# The Efficiency of Binaural Beats on Anxiety and Depression--A Systematic Review
## 4 Discussions  
Researchers support the use of this therapy to reduce and alleviate anxiety symptoms, but these effects are primarily demonstrated in the short term. The studies included in this review support the modification of patients' perceptions of anxiety symptoms, as demonstrated in the meta-analysis conducted by [PERSON] et al. [38] where, in addition to the effect on anxiety, the effects of binaural beats on patients' cognition, pain perception, and moods were also evaluated. Most of the studies included in this paper assessed the effect of binaural beats on the reduction in anxiety generated by a medical procedure such as dental removal [19] or cataract surgery [26]. The intervention was mainly made before the procedure, but some authors used it even post-procedure. Further research is needed to see whether this therapy can have long-term effects. Based on our research, we identified studies that provide evidence suggesting that the effects of binaural beats are not superior to those of music therapy. This review included three studies that did not report a significant change in anxiety levels when comparing the effects of binaural beats and music, whether the music was selected by the patients [31] or was 432 Hz music chosen by the authors [24]. This outcome may be influenced by the greater inclination of individuals to listen to music rather than use binaural beats, as music is a ubiquitous part of human life and more commonly utilized. As noted by [PERSON] et al. [39], music therapy can help alleviate stress and promote relaxation. Additionally, some patients may be more hesitant to engage with binaural beats than music, particularly when they can choose the music themselves. Regarding the binaural beat pattern used to reduce anxiety symptoms, it can be seen that the alpha pattern is the most often used by authors. Although this model is found in most studies, some authors have obtained favorable results using other models, such as the delta pattern. These patterns are responsible for modifying the state of consciousness, as [PERSON] et al. [40] stated in their study; therefore, patients can focus more on the music embedded with binaural beats than focusing on the negative part of their situation at that moment in time. An integral aspect that substantiates and enhances this argument is the conclusion drawn by [PERSON] et al. [41]; their study indicates that binaural beats contribute to heightened patient comfort during medical procedures. Additionally, these beats foster a pleasant environment, boosting patient confidence, encouraging the willingness to return for future medical procedures, and improving compliance. Another pivotal consideration in the implementation of binaural beat therapy is the careful selection of carrier tones employed to create frequency disparity. The choice of carrier tones plays a significant role in determining the effectiveness and specificity of the binaural beat therapy. Interestingly, this diversity in carrier tone selection persists even when the underlying frequency patterns remain consistent across studies or diverge in their objectives. Furthermore, this underscores the nuanced nature of binaural beat therapy, where researchers tailor the choice of carrier tones to suit their specific therapeutic goals and target populations. [PERSON] et al. [42] concluded that the most efficient type of frequencies for the carrier tones are the ones between 200 Hz and 900 Hz. In the case of this review, we found a significant discrepancy in carrier tones, but on average, most of the authors preferred carrier tones close to 200 Hz. The exposure time used for binaural beat therapy exhibits considerable variation across studies. Many authors report a preferred duration of 10 min, although there are instances where therapy is extended to 30 min. Currently, no standardized protocol clearly defines the optimal exposure time for each individual binaural pattern or specific pathology.