Effect of binaural beats on pain, anxiety, and procedure tolerance in patients undergoing colonoscopy without sedation: A randomized controlled trial

Authors

Selim Demirci, Semih Sezer, Ferdane Pirinççi Sapmaz
https://doi.org/10.18621/eurj.1604977
Objectives: This study aimed to investigate the effect of binaural beats on pain, anxiety,and tolerance during colonoscopy of patients without sedation.
Methods: This is a prospective, randomized, controlled, single-blind procedural study that included 92 Turkish patients who underwent colonoscopy. The patients were randomly divided into two groups: the binaural beat music group (n=46) and the control group (n=46). The binaural music group was subjected to music through headphones during the colonoscopy, while the control group was provided headphones without music. The anxiety levels were measured using a Visual Analog Scale for Anxiety (VAS-anxiety), while the pain levels were assessed using a Visual Analog Scale for Pain (VAS-pain). Hemodynamic changes, procedure tolerance, cecal insertion and withdrawal times, polyp detection, and patients’ experiences related to colonoscopy were recorded. Likert scales, indicating procedure satisfaction, were also administered immediately after the colonoscopy.
Results: The music group demonstrated significantly lower anxiety scores compared to the control group, along with better tolerance scores, a higher willingness to repeat the procedure, and a significant preference to listen to the same music again for any upcoming unsedated colonoscopy procedures (P<0.05). No significant difference was observed between the groups in terms of pain experienced during the procedure, vital parameters, cecum insertion time, procedure time, and polyp detection rate (P>0.05).
Conclusions: For patients undergoing colonoscopy without being sedated, listening to music composed of binaural beats demonstrated a significant decrease in anxiety levels and improved patient tolerance during the procedure, presenting an alternative to sedative medications.
Binaural beats, anxiety reduction, gastrointestinal endoscopy, sedation free procedures, non-pharmacological intervention

1. US Preventive Services Task Force; Davidson KW, Barry MJ, et al. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2021 May 18;325(19):1965-1977. doi: 10.1001/jama.2021.6238.

2. Trevisani L, Zelante A, Sartori S. Colonoscopy, pain and fears: Is it an indissoluble trinomial? World J Gastrointest Endosc. 2014;6(6):227-233. doi: 10.4253/wjge.v6.i6.227.

3. Ma WT, Mahadeva S, Kunanayagam S, Poi PJ, Goh KL. Colonoscopy in elderly Asians: a prospective evaluation in routine clinical practice. J Dig Dis. 2007;8(2):77-81. doi: 10.1111/j.1443-9573.2007.00289.x.

4. Wang MC, Zhang LY, Zhang YL, Zhang YW, Xu XD, Zhang YC. Effect of music in endoscopy procedures: systematic review and meta-analysis of randomized controlled trials. Pain Med. 2014;15(10):1786-1794. doi: 10.1111/pme.12514.

5. Cook JD. The therapeutic use of music: a literature review. Nurs Forum. 1981;20(3):252-266. doi: 10.1111/j.1744-6198.1981.tb00754.x.

6. Mollaog Lu MC, Mollaog Lu S, Akin EB, Mollaog Lu M, Yanmiş S. The Effect of Art Therapy on Pain, Emesis, Anxiety, and Quality of Life in Operated Breast Cancer Patients: Randomized Control Trials. J Integr Complement Med. 2024;30(4):371-382. doi: 10.1089/jicm.2023.0062.

7. Barlas T, Sodan HN, Avci S, Cerit ET, Yalcin MM. The impact of classical music on anxiety and pain perception during a thyroid fine needle aspiration biopsy. Hormones (Athens). 2023 Dec;22(4):581-585. doi: 10.1007/s42000-023-00473-3.

8. Mata Ferro M, Falcó Pegueroles A, Fernández Lorenzo R, et al. The effect of a live music therapy intervention on critically ill paediatric patients in the intensive care unit: A quasi-experimental pretest-posttest study. Aust Crit Care. 2023;36(6):967-973. doi: 10.1016/j.aucc.2023.01.006.

9. Mishra K, Jesse E, Bukavina L, Sopko E, et al. Impact of Music on Postoperative Pain, Anxiety, and Narcotic Use after Robotic Prostatectomy: A Randomized Controlled Trial. J Adv Pract Oncol. 2022;13(2):121-126. doi: 10.6004/jadpro.2022.13.2.3.

10. Demirci H, van der Storm SL, Huizing NJ, et al. Watching a movie or listening to music is effective in managing perioperative anxiety and pain: a randomised controlled trial. Knee Surg Sports Traumatol Arthrosc. 2023;31(12):6069-6079. doi: 10.1007/s00167-023-07629-z.

11. Oster G. Auditory beats in the brain. Sci Am. 1973;229(4):94-102. doi: 10.1038/scientificamerican1073-94.

12. Draganova R, Ross B, Wollbrink A, Pantev C. Cortical steady-state responses to central and peripheral auditory beats. Cereb Cortex. 2008;18(5):1193-1200. doi: 10.1093/cercor/bhm153.

