SYSTEMATIC REVIEW article
Front. Psychol.
Sec. Health Psychology
Effect of music intervention on heart rate variability: a systematic review and meta-analysis of randomized controlled trials
Enyuan Zhang 1
Xiaoyan Wu 2
Jing Xu 1
Fengmin Lu 1
Dongyan Wu 1
Yitong Yin 3
Le He 1
Henan Zhang 1
Pengyuan Liu 1
Qingliang Chen 1
Wei Ma 1
1. Tianjin Chest Hospital, Tianjin, China
2. Tianjin Medical University General Hospital, Tianjin, China
3. Tianjin Medical University, Tianjin, China
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Abstract
Objective: To evaluate the effects of music intervention on heart rate variability (HRV). Methods: 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 to 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 minutes) 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. Conclusions: Music intervention significantly improved LFnu and HFnu compared to control groups. People with emotional disorders can improve their HRV through music intervention.
Summary
Keywords
Heart rate variability, Meta-anaIysis, Music intervention, randomized controlled trials, Systematic review
Received
20 November 2025
Accepted
03 February 2026
Copyright
© 2026 Zhang, Wu, Xu, Lu, Wu, Yin, He, Zhang, Liu, Chen and Ma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Enyuan Zhang; Wei Ma
Disclaimer
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