The Effects of Quartz Crystal Singing Bowl Music and Guided Relaxation on Mood and Sleep in Young Adults
Phase: NA
Conditions: Healthy Young Adults
Sponsor: The University of Waikato

 
 
 
The Effects of Quartz Crystal Singing 
Bowl Music and Guided Relaxation on 
Mood and Sleep in Young Adults 
 
Study Protocol 
Version 1 
10/04/2024 
 
Principal Investigators 
Professor Nicola Starkey 
Email: nstarkey@waikato.ac.nz 
Associate Professor Michael Jameson 
Email: michael.jameson@auckland.ac.nz 
 
 

2 
 
Table of contents 
 
1. Key Contact Details / Study Team 
3 
2. Background 
4 
3. Study Design and Method 
5 
4. Study Population 
6 
5. Study Procedures 
7 
6. Statistical Analysis 
7 
7. Safety Concerns 
8 
8. Publications 
8 
9. References 
9 
10. Appendix 1- Eligibility questionnaire 
11 
11. Appendix 2 – Demographic Questionnaire 
12 
12. Appendix 3 - POMS 
14 
13. Appendix 4 – Auckland Sleep Questionnaire 
15 
14. Appendix 5 – Visual Analogue Scales 
17 
15. Appendix 6 – Example PMR Script 
18 
16. Appendix 7 – Study Flyer 
21 
17. Appendix 8 – Participant Information Sheet 
22 
 
 
 

3 
 
1. Key Contact Details / Study Team 
 
Professor Nicola Starkey 
 
School of Psychology, 
Faculty of Arts and Social Sciences, 
The University of Waikato, 
Private Bag 3105, 
Hamilton, 
New Zealand 
p: 07 8379230 
e: nstarkey@waikato.ac.nz 
Assoc. Prof. Michael Jameson 
 
Assistant Dean, Waikato Clinical Campus,  
Faculty of Medical and Health Sciences,  
Waipapa Taumata Rau, The University of Auckland 
Peter Rothwell Academic Centre,  
Waikato Hospital, 
Private Bag 3200, Hamilton 3240  
p: +64 7 8398750  
m 021 759547  
f 07 8398712  
e michael.jameson@auckland.ac.nz   
Jacqueline Woodland (M.Ed) 
Education Consultant/ Maori Advisor 
Ngati Whakaue Education Endowment Trust Board, Rotorua & 
Establishment Board Presiding Chair Mangakōtukutuku College, Hamilton 
Email: jackiewoodland11@gmail.com  
Dawn Willix-Payne 
Senior Clinical Psychologist 
The Psychology Centre,  
University of Waikato, 
Hamilton 
Kellianne Hamilton 
Annelise Bech 
Alice Wilson 
Masters student, School of Psychology, University of Waikato 
Honours student, School of Psychology, University of Waikato 
Honours student, School of Psychology, University of Waikato 
 
 
 

4 
 
2. Background 
The number of people reporting poor mental wellbeing is increasing, with rates exceeding 25% of 
the population. Rates of psychological distress in young people (aged 15-24 years) increased from 
19.7% to 26% between 2019 and 2021, with one in five (21.2%) reporting high or very high levels of 
distress [1]. Whilst several treatment options are available, the most accessible are pharmacological 
interventions which take time to be effective, have unwanted side effects, and fail to take into 
account cultural beliefs and practices [2]. Access to professional help and support for psychological 
distress is also an issue with young adults reporting the highest rates of unmet need in the 
population (15.5% for 15–24 years and 11.5% for 25–34 years) [3] . Meditation and mindfulness are 
reported to be effective in decreasing stress and enhancing mood [4, 5] but time, practice, self-
motivation and patience are required to fully realise the benefits. Indeed, some authors suggest that 
the adhering to the meditation sessions or mindfulness programs may become a source of stress [6]. 
Given the high rates of distress, and difficulties accessing professional mental health support, there 
is a need to explore alternate options that are easily accessible and can be made readily available to 
young people to improve their mental health and wellbeing.  
Music and sound have been used for centuries to aid relaxation and improve mood [7]. Many people 
use music to help them relax and sleep better, which has been confirmed as effective in studies with 
general population and clinical samples [8-11]. Music has long played a key role in young peoples’ 
lives, and serves a variety of purpose including helping to regulate emotions, expressing ones 
identity and relating to others [12]. Young people tend to choose music to match the context or 
situation with high- arousal music chosen for exercise and low arousal music for relaxation [13]. 
Listening to music prior to classes at school, led to improvements in mood, motivation, 
concentration and learning [14]. These effects were explained by the music creating positive 
emotions, increasing attention, and providing routine and rest between classes [14]. Music based 
therapies are also reported to reduce depression and anxiety in adolescents [15], and in university 
students listening to music had significant effects on both subjective stress and salivary cortisol 
levels, with the most profound effects being seen when using relaxation music [16]. 
Sounds with a repetitive beat are traditionally used by Shamans to enter trance like states, and 
Tibetan monks also use sound when practicing meditation. Sound healing has been used by cultures 
across the world, for example, the Didgeridoo has been used by aboriginal tribes in Australia for over 
40, 000 years [7]. Relaxation music played on “singing bowls” (Himalayan or Tibetan metal bowls or 
quartz crystal bowls) is readily available and is reported to have rapid, remarkable benefits on stress, 
mood and sleep. One clinical study in adults, using a pretest-post-test design, reported that an hour-
long session of listening to metal and quartz crystal singing bowls resulted in an immediate mean 
71% reduction in negative mood scores on the Profile of Mood States [16]. Another study used a 
randomised sequential crossover design to test the effect of adding either a 12 minute session of 
silence or listening to Himalayan singing bowls, prior to a 20 minute session of directed relaxation; 
the singing bowl intervention produced greater beneficial effects on physiological stress measures 
and mood [17]. In addition, another study reports that a single session of listening to Tibetan singing 
bowls led to greater physiological and psychological relaxation response (as shown by EEG and heart 
rate variability) compared with progressive muscle relaxation [18]. There is also preliminary evidence 
of the efficacy of Tibetan singing bowls in improving mood in young people; using a pre-test post-
test design, one 25 minutes session of relaxation music played on quartz crystal singing bowls to a 
small group (n=11) of NZ adolescent males significantly reduced depression scores (on the Profile of 
Mood States) immediately after the session, as well as lowering tension scores [19].  
 

