2018 IEEE Asia Pacific Conference on Circuits and Systems
Study of Music Effect on Mental Stress Relief
Based on Heart Rate Variability
Maya Chennafi, Muhammad Adeel Khan, Gang Li, Yong Lian, IEEE Fellow, and Guoxing Wang,
Senior Member, IEEE
Abstract—In the modern era, mobile device and cloud database
have become ubiquitous which provides unprecedented
opportunity for psychologists and neuroscientists to develop
personalized music therapy for mental stress relief. However few
of studies go further to compare the effect of different music
genres and the timing of listening to music on stress relief, and
none uniquely integrates heart rate variability (HRV)-based
physiological evidence together. Therefore, this study aims to
analyze the impact of different music types (classic vs self-selected
relaxing music) as well as timing of listening to music (before vs
during vs after stress stimulus tasks) on HRV evidence-based
stress recovery. Forty-eight healthy young males were randomly
assigned to either preferred relaxing music or classic music group
or control group (rest in silence). HRV parameters in time and
frequency domain as well as self-reported stress scores were
assessed. Results show that the averaged stress score in classic
group is slightly lower (no statistical difference) than that in
personal preferred music group, while both HRV time and
frequency parameters were significantly different between the two
genres. These results not only reveal that classic music is more
effective than personalized relaxing music, but also indicate that
physiological parameters are able to provide much more richer
emotional information if compared to pure subjective assessment.
Regarding the timing of listening to music, there is no mutually
statistical difference, indicating that listening to music before,
during and after the stressful events has a similar relief effect.
Index Terms— Classic Music, Heart Rate Variability, Preferred
Relaxing Music, Stress Recovery.
I. INTRODUCTION
D UE to the detrimental impact of stress on health, many
researchers are committed to develop diverse stress relief
therapies [1], [2], [3], and [4]. Among them, the music is the
commonly-used one. For example, several studies stated that
music therapy reduces pain, improves mood disturbance,
relieves anxiety and alleviates panic for patients who are under
cardiac care, suffering from cancer [5], and relieves from stress
in patients waiting for surgery [6], [7], as well as in healthy
population [8], [9], [10], and [11].
Regarding to the music genre used, while classic music has
been the widely-used one due to its high degree of accessibility
[10], the self-selected music is emerging and has gained
increasing attention with the rapid development of smart mobile
Manuscript received June 11, 2018. This research is sponsored by Shanghai
Sailing Program under Grant 17YF1426900.
Maya Chennafi, Muhammad Adeel khan, Yong Lian, Gang. Li, and Guoxing.
Wang are with the Department of Micro/Nano Electronic Engineering, Shanghai
Jiao Tong University, Shanghai, 200240, China (*corresponding author: Gang. Li;
e-mail: rivermandy@sjtu.edu.cn, lixiaogang110217@hotmail.com).
978-1-5386-8240-1/18/$31.00 ©2018 IEEE
devices and music cloud database [12]. Therefore, the
comparative study across classic music-based “one-size-fit-all”
therapies and self-selected music-based personalized therapies
would be interesting and necessary. However, few studies
focused on this topic and conclusions are also less consistent.
For instance, Prof Elise Labbé conducted a comparative study
[1], where classic music, self-selected relaxing music and heavy
metal were used. Results have shown that participants listening
to self-selected relaxing music experienced the lowest heart rate
(HR) and stress ratings. On the contrary, a research conducted
by Prof Jason L. Burns found that participants listening to
classic music had the lowest HR compared to participants
listening to their own believed relaxing musical pieces [13].
It is believed that a combined music-HR methodology is
superior to pure self-rating approaches, providing much more
precise and deeper insights of the correlates of stress and music.
