Binaural beats produced an overall medium, significant effect (g = 0.45) across 35 effect sizes from 22 studies on memory, attention, anxiety and pain perception (Garcia-Argibay et al., Psychological Research 2019), the most-cited quantitative estimate for an audio technique that now fills streaming playlists and meditation apps. Demand is real: the WHO counts 470 million people with an anxiety disorder in 2023, and only 27.6% of people in need receive any treatment. Yet the evidence is uneven: a 2023 PLOS ONE review found that only 5 of 14 studies supported the brainwave entrainment theory behind binaural beats, and the 2013 Cochrane review on music for pre-operative anxiety rated its evidence as low quality. This roundup separates what the trials measured from what the marketing claims, and builds on our broader sound therapy statistics. We aggregated data from the World Health Organization, the National Institute of Mental Health, the CDC National Center for Health Statistics, the American Psychological Association, the NIH National Center for Complementary and Integrative Health, Cochrane, and more than 15 peer-reviewed trials and systematic reviews.
TL;DR
- 470 million people (5.8% of the world) had an anxiety disorder in 2023; only 27.6% of those in need get any treatment (WHO, Anxiety disorders fact sheet).
- 19.1% of US adults had an anxiety disorder in the past year and 31.1% will in their lifetime (NIMH, NCS-R).
- 36.7% of US adults used a complementary health approach in 2022, up from 19.2% in 2002; meditation led at 17.3% (Nahin et al., JAMA 2024).
- Binaural beats: overall medium effect g = 0.45 across 22 studies (Garcia-Argibay et al., Psychological Research 2019).
- Only 5 of 14 EEG studies supported brainwave entrainment from binaural beats; 8 contradicted it (Ingendoh et al., PLOS ONE 2023).
- Pre-operative binaural beat audio cut anxiety scores by 26.3%, vs 11.1% for the same audio without beats (Padmanabhan et al., Anaesthesia 2005).
- After a singing bowl meditation, tension fell from 1.26 to 0.14 on the POMS-SF scale in 62 adults (Goldsby et al., 2017).
- A 2026 RCT of 100 adults found sound meditation lowered HADS-A anxiety by 2.55 points more than a music control (Ravikumar and Sathyanarayanan, Cureus 2026).
- Music therapy reduces anxiety with a medium effect, g = 0.357 across 51 studies and 3,276 participants (de Witte et al., eClinicalMedicine 2025).
- Music before surgery lowered STAI-S anxiety by 5.72 points vs standard care across 26 trials (Cochrane, Bradt et al. 2013).
- 62% of US adults call societal division a significant source of stress, and 54% felt isolated (APA, Stress in America 2025).
1. The Anxiety Burden Behind the Sound-Therapy Boom
Sound therapy is selling into one of the largest unmet needs in medicine. The WHO estimates that 470 million people had an anxiety disorder in 2023, 5.8% of the global population, and that only about 1 in 4 people in need (27.6%) receive any treatment (WHO, Anxiety disorders fact sheet). A treatment gap that wide pushes people toward low-cost, self-directed tools, and headphones plus a free playlist are about as low-cost as it gets.
The US numbers point the same way. An estimated 19.1% of US adults had any anxiety disorder in the past year and 31.1% will experience one in their lifetime, with women (23.4%) well ahead of men (14.3%) (NIMH, Any Anxiety Disorder). The CDC’s symptom screen found 15.6% of adults reporting at least mild anxiety symptoms in 2019, and 6.1% at moderate or severe levels that may signal a clinical condition (CDC NCHS, Data Brief 378). The prevalence picture is covered in depth in our anxiety statistics.
