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Table of Contents
Year : 2021  |  Volume : 10  |  Issue : 1  |  Page : 14-19

Impact of instrumental music on heart rate variability in ardent music listeners

1 Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Telengana, India
2 Department of Physiology, Hind Institute of Medical Sciences, Barabanki, Uttar Pradesh, India
3 Department of Biochemistry, All India Institute of Medical Sciences, Nagpur, Maharashtra, India

Date of Submission08-Feb-2021
Date of Decision11-Apr-2021
Date of Acceptance05-May-2021
Date of Web Publication29-Jun-2021

Correspondence Address:
Dr. Pramita Dubey
Assistant Professor, Department of Physiology, Hind Institute of Medical Sciences, Barabanki, Uttar Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/rcm.rcm_8_21

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Purpose: The autonomic nervous system serves as the final gateway by which music exerts a therapeutic effect on health and disease. The aim of the study is to find the effect of different instrumental music on heart rate variability (HRV) as a part of our pilot protocol for identifying suitable auditory stimuli for evaluating the autonomic functions by HRV analysis. Methodology: The effect of music on HRV was assessed by frequency domain parameters of HRV, i.e. total power (TP, variance of N-N intervals over temporal segment), low frequency (LF, power in LF range), high frequency (HF, power in HF range), LF/HF ratio, LF%, and HF% using fast Fourier transform technology. Results: Flute was found to increase LF and HF as well as TP. Tabla and violin were found to increase HF% but had no effect on TP. This makes flute, table, and violin tranquilizing music. Piano was found to lower LF% and increase TP. Sitar and guitar were found to decrease HF%, as well as increase LF/HF ratio. They also increase TP. Conclusion: Although the results were not statistically significant, music is a low-cost and safe adjuvant for intervention and therapy. Therefore, there is growing need for high-quality research on the effects of music on the heart in both healthy individuals and patients.

Keywords: Heart rate variability, music, parasympathetic, sympathetic

How to cite this article:
John NA, Dubey P, John J. Impact of instrumental music on heart rate variability in ardent music listeners. Res Cardiovasc Med 2021;10:14-9

How to cite this URL:
John NA, Dubey P, John J. Impact of instrumental music on heart rate variability in ardent music listeners. Res Cardiovasc Med [serial online] 2021 [cited 2022 Dec 9];10:14-9. Available from: https://www.rcvmonline.com/text.asp?2021/10/1/14/319792

  Introduction Top

Listening to music is a favorite past time seen among people irrespective of their ages. Many individuals develop intense liking for listening to song and instrumental music, and few develop craving for playing these musical instruments. Music is a part of curriculum in many schools, colleges, and universities as one of the supplementary subjects, worldwide. These changes in educational trends have popularize music among common public in the community, and eventually, many become ardent music listeners, musical instrument players, or ever enjoy singing in accompanying music background. Many of these habitual ardent music listeners who enjoy the pitch, chords, harmony, and timber of these musical instruments are the ones who have deeper knowledge and understanding of physical principles and physics of musical instrument sounds. Musical has been a part of complementary therapy in the management of diseases since few decades.[1] Music has been implicated in medical practice for the management of stress-related disorders, and moreover, listening to music also has stress- and pain-relieving effects.[1],[2] Music has a greater influence over human psyche as well as over somatic expression of life. It influences and modulates the circulatory, respiratory, and endocrine functions of the human body.[2],[3] Music is known to reduce blood pressure in patients of hypertension.[4] Music listening is known to evoke higher level of emotional arousal and lead to increased heart rate in response to musical sound. The limbic and paralimbic structures of the brain cortex modulate emotional impact of music on heart rate and the heart rate variability (HRV).[5]

As per the Neuro-Visceral Integration Model proposition, the HRV mediates through vagal nerve the prefrontal cortex activity, and prefrontal cortex exerts an inhibitory influence over sympathetic excitatory circuits in the limbic cortex, eventually influencing emotion, mental state of mind, and cognition.[6],[7] The parasympathetic response in music listeners depends upon the tone, overtones, frequency, intensity of sound, and timber or quality of sound produced by the musical instruments.[5]

The musical instruments produce sound when any of its parts are set into vibration rapidly. The sound waves are generated because of these vibrations represented in the musical notes. The impact of musical note on the human body, especially over brain and heart, is reflected by the pitch, quality or timber, and sound level or loudness. A positive influence of musical instrument over mind and body depends on tone and harmonics (over tone produced by higher frequency vibration set in the musical instrument). The variation in intensity of various over tones produces a characteristic timber or sound quality.[8]

