Evaluation of the Anxiety-Reducing Effects of Aroma Stones with Bergamot Essential Oil before Examinations: A Randomized Controlled Trial.

Authors

Nobuyuki Wakui, Hinako Kagi, Yuna Hirota, Yuna Koakutsu, Aika Okami, Shoko Kawakubo, Shunsuke Shirozu, Yoshiaki Machida

Published in

Journal of integrative and complementary medicine. Pages 27683605261488658. Sep 18, 2026. Epub Sep 18, 2026.

Abstract

Examinations are highly stressful for students and can impair their academic performance and mental well-being. While aromatherapy is used to relieve stress, its effectiveness during acute stress periods, such as pre-exam situations, remains underexplored.
To evaluate the effectiveness of aromatherapy with bergamot essential oil using aroma stones in reducing pre-exam anxiety among university students.
A randomized, parallel-group, open-label trial was performed with 57 Hoshi University undergraduates. Participants were assigned to either an intervention group (aroma stones infused with bergamot essential oil) or a control group (stones with water) for 3 days. The primary outcome was the change from baseline in the State Anxiety Inventory (SAI) scores at 180 min on each of the 3 days immediately preceding the regular examinations; secondary outcomes included the Short-form Measure of Relaxation Effects (S-MARE), Stanford Sleepiness Scale (SSS), Depression Anxiety Stress Scale (DASS-21), and Subjective Happiness Scale (SHS).
The intervention group showed significantly lower SAI scores at 180 min on all 3 days compared with the control group (all p < 0.0167, the Bonferroni-adjusted significance threshold; Cohen's d > 0.8). Improvements were observed in the total and subscale scores of the S-MARE. The SSS scores indicated lower sleepiness only on Day 2. The SHS scores were significantly higher on the day before the exam. No significant between-group differences in DASS-21 scores were observed. Moreover, no intervention-related adverse events were reported.
Aromatherapy with bergamot essential oil using aroma stones may reduce pre-exam anxiety and promote relaxation and well-being. This simple, noninvasive method may have potential as a practical psychological support tool in pre-examination educational settings, although the findings should be interpreted cautiously given the single-center design and relatively small sample size.

PMID:
42755326
Bibliographic data and abstract were imported from PubMed on 18 Sep 2026.

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