A clinical trial finds deliberate laughter therapy exercises are as effective as traditional breathing techniques for improving symptoms and overall health.
RT’s Three Key Takeaways:
- Comparable Symptom Relief: Clinical trial findings indicate that deliberate laughter exercises reduce breathlessness in patients with COPD as effectively as traditional pursed-lip breathing techniques.
- Accessible At-Home Option: The technique requires no equipment or specialized support, providing an accessible, low-cost self-management tool to complement medical treatments and pulmonary rehabilitation programs.
- Sustained Patient Outcomes: Patients practicing laughter therapy maintained significant reductions in breathlessness and improvements in overall health a month following the eight-week program.
A clinical trial for patients with COPD shows that laughter therapy can reduce breathing difficulties and is as effective as traditional breathing exercises, according to research presented at ERS 2026.
In the trial, investigators evaluated whether deliberate laughter could serve as an effective breathing exercise by directly comparing it with pursed-lip breathing and a control group that performed no breathing exercises. Researchers reported that laughter therapy provides a low-cost intervention that patients can practice at home without equipment or specialist assistance, alongside standard medical therapy.
“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,” said Dr Goncagul Aldan, a lecturer and nurse graduated from Hacettepe University Faculty of Nursing.
“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,” said Dr Goncagul Aldan, a lecturer and nurse graduated from Hacettepe University Faculty of Nursing.
Evaluating Clinical Outcomes and At-Home Practice
The study enrolled 63 patients with COPD receiving treatment at Ankara Bilkent City Hospital in Türkiye. Researchers randomly assigned one-third of participants to laughter therapy, one-third to pursed-lip breathing exercises, and one-third to a control group receiving no breathing exercises.
Pursed-lip breathing involves inhaling through the nose and exhaling slowly through pursed lips, an established method designed to release stale air trapped in diseased lungs. For the laughter therapy cohort, patients learned a routine consisting of rhythmic clapping with vocal sounds, playful exercises such as mimicking a lion’s roar or a starting motorcycle, spontaneous laughter meditation, and relaxation with calm breathing and smiling.
Participants in both active treatment arms received face-to-face instruction before being asked to practice for 30 minutes, three times weekly for eight weeks, supported by video calls and text messages. Investigators evaluated breathing difficulties, overall health status, and daily care dependency before, during, and after the intervention.
Following the eight-week intervention, patients performing laughter therapy and those doing pursed-lip breathing experienced significant reductions in breathing difficulty compared with the control group. Both active groups also achieved improvements in overall health, though daily care needs remained unchanged across cohorts.
“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,” said Dr Goncagul Aldan, a lecturer and nurse graduated from Hacettepe University Faculty of Nursing.
Mechanisms and Implications for Respiratory Care
According to the researchers, airways in patients with COPD tend to collapse during exhalation, trapping air within the lungs. While pursed-lip breathing creates back pressure to release trapped volume and slow respiration, laughter therapy may exercise the respiratory musculature, encourage deeper exhalation, and stimulate endorphin release.
“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 programs,” said Dr Goncagul Aldan, a lecturer and nurse graduated from Hacettepe University Faculty of Nursing.
Dr Marc Miravitlles, vice president of the European Respiratory Society and senior researcher and consultant at Vall d’Hebron University Hospital in Barcelona, Spain, who was not involved in the trial, noted the importance of accessible interventions in chronic disease management.
“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,” said Dr Marc Miravitlles, vice president of the European Respiratory Society and senior researcher and consultant at Vall d’Hebron University Hospital.
“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,” said Dr Marc Miravitlles, vice president of the European Respiratory Society and senior researcher and consultant at Vall d’Hebron University Hospital.
The study authors noted plans to evaluate laughter therapy across larger patient cohorts and pursue international collaborations to test these nonpharmacological approaches across diverse clinical healthcare settings.
