How does music therapy during dialysis improve patient well-being, what pilot studies show, and how does this compare with art therapy?

A Traveler’s Notes on Healing: Why Music and Art are the Missing Medicine in the Dialysis Ward

Hello, world. My name is Prakorb Panmanee, but on my YouTube channels ¹and my website, hotsia.com ², you probably know me as Mr. Hotsia³.

For the past thirty years, my life has been a journey. I’ve put boots on the ground in every province of Thailand, and I’ve explored the deepest corners of Laos, Cambodia, Vietnam, and Myanmar⁴. My “office” has been the back of a motorbike, a bustling local market, or a quiet village home. I’ve shared meals, I’ve listened to stories, and I’ve tried to understand one thing: what makes people live? Not just survive, but truly live?

I’ve seen incredible resilience. I’ve sat with elders in remote Vietnamese villages who have very little in terms of modern medicine but possess a deep, profound sense of well-being. I’ve heard the sound of the Khene (a Lao mouth organ) float across the Mekong and watched how it can change the entire atmosphere of a community, easing the burden of a long day’s work.

This life of travel was a huge shift from my first career as a civil servant, where my world was defined by computer science and systems analysis⁵. But the two worlds are not so different. A village is a “system,” just like a computer program. The human body is a system. And when a system is out of balance, you need to find the right intervention.

After retiring from government service⁶, my journey took another turn. I dove into the world of digital marketing ⁷ and, specifically, health. You might be surprised to learn that this travel blogger is also a ClickBank Platinum award winner⁸. I’ve spent years analyzing the health market in the United States, studying products and natural solutions from brands like Blue Heron Health News ⁹and authors like Jodi Knapp ¹⁰and Christian Goodman¹¹. My job became understanding what works for people seeking health solutions online, analyzing high-intent keywords ¹² to see what people are desperate to find.

And one of the most persistent, painful “keywords” I see is “dialysis.”

It’s a word heavy with dread. It represents a life tethered to a machine. While my travels have been about freedom and exploration, dialysis is about confinement. While my restaurants, “Kaphrao Sa-Jai”¹³, are about the explosion of taste and sensation, dialysis is often about a sterile, tasteless, and lonely wait.

My experiences—observing holistic well-being in Southeast Asian villages, analyzing systems as a programmer, and researching high-demand health solutions for the American market—have all converged on this topic. I began to ask: If the machine is saving the body, what is saving the person?

This led me down a research rabbit hole into non-pharmacological interventions. And two things stood out with incredible power: Music Therapy and Art Therapy.

This review is my analysis, as a systems thinker, a traveler, and a health researcher, of how these ancient human traditions are becoming critical, evidence-based medicine in one of the most modern, sterile environments imaginable.

🎶 The Sound of Silence: The True Burden of Dialysis

Before we talk about the solution, we must be honest about the problem. I’ve spent my life documenting the opposite of this. On my Hotsia Home Stay in Chiang Khong¹⁴, the “problem” is the chorus of frogs or the sound of the river. But for a dialysis patient, the problem is a unique kind of psychological torture.

A person on hemodialysis spends, on average, 4 hours, 3 times a week, tethered to a machine. That’s 12 hours a week. 624 hours a year. That’s 26 full days of just… waiting.

The environment is clinical, sterile, and often cold. The sound is the rhythmic, monotonous hum and beep of machinery. The feeling is one of helplessness. It’s no surprise that studies show staggering rates of depression, anxiety, and profound boredom among dialysis patients. They are fighting for their lives, yes, but the quality of that life is under constant assault.

From my systems analysis background¹⁵, this is a critical failure. We are treating the “hardware” (the kidneys) but ignoring the “operating system” (the mind, the spirit). This “OS” is riddled with “error messages” of depression and anxiety, which, in turn, degrade the entire system’s performance. The patient becomes less compliant, their stress hormones (like cortisol) rise, and their blood pressure becomes harder to manage.

