How Christmas Carolling Can Boost Lung Health for People with COPD

Singing is emerging as a powerful, evidence-based way for people with COPD to breathe easier, feel better, and stay active – and the festive carol season is the perfect time to embrace its benefits.

Recent research shows that structured “Singing for Lung Health” (SLH) can improve walking distance just as effectively as traditional exercise training in pulmonary rehabilitation, while also supporting quality of life and emotional wellbeing.​

Why singing helps people with COPD

People living with COPD often describe breathlessness as a barrier that shapes every part of daily life, from walking to the shops to joining in with family activities. Singing changes the focus: instead of concentrating on every uncomfortable breath, attention shifts to melody, lyrics and rhythm – and breathing is gently retrained in the background. SLH sessions are designed to use long phrases, controlled exhalation and relaxed inhalation to help empty the lungs more effectively, reducing air trapping and easing the work of breathing.

Kaasgaard et al. showed that when SLH was used as the main training element in a 10-week community pulmonary rehabilitation programme in Denmark, people with COPD improved their 6-minute walk distance to a very similar extent as those doing conventional gym-based exercise. In both groups, those who attended regularly achieved the greatest gains, highlighting that an enjoyable, sustainable activity like singing can be a practical way to keep people engaged with rehabilitation.

Breathing, posture and symptom control

The British Lung Foundation’s Singing for lung health information explains three key ways singing can improve breathing: teaching slower, deeper breaths; enhancing the sense of control over breathing; and improving posture to support the lungs. Many people with COPD habitually breathe from the upper chest and overuse neck and shoulder muscles – patterns that are tiring and inefficient. Singing long phrases encourages a longer, more complete outbreath and recruits abdominal muscles, which can make everyday breathing feel easier.

Participants in SLH groups often report feeling less short of breath, more in control of their breathing and better able to manage symptoms such as cough or anxiety-related “panic breathing”. In the Danish trial, Singing for Lung Health was carefully adapted to COPD, blending physical warm-ups, breathing and vocal exercises, movement and song – a structure that mirrors the BLF approach of combining posture, rhythm and relaxation to support breath control.

Mental wellbeing, confidence and community

The benefits of singing go well beyond lung mechanics. People with long-term lung conditions frequently experience low mood, stress and social isolation, especially when their world has shrunk around breathlessness. Group singing is consistently described as uplifting, joyful and mentally refreshing, with many participants saying that worries fade during a session and that their positive mood continues afterwards.

Singing also changes identity: instead of seeing themselves only as “patients”, people become “choir members”, working together on harmonies rather than hospital visits. Regular sessions build confidence, create new friendships with others who truly understand the challenges of living with a lung condition, and can motivate people to try other forms of activity and self management. As one British Lung Foundation participant put it, the most important thing is improving health – “but we don’t sound too bad either”.

Carol singing as seasonal pulmonary rehab

In the run-up to Christmas, carol services and community choirs offer a natural opportunity to bring these benefits to life. Structured SLH programmes typically include physical warm-ups, breathing exercises, vocal games and around 40 minutes of singing – not unlike a well-run carol rehearsal with a health focus built in!

For people who feel intimidated by treadmills and weights, an invitation to “come and sing carols for your lungs” may be far more appealing, while still contributing to improvements in exercise capacity and breath control.

Respiratory teams and partners can harness this seasonal momentum by signposting local Singing for Lung Health or BLF-affiliated groups, integrating singing into community-based pulmonary rehabilitation, and using objective measures such as spirometry and 6-minute walk tests to track progress over time. The message to patients is simple and hopeful: you do not have to be a “good singer” to benefit – you just need to be willing to join in, share a song, and let your breath support something joyful as well as functional.

Key references

1. Kaasgaard, M., Rasmussen, D.B., Andreasson, K.H., Hilberg, O., Løkke, A., Vuust, P. and Bodtger, U. (2022) ‘Use of Singing for Lung Health as an alternative training modality within pulmonary rehabilitation for COPD: a randomised controlled trial’, European Respiratory Journal, 59, 2101142. doi:10.1183/13993003.01142-2021.

2. Singing for lung health, published by the British Lung Foundation