what do you think is more opressing? When everything’s about to go black. Just one lonely note being played every second or so, or 4 tracks loud an strident like an alarm that just went off?
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I just replayed your game and I actually think it would be cool if the music you have already started devolving (i.e. getting more dissonant or moving down chromatically, while getting louder) as you're hit. And then when you get as close to death as possible, do just one note. I'm not familiar with pico so I'm not sure what's possible but I hope you can use this idea in some way.