People with chronic lung disease breathe better after two months of laughter therapy, results from a small trial show. The promising results may prompt further research into the low-cost treatment option.
In chronic obstructive pulmonary disease (COPD) – a leading cause of disability and death worldwide – air isn’t fully expelled when exhaling, meaning stale air remains trapped inside the lungs. The millions of people who are affected by the condition often feel breathless, even during simple daily activities.
Doctors treat COPD with medications like bronchodilators and corticosteroids, and may also recommend specialised breathing exercises. These include pursed-lip breathing, in which patients breathe in through the nose and out slowly through the lips, which creates a gentle build-up of pressure that helps release some of the air trapped in the lungs. But many people with COPD continue to become increasingly dependent on others for care over time, reducing their quality of life.
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, formerly at Hacettepe University Faculty of Nursing in Ankara, Turkey, had seen research showing that laughter therapy shows promise in people with , and and thought it might help those with COPD as well – both physically and mentally.
To find out, she and her colleagues recruited 63 people who were already being treated for COPD at Ankara Bilkent City Hospital and divided them into three groups of 21. In their randomised controlled trial, all participants continued their medications, but those in one group additionally performed pursed-lip breathing exercises and those in another group received laughter therapy. Participants in the third, control, group did neither.
The laughter therapy is an established programme that differs from simple responses to humour. It includes playful exercises like mimicking a motorcycle starting or a lion roaring, rhythmic clapping with vocal sounds and relaxation with calm breathing and smiling. The participants were coached by laughter therapists in face-to-face sessions and then instructed to perform the techniques on their own for 30 minutes, three times per week.
After eight weeks, participants in the laughter therapy and the pursed-lip breathing groups had less difficulty breathing and better overall health than those in the control group. Those benefits were still ongoing even a month after the trial ended, says Aldan. Even so, the therapies didn’t change how much daily assistance participants needed from caregivers. Aldan and her colleagues didn’t directly compare the effects of pursed-lip breathing and laughter therapy. They at the European Respiratory Society (ERS) Congress in Barcelona, Spain.
While more research could help clarify exactly how laughter therapy helps, Aldan suspects it might exercise the breathing muscles, promote deeper exhalation, improve lymphatic flow and trigger the release of endorphins, while also lowering levels of stress hormones.
“This structured approach may help facilitate gentle air expulsion and reduce air trapping without overwhelming the respiratory system,” she says. “Psychologically, it can also offer a safe, enjoyable way to reduce anxiety and support emotional wellbeing.”
Importantly, however, laughter therapy is distinct from intense or unguided laughter – like the response to a funny social media video – which can actually trigger adverse effects like acute airway collapse or exertion, says Aldan. “Laughter therapy is not merely ‘laughing’ – it is a structured protocol that naturally incorporates deep breathing exercises and rhythmic warm-ups to prepare the lungs and body for laughter.”
“This is a small but well-run study,” says at Vall d’Hebron University Hospital in Barcelona, Spain, who wasn’t involved in the research. “These results – showing that patients can breathe more easily and feel better in general – are promising. Laughter therapy is simple and low-cost, meaning it could be used by anyone, anywhere in the world. We look forward to further research in this area.”
The team hopes to expand its work with international collaborators.
