A clinical trial for patients with chronic obstructive pulmonary disease (COPD) shows that laughter therapy can reduce breathing difficulties and is as effective as more traditional breathing exercises. The research is presented at the European Respiratory Society (ERS) Congress in Barcelona, Spain [1].
In the trial, patients were taught how to use deliberate laughter as a breathing exercise and this was directly compared with patients using traditional breathing exercises and a control group who were not doing any breathing exercises.
Researchers say laughter therapy offers an effective low-cost treatment that patients can practice at home without any equipment or specialist support, alongside their other treatment.
Results of the trial were presented by Dr Goncagul Aldan, a lecturer and nurse graduated from Hacettepe University Faculty of Nursing, Ankara, Türkiye. She said: "COPD is a serious lung disease that makes it hard to breathe. It affects millions of people worldwide and is a leading cause of disability and death. People with COPD often feel breathless, even during simple daily activities. This reduces their quality of life and makes them increasingly dependent on others for care. Managing COPD requires more than medication alone. Patients need a holistic, approach to help them cope with their symptoms, the physical burden of the disease, and its emotional and psychological impact.
"With this research we wanted to explore whether additional simple, low-cost techniques could complement existing care. Laughter therapy had already shown promising results in a number of other chronic conditions. Its accessible, enjoyable nature suggests it could equally benefit COPD patients, not only in coping with the daily stress of living with a chronic illness, but also in directly supporting their respiratory health."
The study included 63 people with COPD being treated at Ankara Bilkent City Hospital, Türkiye. One third of patients were randomly assigned to laughter therapy, one third to pursed-lip breathing exercises and one third to no breathing exercises.
Pursed-lip breathing exercises, where patients are taught to breathe in through the nose and out slowly through pursed lips, is an established technique for COPD patients which helps to release the stale air that can become trapped in diseased lungs. For the laughter therapy, patients were taught how to do a series of exercises including rhythmic clapping with vocal sounds; playful laughter exercises, such as mimicking a motorcycle starting or a lion's roar; a laughter meditation with spontaneous unforced laughter, and a relaxation with calm breathing and smiling. In both cases, patients were taught face-to-face how to do their assigned exercises then asked to practice for 30 minutes, three times per week for eight weeks. They were supported with a video call and text messages.
Before, during and after the treatment, patients were assessed for their breathing difficulties, overall health and how much care they needed day-to-day.
After the treatment period, patients having laughter therapy and patients using pursed-lip breathing exercises had less difficulty breathing, compared with the patients who had not been doing either breathing exercise. Patients in the two treatment groups also had better overall health, but there was no different in how much care they needed.
Dr Aldan said: "The results of this study show that both pursed-lip breathing exercises and laughter therapy can significantly reduce the severity of breathlessness in COPD patients, and this effect was sustained, even a month after the programme ended. Both interventions also showed promising results in improving overall health, suggesting that laughter therapy may be a worthwhile area for further investigation alongside pursed-lip breathing in COPD care.
"In COPD, the airways tend to collapse during exhalation, trapping stale air inside the lungs. Pursed-lip breathing creates a gentle back pressure that allows this trapped air to escape, slows the breathing rate, and helps patients feel more in control of their breathing. Laughter may exercise the breathing muscles, promote deeper exhalation, and trigger the release of endorphins, offering both physical and emotional relief. Laughter therapy aims to evoke the effects of genuine laughter in the body. However, the mechanisms behind laughter therapy in COPD remain poorly understood, and more comprehensive research is needed.
"These findings offer hope that simple, low-cost techniques which patients can practice at home — without any equipment or specialist support — may reduce breathlessness and improve daily wellbeing. Both pursed-lip breathing exercises and laughter therapy could be valuable additions to existing COPD care, complementing medication and pulmonary rehabilitation programmes."
The researchers now hope to study laughter therapy on a larger scale with more patients and to collaborate internationally to study these approaches in clinical settings across different countries.
Dr Marc Miravitlles, Vice President of the European Respiratory Society, Senior Researcher and Consultant at Vall d'Hebron University Hospital, Barcelona, Spain who was not involved in the research, said: "COPD is a common, serious and long-term condition with no cure. It's vital that we help patients to manage their condition as well as possible, so they can continue to live a normal life. Treatment and care usually involves inhaler treatment, exercise and vaccinations against respiratory infections.
"This is a small but well-run study looking at the potential benefits of laughter therapy or breathing exercises for people with COPD. Patients were taught how to do these exercises then given support to continue at home. 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."