5 
 
Taken together these findings suggest that relaxation music played on singing bowls may be 
beneficial in improving mood, decreasing stress, and improving sleep. Extending the previous work 
by co-PI Jameson [19], this study seeks to compare the effects of listening to quartz crystal singing 
bowl music with guided relaxation on mood, stress and sleep in a larger sample of young adults. 
Participants will be randomly assigned to either the singing bowl (SB) or guided progressive muscle 
relaxation (PMR) condition. Participants will be asked to listen to singing bowl music or complete the 
PMR exercises for 10 minutes three time a week for four weeks (delivered online via the Qualtrics 
platform) and will then be given free access to the music or guided meditation for another four 
weeks whilst their use is monitored. Ratings of mood, stress and sleep with be completed at 
baseline, 4 weeks and 8 weeks. For one session per week, participants will be asked to complete 
visual analogue rating scales of their mood/stress immediately before and after the session to 
determine the acute effects of the intervention. 
 
3. Study Design and Method 
 
a) Hypothesis 
Listening to singing bowl music will result in equivalent improvements in mood, stress 
and sleep compared with guided relaxation immediately after the session, and at 4- and 
8-weeks post-intervention. 
b) Design 
Randomised controlled trial. 
 
c) Intervention 
Singing bowl music (SB) 
The singing bowl relaxation music (‘Tranquility’ available on Spotify) was played by Annie Jameson 
and professionally recorded. The sound is produced by tapping the bowls and rubbing them with a 
rubber mallet. Each session took approximately 10 minutes. 
 
Guided relaxation (PMR) 
A guided progressive muscle relaxation audio (recorded by the NZ Cancer Society 
https://www.youtube.com/watch?v=Zydrp3rfJdY) and similar to the PMR script from the Anxiety 
and Phobia Workbook by Edmund Bourne[20]) was used. The session took approximately 12 
minutes. Participants were instructed to start by sitting or lying comfortably, taking some deep 
breaths and then tense and relax muscles in a sequential manner from the head to the feet (see 
Appendix 6 for an example of the PMR script). 
 
d) Outcome measures 
Profile of Mood States Abbreviated [21]. Participants are presented with a list of 40 words that 
describe feelings people have. They are asked to circle the number that best describes how they feel 
right now from 0 (not at all), 1 (a little), 2 (moderately), 3 (quite a lot) to 4 (extremely). Alogue scales 
- . A Total Mood Disturbance score (TMD) is also calculated by summing the totals for the negative 
subscales (Tension, Depression, Anger, Fatigue, Confusion), and subtracting the totals for the 
positive scales (Vigour, Esteem-related Affect [Note that 2 item are reverse scored for the ERA 
subscale). See Appendix 3. The primary outcome measure is the TMD, but we will conduct secondary 
analyses to examine the effects of the interventions on the subscale scores. 
 

6 
 
Modified Auckland Sleep Questionnaire [22]. The Auckland Sleep questionnaire was developed to 
diagnose common sleep disorders in primary care. We will use the items about current sleep and 
asked participants to rate them in reference to the previous week (rather than the previous month 
as in the original questionnaire). The overall sleep quality rating will be used in the analysis 
(Appendix 4). 
 
Visual Analogue Scales 
To assess the acute effects of the intervention, participants will be asked to complete ratings of 
overall mood, relaxation, and stress before and after one session each week. Participants are asked 
to rate how they are feeling right now using a visual analogue scale (VAS) from 0 (worst I’ve ever felt 
not relaxed, not stressed,) to 100 (very stressed, very relaxed, best I’ve ever felt)[23, 24] see 
Appendix 5. 
 
e) Objectives 
Primary Objective 
To determine if the effects of listening to singing bowl music are equivalent to that of progressive 
guided muscle relaxation on self-report measures of mood in young adults (Total Mood Disturbance 
of the POMS) at 4- and 8- weeks post intervention.  
 
