Classical beats and white noise: Unveiling the effect of different music characteristics on heart rate variability

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Healthy participants (n=242). Intervention: Classical music and white noise vs. Electronic, rock, and personal music. Primary outcome: Heart rate variability (RMSSD) (Regression coefficient 1.517, 95% CI 0.191-2.844, p=0.025).

Q: What does this research mean for the field?

While slow classical music significantly increases heart rate variability compared to electronic or personal music, white noise produces the greatest increase in heart rate variability across all metrics. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Shari Pepplinkhuizen; Nicole J. van Steijn; E. Madelief Marsman; Sanne ten Berg; Lucas M. de Haas; Pieter Kleer; I. Tarik Küçük; Kay Lamerigts; Astrid van Nieuwkerk; Jolien A. de Veld; Jos Twisk; Puck J. Peltenburg; T J Van Trier; Michiel M. Winter

doi:10.1016/j.ctim.2025.103288

October 31, 2025Complementary Therapies in MedicineOpen Access

Classical beats and white noise: Unveiling the effect of different music characteristics on heart rate variability

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Key result

Classical music increases HRV compared to electronic music, though white noise produces the highest variability.

Regression coefficient 1.517
95% CI 0.191-2.844
P=0.025
n=242

Graphical abstract published by Complementary Therapies in Medicine — Graphical abstract · Published by Complementary Therapies in Medicine · CC BY-NC-ND 4.0

Why the study?

Although music can enhance heart rate variability, which is linked to morbidity and mortality, it remains unclear which music characteristics are most effective.

Does listening to different music genres, tempos, and white noise improve heart rate variability in a general population?

Key Points

To evaluate the influence of music genre, white noise, tempo, and personal preference on heart rate variability.
Conducted a single-blind, randomised, within-subject trial in N=242 participants without atrial fibrillation or pacemakers, who listened to 3-minute clips of white noise and four music genres (classical, rock, electronic, and personal preference).
Randomised participants to either a slow tempo group (n = 117, 48 %) or a fast tempo group (n = 125, 52 %), recording heartbeat intervals with a smartwatch photoplethysmography sensor.
Evaluated heart rate variability metrics using a general linear mixed model adjusted for heart rate, sex, age, tempo, alcohol, drug use, and sleep duration.
Listening to white noise produced the highest heart rate variability across all measured metrics (SDNN, RMSSD, LF, and HF) compared with all musical genres.
Classical music produced higher RMSSD than electronic music (regression coefficient = 1.517, P = 0.025, 95% CI [0.191–2.844]) and personal music (regression coefficient = 1.523, P = 0.030, 95% CI [0.152–2.894]).
Tempo interacted significantly with genre for RMSSD (regression coefficient = 2.766, p = 0.047, 95% CI [0.037–5.495]), driven by slow classical music outperforming slow personal music (regression coefficient = 2.917, p = 0.003, 95% CI [0.985–4.848]).

Study Design

Type

RCT (n=242)

Blinding

Single-blind

Randomization

Randomized

Multicenter

No

Structured PICO

Does listening to different music genres, tempos, and white noise improve heart rate variability in a general population?

P

Population

242 participants from the general public at a music festival (Lowlands, the Netherlands), median age 28, 56.2% female. Exclusion criteria: self-reported hearing impairment, permanent atrial fibrillation, or pacemaker dependency.

I

Intervention

Listening to 3-minute fragments of white noise and four music genres (classical, rock, electronic, and personal music) via active noise-cancelling headphones. Participants were randomized to a slow tempo group (70-95 BPM) or a fast tempo group (120-140 BPM).

C

Comparator

Within-subject comparison across the different music genres and white noise (which was intended as a baseline measurement).

O

Outcome

Heart rate variability (HRV) metrics including standard deviation of normal-to-normal intervals (SDNN), root mean square of successive differences (RMSSD), low-frequency power (LF), and high-frequency power (HF), calculated using the last two minutes of each 3-minute measurement.surrogate

Main Result

Effect estimate: Regression coefficient 1.517 (95% CI 0.191-2.844)

p-value: p=0.025

White noise and slow classical music significantly enhance heart rate variability compared to other music genres, suggesting potential simple therapeutic interventions for autonomic modulation.

Limitations

Sleep deprivation during the three-day festival could reduce HRV
High number of self-reported intoxications with coffee, alcohol, and recreational drugs
White noise was always presented first rather than in a randomized order, potentially introducing an onset effect bias
HRV was assessed using beat-to-beat intervals based on pulse oximetry rather than an electrocardiogram
No correction for multiple testing was applied
High-energy festival environment could reduce HRV in participants
High number of self-reported intoxications (coffee, alcohol, recreational drugs) without objective verification
White noise was always presented first rather than in a randomised order, potentially introducing an onset effect bias
HRV assessed using beat-to-beat intervals based on pulse oximetry rather than an electrocardiogram, potentially missing arrhythmias

Implication

Supports white noise or classical music for HRV enhancement now; extends randomized evidence for non-pharmacologic autonomic modulation.

Abstract

AIMS: Low heart rate variability (HRV) is associated with increased morbidity and mortality in various health conditions. Music can enhance HRV, but it remains unclear which music characteristics are most effective. This study aimed to assess the impact of music genre, white noise, tempo, and personal music preferences on HRV. METHODS: In this single-blind, randomised, within-subject study, participants without atrial fibrillation or pacemaker dependency listened to three-minute fragments of white noise and four music genres (classical, rock, electronic and a personal music) in random order. Participants were randomised to a slow or fast tempo group. Heart beats were recorded using a smartwatch containing a photoplethysmography (PPG) sensor; non-sinus beats were excluded using a custom algorithm. HRV was analysed using a general linear mixed model adjusted for heart rate, sex, age and tempo, with interaction analysis for tempo effects. RESULTS: A total of 242 participants were included. White noise was associated with the highest HRV across all tested metrics: standard deviation of normal-to-normal intervals (SDNN), root mean square of successive differences (RMSSD), low-frequency power (LF), and high-frequency power (HF). Furthermore, HRV (RMSSD) was higher during classical music compared to electronic and personal music (P = 0.025 and P = 0.030). Interaction analysis showed the latter was due to differences only in slow music tempo. CONCLUSION: Slow, classical music enhances HRV more than electronic or personal music, suggesting its therapeutic potential. Remarkably, white noise showed the greatest increase in HRV compared to all music genres, possibly due to its consistent and monotonous sound characteristics inducing a relaxation response and increased parasympathetic activity.

Discussion

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Cite This Study

Pepplinkhuizen et al. (2025) conducted an RCT in Healthy participants (n=242). Classical music and white noise vs. Electronic, rock, and personal music was evaluated on Heart rate variability (RMSSD) (Regression coefficient 1.517, 95% CI 0.191-2.844, p=0.025). Classical music significantly increased heart rate variability (RMSSD) compared to electronic music (regression coefficient 1.517), although white noise produced the highest variability across all metrics.

synapsesocial.com/papers/6a1758b43275b64d0e6e892b https://doi.org/10.1016/j.ctim.2025.103288

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Classical beats and white noise: Unveiling the effect of different music characteristics on heart rate variability

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Classical beats and white noise: Unveiling the effect of different music characteristics on heart rate variability

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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