In a interventional study, researchers have discovered that listening to Holy Quran recitation significantly reduces pain and stabilizes heart rates in intubated patients undergoing one of the most painful procedures in intensive care—endotracheal suctioning.
Imagine being awake, unable to speak, and connected to a machine that breathes for you. Now imagine a nurse inserting a tube down your throat to suction out secretions—a procedure described by ICU survivors as one of their most distressing memories. For millions of mechanically ventilated patients worldwide, this is a daily reality. And for too long, the primary tools to manage this pain have been powerful sedatives and opioids—drugs that can delay recovery, prolong ICU stays, and carry serious side effects.
But a remarkable new study, published on January 15, 2025 in the Iranian Journal of Nursing and Midwifery Research, offers a simple, cost-effective, and side-effect-free solution: listening to the recitation of the Holy Quran.
The study, titled “The Impact of Listening to Quran Recitation during Pain-Inducing Procedure among Patients Receiving Mechanical Ventilation Support: An Interventional Study,” was conducted at King Abdullah University Hospital in Irbid, Jordan. It is the first experimental study of its kind to test Quranic recitation as a pain relief intervention specifically for adult intubated patients during endotracheal suctioning—a procedure that patients consistently rate as the most painful routine nursing care in the ICU.
The Hidden Epidemic of ICU Pain
Pain in intensive care units is shockingly common. More than 50% of medical and surgical ICU patients experience significant pain, and over 80% of survivors remember the pain associated with their breathing tube and suctioning long after they leave the hospital. Chronic pain among ICU survivors is linked to higher rates of depression, anxiety, and reduced quality of life for years after discharge.
Endotracheal suctioning—the process of clearing secretions from a patient’s airway—is particularly brutal. According to ICU procedural pain surveys, it consistently receives the highest pain intensity scores compared to other nursing procedures like position changes or wound care. Patients experience moderate to severe pain each time suctioning occurs, often multiple times per day.
Traditionally, this pain is managed with sedatives and analgesics. But there is a dangerous misconception among some healthcare providers: that sedation equals pain relief. It does not. Heavy sedation delays extubation, prolongs ICU stays, suppresses the immune system, and can lead to delirium and long-term cognitive impairment.
The medical community has been searching for effective nonpharmacological interventions—treatments that don’t involve drugs. The PADIS guidelines (Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption) from the Society of Critical Care Medicine recommend music therapy as one such option. But what about a therapy that is not only relaxing but also deeply meaningful for the world’s 1.8 billion Muslims?
The Study: How It Was Done
Researchers led by a team from Jordan University of Science and Technology designed a rigorous experimental pilot study. They enrolled 32 intubated patients—all practicing Muslims—admitted to medical or surgical ICUs. The patients were randomly divided into two groups of 16:
- Intervention Group: Listened to Quran recitation through headphones for 20 minutes before, during, and 20 minutes after endotracheal suctioning (45 minutes total). Families were asked about each patient’s preferred reciter and verses to personalize the experience.
- Control Group: Wore headphones with no sound (to control for the sensory effect of wearing them).
The researchers measured pain using the Behavioral Pain Scale (BPS) , a validated observational tool that assesses facial expressions, upper limb movements, and compliance with ventilation. They also monitored key physiological parameters: heart rate (HR), systolic and diastolic blood pressure (SBP, DBP), and oxygen saturation (O2 sat). Sedation levels were measured using the Ramsay Sedation Scale (RSS) and statistically controlled for.
The results were striking.
The Results: A Dramatic Difference
After controlling for sedation levels, the researchers found significant multivariate effects for the study group (F5,26 = 11.47, p < 0.001, η² = 0.69)—meaning the intervention had a large, statistically powerful effect.
Patients who listened to Quran recitation had significantly lower pain scores and lower heart rates during suctioning than those who did not.
Let’s look at the numbers:
Table 1: Pain Scores (Behavioral Pain Scale) During Suctioning
| Time Point | Control Group (No Quran) Mean (SD) | Intervention Group (Quran Recitation) Mean (SD) | Statistical Significance |
|---|---|---|---|
| Before Suctioning | 5.06 (2.18) | 3.06 (0.12) | p = 0.001 |
| During Suctioning | 8.81 (2.23) | 5.13 (1.31) | p < 0.001 |
| After Suctioning | 5.81 (1.22) | 3.06 (0.25) | p < 0.001 |
Note: BPS scores range from 3 (no pain) to 12 (maximal pain).
The control group’s pain score during suctioning soared to 8.81—severe pain. The Quran group’s peak pain was only 5.13, a dramatically lower level. Even more remarkably, after suctioning ended, the Quran group’s pain returned to baseline (3.06), while the control group remained elevated.