Secondary Objectives 
To compare the effects of the interventions on: 
• 
Profile of Mood States-Abbreviated (POMS) subscale scores  
• 
Overall sleep quality from the Auckland Sleep Questionnaire  
• 
VAS ratings of mood, stress and relaxation 
Exploratory analyses will be undertaken to determine i) how frequently the participants use the 
interventions in weeks 4-8, and ii) the acceptability of the interventions. 
4. Study population 
Members of the general population aged 16-25 years will be recruited to participate in the study. To 
be eligible to take part, potential participants need to have good hearing, good understanding of 
English and have a mobile phone or computer to access the intervention and questionnaires via the 
Qualtrics application. Participants will be excluded if: they are regular users of relaxation music from 
quartz crystal singing bowls or progressive muscle relaxation, have an untreated mental health 
diagnosis, or are receiving treatment from a psychologist or psychiatrist. (See Appendix 1 for the 
eligibility questionnaire). 
Participants will initially be recruited from the first-year psychology participant research pool (IPRP) 
and will receive up to 10% course credit for participation (as outlined in the flyer and participant 
information sheet (PIS) appendices 7 and 8. Study flyers will also be posted around the University to 
recruit more widely (participants can choose to enter a prize draw). In the next stage of the study, 
we will approach secondary schools to advertise the research to their students (subject to additional 
ethics approval). 
We aim to recruit at least 100 participants, with a minimum of 50 university students. 
 
 

7 
 
5. Study Procedures 
The study/questionnaires will be delivered via the Qualtrics software. Those interested in 
participating will contact the researchers via a study email address singingbowls@waikato.ac.nz. 
Each participant will be allocated to one of the students who will be responsible for monitoring 
the participant's completion of the questionnaires and sending reminders to complete the 
intervention as needed. Participants will be sent an individual link to the information sheet, 
consent form, and eligibility form (Appendices 1, 8). Those meeting the eligibility criteria will 
automatically be directed to complete the demographic questionnaire (Appendix 2), and the 
mood (POMS) and sleep measures (modified Auckland Sleep questionnaire) Appendix 3 & 4, 
(T1).  
Participants will then be randomised to either the singing bowl (SB) (Tranquility by Annie 
Jameson) or the guided relaxation group (PMR; example script is in Appendix 6) and given access 
to the relevant audio on the qualtrics platform (to allow us to monitor when and for how long 
participants engaged with the intervention). Participants will be asked to listen to the relevant 
intervention 3 times a week for four weeks (each session is approximately 10 minutes). Before 
and after one session each week, participants will be asked to complete the visual analogue 
ratings scales to assess the acute effects of the intervention on their mood, stress and relaxation 
(Appendix 5). Participants will be sent reminders 3 x per week to complete the intervention. 
Participants will be asked to complete the mood and sleep measures again after 4- (T2) and 8-
weeks (T3) 
The students will actively monitor participant’s engagement in the study and send email 
reminders to complete the intervention sessions (Qualtrics is set up to automatically send email 
notifications to the study email address when participants complete each session so we can 
keep track of where they are up to) and the questionnaires at 4 and 8 weeks after the start of 
the study. After the first four weeks, participants will have free access to either the SB or PMR 
audio to use as much as they like, and we will monitor the frequency of use via the qualtrics app 
for the next four weeks. We will send out the link to the intervention weekly in weeks 4-8. 
After completion of the 8 week questionnaire (T3) participants will be provided unlimited (and 
unmonitored) access to both audio tracks and will be asked to provide any feedback on the 
study. 
 
6. Statistical Analysis 
Primary outcomes 
Difference scores between baseline (T1) and T2 (4 weeks), and T3 (8 weeks) for the POMS TMD will 
be calculated. 
Secondary outcomes 
a) Difference scores between baseline (T1) and T2 (4 weeks), and T3 (8 weeks) for the POMS 
subscale scores and Auckland Sleep questionnaire will be calculated.  
b) The number of intervention sessions completed between T1 and T2, and T2 and T3. 
c) Feedback on the acceptability and effectiveness of each intervention. 
 
Sample size 

8 
 
A previous study examining the effects of an in person Tibetan singing bowl (n=62) session showed 
mean reductions of 0.49 to 1.23 (SD 0.19-1.05) in five POMS subscale scores [16]. A study with a 
much smaller group of teenage males (n= 11) showed significant reductions in POMS depression 
scores post-intervention [19]. In person PMR or Autogenic relaxation sessions in young soccer 
players (n=8) produced significant reductions in four of the six POMS-A subscales (mean difference 
2.13 to 4.25; SD 2.38 to 4.47) [25]. As the current study is online rather then in-person, and the 
sessions are shorter, the effects may be somewhat smaller. Given this we are aiming to recruit a 
minimum of 100 participants (50 per group). This will provide > 90% power (2-sided =0.05) to 
detect a medium size effect of the intervention on the POMS subscales. 
Analysis Plan 
Univariate repeated measures ANOVA will be used to examine the effects of the intervention on the 
overall TMD score from the POMS, VAS scores and sleep scores. Repeated measures MANOVA will 
be used to examine changes in the POMS subscale scores.  
Participants will be excluded from the analyses if they have not completed at least one intervention 
session per week for the first four weeks. The number of sessions completed during the first four 
weeks may be included as a covariate in the analyses. 
 
