24 minutes: the right amount of 'tailor-made' music to deal with anxiety

Music becomes even more of a therapy for those suffering from anxiety disorders. Like a pharmacological cure, one must choose the treatment, so one must focus on targeted sounds. Then, the dosage must be correct. And if with the pill we take the milligrams of active ingredient that the doctor thinks will cure us, with exposure to the seven notes we must do the same, in terms of the duration of the stimulus. 24 minutes a day, those dealing with anxiety, seems to be the optimal dosage. Welcome to the age of digital therapies, real treatments with a scientific basis, even when it comes to psychological distress. Demonstrating, as if it were a drug, the efficacy and dosage of this cure made of notes and agreements is research co-ordinated by Danielle K. Mullen and Frank A. Russo. Mullen and Frank A. Russo of Toronto Metropolitan University (TMU) in collaboration with a digital therapy company born in the same university's ecosystem. The music was combined with rhythmic auditory stimulation, a technique that uses rhythmic sound patterns to act directly on brain activity. The study paves the way for a non-pharmacological treatment for anxiety, offering important information for future use of this approach, and appeared in PLOS Mental Health.

On the treatment front, today the approach to serious forms of anxiety is through medication and cognitive-behavioural therapy. Digital therapies set to music could therefore offer a cheaper and certainly easy alternative for those who have to manage their symptoms, as listening can be done at any time. The research looked at what happened in 144 adults with moderate anxiety already on medication to manage their symptoms, randomly divided into four groups. In the first one a pink noise was played as a control for 24 minutes, in the other three they listened to music with rhythmic auditory stimulation for different times, 12, 24 and 36 minutes respectively. Before and after the listening sessions, participants completed standardised assessments measuring anxiety levels and mood. The survey revealed a good 'cost-benefit' ratio with particularly significant positive effects in subjects exposed to the advanced 24-minute music therapy mode. In particular, listening to music with rhythmic auditory stimulation significantly reduced both cognitive and somatic symptoms of anxiety compared to the control group with pink noise, with improvements in mood.

'This study is interesting because it introduces a concept very familiar to medicine, that of the "dose", applied to a non-pharmacological intervention,' explains Claudio Mencacci, co-president of the Italian Society of NeuroPsychopharmacology. 'The idea that even a stimulus such as music can have an optimal exposure time, capable of modulating anxiety symptoms, is consistent with what we know about the functioning of the brain circuits involved in anxiety. Rhythmic auditory stimulation, in particular, seems to act on emotional and attentional regulation mechanisms, favouring a reduction in both cognitive symptoms, such as excessive worrying, and somatic symptoms. Of course, this is not an alternative to validated treatments, but a complementary tool that, if confirmed by further studies, could become part of an integrated approach to treatment'.

Further interesting data also emerged from the survey. Of the listening durations tested, the 24-minute session produced the greatest overall reduction in anxiety, with effects similar to those observed in the longer session but significantly greater than those of the 12-minute session. In practice, therefore, as with medication, a dose-response relationship was observed in which approximately 24 minutes of music with rhythmic auditory stimulation seems to represent the optimal duration. And above all, according to the experts, it is the 'convenience' in taking the treatment that could help. In fact, less than half an hour is required, without having to modify daily activities. and this could help, if this digital therapy goes ahead, adherence to treatment. "The figure of 24 minutes is particularly relevant because it suggests a threshold of effectiveness that is concrete and easily applicable in everyday life,' Mencacci concludes. 'In an area such as anxiety disorders, where adherence to treatment is often a critical issue, the possibility of flanking simple, accessible and low-cost interventions can make all the difference. Digital therapies, if supported by solid evidence, can expand the tools available to clinicians and individuals, making anxiety management more personalised and sustainable over time. The point, however, remains the same: to complement, not replace, within a structured care pathway'.