Bob Marley knew it when he sang on Trenchtown Rock: “One good thing about music when it hits you, you feel no pain.” Now trials are under way at an NHS trust to see if an algorithm can curate music playlists to reduce suffering in Alzheimer’s patients as well as in stressed medical staff. A test among people with dementia found an algorithm that “prescribes” songs based on listeners’ personal backgrounds and tastes resulted in reductions in heart rate of up to 22%, lowering agitation and distress in some cases. This week, Lancashire teaching hospitals NHS trust is extending trials to medical staff who worked in critical care during Covid to see if it can ease anxiety and stress. It is also planning to test it on recovering critical care patients, needle-phobic children and outpatients coping with chronic pain in the hope of reducing opiate prescriptions. The technology operates as a musical “drip”, playing songs to patients and monitoring their heart rates as they listen. A 90-year-old might be prescribed big band music, while a 50-year-old might get a dose of Van Halen and Paul McCartney. An algorithm allows the software, which is linked to a streaming service like Spotify, to change forthcoming tracks if the prescription doesn’t appear to be working. Its artificial intelligence system assesses the “DNA” of songs, examining 36 different qualities including tempo, timbre, key, time signatures, the amount of syncopation and the lowest notes. Gary Jones, the chief executive of MediMusic, the company developing the software, said these were among the factors that can shape the heart rate and blood pressure response to a track. A trial of 25 people with Alzheimer’s aged from their 60s, to their 90s conducted at the Lancashire NHS trust has shown some promising results, the trust said. “There has been an up to 22% reduction in heart rates in these patients,” said Dr Jacqueline Twamley, academic research and innovation manager. “Some people it doesn’t affect the heart rate at all, but you can see the effect in their facial expressions and in them tapping along. One patient burst out crying. He said the song brought back happy memories and they were happy tears.” The playlist of a patient in their 60s included Mull of Kintyre by Wings and Peter Gabriel’s Solsbury Hill, said Twamley, adding: “I thought Mull of Kintyre would increase agitation, but that’s a matter of taste.” When Twamley tried it, she was surprised to see the algorithm prescribed her songs by Gloria Estefan, the Pretenders, Lionel Richie and Billy Ocean. She is a fan of more raucous bands including Led Zeppelin, Queens of the Stone Age and the niche progressive rock outfit Porcupine Tree. But it still had an effect. “I was quite stressed at the beginning of it, but I just felt calm afterwards,” she said. The system aims to select songs that create a gradation in heart rate, starting with something bracing like Tchaikovsky’s 1812 overture and moving towards a lullaby. The technology aims to build on research showing the effectiveness of using music to manage chronic pain and on managing anxiety and depression in dementia patients. It tailors its playlist in part by scanning the user’s music preferences based on the listening patterns recorded on their streaming service, if they have one. It also examines their age, gender, nationality, and ethnicity. Jones said a calming track would often have a major key, would be relatively slow and with spaced out instrumentation. The system is aware that music can be upsetting too. There are “red flag tracks” that are filtered out if the patient fears they may trigger upset by reminding them of a traumatic event. And if Twamley or anyone else, really doesn’t want to hear Mull of Kintyre when they are trying to reduce their blood pressure, they can put their own red flag in it. Three recommended playlists The playlists are intended to start with more energy, becoming calmer to lower the heart rate. They are tailored to broad demographic categories as well as personal listening habits and preferences. These are highlights of three lists produced by the algorithm: For a 90-year-old white British woman Teresa Brewer – Music! Music! Music! Bing Crosby – Galway Bay Frank Sinatra – Among My Souvenirs For a 60-year-old woman of British Indian origin Mere Dil Mein Aaj Kya Hai – Rajesh Khanna, Sharmila Tagore, Kishore Kumar Pyaasa – Geeta Dutt & Mohd Rafi Lag Jaa Gale – Sadhana, Lata Mangeshkar For a 40-year-old black British man with interest in soul, R&B hip-hop and pop The Notorious B.I.G. – Mo Money Mo Problems Ashanti – Foolish Fugees – Killing Me Softly With His Song