7. Safety Concerns 
Participants will be encouraged to contact us if they have any concerns. We will discuss the issue 
with the clinical advisor (with the participants consent) and encourage the participants seek support 
from their GP in the first instance. We will also have a list of support organisations available for 
participants.  
8. Publication 
All listed investigators will be co-authors on any presentation or manuscript published from this 
study. The principal investigators will be the first authors on the study manuscript. 
 
 

9 
 
9. References 
1. 
Health Mo. Annual Data Explorer 2022/23: New Zealand Health Survey [Data File]. 2023. 
2. 
Paterson R, Durie M, Disley B, Rangihuna D, Tiatia-Smith J, Tualamali'l J. He Ara Oranga: 
Report of the Government Inquiry into Mental Health and Addiction. Wellington: Government 
Inquiry into Mental Health and Addiction, 2018. 
3. 
Wilson A, Nicolson M. Mental Health in Aotearoa: Results from the 2018 Mental Health 
Monitor and the 2018/19 New Zealand Health Survey. 2020. 
4. 
Khoury B, Sharma M, Rush SE, Fournier C. Mindfulness-based stress reduction for healthy 
individuals: A meta-analysis. Journal of Psychosomatic Research. 2015;78(6):519-28. doi: 
10.1016/j.jpsychores.2015.03.009. 
5. 
Lane JD, Seskevich JE, Pieper CF. Brief meditation training can improve perceived stress and 
negative mood. Alternative Therapies in Health and Medicine. 2007;13(1):38-44. 
6. 
Philips KH, Brintz CE, Moss K, Gaylord SA. Didgeridoo Sound Meditation for Stress Reduction 
and Mood Enhancement in Undergraduates: A Randomized Controlled Trial. Glob Adv Health Med. 
2019;8:2164956119879367. Epub 20190930. doi: 10.1177/2164956119879367. PubMed PMID: 
31632840; PubMed Central PMCID: PMCPMC6769210. 
7. 
Gaynor ML. Sounds of healing: A physician reveals the herapeutic power of sound, voice and 
music. New York: Broadway Books; 1999. 
8. 
Davis WB, Thaut M. The Influence of Preferred Relaxing Music on Measures of State Anxiety, 
Relaxation, and Physiological Responses. J Music Therapy. 1989;26(4):168-87. 
9. 
de Niet G, Tiemens B, Lendemeijer B, Hutschemaekers G. Music-assisted relaxation to 
improve sleep quality: meta-analysis. Journal of Advanced Nursing. 2009;65(7):1356-64. doi: 
10.1111/j.1365-2648.2009.04982.x. 
10. 
Linnemann A, Ditzen B, Strahler J, Doerr JM, Nater UM. Music listening as a means of stress 
reduction in daily life. Psychoneuroendocrinology. 2015;60:82-90. doi: S0306-4530(15)00212-7 
[pii];10.1016/j.psyneuen.2015.06.008 [doi]. 
11. 
Lund HN, Pedersen IN, Heymann-Szlachcinska AM, Tuszewska M, Bizik G, Larsen JI, et al. 
Music to improve sleep quality in adults with depression-related insomnia (MUSTAFI): randomized 
controlled trial. Nordic Journal of Psychiatry. 2023;77(2):188-97. doi: 
10.1080/08039488.2022.2080254. 
12. 
North AC, Hargreaves DJ, O'Neill SA. The importance of music to adolescents. British Journal 
of Educational Psychology. 2000;70(2):255-72. doi: 10.1348/000709900158083. 
13. 
North AC, Hargreaves DJ. Musical preferences during and after relaxation and exercise. 
American Journal of Psychology. 2000;113(1):43-67. doi: 10.2307/1423460. 
14. 
Vigl J, Ojell-Järventausta M, Sipola H, Saarikallio S. Melody for the Mind: Enhancing Mood, 
Motivation, Concentration, and Learning through Music Listening in the Classroom. Music and 
Science. 2023;6. doi: 10.1177/20592043231214085. 
15. 
Geipel J, Koenig J, Hillecke TK, Resch F, Kaess M. Music-based interventions to reduce 
internalizing symptoms in children and adolescents: A meta-analysis. Journal of Affective Disorders. 
2018;225:647-56. 
16. 
Goldsby TL, Goldsby ME, McWalters M, Mills PJ. Effects of Singing Bowl Sound Meditation on 
Mood, Tension, and Well-being: An Observational Study. J Evid Based Complementary Altern Med. 
2017;22(3):401-6. Epub 20160930. doi: 10.1177/2156587216668109. PubMed PMID: 27694559; 
PubMed Central PMCID: PMCPMC5871151. 
17. 
Landry JM. Physiological and psychological effects of a Himalayan singing bowl in meditation 
practice: a quantitative analysis. Am J Health Promot. 2014;28(5):306-9. doi: 10.4278/ajhp.121031-
ARB-528 [doi]. 
18. 
Rio-Alamos C, Montefusco-Siegmund R, Cañete T, Sotomayor J, Fernandez-Teruel A. Acute 
Relaxation Response Induced by Tibetan Singing Bowl Sounds: A Randomized Controlled Trial. 
European Journal of Investigation in Health, Psychology and Education. 2023;13(2):317-30. doi: 
10.3390/ejihpe13020024. 

