Breathe Sing for Lung Health - Breathe

Our Research

Breathe Sing for Lung Health

There is a growing body of evidence which explores the benefits of singing for lung health

A systematic review of evidence was undertaken in 2016 exploring the existing evidence and gaps in evidence.

“Quantitative data suggest that singing has the potential to improve health-related quality of life, particularly related to physical health, and levels of anxiety without causing significant side effects… Qualitative data indicate that singing is an enjoyable experience for patients, who consistently report that it helps them to cope with their condition better.” [1]


The benefits of singing for lung health

The benefits – physical, psychological and social – have a positive impact on quality of life of participants in a number of ways:

  • Improves breath control and distracts from breathlessness
  • Tools for self-management of posture, breath and anxiety
  • Tailored to those with respiratory conditions (unlike normal choirs)
  • Social participation reduces feelings of isolation in an enjoyable, musical activity


The wider evidence

Research since 2008 mainly focuses on people with Chronic Obstructive Pulmonary Disease (COPD).

“There is considerable qualitative data to support participation in singing groups as a safe and potentially valuable strategy.” [2]

Multiple qualitative studies support participation for individuals with respiratory conditions, indicating improvement in:

  • Physical and mental health and wellbeing
  • Disease management and symptom reduction

“Qualitative research into the wellbeing and health benefits of COPD singing groups offers more positive results because qualitative methods can discover what quantitative methods largely cannot.” [3]  Direct feedback from participants consistently confirms the positive and transformative impact on individual lived experience.

Randomised control trials support the qualitative data for physical health improvements for individuals with COPD but there remains less evidence of benefit for other conditions or from commonly used outcome measures.

Lord et al. performed a randomised controlled trial (RCT) comparing a 6-week course of twice weekly singing classes to usual care, in 28 COPD patients. In this RCT, the physical component score of the SF-36 (36-Item Short Form Survey) improved in the singers, compared to the controls. Singers also had a significant fall in Hospital Anxiety and Depression (HAD) score.

In the qualitative element, positive effects on physical sensation, general well-being, community/social support and achievement/efficacy emerged as common themes. In addition to outcomes from the RCT, Lord et al. also reports on an additional 150 participants in open singing workshops, run in the same hospital, who completed a questionnaire about the experience.



98% of participants thought the workshop had taught them something about breathing in a different way and 81% of attendees felt a "marked physical difference" after the workshop

Once more data becomes available, the clinical effectiveness of Singing for Lung Health can be compared with recommended treatments and therapies within a biomedical model in current NHS guidelines.

Singing classes have an impact on health status distinct from that achieved simply by taking part in a group activity. [5]

There's a number of trials that are ongoing at the moment, investigating the clinical effectiveness of singing for lung health in COPD particularly, with randomised control trials looking at singing versus standard or usual care. It's really important that solid, high-quality evidence is made available for singing for lung health, which builds on the original randomised control trials that were now done a decade ago in the UK.
Adam Lewis, PhD, Lecturer Physiotherapy, Brunel University London, team member at The Musical Breath Ltd

Results from our programme

A recent participant evaluation into our weekly Breathe Sing for Lung Health programme, further supports the existing evidence;

  • 100% reported an improvement in their breathlessness levels
  • 100% reported benefits to their breathing control
  • 80% of participants who use a blue inhaler reported needing to use it less often since singing regularly
  • 100% reported an impact on their general wellbeing
  • 100% reported an improvement in their self confidence
  • 90% reported that it improved their mood
  • 81% reported that the breathing exercises were the most valuable part of the session



Adam Lewis, PhD. Lecturer Physiotherapy, Brunel University London, team member at The Musical Breath Ltd

Phoene Cave, MA Music Therapy. Creative Director of The Musical Breath Ltd

Our Partners


Lewis, A., Cave, P., Stern, M. et al. Singing for Lung Health—a systematic review of the literature and consensus statement. npj Primary Care Respiratory Medicine 26, 16080 (2016). [DOI].

Carel, H. (2018). Breathlessness: the rift between objective measurement and subjective experience. The Lancet Respiratory Medicine, 6(5), 332-333

Cave P., Lewis A. & Fancourt D. (2020) Singing For Lung Health in Heydon, Fancourt, Cohen (ed.) The Routledge Companion to Interdisciplinary Studies in Singing, Volume III: Wellbeing, Routledge

Lewis A, Cave P, Hopkinson N. Singing for Lung Health: service evaluation of the British Lung Foundation programme. Perspectives in Public Health. 2018;138(4):215-222. [DOI]. [1]

Lord, V. M. et al. Singing teaching as a therapy for chronic respiratory disease–a randomised controlled trial and qualitative evaluation. BMC Pulm. Med. 10, 41 (2010). [2]

Yoeli H, Macnaughton J. ‘To more than I can be’: A phenomenological meta-ethnography of singing groups for people with chronic obstructive pulmonary disease. Health. December 2020. [DOI]. [3]

Lewis, A., Cave, P., Stern, M. et al. Singing for Lung Health—a systematic review of the literature and consensus statement. npj Primary Care Respiratory Medicine 26, 16080 (2016). [DOI]. [4]

Randomized Controlled Trial / BMC Pulm Med;  Singing classes for chronic obstructive pulmonary disease: a randomized controlled trial. Victoria M Lord 1, Victoria J Hume, Julia L Kelly, Phoene Cave, Judith Silver, Maya Waldman, Chris White, Cayley Smith, Rebecca Tanner, Melissa Sanchez, William D-C Man, Michael I Polkey, Nicholas S Hopkinson

The Musical Breath website

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