| Metric | Value | Source |
|---|---|---|
| People with an anxiety disorder worldwide, 2023 | 470 million (5.8% of population) | WHO, Anxiety disorders fact sheet |
| Share of people in need who receive any treatment | 27.6% (about 1 in 4) | WHO, citing World Mental Health Surveys (21 countries) |
| US adults with any anxiety disorder, past year | 19.1% (women 23.4%, men 14.3%) | NIMH, National Comorbidity Survey Replication |
| US adults, lifetime anxiety disorder | 31.1% | NIMH, National Comorbidity Survey Replication |
| US adolescents, lifetime anxiety disorder | 31.9% (8.3% with severe impairment) | NIMH, NCS Adolescent Supplement |
| US adults with any anxiety symptoms, 2019 | 15.6% (mild 9.5%, moderate 3.4%, severe 2.7%) | CDC NCHS, Data Brief 378 (NHIS 2019) |
| Moderate or severe symptoms, 2019 | 6.1% of adults | CDC NCHS, Data Brief 378 |
| Any anxiety symptoms, ages 18-29 vs 65+ | 19.5% vs 11.2% | CDC NCHS, Data Brief 378 |
Context note: the NIMH prevalence estimates come from the National Comorbidity Survey Replication fielded in 2001-2003 (most recent available data: NIMH, NCS-R). The CDC GAD-7 symptom data are from the 2019 National Health Interview Survey and measure symptoms, not diagnoses.
2. Self-Care Demand: Stress, Isolation and Complementary Health Use
The audience for sound baths and binaural playlists is not only people with a diagnosis. 36.7% of US adults used at least one complementary health approach in 2022, nearly double the 19.2% recorded in 2002, and meditation was the single most common practice at 17.3% (Nahin et al., JAMA 2024). Meditation and relaxation practice is the natural entry point for sound-based sessions, which often market themselves as meditation for people who cannot sit in silence; see our meditation statistics for the wider practice data.
Stress is the other driver. In the APA’s 2025 survey of 3,199 adults, 62% named societal division as a significant source of stress, 54% said they felt isolated from others, and among those stressed by division, 83% reported at least one physical symptom, with 42% feeling nervous or anxious (APA, Stress in America 2025). That mix of stress and loneliness is exactly the space where group sound baths sell a communal, low-commitment experience.
| Metric | Value | Source |
|---|---|---|
| US adults using any complementary health approach | 36.7% in 2022 vs 19.2% in 2002 | Nahin et al., JAMA 2024 (NHIS) |
| US adults practicing meditation, 2022 | 17.3% (highest of the approaches tracked) | Nahin et al., JAMA 2024 |
| US adults practicing yoga | 5.0% (2002), 9.0% (2012), 15.8% (2022) | Nahin et al., JAMA 2024 |
| Users of these approaches who used them for pain | 42.3% (2002) to 49.2% (2022) | Nahin et al., JAMA 2024 |
| Adults citing societal division as a significant stressor | 62% | APA, Stress in America 2025 (Harris Poll, n = 3,199) |
| Adults who felt isolated from others | 54% (50% felt left out) | APA, Stress in America 2025 |
| Physical symptoms among those stressed by division | 83% at least one; 42% nervous or anxious; 39% headaches | APA, Stress in America 2025 |
| Adults stressed by the rise of AI | 57% (up from 49%) | APA, Stress in America 2025 |
Context note: the NHIS complementary health module tracks yoga, meditation, massage, chiropractic, acupuncture, guided imagery and art or music therapy as a group; the JAMA paper reports no stand-alone figure for sound baths or binaural beats, so no national usage rate for them exists in federal data. The NHIS samples were 31,044 adults in 2002 and 27,651 in 2022.
3. Binaural Beats: What the Meta-Analyses Actually Show
The headline number for binaural beats is real but often misquoted. Garcia-Argibay and colleagues pooled 35 effect sizes from 22 studies and found an overall medium, significant effect of g = 0.45 (Psychological Research, 2019), but that estimate combines memory, attention, anxiety and pain outcomes, so it is not an anxiety-only effect size. The same paper found that masking the beats with white or pink noise made no difference and that longer exposure, and exposure before a task, worked better.
The mechanism is where the evidence wobbles. A 2023 systematic review of 14 EEG studies found 5 supporting the brainwave entrainment hypothesis, 8 contradicting it and 1 mixed, blaming methodological heterogeneity (Ingendoh et al., PLOS ONE 2023). A 2026 review of 13 theta-frequency RCTs (630 participants) could pool only pain outcomes (SMD = -0.53, low-certainty evidence) because anxiety measures were too varied to combine (Fatima et al., Explore 2026). The most rigorous recent trial tested music with auditory beat stimulation against pink noise in 144 adults with moderate trait anxiety: the 24-minute session cut cognitive anxiety with Cohen’s d = 0.72 (Mullen et al., PLOS Mental Health 2026). More background on the format is in our binaural beats statistics.
