Medical Examiner

Can ASMR Be Used to Treat Anxiety or Insomnia?

Anyone who experiences the phenomenon knows how relaxing it can be. Now, researchers are starting to take the possibility of therapeutic uses seriously.

A woman holds a rainstick with a camera and lighting gear pointed toward her.
Ashlie Holbrook, known by her YouTube name WhispersUnicorn, records an ASMR video with a rain stick at her home in Westminster, Colorado, on July 8, 2015. Aaron Ontiveroz

Trisha Robertson was 12 years old when she came down with a really nasty case of mono. It’s not an unusual illness for a kid of her age, but hers was especially severe, leaving her bed-ridden for several months and unable to do pretty much anything. So, she spent all of her time at home, switching between lying down in her bed, lying down on her couch, and lying down on the floor in front of the television. The chief symptom of mononucleosis is fatigue, so the only thing Robertson had the energy to do was flip through the channels, looking for something good to watch. And then she landed on PBS, which at the time was airing reruns of Bob Ross’ television show, The Joy of Painting. The show mainly consisted of Ross talking the viewer through how to do a simple painting, usually of a landscape.

Maybe it was Ross’ soft, even voice, the tapping of the painting knives on his easel, or the bristles of the paintbrush slowly dragging across the canvas, but something about it entranced her. It caused an inexplicable, almost tickling feeling, which started on the top of her head, trickled down her skull, paused at her cheeks, and moved down the back of her spine. Eventually, she’d drift off to sleep. “It was the most amazing feeling and it put me into almost this meditative state,” said Robertson, who’s lived on the Jersey Shore for most of her life. “It was a feeling I just wanted to chase.” And she did, whenever The Joy of Painting was on, she was right there on her couch watching Ross paint mountains and clouds and the like—that is, until she finally got better and had to go back to school.

For the most part, she forgot all about it, until it happened again years later. Then, Robertson was in her 20s, watching the Home Shopping Network while looking for a present for her mom. This time it wasn’t Bob Ross’ smooth baritone, but rather the longtime presenter Colleen Lopez, who was showing jewelry and handbags for sale. The sound of the metal and stones clinking together, and Lopez’s voice, how delicately she handled all of the merchandise, was enough to send Robertson into a trance. It helped her drift off to sleep, which was something she’d been having trouble doing.

This time, she didn’t forget. She went online and gathered all the clips she could find of Lopez on the Home Shopping Network and compiled them into a YouTube playlist so she could play them back whenever she was stressed out or had trouble sleeping. It became an essential stress reliever in her life, seeing her through a trying divorce and a taxing job as a social worker for child protective services.

What Robertson was experiencing, and didn’t have a name for yet, was ASMR, which stands for autonomous sensory meridian response, also commonly referred to as “the tingles.” If you’ve ever found yourself lost in the depths of YouTube, you may have come across some ASMR videos, which are understandably bizarre if you don’t know what you’re watching. Such videos might feature a person speaking in a raspy whisper to the viewer, or eating food with her mouth especially close to the microphone, or repeatedly tapping her fingernails on an object, all in the hope of making sounds (or triggers) that elicit the relaxing, tingling, or staticlike sensation on the skin that people who experience ASMR tend to chase. Robertson is far from alone in this pursuit. A quick YouTube search of ASMR yields more than 13 million results. “I was floored, there’s a whole community of wackadoodles like myself,” she said of the time she discovered that her favorite makeup YouTuber had a separate channel for ASMR videos, introducing her to the internet community of other people who experience ASMR.

It’s also clear that Robertson is not the only one using ASMR for the purpose of relaxation, stress management, or insomnia. She likens the effects to doing yoga or meditation. Since the online community was established around 2007, the phenomenon has only grown exponentially, with more and more people watching the videos and recognizing that they experience and enjoy ASMR. But even as the phenomenon and its large online community have become relatively common knowledge, there’s a surprising lack of understanding of what, exactly, makes it enjoyable; what is happening in the body and brain when you’re experiencing it; why some people get the tingles while others feel nothing; and what applications it could all have.