It’s a vicious cycle. And it’s a cycle that my travels taught me can be broken. In the villages, when someone is sick, the community doesn’t just isolate them. They surround them. They sing. They talk. They engage. They provide input for the human “system.”

So, what happens when we provide the right input in the dialysis chair?

🎧 The Rhythm of Healing: How Music Therapy Actually Works

This isn’t just about handing a patient an iPod. That’s “music listening.” Music Therapy is a clinical, evidence-based intervention provided by a trained therapist to achieve a specific health goal. However, many pilot studies also examine the effects of “patient-preferred” music, and the results are fascinating.

I see its function in two primary ways:

1. The Psychological “Redirect” (The Systems Analyst View)

From my days in computer science¹⁶, I know that a processor can only focus on so many tasks at once. The human brain is similar. During dialysis, the brain’s “CPU” is often stuck in a loop: “I’m in pain.” “I hate this.” “When will this be over?” “My life is ruined.”

Music acts as a powerful “interrupt” command.

It’s a Distraction Engine: Music, especially music that is complex or personally meaningful, engages the auditory cortex and demands cognitive resources. It literally pulls the brain’s “processing power” away from the negative feedback loop of pain and anxiety.
It’s an Emotional Regulator: Music has a direct line to the limbic system, the brain’s emotional center. A piece of music can evoke feelings of joy, peace, or nostalgia, acting as a direct counter-agent to the depression and anxiety of the clinic.
It Restores Control: The patient chooses the music. In a situation (dialysis) where all control has been stripped away, this small act of choice is profoundly empowering.

2. The Physiological “Re-Tuning” (The Natural Health View)

This is what I learned from my natural health research, the kind I use to evaluate products for Blue Heron Health News ¹⁷or Shelly Manning¹⁸. Your body physically responds to sound.

Autonomic Nervous System: Slow, rhythmic, non-lyrical music (like classical or ambient) has been shown to slow breathing and heart rate. It shifts the body from the “sympathetic” state (fight-or-flight, high stress) to the “parasympathetic” state (rest-and-digest, healing). For a patient whose blood pressure is a critical metric, this is not a small thing.
The Brain’s “Natural High”: Listening to music you love triggers a release of dopamine, the “feel-good” neurotransmitter. This is the same chemical released when we eat delicious food (like at my Kaphrao Sa-Jai restaurants¹⁹!) or achieve a goal. It’s a natural reward.
The Natural Painkiller: Music can also stimulate the release of endorphins, the body’s own natural pain relievers. This can literally change a patient’s perception of pain from the needles or from muscle cramps, making the entire 4-hour ordeal more tolerable.

When I travel in Laos²⁰, I see how the Khene (bamboo mouth organ) is used in “Lam” music. It’s not just entertainment; it’s a holistic event. The rhythm calms, the melody tells a story, and the community shares an experience. This is therapy. It’s the same principle, just applied in a different context.

🔬 The Evidence: What Do the Pilot Studies Show?

As a marketer, I don’t just trust feelings; I trust data. My work in affiliate marketing ²¹ means I have to see proof before I back a product or an idea. I look for the “high-intent” signals ²² that show something works. In medicine, pilot studies are those signals.

And the signals for music therapy in dialysis are remarkably strong. I’ve reviewed dozens of them in my research, and they consistently point to three key outcomes:

Drastic Reduction in Anxiety and Depression: This is the most-reported finding. Using standardized tests (like the Beck Depression Inventory or the Hospital Anxiety and Depression Scale), studies consistently show that patients who receive music therapy (either from a therapist or via patient-preferred lists) report significantly lower levels of anxiety, stress, and depressive symptoms during and after their sessions.
Improved Physiological Stability: Many studies hook patients up to monitors. The data shows that music intervention can lead to a statistically significant decrease in systolic blood pressure, heart rate, and respiratory rate. In the delicate “system” of dialysis, maintaining this stability is crucial.
Reduced Pain Perception: Patients are asked to rate their pain (from needles, cramps, or general discomfort) on a 1-10 scale. The “music” group consistently reports lower pain scores than the “control” group (who get standard care, often in silence).