| Metric | Value | Source |
|---|---|---|
| Overall effect, cognition plus anxiety plus pain | g = 0.45 (35 effect sizes, 22 studies) | Garcia-Argibay et al., Psychological Research 2019 |
| EEG studies supporting brainwave entrainment | 5 of 14 (8 contradicting, 1 mixed) | Ingendoh et al., PLOS ONE 2023 |
| Theta binaural beat RCTs reviewed | 13 RCTs, 630 participants; anxiety not poolable | Fatima et al., Explore 2026 |
| Theta binaural beats vs control, pain | SMD = -0.53 (4 trials, n = 173, low certainty) | Fatima et al., Explore 2026 |
| Music with beat stimulation vs pink noise, cognitive anxiety | d = 0.45 (12 min), 0.72 (24 min), 0.50 (36 min) | Mullen et al., PLOS Mental Health 2026 |
| Same trial, negative affect | d = 0.97 at 36 min; 36 vs 12 min difference d = 0.55 (p = 0.024) | Mullen et al., PLOS Mental Health 2026 |
| 40 Hz binaural beats, healthy adults (n = 58) | No effect on self-rated anxiety or attention (p > 0.05) | Leistiko et al., Current Psychology 2023 |
| Binaural beats in Parkinson’s disease | No significant change in anxiety level | Galvez et al., International Journal of Neural Systems 2018 |
Context note: the Mullen trial ran entirely online, did not verify anxiety diagnoses and compared music plus beats against pink noise, so it cannot isolate the beats from the music. Garcia-Argibay 2019 is the most recent available broad meta-analysis; newer reviews are narrower.
4. Binaural Beats in Hospitals, Dental Chairs and Procedure Rooms
The strongest binaural beat signal comes from short, acute, stressful moments: waiting for surgery, a dental procedure or an endoscopy. In a 2005 randomized trial, binaural beat audio reduced pre-operative anxiety scores by 26.3%, against 11.1% for identical audio without the beats and 3.8% for no intervention (Padmanabhan et al., Anaesthesia 2005). The pattern repeats in later trials: in 112 bronchoscopy patients, STAI scores fell 7.26 points with binaural beat music, 3.92 with plain music and 1.12 with no music (Opartpunyasarn et al., Medicine 2022).
The music-versus-beats question is not settled. In 141 cataract patients, both music groups cut anxiety versus controls (P < 0.001), but the binaural group did not differ significantly from plain music (p = 0.085), though only it lowered heart rate (Wiwatwongwana et al., Eye 2016). In a 2025 periodontal surgery trial of 50 patients, STAI scores fell from 49.5 to 38.7 with 30 minutes of 6 Hz beats while controls rose from 45.6 to 49.5, but there was no sham-audio arm (Madhumitha et al., Journal of Indian Society of Periodontology 2025).
| Metric | Value | Source |
|---|---|---|
| Pre-operative anxiety reduction, day-case surgery | Binaural 26.3%; audio only 11.1%; control 3.8% | Padmanabhan et al., Anaesthesia 2005 |
| Bronchoscopy, STAI change (n = 112) | Binaural -7.26; plain music -3.92; no music -1.12 | Opartpunyasarn et al., Medicine 2022 |
| Cataract surgery, binaural vs plain music (n = 141) | No significant difference (p = 0.085); only binaural lowered heart rate | Wiwatwongwana et al., Eye 2016 |
| Periodontal surgery, STAI (n = 50) | Test 49.5 to 38.7; control 45.6 to 49.5 | Madhumitha et al., J Indian Soc Periodontol 2025 |
| Same trial, heart rate | Test 93.4 to 83.2 bpm; control 90.5 to 96.5 bpm | Madhumitha et al., J Indian Soc Periodontol 2025 |
| Spinal anaesthesia, STAI-6 (n = 108) | Binaural 7.8; noise cancelling 11.7; control 14.7 | Ligree et al., Indian Journal of Anaesthesia 2023 |
| Unsedated upper GI endoscopy (n = 96) | Lower state anxiety with binaural music (p = 0.016); no change in heart rate or blood pressure | Demirci and Sezer, J Integr Complement Med 2024 |
| Anxiety outpatients, psychiatry plus beat meditation (n = 8) | State anxiety -26.5% vs -8.4% psychiatry only | Yusim and Grigaitis, J Nerv Ment Dis 2020 |
Context note: almost all of these trials are single-center, small and unblinded to the listener, and several compare beats with silence rather than with the same music minus the beats. The 2020 psychiatric pilot had only 28 participants. Noise-cancelling headphones alone cut STAI-6 scores from 14.7 to 11.7 in the Ligree trial, a reminder that part of the effect may come from blocking out the operating room.