10 
 
19. 
Matthews A, Phillips MCL, L.R. M, Kumar S, Pillar A, M.B. J. A Pilot Study Evaluating the 
Effects of Relaxation Music Played on Quartz Crystal Singing Bowls on Mood in Teenage Males. 
Journal of Psychiatry and Behavioral Sciences. 2023;6. 
20. 
Bourne EJ. The Anxiety and Phobia -Workbook Seventh Edition. USA: Harbinger; 2020. 
21. 
Grove JR, Prapavessis H. Preliminary evidence for the reliability and validity of an 
abbreviated Profile of Mood States. Int J Sport Psychol. 1992;23:93-109. 
22. 
Arroll B, Fernando A, III, Falloon K, Warman G, Goodyear-Smith F. Development, validation 
(diagnostic accuracy) and audit of the Auckland Sleep Questionnaire: a new tool for diagnosing 
causes of sleep disorders in primary care. J Prim Health Care. 2011;3(2):107-13. 
23. 
Kampa M, Finke J, Stalder T, Bucher L, Klapperich H, Mertl F, et al. Facilitating relaxation and 
stress reduction in healthy participants through a virtual reality intervention: study protocol for a 
non-inferiority randomized controlled trial. Trials. 2022;23(1). doi: 10.1186/s13063-022-06307-8. 
24. 
Ahearn EP. The use of visual analog scales in mood disorders: A critical review. Journal of 
Psychiatric Research. 1997;31(5):569-79. doi: https://doi.org/10.1016/S0022-3956(97)00029-0. 
25. 
Hashim HA, Hanafi H, Yusof A. The effects of progressive muscle relaxation and autogenic 
relaxation on young soccer players' mood states. Asian Journal of Sports Medicine. 2011;2(2):99-
105. doi: 10.5812/asjsm.34786. 
 
 
 

11 
 
Appendix 1 
Eligibility Questionnaire 
The next few questions are to confirm that you are eligible to participate in the study. After that we 
will ask you to provide some information about you, and answer some questions about your mood 
and your sleep. You can then complete the first relaxation exercise, so make sure you are 
somewhere comfortable and quiet and have some headphones. 
 
How old are you? 
▼ 16 (16) ... 25 (25) 
 
Do you have access to a mobile/tablet or laptop, and headphones so that you can access the 
intervention? 
No  (1)  Yes  (2)  
 
Do you use singing bowls music regularly (more than once a month)?  
No  (1) Yes  (2)  
 
Do you use guided meditation regularly (more than once a month)? 
No  (1) Yes  (2)  
 
Are you currently receiving treatment from a psychologist or psychiatrist?  
No  (1) Yes  (2)  
 
 
 

12 
 
Appendix 2 
Demographic questionnaire 
Now we want to know a little bit about you... What gender do you most identify as? 
Male  (1)  
Female  (2)  
Non-binary/third gender  (3)  
Prefer to self-describe:  (4) __________________________________________________ 
Prefer not to say  (5)  
 
Q4.3 What is your ethnicity? (Select all those that apply) 
New Zealand European  (1)  
Maori  (2)  
Samoan  (3)  
Cook Island Maori  (4)  
Tongan  (5)  
Niuean  (6)  
Chinese  (7)  
Indian  (8)  
Other, such as Dutch, Japanese, Tokelauan  (9) 
__________________________________________________ 
 
Q4.4 What is your first language? 
________________________________________________________________ 
 
Q4.5 Please tell us a bit about your education 
Still at secondary school  (1)  
Completed secondary school  (2)  
At University/Tec  (3)  
Completed University/Tec  (4)  
 
Q4.6 What qualifications have you completed? (tick all that apply) 
Nil  (1)  
NCEA Level 1 or equivalent  (2)  
NCEA Level 2 or equivelent  (3)  
NCEA Level 3 or equivalent  (4)  

13 
 
Trade - Specify  (5) __________________________________________________ 
Professional - Specify  (6) __________________________________________________ 
Tertiary - Specify  (7) __________________________________________________ 
Other - Specify  (8) __________________________________________________ 
 
 
 

14 
 
Appendix 3 
Abbreviated POMS (Revised Version) 
Below is a list of words that describe feelings people have. Please CIRCLE THE NUMBER 
THAT BEST DESCRIBES HOW YOU FEEL RIGHT NOW. 
 