However, it is important to note that studying stress recovery
requires to take into account heart rate variability (HRV) indices
as HR alone does not give detailed and clear understanding of
the emotional states experienced by a person [14]. HRV are
defined as the variation of the beat-to-beat interval, which can
be easily derived from electrocardiograph (ECG) and used as
indicators of the responses of the autonomic nervous system
(ANS) to different stimulus [15], [16], [17], and [18], since the
ANS is subject to the sympathetic nervous system (SNS) and the
parasympathetic nervous system (PNS). Numerous studies have
confirmed that HRV-based methods are able to recognize
human mental stress [15], [16], [19], and [17]. Several studies
have shown that HRV is a more accurate predictor than HR to
evaluate stress [14]. Also, few studies further argued that it is
more sensitive to evaluate mental stress if compared to blood
pressure [16] & galvanic skin response [20]. Thus, a combined
music-HRV method is used to explore the different effects of
classic and preferred music on stress relief. Additionally, from
the point of view of “early-detection and early-treatment”, we
believe that the timing of listening to music might play an
important role in stress recovery. However, unfortunately, most
of the aforementioned studies did not play music until the stress
session had ended. Only one work reported that playing music
before the stress leaded to a better recovery [10].
Therefore, the aim of this study is to explore two essential
factors in the design of music therapy for stress relief: the music
type (i.e. self-selected relaxing music and classic music) and the
timing of listening to music (i.e. before, during and after the
stress) and uniquely leverage HRV metrics as an objective
measures.
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 II. METHODS
Participants recruitment and study design
Forty-eight healthy young males aged between 18 and 26
years old (22.92 ±1.91), have a BMI (body mass index) between
18.8 and 24.7 kg/m2 (22.01 ±1.56), and low caffeine and alcohol
intake habit (3.5 ± 8.5 and 1.5 ± 4.5 times per month,
respectively) were recruited from Minhang campus, Shanghai
Jiao Tong University (SJTU). Females were excluded to
prevent biasing effect on the HRV response in either baseline
measurement [17], [23] or stimulus (stress) induction [10] and
music listening [11]. All participants were paid 100 RMB
(Chinese currency) for their participation and have given their
written informed consent before participation.
Overall, two independent between-group variables (IVs), the
musical genre – classic and preferred relaxing music– and
timing of listening to music – listening to music before, during
and after the stress induction task–, and one dependent variable
(DV) – HRV-based stress recovery or self-reported stress
recovery – were designed in this single-blinded experiment that
the participants did not know the study purpose. The influence
of the two IVs on DV was analyzed by classic statistic approach.
According to the structure of 2×3 elements of the IVs, six
groups, as shown in Table I, are further designed. All
participants (48 in total) were randomly assigned to the six
groups, eight participants per group, where CM, SSM, R, NM
stand for classic music, self-selected relaxing music, rest in
silence, no music, respectively. Fig. 1 shows the diagram of the
allocation and stimulus process.
The experiment was 1-hour long for each participant and
conducted at daytime. The STAI-Y1 was measured at the end of
every stage of the experiment to assess the participants’ stress
level. Participants assigned to classic music listened to “Chopin
Nocturne Op 9 No 1 & 2” as used in previous related research
[8], while participants assigned to the self-selected music
groups were requested to use their mobile devices to store at
least 15-minute long musical pieces that they usually listen to
when they want to relax. The chosen musical pieces were
required to be soft, relaxing and lyrics-free style.
The STAI-Y1 was created by Spielberg with the aim of
assessing the instantaneous anxiety perception of a person. It
includes 20 statements of positive and negative feelings that
have to be rated on a scale of 4 (ranging from Not At All to Very
Much So). The higher is the anxiety score the more stressed the
person perceives the situation.
III. ECG PREPROCESSING AND FEATURES EXTRACTION
After data recording, offline processing was performed using
MATLAB® (Mathworks, Natick, MA, USA). First a band pass
TABLE I
Group Design
Group
1 2 3 4 5 6
Stage
Pre-stress CM SSM R R R R
Stress NM NM CM SSM NM NM
Recovery R R R R CM SSM
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Fig. 1. Diagram of the process through the phases of allocation and stress
stimulus. SCWT- Stroop Color Word Task, MAT- Mental Arithmetic Task
filter with cutoff frequencies at 0.5 and 20 Hz is used. The
QRS-ECG peak’s frequency range is between 8-20 Hz, which is
our point of interest. Then, an FFT (Fast Fourier Transform)
spectrum is applied in order to locate the frequency ranges of
the present noise in the signals. We have applied several Notch
filters with cutoff frequencies of 25Hz, 50Hz and 75Hz to the
signal. Further, we used polynomial fitting and high pass filter
with cutoff frequency of 0.6Hz to detrend the signal and remove
the Baseline Wander (BW) respectively. Finally, the data that
was completely damaged by motion noise was deleted.