5. Sound Baths and Singing Bowls: Promising, Small, Mostly Uncontrolled
Sound baths have the thinnest evidence of any format in this roundup, and the most enthusiastic marketing. In the most-cited study, 62 adults reported tension falling from 1.26 to 0.14 on the POMS-SF scale after a 60-minute singing bowl meditation, with HADS anxiety dropping from 1.11 to 0.44 (Goldsby et al., Journal of Evidence-Based Complementary and Alternative Medicine 2017). It had no control group, 87% of participants already meditated, and first-timers saw larger drops in tension (1.29 points) than experienced participants (0.86).
The first randomized evidence is arriving. A 2025 review of 14 Tibetan singing bowl studies found 5 RCTs, 4 controlled quasi-experiments and 5 single-group designs, with samples of only 12 to 81 people, and judged the field too heterogeneous for a meta-analysis (Lin et al., Healthcare 2025). A 2026 RCT of 100 adults in India found four weeks of daily 60-minute sound meditation lowered HADS-A anxiety by 2.55 points and systolic blood pressure by 7.62 mmHg more than a remote music control, with full retention, though it was industry-funded and compared in-person sessions with online ones (Ravikumar and Sathyanarayanan, Cureus 2026).
| Metric | Value | Source |
|---|---|---|
| Tension, before vs after singing bowl meditation (n = 62) | 1.26 to 0.14 (eta squared .51) | Goldsby et al., 2017 |
| HADS anxiety, before vs after | 1.11 to 0.44 (eta squared .49) | Goldsby et al., 2017 |
| Tension drop, bowl-naive vs experienced | 1.29 vs 0.86 points | Goldsby et al., 2017 |
| Singing bowl studies in latest systematic review | 14 (5 RCTs), samples of 12 to 81 people, no meta-analysis | Lin et al., Healthcare 2025 |
| Peer-reviewed studies in the 2020 singing bowl review | 4 | Stanhope and Weinstein, Complementary Therapies in Medicine 2020 |
| Sound meditation vs music control, HADS-A (n = 100) | -2.55 points (95% CI -3.62 to -1.48; partial eta squared 0.19) | Ravikumar and Sathyanarayanan, Cureus 2026 |
| Same trial, cortisol and systolic blood pressure | -2.54 nmol/L; -7.62 mmHg | Ravikumar and Sathyanarayanan, Cureus 2026 |
| Gong sound sessions, participants (non-controlled) | 93 (62 highly sensitive persons, 31 controls) | Ponce-Valencia et al., Healthcare 2026 |
Context note: a 2026 lab study of 59 healthy adults found singing bowl sounds at 40, 73 and 110 Hz raised positive and lowered negative emotions in every room condition, but arousal rose during the first 15 minutes before falling until 40 minutes (Oomen et al., Frontiers in Cognition 2026). Short sessions may not show the full effect.
6. The Benchmark: Music Listening and Music Therapy
Music interventions are the best-studied sound therapy for anxiety, and they set a realistic ceiling for what binaural beats or bowls should be expected to beat. A 2025 multilevel meta-analysis of 51 studies and 3,276 participants found a medium overall anxiety effect for music therapy (g = 0.357), with self-reported anxiety at g = 0.410 and physiological measures at a non-significant g = 0.153 (de Witte et al., eClinicalMedicine 2025). Listening-based (receptive) methods (g = 0.417) beat active-only music making (g = 0.070), which is good news for anyone pressing play rather than picking up an instrument.