 
 
Not At All 
A Little 
Moderate
ly 
Quite a 
lot 
Extremely 
1 
Tense 
0 
1 
2 
3 
4 
2 
Angry 
0 
1 
2 
3 
4 
3 
Worn Out 
0 
1 
2 
3 
4 
4 
Unhappy 
0 
1 
2 
3 
4 
5 
Proud 
0 
1 
2 
3 
4 
6 
Lively 
0 
1 
2 
3 
4 
7 
Confused 
0 
1 
2 
3 
4 
8 
Sad 
0 
1 
2 
3 
4 
9 
Active 
0 
1 
2 
3 
4 
10 
On-edge 
0 
1 
2 
3 
4 
11 
Grouchy 
0 
1 
2 
3 
4 
12 
Ashamed 
0 
1 
2 
3 
4 
13 
Energetic 
0 
1 
2 
3 
4 
14 
Hopeless 
0 
1 
2 
3 
4 
15 
Uneasy 
0 
1 
2 
3 
4 
16 
Restless 
0 
1 
2 
3 
4 
17 
Unable to concentrate 
0 
1 
2 
3 
4 
18 
Fatigued 
0 
1 
2 
3 
4 
19 
Competent 
0 
1 
2 
3 
4 
20 
Annoyed 
0 
1 
2 
3 
4 
21 
Discouraged 
0 
1 
2 
3 
4 
22 
Resentful 
0 
1 
2 
3 
4 
23 
Nervous 
0 
1 
2 
3 
4 
24 
Miserable 
0 
1 
2 
3 
4 
25 
Confident 
0 
1 
2 
3 
4 
26 
Bitter 
0 
1 
2 
3 
4 
27 
Exhausted 
0 
1 
2 
3 
4 
28 
Anxious 
0 
1 
2 
3 
4 
29 
Helpless 
0 
1 
2 
3 
4 
30 
Weary 
0 
1 
2 
3 
4 
31 
Satisfied 
0 
1 
2 
3 
4 
32 
Bewildered 
0 
1 
2 
3 
4 
33 
Furious 
0 
1 
2 
3 
4 
34 
Full of pep 
0 
1 
2 
3 
4 
35 
Worthless 
0 
1 
2 
3 
4 
36 
Forgetful 
0 
1 
2 
3 
4 
37 
Vigorous 
0 
1 
2 
3 
4 
38 
Uncertain about things 
0 
1 
2 
3 
4 
39 
Bushed 
0 
1 
2 
3 
4 
40 
Embarrassed 
0 
1 
2 
3 
4 
 
 

15 
 
Appendix 4 
Auckland Sleep questionnaire (current sleep) 
Please answer the following:  
a.  Do you have problems getting to sleep, staying asleep, poor quality sleep, or waking early such 
that it affects your functioning the next day – this includes feeling excessively sleepy the next 
day?  
No   
Yes  
b. Does this occur 3 or more times per week?  
 No   
Yes  
c. Has it been like this for more than one week?  
No   
Yes  
d. How long have you had this problem? _________________  
e.  If yes, was there some event that caused this? (Please describe.)  
Were there specific reasons for your poor sleep? i.e. baby crying, sick family member, partying 
too late, work/school requirements? _______________________________  
f. Do you need medication to help your sleep, mood or stress?  
 
Please tick one:  
Not during the past month  
Less than once a week  
Once or twice a week  
Three or more times a week  
g. If yes, what is the name of this medicine(s) ____________________  
h. During the past week, how would you rate your sleep quality overall?  
Please tick one:  
Very good  
Fairly good  

16 
 
Fairly bad  
Very bad 
 
Last time point only 
Do you have any feedback on the intervention? What did you think about it? Did you like it? 
 
Would you recommend the intervention you experienced to other rangitahi? 
 
Thank you for answering the questions. You've now completed the study. Over the next few days 
you will receive an email with links to the progressive muscle relaxation and singing bowls tracks so 
you can use them whenever you like 
 
 
 
 

17 
 
Appendix 5 
Visual analogue scales 
Overall, how do you feel right now? Move the slider along the line to indicate your response. 
 
 
0 = Worst I have ever felt 100 = Best I have ever 
felt 
 
 
0 
10 20 30 40 50 60 70 80 90 100 
 
Q1.3 How relaxed do you feel right now? Move the slider along the line to indicate your response. 
 
 
0 = Not relaxed 
100 = Very relaxed 
 
 
0 
10 20 30 40 50 60 70 80 90 100 
 
Q1.4 How stressed do you feel right now? Move the slider along the line to indicate your response. 
 
 
 
0 = Not stressed 
100 = Very stressed 
 
 
0 
10 20 30 40 50 60 70 80 90 100 
 
 
 
 

18 
 
Appendix 6 
Progressive Muscle Relaxation Script (Adapted from The Anxiety & Phobia Workbook, by Edmund J. 
Bourne) 
Progressive muscle relaxation is an exercise that relaxes your mind and body by progressively 
tensing and relaxation muscle groups throughout your entire body. You will tense each muscle group 
vigorously, but without straining, and then suddenly release the tension and feel the muscle relax. 
You will tense each muscle for about 5 seconds. If you have any pain or discomfort at any of the 
targeted muscle groups feel free to omit that step. Throughout this exercise you may visualize the 
muscles tensing and a wave of relaxation flowing over them as you release that tension. It is 
important that you keep breathing throughout the exercise. Now let’s begin…. 
 
Begin by finding a comfortable position either sitting or lying down in a location where you will not 
be interrupted.  
 
Allow your attention to focus only on your body. If you begin to notice your mind wandering, bring it 
back to the muscle you are working on.  
 
Take a deep breath through your abdomen, hold for a few second, and exhale slowly. Again, as you 
breathe notice your stomach rising and your lungs filling with air.  
 