The HRV measures in time domain (Mean RR-Mean inter
beat intervals, SDNN-Standard Deviation of RR intervals, and
RMSSD-Root Mean Square of the Successive Differences) as
well as frequency domain (LF: 0.04-0.15Hz and HF:
0.15-0.4Hz) were obtained by Kubios-HRV software version
3.0 (Kubios, Kuopio, Finland) from ECG signals that were
acquisitioned by our lab-made single-channel device. The ECG
active electrode was placed on the wrist. The reference and
ground electrodes were placed behind the ears of the
participant, respectively. The active electrode is widely-used
clinical metal wrist clip, both reference and ground electrode
are disposable Ag/AgCl patch electrode.
Statistical Analysis
First of all, one-way ANOVA was used to verify the
effectiveness of music on stress recovery (music group
(CM+SSM) vs control group (R group)). Then, according to our
study design, the two-way ANOVA was used to explore the
effect of the two IVs (music type and timing of listening to
music) on single DV (HRV-based or self-reported stress
recovery) respectively. For all statistical analyses, results were
considered significant at p ≤ 0.05 level [15].
IV. RESULTS
A. HRV analysis
Regarding music genre, Fig. 1(a), shows that Mean RR of
participants in classic and preferred music is significantly
higher than that in control group with F (3.46) = 3.85, p = .037
indicating that participants listening to music expressed a better
recovery. Fig. 1(b) shows the HF power of the above mentioned
groups. It is clear that HF component is higher in music groups
compared to silence group suggesting a better recovery. Mean
RR showed a significant difference. SDNN, RMSSD and HF
power were observed to be higher in music groups compared to
silence, however there is no significant difference (all p > .05).
Two-way ANOVA shows that there is a significant
difference in the main effect music type across HRV time and
frequency domain parameters. Fig. 2(a) shows that participants
allocated to classic music group experienced a significantly
higher Mean RR, F (4.073) = 9.26, p < 0.01, compared to the
groups allocated to preferred relaxing music. The same pattern
was observed for the SDNN and RMSSD with F (4.07) = 9.30,
p < 0.01 and F (4.07) = 6.09, p = 0.01, respectively (not shown
in the figure). Further, Fig. 2(b) illustrates the HF power that
appeared to be significantly higher in participants listening to
classic compared to participants listening to the music they
believed was relaxing, F (4.07) = 4.35, p = 0.04, indicating that
the PSNS was dominating the body and allowing the body to
function in a rest state. However, even though LF power
appeared to be lower in participants listening to their preferred
relaxing music, no significant difference was observed, F (4.07)
= 3.21, p > 0.05, indicating that the effect of personalized music
on SNS’s inactivation was not prominent. These results are
consistent with [22], that classic music is more effective for
mental stress recovery if compared to self-selected music.
With respect to timing of listening to music, Fig. 3(a) shows
that RMSSD is higher for the participants listening to music
after the stress task. The same pattern is observed in Fig. 3(b)
for HF power, indicating that listening to music after the
stressful situation leads to better recovery. However, no
significant difference was observed in all the above mentioned
parameters (F (3.21) = 1.62, p = 0.21 and F (3.21) = 1.34, p =
0.27, respectively). In contrast, Mean RR and SDNN showed
higher values for participants listening to music before the stress
test (not shown) with no significant difference (F (3.21) = 0.13,
p = 0.87 and F (3.21) = 0.5, p = 0.6, respectively). This might be
due to the effect of both branches of the ANS on HRV. In
addition, no significant interaction music type ×time of listening
to music was observed for all the above mentioned parameters.

Fig. 1. HRV time and frequency domain parameters and STAI-Y1 ratings scores during Recovery stage of CM vs SSM vs R (silence). (a) Mean RR- Mean Inter
beat Intervals expressed in milliseconds (ms), (b) HF- High Frequency power expressed in milliseconds squared (ms2), and (c) Mean scores of stress ratings.
Error bars reflect the standard error of the mean.

Fig. 2. HRV time and frequency domain parameters and STAI-Y1 ratings grouped by main effect music genre during Recovery stage. (a) Mean RR- Mean
Inter beat Intervals expressed in milliseconds (ms), (b) HF- high frequency power expressed in milliseconds squared (ms2), (c) Mean scores of stress ratings.

