Explore the health benefits of bursting into song

This summer’s heatwave has caused problems for asthma sufferers and others with chronic respiratory problems caused by high pollen counts. Singing lessons may help with breathing all year round, but it’s a controversial approach.

Whether you regularly serenade your loved ones with Motown classics or limit your warbling to behind the bathroom door, most of us have been known to hit a few high notes when we are feeling good.

Over the years, exercising the vocal cords has been credited with helping people to overcome speech disorders, anxiety problems and even some mental-health issues. A revolutionary new programme in the UK claims that singing can also help patients with respiratory disorders to increase their lung capacity and regulate their breathing.

The Singing for Breathing classes at the Royal Brompton and Harefield hospitals in London have been designed to educate people about breathing properly and making the best possible use of their lung capacity. Workshops include lessons on how best to use the stomach muscles, which in turn allows air to be drawn into the upper body, and how to breathe out slowly, which helps to increase oxygen absorption.

Experts are divided as to whether singing improves respiratory health. A research paper published in the International Journal of Chronic Obstructive Pulmonary Disease examined the effect and found that while patients enjoyed the participation, more studies were needed.

“Despite its limitations, the present study indicates that singing classes are an amusing, non-risky and well-tolerated activity for selected subjects with COPD,” concludes the report.

"Its regular practice may also improve quality of life and preserve the PEmax [expiratory pressure at mouth level] of these patients. Additional studies are recommended to better define the potential role of singing as a new tool for pulmonary rehabilitation."

Little evidence

Dr Basil Elnazir, consultant respiratory paediatrician, is the medical chairperson of the Asthma Society of Ireland. He says that although there is little evidence to show that singing works as a cure for asthma or even as a means of improving lung function, it can be beneficial in other ways.

“There is scant evidence to prove that singing actually works as a means of facilitating the treatment of a respiratory problem,” he says. “So I would say that it is more likely to be beneficial as part of a pulmonary rehabilitation programme rather than an objective cure. I deal a lot with children who have asthma and, while I would agree that singing can be very good for them, I wouldn’t be able to say that it improves their lung capacity.”

Patrick McKeown is the founder of Asthma Care and the author of six books on treating the condition. He is a practitioner of the Buteyko method of breathing, which is an alternative treatment for asthma and other respiratory conditions. He also believes that while singing is good for overall health and wellbeing, it does not offer any specific benefits to people with respiratory problems.

“I am an asthmatic but am not much of a singer so instead of breaking windows with my voice I’ll rely on what I know instead,” says McKeown. “So I employ nasal breathing and the Buteyko method to remain symptom and medication free.

“This method is quite different to singing as it involves teaching asthmatics to unblock the nose and to breathe through it on a permanent basis. Buteyko breathing exercises are also employed to bring the breathing volume of an asthmatic towards normal – in clinical trials, asthmatics breathe two to three times more volume than normal,” McKeown asserts.

“Asthmatics for the most part display dysfunctional breathing including breathing through the mouth, upper chest breathing, sighing and noticeable breathing. The Buteyko method aims to reverse these poor habits, while singing does not. Six clinical trials of the Buteyko method for asthma show a significant improvement to quality of life and reduction in the need for medication,” he says.

But Dermot O'Callaghan, chief executive of the Association of Irish Choirs, says singing is hugely beneficial both mentally and physically. "It is most definitely good to sing and is a stimulating experience in many ways," he says. "Your entire body is involved in singing. Your mind needs to actively engage for various reasons: to create a good sound, to sing the correct notes and to blend with fellow singers. The more you sing, the more you will realise that you will achieve better and varied results if you engage your body in different ways," he says.

Benefits of singing

“There are many research projects and findings that prove time and again that singing has an undeniable impact on positive mental health. Some of the obvious direct results of singing are elevated mood, improved memory and increased concentration,” he says.

Stress and anxiety have also been proved to be significantly reduced after singing. There are also many physical benefits which include better posture, stronger stomach muscles and toned facial muscles. And research at the University of Frankfurt points to immune system benefits and improved lung capacity as well.

"The US Journal of Behavioural Medicine reported that blood samples taken from choir members before and after they sang found raised levels of immunoglobulin A and cortisol. Their blood composition was unaffected when the singers simply listened to the same music.

“The inherent value that is derived from singing is there for people of all abilities. The physical and mental process is similar for all who engage in it,” O’Callaghan says.