In the world of chronic obstructive pulmonary disease (COPD) management, treatments tend to fall into familiar categories: inhalers, pulmonary rehabilitation, breathing exercises, and medications. But a new clinical trial presented at the European Respiratory Society (ERS) Congress in Barcelona suggests an unconventional addition to the therapeutic arsenal – laughter therapy.
The Study
Researchers at Ankara Bilkent City Hospital in Türkiye conducted a randomized trial involving 63 people with COPD. Participants were divided into three groups: one-third received laughter therapy, one-third practiced traditional pursed-lip breathing exercises, and one-third served as a control group with no breathing exercises.
Both intervention groups were taught their assigned techniques face-to-face, then asked to practice for 30 minutes, three times per week for eight weeks. Researchers supported them with video calls and text messages to encourage adherence.
The results, presented by Dr. Goncagul Aldan, a lecturer and nurse from Hacettepe University Faculty of Nursing, showed that both laughter therapy and pursed-lip breathing significantly reduced breathing difficulties compared to the control group—and the effect persisted even one month after the program ended.
What Is Laughter Therapy?
Laughter therapy is a structured intervention designed to evoke the physiological effects of genuine laughter in the body. In this trial, patients learned a series of specific exercises:
Rhythmic clapping with vocal sounds
Playful laughter exercises, such as mimicking a motorcycle starting or a lion’s roar
Laughter meditation with spontaneous, unforced laughter
Relaxation with calm breathing and smiling
The approach is based on the principle that the body cannot distinguish between simulated and genuine laughter—both produce similar physiological responses.
How Does It Work in COPD?
The mechanism isn’t fully understood, but Dr. Aldan offered several hypotheses. In COPD, airways tend to collapse during exhalation, trapping stale air inside the lungs. Pursed-lip breathing—the established comparator in this trial—creates gentle back pressure that allows trapped air to escape, slows the breathing rate, and helps patients feel more in control.
Laughter therapy may work through different but complementary pathways:
Exercising the breathing muscles through the physical act of laughing
Promoting deeper exhalation, potentially helping clear trapped air
Triggering endorphin release, offering both physical and emotional relief
Reducing stress and anxiety, which can worsen breathlessness perception
The Results
After the eight-week intervention period:
Breathlessness: Both laughter therapy and pursed-lip breathing groups had significantly less difficulty breathing compared to the control group
Overall health: Both treatment groups showed better overall health scores
Care needs: No difference between groups in how much day-to-day care patients required
The sustained effect—one month post-program—is particularly noteworthy, suggesting patients continued practicing or retained benefits beyond the formal intervention period.
“Managing COPD requires more than medication alone,” Dr. Aldan said. “Patients need a holistic approach to help them cope with their symptoms, the physical burden of the disease, and its emotional and psychological impact.”
The study was also positively assessed by Dr. Marc Miravitlles, Vice President of the European Respiratory Society. According to his assessment, despite its small scale, this is a well-organized study with promising results. The expert emphasized that laughter therapy is a simple, inexpensive, and universally accessible method that helps patients with COPD improve their breathing and alleviate their overall condition.
Important Caveats
The researchers are careful not to overstate the findings:
Small sample size: 63 patients is relatively modest for a clinical trial
Mechanism unclear: How exactly laughter therapy reduces breathlessness needs further investigation
Not a replacement: This is positioned as complementary to existing care, not a substitute for standard treatment
More research needed: The team hopes to study laughter therapy on a larger scale with more patients and collaborate internationally across different clinical settings
The researchers plan to expand their work with larger-scale studies and international collaborations. Understanding the mechanisms—whether through respiratory muscle training, improved exhalation dynamics, endorphin-mediated symptom modulation, or stress reduction—will be crucial for optimizing the intervention.
Sometimes, the old adage that “laughter is the best medicine” might have more truth to it than we realized—at least when it comes to breathing easier with COPD.
Source: ERS