Fig. 3. HRV time and frequency domain and STAI-Y1 ratings parameters grouped by Main Effect Time of Listening to Music during Recovery stage. (a)
RMSSD- Root mean square of successive differences in ms, (b) HF- high frequency power expressed in milliseconds squared (ms2), and (c) Mean scores of
stress ratings. Before, during and after stand for : listening to music before the stress test, listening to music during the stress test, and listening to music after
the stress test.

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 B. Stress Scores
Considering the stress rating scores, no significant differences
were found for both music type and time of listening to music
(Fig.2 and Fig.3 (c)), however we can see clear that the scores in
music groups are much lower than non-music group as shown in
Fig. 1(c), indicating the effectiveness of the music on stress
recovery. More importantly, based on our results on HRV
analysis, we can draw a conclusion that physiological
parameters are able to provide richer emotional information if
compared to pure subjective assessment.
V. DISCUSSION
In this study, by leveraging HRV metrics, we studied two
critical design elements on music therapy: music genre and the
timing of listening to music, with an attempt to lay the
foundation of the development of a better approach for stress
relief.
Both subjective (self-reported stress scores) and objective
measures (HRV metrics) show that listening to classic music
leads to a better recovery in comparison with listening to our
preferred relaxing music. A possible explanation behind this
result is that preferred relaxing music delays cardiovascular
recovery due to its emotional impact on the person. This
reasoning is, to some extent, supported by [24] which found that
people performing an emotional task after a stressor did not
recover whereas people who experienced non-emotional task
recovered. Therefore, since self-selected pieces are related to
one’s preference and feelings, we can presume that self-selected
relaxing music has an emotional impact and thus, delays the
recovery process.
Regarding the timing of listening to music, despite there was
not a statistically significant difference on the effect of stress
recovery, we can see clearly from Fig. 3 (c) that listening to
music before the stress stimulus tasks obtained the lowest stress
scores. Additionally, with regards to HRV parameters, Mean
RR and SDNN showed that listening to music prior a stressor
engenders a better recovery, whereas HF power and RMSSD
revealed that the best timing of listening to music is after the
stress test. This inconsistent result is worthy of deeper
multi-modal investigation that integrates HRV with
electroencephalogram technology together.
REFERENCES
[1] Labbé, Elise, Nicholas Schmidt, Jonathan Babin, and Martha Pharr.
"Coping with stress: the effectiveness of different types of
music." Applied psychophysiology and biofeedback 32, no. 3-4 (2007):
163-168.
[2] Jeong, Incheol, Sukhwan Jun, Sungjun Park, Sango Jung, Taemin Shin,
and Hyungro Yoon. "A research for evaluation on stress change via
thermotherapy and massage." In Engineering in Medicine and Biology
Society, 2008. EMBS 2008. 30th Annual International Conference of the
IEEE, pp. 4820-4823. IEEE, 2008.
[3] Hansmann, Ralf, Stella-Maria Hug, and Klaus Seeland. "Restoration and
stress relief through physical activities in forests and parks." Urban
forestry & urban greening 6, no. 4 (2007): 213-225.
[4] Gura, Shira Taylor. "Yoga for stress reduction and injury prevention at
work." Work 19, no. 1 (2002): 3-7.
[5] Olivia Swedberg Yinger. Chapter 7 - Music Therapy in Gerontology,
“Music Therapy: Research and Evidence-Based Practice”. Elsevier,
2018, p. 95-110.
134
[6] Lee, Kwo-Chen, Yu-Huei Chao, Jia-Jean Yiin, Hsin-Yi Hsieh, Wen-Jan
Dai, and Yann-Fen Chao. "Evidence that music listening reduces
preoperative patients’ anxiety." Biological research for nursing 14, no. 1
(2012): 78-84.
[7] Chiu, Hung Wen, L. S. Lin, M. C. Kuo, H. S. Chiang, and Chung-Yi Hsu.
"Using heart rate variability analysis to assess the effect of music therapy
on anxiety reduction of patients." In Computers in Cardiology, 2003, pp.
469-472. IEEE, 2003
[8] Harada, Toshihide, Fumiko Ishizaki, Shoji Ito, Satomi Aoi, Marina
Miyaguchi, Hiromi Ikeda, Yumiko Nitta et al. "Study of Objective
Evaluation of Effect of Psychological Relaxation Using Classic
Music." International Medical Journal 24, no. 1 (2017): 31-33.
