Auditory Biofeedback through Wind Instrument Training: A Breath-Controlled Acoustic Strategy for Modulating Anxiety and Sleep.

Anxiety and sleep disturbances frequently coexist due to common autonomic dysregulation. This review emphasises wind-instrument training as an intervention that integrates intentional breath regulation with self-produced auditory feedback to influence vagal tone and maintain arousal stability. We performed a systematic review and mechanistic analysis, querying PubMed, Embase, PsycINFO and the Cochrane Library (2000-2024) for clinical and experimental studies on wind-instrument training, and synthesised pathways connecting respiration, auditory processing and autonomic regulation. Initial evidence indicates a decrease in anxiety symptoms, enhancements in heart-rate variability and a reduction in nocturnal awakenings; nevertheless, the majority of studies are limited in size and duration, necessitating larger multi-centre trials. Incorporating wind-instrument practice into therapeutic frameworks may enhance existing non-pharmacological strategies by aligning respiratory pacing with consistent and self-produced sound, providing a physiological mechanism for improved emotional regulation and sleep.