The surgical evidence is the deepest. The 2013 Cochrane review of 26 trials and 2,051 participants found music lowered pre-operative STAI-S anxiety by 5.72 points versus standard care, while rating the evidence low quality because listeners cannot be blinded (Bradt et al., Cochrane 2013). A 2025 umbrella review of 6 systematic reviews confirmed a 5.20-point drop and found sessions longer than 20 minutes worked best (Yang et al., BMC Anesthesiology 2025). The NIH’s integrative health center summarizes the field cautiously: much of the research is preliminary, so few definite conclusions have been reached (NCCIH, Music and Health). The clinical workforce behind these results is profiled in our music therapy statistics.
| Metric | Value | Source |
|---|---|---|
| Music therapy, overall anxiety effect | g = 0.357 (51 studies, 3,276 participants) | de Witte et al., eClinicalMedicine 2025 |
| Self-reported vs physiological anxiety | g = 0.410 vs g = 0.153 (not significant) | de Witte et al., eClinicalMedicine 2025 |
| Receptive vs active-only music therapy | g = 0.417 vs g = 0.070 | de Witte et al., eClinicalMedicine 2025 |
| Study quality in that meta-analysis | 23.5% strong, 37.3% moderate, 39.2% weak | de Witte et al., eClinicalMedicine 2025 |
| Music interventions on stress (104 RCTs, 9,617 people) | d = .380 physiological; d = .545 psychological | de Witte et al., Health Psychology Review 2020 |
| Pre-operative music vs standard care | STAI-S -5.72 points (26 trials, 2,051 participants) | Cochrane, Bradt et al. 2013 |
| Umbrella review, pre-operative anxiety | MD -5.20 (19 studies pooled, I2 = 49%) | Yang et al., BMC Anesthesiology 2025 |
| Session length effect | Over 20 min: -7.25; under 20 min: -2.95 | Yang et al., BMC Anesthesiology 2025 |
Context note: the 2022 meta-analysis of 47 music therapy studies (2,747 participants) found a larger effect on stress-related outcomes (d = .723), with bigger effects in non-randomized than in randomized trials, a classic sign of inflation in weaker designs (de Witte et al., Health Psychology Review 2022). In the 2025 meta-analysis, RCTs showed g = 0.413 while controlled clinical trials showed essentially none (g = -0.003).
Summary: Sound Therapy for Anxiety by the Numbers
| Metric | Value | Source |
|---|---|---|
| People with an anxiety disorder worldwide, 2023 | 470 million (5.8%) | WHO, Anxiety disorders fact sheet |
| People in need who receive treatment | 27.6% | WHO, Anxiety disorders fact sheet |
| US adults, past-year anxiety disorder | 19.1% | NIMH, NCS-R |
| US adults with anxiety symptoms, 2019 | 15.6% | CDC NCHS, Data Brief 378 |
| US adults using complementary health approaches, 2022 | 36.7% (19.2% in 2002) | Nahin et al., JAMA 2024 |
| US adults practicing meditation, 2022 | 17.3% | Nahin et al., JAMA 2024 |
| Adults who felt isolated | 54% | APA, Stress in America 2025 |
| Binaural beats, pooled effect across outcomes | g = 0.45 (22 studies) | Garcia-Argibay et al., Psychological Research 2019 |
| EEG studies supporting entrainment | 5 of 14 | Ingendoh et al., PLOS ONE 2023 |
| Music plus beat stimulation vs pink noise, cognitive anxiety | d = 0.72 (24 min) | Mullen et al., PLOS Mental Health 2026 |
| Pre-operative binaural beat anxiety reduction | 26.3% vs 11.1% audio only | Padmanabhan et al., Anaesthesia 2005 |
| Bronchoscopy STAI change, binaural vs plain music | -7.26 vs -3.92 | Opartpunyasarn et al., Medicine 2022 |
| Singing bowl meditation, tension | 1.26 to 0.14 | Goldsby et al., 2017 |
| Singing bowl studies, latest review | 14 (5 RCTs), no meta-analysis | Lin et al., Healthcare 2025 |
| Sound meditation RCT, HADS-A difference | -2.55 points | Ravikumar and Sathyanarayanan, Cureus 2026 |
| Music therapy, anxiety effect | g = 0.357 (51 studies) | de Witte et al., eClinicalMedicine 2025 |
| Physiological anxiety effect of music therapy | g = 0.153 (not significant) | de Witte et al., eClinicalMedicine 2025 |
| Pre-operative music, STAI-S reduction | -5.72 points (26 trials) | Cochrane, Bradt et al. 2013 |
| Music sessions over 20 min vs under 20 min | -7.25 vs -2.95 | Yang et al., BMC Anesthesiology 2025 |
Methodology and Sources
Every figure above was read during research for this article in an agency fact sheet, a federal data brief, a survey report, or the abstract or full text of a peer-reviewed paper (most via PubMed Central or the Europe PMC database). Effect sizes are reported exactly as published; we did not convert or combine them. Nothing here is medical advice, and none of the studies tested sound therapy as a replacement for treatment of an anxiety disorder.
