Does singing really help against COPD?

Singing is healthy, they say. Does this also apply if you suffer from emphysema, chronic bronchitis or another form of COPD? Scientific research has recently been done. With a surprising outcome. Typically, the lung function of COPD patients deteriorates slightly year after year. The researchers had hoped that the lung function of the participants in this ten-month study into the effects of singing in a choir would remain stable. To their pleasant surprise, the lung function of the COPD patients even improved slightly (by 30 ml). Even though it is a relatively small improvement, this is still good news. Do you suffer from chronic bronchitis or emphysema? Or another form of COPD (Chronic Obstructive Pulmonary Disease)? If you suffer from one of these chronic lung diseases, you often suffer from shortness of breath. You may also regularly feel short of breath, despite the fact that you faithfully take your lung medication or take a puff during an attack of shortness of breath. After a short walk or climbing a flight of stairs, you may feel completely out of breath. You may also have to cough a lot, which may or may not also produce mucus. Unfortunately, there is no cure available so far.

How do you contract COPD?

Smokers are at the greatest risk of contracting this chronic lung disease. About 80% of all COPD cases are caused by smoking. But there are even more important causes. Think of polluted air indoors if there is poor ventilation and ventilation. The pollution becomes even worse if people smoke in the house or if the smoke from the fireplace is poorly removed. But also consider air pollution from industry or traffic, including high concentrations of particulate matter. Or working conditions involving dust in the air or certain chemicals. Hereditary factors can also play a role.

What can you do against COPD?

In COPD, the alveoli become increasingly damaged and so far there is no cure for this progressive disease. Treatment for COPD is aimed at preventing the disease from progressing, relieving symptoms, improving exercise tolerance and general health, preventing and treating irritations and complications and reducing mortality.

COPD gives you sensitive lungs. That is why it is a good idea to stay away from smoke, perfume, hairspray and large temperature differences as much as possible. A healthy indoor climate helps keep your symptoms manageable. As for the outdoor environment, try to avoid air pollution and smog whenever possible. You might also benefit from singing in a choir. At least that is the conclusion of a recent scientific study into COPD and choir singing.

Singing actually helps against COPD

Until recently, it was mainly folk wisdom that singing helps with respiratory diseases. Although there had already been some previous small-scale and short-term scientific studies into singing in lung diseases, the results of a somewhat larger and longer-term study have now also been published in June 2013 in the research report An Evaluation of Community Singing for People with COPD ; (Chronic Obstructive Pulmonary Disease) conducted at Canterbury Christ Church University (in Kent) by researchers Stephen Clift and Ian Morrison, among others. They conducted ten months of research (from September 2011 to June 2012) into COPD and singing in a choir.

People who are otherwise constantly aware of their difficult breathing also appear to benefit from singing. According to Dr. Ian Morrison, senior researcher involved in the research project, lung function improved dramatically after five months after the people who participated in the study had become accustomed to singing and had adjusted their breathing habits. Such an improvement is very striking.

People with breathing problems often struggle with inhaling. They then gasp for air. But these short inhalations fill the lungs with air but do not clean them properly, making inhaling and exhaling even more difficult. By gasping for breath, CO2 accumulates in the blood, with all its harmful consequences.

What makes singing beneficial?

Trained singers have learned how to make the most of their lung capacity. That’s why they can hold nuts longer than most other people. By learning singing techniques, people start to breathe much deeper in a controlled manner.

According to Dr. Morrison, beneficial effects occur over time throughout the muscular system surrounding the lungs, throat and upper respiratory tract. COPD patients will then use their breathing capacity much more effectively.

Research into the benefits of singing for COPD patients

The aim of the study was to obtain information about:

  • The effect of regular singing on clinical outcomes of COPD
  • Its effect on the quality of life associated with health
  • The method of recruitment. (Study participants were recruited through GPs, newspaper advertisements and three local support groups; some forms of recruitment proved more effective than others)
  • The retention rate (in this case the percentage of patients who are compliant with singing)
  • The patients’ level of satisfaction with the treatment (this was measured by a questionnaire and examined by an analysis of written comments.

As part of a feasibility study, the scientists had more than a hundred COPD patients with mild to severe respiratory diseases sing in a choir every week for ten months. Their lung capacity was measured with a spirometer. The participants had to fill out a questionnaire to indicate how they felt. On average, the participants had half normal lung function. This means that they could exhale 1.5 liters of air in 1 second. In healthy people this is around 3 liters. Without treatment, COPD patients typically reduce the volume of their exhalation in 1 second by approximately 40 ml per year.

Nearly all participants reported that they could breathe easier. In addition, some of them reported that singing:

  • Helps to breathe properly (including breath control, techniques for daily activities, muscle control and a better understanding of breathing)
  • Improves posture
  • Helps with relaxation
  • Contributes to concentration and provides distraction
  • Is a good workout / gives more energy
  • Opens the lungs / improves lung capacity
  • Facilitates physiotherapy
  • Helps to prevent panic attacks or hyperventilation.

According to Professor Stephen Clift, the lead author of the study, the research team had hoped that by singing regularly for a year, the participants’ breathing capacity would not deteriorate, but would remain stable. To their delight, breathing capacity improved by 30 ml. Even though this is only a small improvement, it is still significant given the deterioration that usually occurs year after year.

Furthermore, singing in a choir has social and psychological benefits, as it provides a break from the isolation that affects so many people with a chronic illness. People leave their homes for choir rehearsals and undertake activities and can support each other and thus increase each other’s well-being.

According to the researchers, there is no question that singing can cure COPD, nor that it can replace other treatment methods. The most important thing a COPD patient can do for their health is to stop smoking.

Dr. Morrison believes singing could be an appropriate tool to help people cope with the condition. The hope is that singing ‘on prescription’ can have a beneficial effect on various chronic diseases.

The study was not randomized nor was there a control group. But given the favorable results, the scientists are now planning to set up a comparative study in which some participants will sing and other participants will not. From a scientific point of view, the results of that research will provide a more powerful signal about the beneficial effect of singing in choir on COPD.

Singing tips

You don’t have to have a beautiful voice to benefit from singing. You don’t even have to be able to sing in tune. Although that is of course a requirement for singing in a choir. In other cases, you can also think of singing at home in the shower or in the kitchen while doing the dishes.

Voice coach Claire Alsop has the following tips for singing. Visualize your lungs expanding. You can do this, for example, by holding your arms in front of you like a ballerina and then moving them outward while you exhale. Keep your shoulders low and your knees slightly bent (not ‘locked’). Make sure your feet are slightly apart, in a ‘ten to two’ position (like the hands of a clock). Now exhale with a ‘tffff’ sound. Feel how your diaphragm pushes the air out.

With singing lessons or a voice training course (often extra beneficial if you are already a member of a choir) you can master the most important techniques of singing. Singing is not only a fun hobby, it apparently also improves your health.