Most of the studies conducted as found in the literature review investigated the effects of music, especially of a musical song or any of the musical instruments (violin, guitar, etc.) over autonomic functions on HRV. However, we designed our study with a novelty approach of investigating the effect of instrumental music of HRV in the same participant subject exposed to musical sound of wood wind instrument (flute), string instruments (guitar, sitar, and piano), and percussion musical instrument (tabla drum) in ardent music listeners only. This would help us assess which of the instrumental sounds have a parasympathetic influence or sympathetic influence, respectively. Hence, as a part of pilot project, we decided to study the impact of instrumental music on HRV by exposing the participant to instrumental music sound of piano, tabla drum, guitar, sitar, and flute. Identifying the best auditory musical sound in our pilot study will be helpful to design future studies with larger sample size. This study focuses on the impact of instrumental music notes as auditory stimuli on HRV.

  Methodology Top


The present research work was conducted in the Department of Physiology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India, after approval of the institutional ethical committee. The study was part of our pilot project to find the most suitable auditory stimuli affecting HRV. We recruited 18 healthy individuals as volunteer participants in our study. They were in the age group of 18–65 years. All volunteer participants selected for our research study were healthy, nonsmoker, nonalcoholic and were not on any drug or therapy. They were all educated up to high school level, belonged to same middle socioeconomic background, and had identical cultural beliefs. All of these participants were ardent listeners of music, were well acquainted with listening to all musical instrument employed in our study, and had studied music as a subject in their school and college studies or as a hobby learned the theory and practices of music. Those excluded from the study were nonregular music listeners, patients of hypertension, cardiorespiratory disorders, endocrine disorders (thyroid, adrenal, etc.), epilepsy, and psychiatric disorders (depression, manic depressive illness, etc.), those undergoing treatment with drugs such as antidepressants, thyroid stimulants, and antithyroid drugs, and those with injuries and painful conditions. The participants were informed about the aims, procedure, and scope of our research work. Written consent was obtained from all the participants. The HRV analysis was conducted on Power Lab AD Instruments, Lexington Drive, New South Wales, Australia.[9]


The volunteer participants reported to the research laboratory of department of physiology. The volunteer participants were asked to avoid smoking, alcohol, vigorous exercise, and eating a large meal within 2 h of testing so that these factors do not affect the metabolism, blood circulation, and heart rate. Any alteration in heart rate will affect the HRV. The tests were performed on the participants at the same time of the day, between 11:00 am to 1:00 pm. The volunteer participants were asked to occupy the examination couch and lie down. The leads and electrodes for HRV recording were appropriately located as per protocol on chest of the participants. Resting lead II ECG was recorded in supine posture for all subjects in a state of physical and mental rest, after a rest of 5 min. After a brief duration of rest for 5 min, a baseline recording of HRV was carried out for 2 min; the volunteer participants were then exposed to music instrumental notes as we played the six audio clips for a duration of 3 min each, after a period of rest of 2 min after each exposure to musical sound of various musical instruments. The HRV recording reached the baseline level after 2 min of rest on each occasion. The different musical instrumental notes which were played were flute, piano, tabla drum, violin, sitar, and guitar. The tabla drum is a percussion type of musical instrument, while sitar is a string musical instrument commonly played in India and Asian subcontinent.[10] All of our participants were from same social, economic, and cultural background. Moreover, all our participants were ardent music listeners as a hobby, and none of them had any ritual or belief behind listening to any particular instruments. As cultural background of the participants being same, its effects on music and music preferences shall not be a confounding factor.


The HRV was recorded during rest, on exposure musical instrument note sounds, and during resting period after each musical instrument was being played as shown in [Figure 1]. The change (variation) of heart rate during short term (5 min) was analyzed with the method of frequency domain so as to ascertain the state of sympathovagal balance and activity of autonomic nervous system. The measurement and physiological interpretation of biosignal processing algorithms was conducted using Lab Chart Pro Software as recommended by “The European Society of Cardiology and The North American Society of Pacing and Electrophysiology 1996.“[9],[11] The HRV analysis was assessed by evaluating the cardiac autonomic modulation, and the same was quantified using frequency domain analysis. As music is a sphere based on fundamental principles of physics of the splitting of the intricate sounds into spectral frequencies and sound band width, frequency responses, phase shift, and resonant frequencies, the frequency domain analysis gives a better understanding than time domain analysis of the impact of these musical instrument sounds on HRV. The HRV analysis in the frequency domain was recorded for low frequency (LF: 0.04–0.15Hz) and high frequency (HF: 0.15–0.40Hz) spectral components, and measurements were reported in ms2. The spectral analysis was calculated using the fast Fourier transform algorithm. The changes in values of LF/HF and LF/HF ration every 30 s were noted during 90 s of stimulation to respective stimuli (music instrumental intervention) and total power (TP) were calculated. (Note: The LF band represents both the vagal and sympathetic tone. HF power represents vagal modulation of heart rate while the ratio of LF to HF power [LF/HF ratio] represents the sympathovagal balance. TP is represented as the sum of the energy in the very LF, LF, and HF bands for short-term recordings.)
Figure 1: Total power at rest and following different instrumental music

