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I think the changing environment is really clever, because as the stress of life comes down on you, you often forget or "lose sight" of what's around you, and you're left with only your problems. I feel like you could go with that idea even more and apply it to the sounds,  i.e. a track that gets more and more intense as you're hit. That way the player feels the stress you're trying to convey even more.

thanks a lot. Just last night I heard a little conference on the global game jam about that kind of stuff and found it really interesting, I think I ll start to add tracks to the maximum 4 (of pico 8). I just got introduced to F MOD and want to play with that idea.

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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?

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.