Table 2: Heart Rate (Beats Per Minute) During Suctioning
| Time Point | Control Group Mean (SD) | Intervention Group Mean (SD) | Statistical Significance |
|---|---|---|---|
| Before Suctioning | 82.75 (13.49) | 79.00 (13.11) | Not significant (p = 0.53) |
| During Suctioning | 100.37 (15.56) | 81.00 (13.18) | p = 0.001 |
| After Suctioning | 83.94 (13.65) | 82.31 (12.48) | Not significant (p = 0.73) |
The control group’s heart rate jumped by nearly 18 beats per minute during suctioning—a classic sign of pain and stress. The Quran group’s heart rate remained almost flat, rising only 2 beats per minute. This suggests that Quran recitation provided a powerful stabilizing effect on the autonomic nervous system.
Other physiological measures (blood pressure, oxygen saturation) showed improvements in the expected direction, though they did not reach statistical significance in this pilot study.
Why Does It Work? The Science of Sound and Faith
The study’s authors propose several mechanisms for why listening to Quran recitation reduces pain:
- Endogenous Opioid Release: The brain’s reward and pain-regulation centers respond to familiar, meaningful, and pleasant auditory stimuli. Listening to Quran recitation may stimulate the release of natural opioid analgesics (endorphins) that block pain signals.
- Stress Hormone Reduction: Quranic recitation has been shown in previous studies to lower cortisol and other stress hormones. Lower stress = lower pain perception.
- Distraction and Relaxation: The rhythmic, melodic nature of Quranic tajweed (proper recitation) captures attention, diverting focus away from the painful procedure. It promotes a state of relaxation that counteracts the body’s “fight or flight” response.
- Spiritual and Emotional Comfort: For a practicing Muslim, the Quran is not just sound—it is the word of God. Listening to it provides profound spiritual reassurance, reducing the fear, anxiety, and sense of helplessness that amplify pain.
The authors note: “Listening to familiar and favorable music can promote relaxation, decrease feelings of discomfort and uncertainty, and act as a method of distraction during painful nursing care procedures.” For Muslim patients, Quran recitation serves this role even more powerfully because of its sacred meaning.
A Call to Action for ICUs Worldwide
This study has immediate, practical implications—especially for hospitals in Muslim-majority countries and any ICU caring for Muslim patients in the West.
For Hospital Administrators and ICU Managers:
- Provide headphones and audio players (or tablets with Quran apps) at every ICU bedside.
- Train nurses to ask families about preferred reciters and verses.
- Integrate Quran recitation into standard pain management protocols, particularly before and during suctioning, dressing changes, and other painful procedures.
For Nurses and Bedside Clinicians:
- You do not need to be Muslim to offer this intervention. Simply ask: “Would your family member like to listen to Quran recitation to help with pain?”
- Coordinate with respiratory therapists to time the recitation with suctioning.
- Document its use as a nonpharmacological pain intervention.
For Muslim Families:
- Advocate for your loved one. Bring a device with Quran recitation to the hospital. Share your family member’s favorite reciter (e.g., Sheikh Abdul Basit, Mishary Alafasy, etc.) with the nursing team.
- Know that this is not “alternative medicine” being pushed to replace drugs. It is a complementary therapy that works alongside medical treatment.
For Educators and Policy Makers:
- The authors note that nursing schools in Jordan and many other countries do not offer courses on complementary and alternative medicine. This must change. Evidence-based spiritual and sound therapies should be part of standard nursing curricula.
What This Study Adds to a Growing Body of Evidence
This research does not stand alone. It joins a growing literature demonstrating the power of Quranic recitation:
- Keivan et al. (2019): Showed Quran recitation decreased pain during dressing changes for critically ill burn patients.
- Ghiasi & Keramat (2018): Systematic review found Quran recitation significantly reduces anxiety across multiple patient populations.
- Mat-Nor et al. (2019): Systematic review showed Quran recitation improved consciousness levels and hemodynamic stability in ICU patients.
- Kocak et al. (2022): Randomized controlled trial found listening to Surah Al-Inshirah reduced labor pain and anxiety in Muslim women.
What makes the current study unique is its focus on intubated, non-communicating patients undergoing a standardized, highly painful procedure—and its rigorous experimental design controlling for sedation levels.
Limitations and Next Steps
The authors honestly acknowledge limitations. This was a pilot study with a sample size of 32. Larger, multi-center trials are needed to confirm the findings and test for other outcomes like duration of mechanical ventilation, ICU length of stay, and long-term post-ICU pain syndromes. The study was conducted in a single geographic area (Irbid, Jordan), which may limit generalizability.
However, the effect sizes were large (η² = 0.69 for the group effect), meaning the intervention had a strong impact. The study provides compelling proof-of-concept that should motivate larger trials.
A Simple, Sacred Solution
In an era of expensive drugs, complex protocols, and high-tech ICU monitors, sometimes the most powerful medicine is also the simplest. A pair of headphones. A recording of the Holy Quran. And a healthcare team willing to ask, “Would this help?”
For the 16-year-old leukemia patient, the elderly grandfather with pneumonia, the accident victim on a ventilator—for millions of Muslim patients around the world—the answer is likely yes.
As the Quran itself declares in Chapter 17, verse 82: “And We send down in the Quran that which is a cure and a mercy for the believers.”
Science is now confirming what faith has known for fourteen centuries. The healing sound of the Holy Quran is not just for the soul. It is for the body, too.
Reference: here
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