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Statistical analysis

All data were calculated from differences from average of 30 s rest period. The mean values of HRV parameters over the 90 s stimulation were analyzed using ANOVA for comparison among the various stimuli. The paired sample t-test was employed for statistical analysis to detect the cases in the respective HRV parameters. One-way ANOVA was applied to compare the differences of the frequency domain parameters of different instrumental musical instrument sounds. Our results were confirmed with post hoc analysis. The interpretation of our results was ascertained in consultation with a cardiologist.

  Results Top

One-way ANOVA shows statistically significant differences among different instruments for LF and TP [Table 1]. Post hoc analysis shows significant differences for LF values between rest and following flute as well as following flute and following tabla [Table 2]. Diagrammatic representation is given in [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6].
Table 1: Significant differences in heart rate variability values on playing different musical instruments

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Table 2: Post hoc analysis showed significant differences for low-frequency values

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Figure 2: Low frequency at rest and following different instrumental music

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Figure 3: High frequency at rest and following different instrumental music

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Figure 4: Low frequency: high frequency at rest and following different instrumental music

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Figure 5: Low frequency % at rest and following different instrumental music

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Figure 6: High frequency % at rest and following different instrumental music

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  Discussion Top

The autonomic nervous system serves as the final gateway by which music experts therapeutic effects on health and disease. HRV indexes through vagus the activity of prefrontal cortex and exerts an inhibitory over sympathetic subcortical circuits. Various research studies exploring impact of music on HRV found out that the music intervention has positive effect on HRV and boost immunity, reduces blood pressure and stress, and calms mind and body.[4],[5],[12] In our study protocol, we have exposed our volunteer individual to various musical instrumental sounds of wood wind instrument (flute), percussion instrument (tabla drum), string cum percussion instrument (piano), and string instrument (sitar, violin, and guitar). The perception, liking, and impact of these musical instrument note sounds may vary from person to person due to their preferences of liking for specific musical instrument note sounds.[13] The relaxation responses is governed and influenced by the pitch overtones, harmony, and timber of the sound produced by the instrument as well as the melody and rhythm of the music genesis.[14] The effects of various compositional musical instrument note sounds will have either excitatory or inhibitory effect on autonomic functions. Music affects human emotion and may produce elation and sense of joy and happiness or ever sadness and depression.[15],[16]

In our study, the wood pipe instrument as flute was found to increase LF, HF and TP on HRV and exhibited a parasympathetic influence of flute over autonomic nervous system. Increase in LF is statistically significant. In percussion instrument (tabla drum) and string instrument (violin), there was increased HF% but had no effect on TP in our study and was statistically not significant. Our findings were suggestive of increased parasympathetic drive on listening to tabla and violin. The piano which is percussion cum string instrument was found to lower LF% and increased TP and thereby reduced the sympathetic drive though these changes were statistically not significant. The soothing tone and timber of piano facilitate parasympathetic modulation of autonomic nervous system as the timber of piano can be well appreciated by listeners due to uniqueness in duration of note, the attack and release, the rations of even and odds partials, and attack time. These characteristics of piano have significant influence over mind and emotion. The loudness and pitch of piano along with its capability of accompanying to different degree of dynamic make it as a unique instrument to be enjoyed by the human mind. The string instruments sitar and guitar decreased HF% as increased the LF/HF ration value and the TP although these values were not found to be statistically significant, suggesting that there is a decreased parasympathetic drive after listening to sitar and guitar musical instrument note sound; thus, we observed that flute, piano, tabla, and violin enhanced parasympathetic drive while sitar and guitar were decreasing the parasympathetic drive in our volunteer participant.