As you exhale, imagine the tension in your body being released and flowing out of your body.  
 
And again inhale…..and exhale. Feel your body already relaxing.  
 
As you go through each step, remember to keep breathing.  
 
Now let’s begin. Tighten the muscles in your forehead by raising your eyebrows as high as you can. 
Hold for about five seconds. And abruptly release feeling that tension fall away.  
Pause for about 10 seconds.  
 
Now smile widely, feeling your mouth and cheeks tense. Hold for about 5 seconds, and release, 
appreciating the softness in your face.  
Pause for about 10 seconds.  
 
Next, tighten your eye muscles by squinting your eyelids tightly shut. Hold for about 5 seconds, and 
release.  
Pause for about 10 seconds.  

19 
 
Gently pull your head back as if to look at the ceiling. Hold for about 5 seconds, and release, feeling 
the tension melting away.  
Pause for about 10 seconds.  
 
Now feel the weight of your relaxed head and neck sink.  
Breath in…and out.  
In…and out.  
 
Let go of all the stress  
In…and out.  
 
Now, tightly, but without straining, clench your fists and hold this position until I say stop. Hold for 
about 5 seconds, and release.  
Pause for about 10 seconds.  
 
Now, flex your biceps. Feel that buildup of tension. You may even visualize that muscle tightening.  
Hold for about 5 seconds, and release, enjoying that feeling of limpness.  
Breath in...and out.  
 
Now tighten your triceps by extending your arms out and locking your elbows. Hold for about 5 
seconds, and release.  
Pause for about 10 seconds.  
 
Now lift your shoulders up as if they could touch your ears. Hold for about 5 seconds, and quickly 
release, feeling their heaviness.  
Pause for about 10 seconds.  
 
Tense your upper back by pulling your shoulders back trying to make your shoulder blades touch. 
Hold for about 5 seconds, and release.  
Pause for about 10 seconds.  
 
Tighten your chest by taking a deep breath in, hold for about 5 seconds, and exhale, blowing out all 
the tension.  
Now tighten the muscles in your stomach by sucking in. Hold for about 5 seconds, and release.  
Pause for about 10 seconds.  
 
Gently arch your lower back. Hold for about 5 seconds, relax.  
Pause for about 10 seconds.  
 
Feel the limpness in your upper body letting go of the tension and stress, hold for about 5 seconds, 
and relax.  
 
Tighten your buttocks. Hold for about 5 seconds…, release, imagine your hips falling loose.  
Pause for about 10 seconds.  
 

20 
 
Tighten your thighs by pressing your knees together, as if you were holding a coin between them. 
Hold for about 5 seconds…and release.  
Pause for about 10 seconds.  
 
Now flex your feet, pulling your toes towards you and feeling the tension in your calves. Hold for 
about 5 seconds, and relax, feel the weight of your legs sinking down.  
Pause for about 10 seconds.  
Curl your toes under tensing your feet. Hold for about 5 seconds, release.  
Pause for about 10 seconds.  
 
Now imagine a wave of relaxation slowly spreading through your body beginning at your head and 
going all the way down to your feet.  
Feel the weight of your relaxed body.  
Breathe in…and out…in…out….in…out 
 
 

21 
 
Appendix 7 
 
The Effects of Quartz Crystal Singing Bowl 
Music and Guided Relaxation on Mood 
and Sleep in Rangatahi (young adults) 
 
What is this study about? 
• An increasing number of rangatahi y(oung adults) report low mood and trouble sleeping 
but accessing help can be challenging. 
• We want to find out if listening to music played on singing bowls or guided relaxation 
exercises improve mood and sleep  
• The study is being led by Professor Nicola Starkey, School of Psychology, University of 
Waikato and Associate Professor Michael Jameson, University of Auckland and has 
received approval from the University of Waikato Human Research Ethics Committee 
(HREC(Health)2024# 03); humanethics@waikato.ac.nz)  
Am I eligible to take part? 
• You are aged between 16-25 years, have a good understanding of English, good 
hearing and have a mobile phone/laptop to access the internet 
• You cannot take part if you already use singing bowls or guided relaxation, or are 
currently receiving treatment from a psychologist or psychiatrist 
What am I being asked to do? 
• To complete questionnaires about your mood and sleep at three time points and 
participate in the online intervention three times a week for four weeks (each session 
is approximately 10 minutes) 
• You can participate in the intervention at a time and place that suits you  
• 
As a thank you for your participation, first-year psychology students can receive up to 
10% course credit via the IPRP scheme. Other participants can opt to enter a prize 
draw to win a $100 warehouse voucher 
Who can I speak with about my participation in this project? 
• Contact Nicola Starkey on 07 8379230 or email nstarkey@waikato.ac.nz  
• 
Or scan the QR code / follow the link (QR code /link to be added) 
 
 

22 
 
Appendix 8 
The Effects of Quartz Crystal Singing Bowl Music and Guided 
Relaxation on Mood and Sleep in Rangatahi (Young Adults) 
 