[9] de la Torre-Luque, Alejandro, Rafael A. Caparros-Gonzalez, Teresa
Bastard, Francisco J. Vico, and Gualberto Buela-Casal. "Acute stress
recovery through listening to Melomics relaxing music: a randomized
controlled trial." Nordic Journal of Music Therapy 26, no. 2 (2017):
124-141.
[10] Thoma, Myriam V., Roberto La Marca, Rebecca Brönnimann, Linda
Finkel, Ulrike Ehlert, and Urs M. Nater. "The effect of music on the
human stress response." PloS one 8, no. 8 (2013): e70156.
[11] De la Torre-Luque, Alejandro, Carolina Díaz-Piedra, and Gualberto
Buela-Casal. "Effects of preferred relaxing music after acute stress
exposure: A randomized controlled trial." Psychology of Music 45, no. 6
(2017): 795-813.
[12] Bakker, David, Nikolaos Kazantzis, Debra Rickwood, and Nikki
Rickard. "Mental health smartphone apps: review and evidence-based
recommendations for future developments." JMIR mental health 3, no. 1
(2016).
[13] Burns, Jason L., Elise Labbé, Brooke Arke, Kirsten Capeless, Bret
Cooksey, Angel Steadman, and Chris Gonzales. "The effects of different
types of music on perceived and physiological measures of
stress." Journal of music therapy 39, no. 2 (2002): 101-116.
[14] Camm, A. John, Marek Malik, J. T. Bigger, Günter Breithardt, Sergio
Cerutti, Richard J. Cohen, Philippe Coumel et al. "Heart rate variability.
Standards of measurement, physiological interpretation, and clinical
use." European heart journal 17, no. 3 (1996): 354-381.
[15] Castaldo, Rossana, Paolo Melillo, Umberto Bracale, M. Caserta, Maria
Triassi, and Leandro Pecchia. "Acute mental stress assessment via short
term HRV analysis in healthy adults: A systematic review with
meta-analysis." Biomedical Signal Processing and Control 18 (2015):
370-377.
[16] Hjortskov, Nis, Dag Rissén, Anne Katrine Blangsted, Nils Fallentin, Ulf
Lundberg, and Karen Søgaard. "The effect of mental stress on heart rate
variability and blood pressure during computer work." European journal
of applied physiology 92, no. 1-2 (2004): 84-89.
[17] ChuDuc, Hoang, Kien NguyenPhan, and Dung NguyenViet. "A review of
heart rate variability and its applications." APCBEE procedia 7 (2013):
80-85.
[18] Acharya, U. Rajendra, K. Paul Joseph, Natarajan Kannathal, Choo Min
Lim, and Jasjit S. Suri. "Heart rate variability: a review." Medical and
biological engineering and computing 44, no. 12 (2006): 1031-1051.
[19] MEDICA-TORINO, EDIZIONI MINERVA. "Effects of anxiety due to
mental stress on heart rate variability in healthy subjects." Minerva
Psichiatr 52 (2011): 227-31.
[20] Fernandes, Atlee, Rakesh Helawar, R. Lokesh, Tushar Tari, and Ashwini
V. Shahapurkar. "Determination of stress using blood pressure and
galvanic skin response." In Communication and Network Technologies
(ICCNT), 2014 International Conference on, pp. 165-168. IEEE, 2014.
[21] Spielberger, Charles D. State‐Trait anxiety inventory. John Wiley &
Sons, Inc., 2010.
[22] Latha, Radhakrishnan, Srinivasan Srikanth, Hariraj Sairaman, and Nissi
Roja Edmand Dity. "Effect of music on heart rate variability and stress in
medical students." International Journal of Clinical and Experimental
Physiology 1, no. 2 (2014): 131.
[23] Stein, Phyllis K., Robert E. Kleiger, and Jeffrey N. Rottman. "Differing
effects of age on heart rate variability in men and women." American
Journal of Cardiology 80, no. 3 (1997): 302-305.
[24] Glynn, Laura M., Nicholas Christenfeld, and William Gerin. "The role of
rumination in recovery from reactivity: Cardiovascular consequences of
emotional states." Psychosomatic medicine 64, no. 5 (2002): 714-726.