- World Health Organization: Anxiety disorders fact sheet
- National Institute of Mental Health: Any Anxiety Disorder statistics
- CDC National Center for Health Statistics: Data Brief 378, Symptoms of Generalized Anxiety Disorder Among Adults, 2019
- Nahin, Rhee and Stussman: Use of Complementary Health Approaches Overall and for Pain Management by US Adults, JAMA 2024
- American Psychological Association: Stress in America 2025, A crisis of connection
- NIH National Center for Complementary and Integrative Health: Music and Health, What You Need To Know
- Garcia-Argibay, Santed and Reales: Efficacy of binaural auditory beats in cognition, anxiety, and pain perception: a meta-analysis, Psychological Research 2019 (DOI 10.1007/s00426-018-1066-8, read via the Europe PMC abstract record)
- Ingendoh, Posny and Heine: Binaural beats to entrain the brain? PLOS ONE 2023
- Mullen, Peng, Stewart, Mallik and Russo: Dose-response relationship between music and anxiety reduction, PLOS Mental Health 2026
- Madhumitha et al.: Binaural beats during periodontal flap surgery, Journal of Indian Society of Periodontology 2025
- Goldsby et al.: Effects of Singing Bowl Sound Meditation on Mood, Tension, and Well-being, 2017
- Lin, Yang and Wang: Effects of Tibetan Singing Bowl Intervention, Healthcare 2025
- Ravikumar and Sathyanarayanan: Sound-Based Meditative Intervention RCT, Cureus 2026
- de Witte et al.: Music therapy for the treatment of anxiety, eClinicalMedicine 2025
- Bradt, Dileo and Shim: Music interventions for preoperative anxiety, Cochrane Database of Systematic Reviews 2013
- Yang et al.: Music intervention as a strategy to reduce preoperative anxiety: an umbrella review, BMC Anesthesiology 2025
- Trial abstracts read via Europe PMC: Padmanabhan et al. (Anaesthesia 2005), Wiwatwongwana et al. (Eye 2016), Yusim and Grigaitis (J Nerv Ment Dis 2020), Opartpunyasarn et al. (Medicine 2022), Ligree et al. (Indian J Anaesth 2023), Leistiko et al. (Current Psychology 2023), Demirci and Sezer (J Integr Complement Med 2024), Galvez et al. (Int J Neural Syst 2018), Fatima et al. (Explore 2026), Stanhope and Weinstein (Complementary Therapies in Medicine 2020), de Witte et al. (Health Psychology Review 2020 and 2022), Oomen et al. (Frontiers in Cognition 2026), Ponce-Valencia et al. (Healthcare 2026)
- Data watch: The Garcia-Argibay g = 0.45 pools memory, attention, anxiety and pain outcomes; we could not access the paywalled full text for an anxiety-only subgroup estimate, so none is quoted. NIMH prevalence figures date from the 2001-2003 NCS-R and CDC symptom data from 2019 (most recent available data for both); WHO cites 470 million cases for 2023, while the 2026 Mullen paper still cites the older figure of 301 million in 2019. The Padmanabhan abstract gives percent reductions but its PubMed page did not load, so per-group sample sizes are not reported here. The Madhumitha abstract lists a baseline of 49 while the full text reports 49.5; we use the full text. The 2026 sound meditation RCT was funded by UNS Digital Technologies and compared in-person sessions with an online control. Most binaural beat trials compare beats with silence or no intervention, not with identical music minus the beats, and listeners are rarely blinded; the Cochrane review rated music evidence low quality for that reason. No federal survey reports usage of sound baths or binaural beats specifically, so we report no adoption rate for them, and we found no market-size estimate for sound therapy from a firm that discloses its methodology.
Last updated: October 3, 2026. We update this roundup quarterly, and the next refresh is expected when the APA publishes its Stress in America 2026 survey and the results of the registered Canadian RCT of music with auditory beat stimulation in anxious students (BMJ Open protocol, 2025) are published.