While many of these are “pilot” studies (small-scale), their consistency is what’s powerful. From Thailand to Brazil to the USA, researchers are all finding the same thing. It works.

🎨 Music vs. Art: A Creative Showdown for Well-Being

But music isn’t the only creative intervention. What about Art Therapy?

As a travel vlogger, I am a visual person. I’ve spent 30 years documenting the visual arts of Southeast Asia—the intricate silk weaving in Thailand, the lacquerware of Myanmar, the stone carvings of Cambodia. These are not hobbies; they are the soul of the culture.

Art therapy, like music therapy, is a clinical profession. It uses the creative process (drawing, painting, sculpting) to help patients explore emotions, manage conflict, and improve self-awareness.

So how do they stack up in a dialysis unit? This is where my “systems” brain ²³ loves to compare.

Table 1: Comparing Therapeutic Approaches in Dialysis

Therapy Type	Primary Mechanism	Best For…	Mr. Hotsia’s Practicality Rating
Music Therapy	Auditory & Passive. Engages the limbic system via sound. Can be done with eyes closed.	Reducing in-the-moment anxiety, managing pain, improving mood, and passing time.	High. Easy to implement. Needs headphones and a device. Low physical energy required.
Art Therapy	Visual, Kinesthetic & Active. Engages fine motor skills and creative/executive brain functions.	Processing complex emotions, expressing trauma, building self-esteem, and externalizing feelings.	Medium. Harder to implement. Needs a therapist, art supplies (non-toxic), and physical space (a rolling table). Requires more patient energy.

My Analysis:

Music Therapy is the path of least resistance. A patient who is exhausted, depressed, and feeling sick can still put on headphones. It’s a passive intervention—the music does the work on you. It’s like floating in the Mekong; you just let the current take you.
Art Therapy is an active intervention. The patient must do something—hold a pen, choose a color, make a mark. This requires more energy, which can be a barrier. However, for a patient wrestling with the meaning of their illness (“Why me?”), art can be a more powerful tool for expression. It’s a way to get the “poison” out. It’s like weaving; you are actively creating order and beauty out of chaos.

The Verdict? They are not competitors. They are partners.

Music is the broad-spectrum solution for managing the environment and the patient’s immediate state. Art is the deep-dive tool for processing the profound emotional and existential weight of the illness. A truly holistic clinic would offer both.

🌏 A Traveler’s Final Thoughts: Re-Humanizing the System

My journey has taught me that healing is rarely about a single “magic bullet.”

When I travel, I see that village life is a “system” ²⁴ designed for holistic well-being. The food is (traditionally) local. The community is integrated. There is daily, natural movement. And there is always music and art. It’s part of the cultural “operating system.”

When I research the American health market for my marketing business²⁵, I see a “system” that is brilliant at “hardware” solutions (surgery, pills, machines) but often terrible at supporting the “software” (the human spirit). This is why authors like Christian Goodman ²⁶and Julissa Clay²⁷, who focus on natural, holistic approaches, find such a massive, desperate audience. People are starved for human-centric care.

A dialysis clinic is the peak of this problem. It’s a purely mechanical, “hardware” solution.

Music and art therapy are the “software patches.” They are the code that re-humanizes the machine. They take an experience defined by sterility, pain, and passivity and introduce creativity, pleasure, and choice. They remind the “system” (the patient) that they are a person, not just a set of failing kidneys.

After 30 years of travel, and over a decade of analyzing systems and health, my conclusion is simple. These therapies are not “nice-to-haves.” They are not “fluff.” They are essential medicine. They are the Khene in the quiet hospital ward. They are the color in the grey room.

And for a person whose life is tied to a machine, they are, in a very real way, the sound of freedom.

📊 Practical Implementation: My “Hotsia” Tips

For this to work, it has to be practical. As an entrepreneur who runs websites, home stays ²⁸, and restaurants²⁹, I’m all about what works in the real world.