13. Aly AE, Hansa I, Ferguson DJ, Vaid NR. The effect of alpha binaural beat music on orthodontic pain after initial archwire placement: A randomized controlled trial. Dental Press J Orthod. 2023;27(6):e2221150. doi: 10.1590/2177-6709.27.6.e2221150.oar.

14. Isik BK, Esen A, Büyükerkmen B, Kilinç A, Menziletoglu D. Effectiveness of binaural beats in reducing preoperative dental anxiety. Br J Oral Maxillofac Surg. 2017;55(6):571-574. doi: 10.1016/j.bjoms.2017.02.014.

15. Brady B, Stevens L. Binaural-beat induced theta EEG activity and hypnotic susceptibility. Am J Clin Hypn. 2000;43(1):53-69. doi: 10.1080/00029157.2000.10404255.

16. Tani A, Tartarisco G, Vagheggini G, Vaccaro C, Campana S, Tomaiuolo F. Binaural beats reduce feeling of pain and discomfort during colonoscopy procedure in not-sedated patients: A randomized control trial. Complement Ther Clin Pract. 2022;48:101605. doi: 10.1016/j.ctcp.2022.101605.

17. Price DD, McGrath PA, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. 1983;17(1):45-56. doi: 10.1016/0304-3959(83)90126-4.

18. Appukuttan D, Vinayagavel M, Tadepalli A. Utility and validity of a single-item visual analog scale for measuring dental anxiety in clinical practice. J Oral Sci. 2014;56(2):151-156. doi: 10.2334/josnusd.56.151.

19. Ball AJ, Rees CJ, Corfe BM, Riley SA. Sedation practice and comfort during colonoscopy: lessons learnt from a national screening programme. Eur J Gastroenterol Hepatol. 2015;27(6):741-746. doi: 10.1097/MEG.0000000000000360.

20. Ovayolu N, Ucan O, Pehlivan S, et al. Listening to Turkish classical music decreases patients' anxiety, pain, dissatisfaction and the dose of sedative and analgesic drugs during colonoscopy: a prospective randomized controlled trial. World J Gastroenterol. 2006;12(46):7532-7536. doi: 10.3748/wjg.v12.i46.7532.

21. López-Cepero Andrada JM, Amaya Vidal A, Castro Aguilar-Tablada T, et al. Anxiety during the performance of colonoscopies: modification using music therapy. Eur J Gastroenterol Hepatol. 2004;16(12):1381-1386. doi: 10.1097/00042737-200412000-00024.

22. Chlan L, Evans D, Greenleaf M, Walker J. Effects of a single music therapy intervention on anxiety, discomfort, satisfaction, and compliance with screening guidelines in outpatients undergoing flexible sigmoidoscopy. Gastroenterol Nurs. 2000;23(4):148-516. doi: 10.1097/00001610-200007000-00003.

23. Costa A, Montalbano LM, Orlando A, et al. Music for colonoscopy: A single-blind randomized controlled trial. Dig Liver Dis. 2010;42(12):871-876. doi: 10.1016/j.dld.2010.03.016.

24. Çelebi D, Yılmaz E, Şahin ST, Baydur H. The effect of music therapy during colonoscopy on pain, anxiety and patient comfort: A randomized controlled trial. Complement Ther Clin Pract. 2020;38:101084. doi: 10.1016/j.ctcp.2019.101084.

25. Harikumar R, Raj M, Paul A, et al. Listening to music decreases need for sedative medication during colonoscopy: a randomized, controlled trial. Indian J Gastroenterol. 2006;25(1):3-5.

26. Martindale F, Mikocka-Walus AA, Walus BP, Keage H, Andrews JM. The effects of a designer music intervention on patients' anxiety, pain, and experience of colonoscopy: a short report on a pilot study. Gastroenterol Nurs. 2014;37(5):338-342. doi: 10.1097/SGA.0000000000000066.

27. Dabu-Bondoc S, Vadivelu N, Benson J, Perret D, Kain ZN. Hemispheric synchronized sounds and perioperative analgesic requirements. Anesth Analg. 2010;110(1):208-210. doi: 10.1213/ANE.0b013e3181bea424.

28. Kliempt P, Ruta D, Ogston S, Landeck A, Martay K. Hemispheric-synchronisation during anaesthesia: a double-blind randomised trial using audiotapes for intra-operative nociception control. Anaesthesia. 1999;54(8):769-773. doi: 10.1046/j.1365-2044.1999.00958.x.

29. Bechtold ML, Puli SR, Othman MO, Bartalos CR, Marshall JB, Roy PK. Effect of music on patients undergoing colonoscopy: a meta-analysis of randomized controlled trials. Dig Dis Sci. 2009;54(1):19-24. doi: 10.1007/s10620-008-0312-0.

There are 29 references in total.
1.
Demirci S, Sezer S, Pirinççi Sapmaz F. Effect of binaural beats on pain, anxiety, and procedure tolerance in patients undergoing colonoscopy without sedation: A randomized controlled trial. Eur Res J. 2025;11(2):270-278. doi:10.18621/eurj.1604977

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Article Information

  • Article Type Research Article
  • Submitted February 21, 2026
  • Published March 3, 2025
  • Issue Vol. 11 No. 2 (2025)
  • Section Research Article
  • File Downloads 1163
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