This variation in study is suggestive of that the music affects individual psychologically and physiologically and this effect depends on the psyche, temperament, and liking of the individual.[16] Moreover, the melody and harmony of musical instrument note sound is determined by the pith, overtones rhythm, tempo, intensity, and smoothness of the sound being produced by the individual instrument. As these musical sounds are more logical, chronological, and predictable in nature, they produce a synchrony. The synchronization leads to harmony and these activities the arousal system of brain in case of high tempo, high pitch, and increasing overtone will excite the sympathetic autonomic nervous system, while in case of tranquilizing music, this may enhance the parasympathetic drive.[17],[18],[19] These facts have likely attributed to variation of effects of various musical instrument note sounds in terms of increase or decrease parasympathetic drive as observed in our study. Our findings regarding autonomic effects are in concurrence with few other studies, but those studies were limited to heavy metal instruments or piano or a music being played, but the name of musical instruments were not specified.[4],[5],[8],[19],[20] A study concluded on music and heart also observed that listening to musical beats of heavy metal music instrument has viscometer sympathetic effects in some individuals, while in few others, it is found to be stress reducing.[19] The meta-analysis conducted to study the effect of music therapy on blood pressure of individuals with hypertension also pointed the parasympathetic influence of music.

The variation and preference factor affecting impact on HRV in our study were ruled out since we included only those participants where were ardent listens of music and had adequate knowledge regarding the physics behind the musical note sound and were habitually listening to all the musical instrument employed by us in the study. The neurohormonal and neuroendocrine mechanisms, patency of corticohypothalamic circuits, and rote of auditory is cortex is vital in influencing the HRV.[5] The auditory perception of the pitch and timber of the musical instrument sound note are important to assess understand and enjoy their melodies and harmonies. The pitch is governed by the individual perception of musical melodies and harmonies while the timber which represents the sound quality helps us differentiate between different musical instrument and speech sound. The cortical strictures involved in perceiving the pitch is the right temporal lobe, while timber is decoded by the associated along the right temporal lobe, and cerebellum processes the rhythm of the music labile frontal lobes responsible for interpreting the emotional content of music.[21] Thus, the perception of music by auditory cortex, intracortical circuits to associated areas involved in appreciating the pitch and timber, corticohypothalamic circuits influencing autonomic nervous system are all involved in exerting the impact of musical instrument sound notes on human mind and body.

It is important to note that inspective of type of musical instrument the pitch, overtone, frequency, loudness, and timber depend on the lyrics for which the instrument is being played, and therefore, the characteristic effect on overtones, frequency, tempo, and timber can be modulated by the musical instrument players to produce stimulatory or depressive effects as observed in the study exploring psychophysiology of flow during piano playing.[20]

Hence, it is the characteristic of the musical instrument sound by the way it is being played along with auditory-motor interactions in music perception and production are factors exerting a excitatory or relaxing effect over autonomic responses such as HRV.[22]

Novelty of our study

Many studies have been carried out for assessing the effect of music on HRV. In most of these studies, the impact of a musical song or a specific musical instrument such as piano or drums have been employed in evaluating the effect of music on functions such as HRV. We in our study have introduced the ardent music listener participants to musical note sound of vacuous musical instrument such as wood pipe (flute), percussion (tabla drum), string (guitar, sitar, violin), and percussion cum string type (piano) in a single sitting so as to assess the best auditory stimuli impacting the autonomic function. The individual interpretation of study was informed to the particular participant so that he/she is aware of their best auditory perception of corticohypothalamic autonomic responses so that they can continue listening to those instruments whenever they are emotionally affected apart during their regular listening habits.

Limitation of our study

The smaller sample size is the limiting factor of the study and future studies with larger sample size shall be helpful to substantiate the autonomic effects of various instrumental music so that these can be part of music therapy in health and disease. The sample size of 18 participants was employed in our study as a sample of convenience, and moreover, our inclusion criterion of ardent music listeners having basic knowledge of physics of musical instrument sound with being accustomed to all musical instrument sound employed in our study was a limiting factor to recruit adequate participants meeting our criterion.

  Conclusion Top

Music modulates our autonomic nervous system to reduce anxiety and stress, elevate mood, regulate emotion, and facilitate parasympathetic response in our body. Its implication in daily life can be helpful for physical and mental stress relaxation and help cope with physical, psychological, and emotional challenges of life.

Ethical clearance

The present work was the preliminary findings of the approved project titled Institutional ethical committee registration no. 5/18 titled physiological effects of visual, tactile, olfactory and auditory stimuli on autonomic functions. We wished to identify the suitable auditory stimuli musical instrument sound / music which could be employed for recording HRV in our planned project and the presented initial preliminary findings for identification of auditory stimuli only are reflected herewith.


We would like to thank all from department of physiology for providing technical support during the work.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

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  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]

  [Table 1], [Table 2]


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