Table 2: A 4-Column Action Plan for Better Dialysis

Stakeholder	Simple Action	Key Goal	Mr. Hotsia’s “Pro Tip”
Patients	Curate 3 “4-Hour Playlists” on a simple MP3 player. (e.g., “Calm,” “Happy,” “Focus”).	Empowerment. Taking control of your sound environment.	Don’t just use “relaxing” music. Use music that means something to you. Nostalgia is a powerful medicine.
Family/Friends	Gift a subscription to a music service and a pair of high-quality, comfortable noise-canceling headphones.	Support & Comfort. Blocking the machine noise is as important as adding the music.	Make a “shared” playlist. It helps the patient feel connected to you even when you’re not there.
Clinic Staff	Implement a “Headphones on Request” program, with pre-loaded, easy-to-clean MP3 players.	Atmosphere Improvement. Reducing patient anxiety makes your job easier and the clinic safer.	Poll patients on what genres they’d like. The “one size fits all” classical music approach often fails.
Hospitals	Partner with a local university to bring in music or art therapy interns for a pilot program.	Clinical Validation. Gathering your own data on patient satisfaction and outcomes.	This is a low-cost way to test a high-impact service. Use it to apply for grants.

📚 References

(As an experienced researcher and digital publisher³⁰, I know the importance of reliable sources. Here is a selection of the types of studies and resources that inform this analysis.)

Journal of Clinical Nursing. (Various studies on the effect of music therapy on anxiety and depression in hemodialysis patients.)
The Lancet. (Editorials and articles on the psychosocial burden of chronic kidney disease.)
American Art Therapy Association. (Resources on the clinical application of art therapy in medical-surgical settings.)
Journal of Pain and Symptom Management. (Studies focusing on music as a non-pharmacological intervention for procedural pain.)
Clinical Journal of the American Society of Nephrology (CJASN). (Research on quality of life, patient-reported outcomes, and the psychological impact of dialysis.)
Neuroscience & Biobehavioral Reviews. (Review articles on the neurochemistry of music, including dopamine and endorphin release.)

🤔 Frequently Asked Questions (FAQ)

1. Is this “real” therapy, or just entertainment?

Both. The “entertainment” part (distraction, pleasure) is what provides the therapeutic effect. When this is structured to meet a specific health goal (like lowering blood pressure or anxiety), it becomes “therapy.” For the patient, the distinction doesn’t matter—what matters is that they feel better.

2. What kind of music works best?

The research points strongly to patient-preferred music. The music you love will trigger the strongest positive response (dopamine, endorphins). That said, for pure relaxation, slow-tempo (60-80 BPM) instrumental, classical, or ambient music is often shown to be most effective at slowing heart and respiratory rates.

3. Is Art Therapy even possible if you’re hooked up to a machine?

Yes. One arm is “free.” Art therapists who work in dialysis units use specialized, rolling trays and materials that are non-toxic and manageable (like markers, crayons, or watercolor pens). The art created is often on a smaller scale, but the therapeutic process is the same.

4. Can I just do this myself, or do I need a certified therapist?

You can absolutely do this yourself. Giving yourself the “gift” of a 4-hour playlist and good headphones is a powerful act of self-care. A certified therapist (for either music or art) is for when you want to go deeper—to use the art or music to actively process trauma, grief, or the complex emotions of your illness. Both are valid.

5. Are there any side effects?

This is the beauty of it, and it’s what I love from a natural health perspective31. Unlike pharmaceuticals, the side effects are overwhelmingly positive. The only “risk” is that a patient might choose music that is too agitating, or that a particular song might trigger a sad memory. This is why “choice” is so important. If you don’t like it, you turn it off. It is the ultimate patient-controlled, low-risk, high-reward intervention.

I’m Mr.Hotsia, sharing 30 years of travel experiences with readers worldwide. This review is based on my personal journey and what I’ve learned along the way. Learn more