Participant Information Sheet (IPRP) 
What is this study about? 
The number of people reporting poor mental wellbeing is increasing, with rates exceeding 25% of 
the population. Rates of psychological distress in young people (aged 15-24 years) are rapidly 
increasing but many cannot access professional help. Meditation and mindfulness are effective but 
require a lot of practice, so other treatment options are needed. 
Music and sound (sound healing) have been used for centuries to aid relaxation and improve mood , 
and studies have shown that listening to music improves mood and aids relaxation. We want to 
compare the effectiveness of quartz crystal singing bowl music with guided relaxation on mood, stress 
and sleep in rangatahi. 
The study is being led by Professor Nicola Starkey, School of Psychology, University of Waikato, 
Associate Professor Michael Jameson, Waikato Clinical School, University of Auckland with the 
assistance of a Masters student, Kellianne Hamilton and two Honours students, Annalise Bech and 
Alice Wilson. Jacqueline Woodland is our Māori advisor and Dawn Willix-Payne is providing the 
clinical psychology support. 
Am I eligible to take part?  
• 
You are eligible to take part in this study if you are aged 16 – 25 years of age, have a good 
understanding of English, good hearing and have a mobile phone/laptop to access the 
internet 
• 
You cannot take part if you already use singing bowls or guided relaxation (because we 
won’t know if the interventions we are testing are effective), or are currently receiving 
treatment from a psychologist or psychiatrist (because we do not want to interfere with 
your ongoing treatment) 
What am I being asked to do? 
If you agree to take part in this study, we will ask you to answer some questions about you, your 
mood, and how well you are sleeping. You will then be given a link to access the online intervention 
(singing bowl music or guided relaxation). We would like you to complete the intervention three 
times a week for four weeks (each session takes 10 minutes) whenever is convenient for you. We 
will keep track of how often you complete the intervention and send you reminders. Occasionally we 
will ask you to complete ratings of your mood at the beginning and end of one of the intervention 
sessions.  
After four weeks we will ask you to complete the mood and sleep questionnaires again and give you 
free access to the intervention for another four weeks (you can use it as much as you like). We will 
then ask you to complete the mood and sleep questionnaires again, and ask you for feedback on the 

23 
 
study. You will then be given free access to both the singing bowl music and guided relaxation so you 
can continue to use it if you wish. 
As an acknowledgment of your contribution to the research, first-year Psychology students enrolling 
in the study through IPRP can obtain up to 10% course credit for participating. Your participation is 
voluntary (your choice). 
What will happen to my information? 
Four weeks after you complete the final questionnaire we will download the data from Qualtrics and 
remove any identifying information (ie it will be anonymised) and the data will be stored on a server 
in a password-protected file at the University of Waikato. We will send an electronic summary of our 
findings to the participants who have indicated they would like to receive this information. The study 
findings will be written up for publication as a journal article and included as part of one Masters 
thesis and two Honours theses. 
This research project has been approved by the Human Research Ethics Committee (Health) at the 
University of Waikato as HREC(Health)2024#03. Any questions or concerns about the ethical conduct 
of this research may be sent to the Secretary of the Committee, email humanethics@waikato.ac.nz, 
postal address, Human Research Ethics Committee (Health), University of Waikato, Te Whare 
Wananga o Waikato, Private Bag 3105, Hamilton 3240. 
What are the possible benefits and risks of this study? 
Taking part in this study will take some of your time. There are no known risks caused by this study, 
and we hope you find the interventions enjoyable. There is no guarantee that you will benefit 
directly from being involved in this study, but the results obtained from your participation will help 
us understand if singing bowl music or guided relaxation improves mood and sleep in rangatahi. 
What can I expect from the researchers? 
If you decide to participate in this project, the researchers will respect your right to: 
• 
ask any questions of the researchers about the study at any time during participation; 
• 
decline to answer any particular questions or carry out any of the tasks; 
• 
withdraw from the study up to four weeks after completing the final questionnaire; 
• 
provide information on the understanding that it is confidential to the researchers. It will not 
be possible to identify you in any articles produced from the study; 
• 
be given an electronic summary of the findings 
Who can I speak with about my participation in this project? 
If you, or anyone you know is interested in taking part in this research, or have any questions 
please email singingbowls@waikato.ac.nz for more information.  
 
 

24 
 
The Effects of Quartz Crystal Singing Bowl Music and Guided 
Relaxation on Mood and Sleep in Rangatahi (Young Adults) 
 
Consent Form 
 
Please tick to indicate you consent to the following 
 
 
Yes 
 
I have read, , and I understand the Participant Information Sheet.   
 
 
I have been given sufficient time to consider whether or not to participate 
in this study. 
 
 
I am satisfied with the answers I have been given regarding the study  
 
 
I understand that taking part in this study is voluntary (my choice) and 
that I may withdraw from the study within 4 weeks of the final 
questionnaire  
 
 
 
I understand that my participation in this study is confidential and that no 
material, which could identify me personally, will be used in any reports 
on this study. 
 
 
I know who to contact if I have any questions about the study in general. 
 
 
I understand my responsibilities as a study participant. 
 
 
I wish to receive a summary of the results from the study. 
Yes  
No  
If yes, please provide your name and email address so we can send a summary of the results 
 
Declaration by participant: 
I hereby consent to take part in this study. 
Participant’s name: 
By clicking the submit button you give consent to 
participate 
 
SUBMIT