Those questions are what made Giulia Poerio, professor of psychology at the University of Sheffield in the U.K., determined to empirically establish what ASMR’s effects are physiologically, to gain a better understanding of the phenomenon. “I thought there must be some research in this already, so I was searching and searching. I couldn’t find anything,” said Poerio, who has experienced ASMR herself since she was young. “The more people I spoke to, I realized that people who don’t experience ASMR find it quite hard to believe that it’s a genuine experience.” And that’s a problem that Poerio, and many proponents of ASMR, face. It’s hard for people who don’t experience it to wrap their heads around why one might want to listen to people tapping on Tupperware or performing fake doctors’ examinations—it just seems so out of the ordinary.

The first step in studying the phenomenon is establishing that it happens at all. Poerio had to show evidence of what anyone that uses ASMR already knows—that it produces feelings of calmness and relaxation. In the first of two experiments, Poerio and her team tracked how 1,000 participants, 81 percent of whom identified as experiencing ASMR. The participants responded to various videos, some which had no ASMR effects, while others showed different types of ASMR effect. The researchers had them rate their moods before and after watching the videos. They found that people that experience ASMR reported higher levels of excitement and calmness, and lower levels of stress and sadness after watching ASMR-focused videos compared with people who don’t experience ASMR but watched the same videos. In the second experiment, they showed a set of videos to both groups of people while monitoring their physiological changes and found that people that experienced ASMR experienced more dramatic decreases in heart rate and levels of stress compared with their non-ASMR peers.

For Poerio, these findings were promising but just a first step. She said the next important step is to develop a system of measuring the ASMR response and, of course, to determine what exactly is going on in the brain while it is happening. Collecting the evidence for all of this will take more time, and Poerio hopes her work can at least start to provide a framework for further studies. “It could have applications for things like insomnia, anxiety, and other issues,” she said. “We know some people are using it for those things.”

Deploying something currently thriving on YouTube toward alleviating anxiety is a strangely positive if very 2018 Mad Libs idea. But ASMR has some interesting potential applications—for one thing, compared with some other anxiety treatments, it’s probably safe to say that enjoying ASMR videos isn’t dangerous, for the same reasons that meditating or doing yoga is harmless, and it’s also readily available, in terms of cost and access. One big question it raises is could this be effective in the long term for dealing with issues like anxiety and stress? The answer is likely to depend on the type of person, and the type of anxiety or stress.

David Kaplan, chief professional officer for the American Counseling Association, declined to comment specifically on its efficacy but said he thought it could fall into the same category as other “mindfulness” techniques (think, guided meditation, intentional breathing), which he says can play an important role in managing anxiety and stress. “You can’t be relaxed and stressed at the same time. Mindfulness techniques help you relax at the physical level, and that can help your emotional state,” he said. It shouldn’t necessarily be used in lieu of other more robust forms of treatment, like the help of a counselor, other professional, or medication, but it could be a useful tool kept on hand, to be deployed in critical moments to minimize stress.

For people that already use ASMR for stress reduction and insomnia, among other things, it’s just a matter of time before the science catches up to lived experience. Like so many others, Kat Tenbarge discovered ASMR long before she had a name for it—when she was role-playing as a kid. “We’d play doctor and patient, or teacher and student,” said Tenbarge, who is a student at Ohio State University, studying journalism. “And I always loved being the patient or the student, because I always got these tingles in the back of my head, and it was this super-relaxing experience.” She stumbled across ASMR after watching a parody video in high school and got curious. Since, it’s become a central part of her life and has helped her deal with her own persistent insomnia. “It helps your brain become more focused and less all over the place, so it’s a really great relaxation aid,” she said.

She feels so strongly about it that she even started her own YouTube channel, where she makes videos of her own, some by request of her viewers. Her videos are pretty traditional (as far as ASMR videos go). They are mostly role-playing, where she acts as a friend giving you a facial or a waitress—sometimes she even assumes the role of a character from a TV show—and she says the response she gets from viewers is overwhelmingly positive. She even gets commissions to make videos for people that have specific triggers they want catered to. “That idea of creating content that people use to actually make their lives better is a real draw for me,” said Tenbarge. “You can always make a difference in your little corner of the internet.” And that she is, one YouTube video at a time.