Effect of music intervention on heart rate variability: a systematic review and meta-analysis of randomized controlled trials
Zhang E, Wu X, Xu J, Lu F, Wu D, Yin Y, He L, Zhang H, Liu P, Chen Q, Ma W
Frontiers in psychology · 4 citations
How it was studied
- Design
- Systematic review (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Independent funding
- Government
- Tianjin Municipal Health Commission
Based on 1 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2026-02-25 · Front Psychol · vol. 17 · p. 1750786
- Publisher
- Frontiers Media
- Cited
- 5 citations · more than 99% of similar papers · 13.2× the field average
- Impact
- Top 10% most cited in its field
- References
- 55 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Heart Rate Variability and Autonomic Control · Music Therapy and Health · Sleep and related disorders
- Keywords
- Randomized controlled trial, Meta-analysis, Heart rate variability, Intervention (counseling), Psychological intervention, Music therapy, Funnel plot, Confidence interval
11 authors
From US, CN
- Enyuan Zhang · correspondingHeart Rhythm Society; Tianjin Chest Hospital; Tianjin Medical University
- Xiaoyan WuTianjin Medical University General Hospital
- Jing XuHeart Rhythm Society; Tianjin Chest Hospital
- Fengmin Lu · correspondingHeart Rhythm Society; Tianjin Chest Hospital
- Dongyan WuHeart Rhythm Society; Tianjin Chest Hospital
- Yitong YinTianjin Medical University
Abstract
Objective
To evaluate the effects of music intervention on heart rate variability (HRV).
Methods
The protocol of this systematic review has been submitted for registration in the PROSPERO databa se, an international prospective register for sys tematic reviews, with ID number CRD420261283257. Data sources included electronic databases searched from inception through January 2026. Randomized clinical trials comparing music intervention with control were included. The primary outcomes were changes in HRV parameters after music intervention or control compared to baseline within each group. Mean differences (MD) with 95% confidence intervals (CI) were calculated for continuous variables. The methodological quality of the studies was assessed according to the Cochrane Handbook. Publication bias was evaluated using funnel plots and Egger's regression test.
Results
A total of 24 randomized controlled trials involving 1,295 participants were analyzed. The meta-analysis demonstrated that music intervention significantly increased high-frequency power in normalized units (HFnu) compared to control groups (MD = 7.05, 95% CI: 1.00-13.10, p = 0.02), while significantly decreasing low-frequency power in normalized units (LFnu) (MD = -4.94, 95% CI: -9.13 to -0.76, p = 0.02). Subgroup analyses revealed that patients with stress/anxiety/fear/sleep disorders showed the most substantial improvements across multiple HRV parameters. Short-term interventions (≤30 min) were particularly effective for enhancing HFnu, and participant-selected music yielded superior outcomes compared to standardized music. The overall evidence quality was rated as moderate for the primary outcomes.
Conclusion
Music intervention significantly improved LFnu and HFnu compared to control groups. People with emotional disorders can improve their HRV through music intervention.
Systematic review registration
PROSPERO, Identifier: CRD420261283257.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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