failure-III
01:29Mechanical Ventilation I: Indication and Settings
01:21Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
01:30Assessment of Airway, Skin Color, and Use of Accessory Muscles
Introduction
The initial evaluation of a patient's respiratory system...