Influence of Music on Cortisol Levels in Mechanically Ventilated Critically Ill Patients: A Systematic Review.
Carmen Fernández-Álvarez, David Zuazua-Rico, M Pilar Mosteiro-Díaz and 1 others
PMID 41947352WHAT IT FOUND
Music lowered serum cortisol in three of five small trials of adults receiving invasive mechanical ventilation, but did not show a consistent effect.
Patient-preferred music may be a low-risk comfort option, not proven treatment.
Key findings
01Three of the five included randomised trials reported statistically significant reductions in serum cortisol after music.
02Chlan and Migneault trials found no significant between-group differences in cortisol concentrations.
03The review did not combine results statistically because the trials differed too much in patients, music and timing.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only five randomised trials were included, and sample sizes were small. The trials were too different to combine statistically, so no meta-analysis was possible. Populations varied from conscious ICU patients to sedated ICU patients and perioperative patients under general anaesthesia. Music selection, session length, timing and delivery differed across trials. Control groups often wore silent headphones, which may have reduced noise as well as music, making it hard to separate the effect of music from acoustic isolation. Sedatives and analgesics were not consistently controlled, and these can affect cortisol. Only English and Spanish articles were searched, and unpublished grey literature was not included.
The easy way to misread this
Do not conclude that music reliably lowers cortisol in ventilated patients. Three of five trials were positive, but other trials found no significant between-group difference, and the review could not combine them because patients, music and timing differed. Music was also given alongside sedation, anaesthesia and ventilator care, so its independent effect cannot be separated.