When breathing becomes a daily battle, even the simplest acts can feel exhausting. Now, a new study has found the key to easing chronic breathlessness caused by lung disease: singing.
Chronic breathlessness is a common feature of the lung conditions chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD), the latter being the umbrella term for conditions that lead to lung inflammation and scarring.
In a new study, researchers have trialed a fairly novel approach to reducing the breathlessness caused by lung disease to improve people’s quality of life. That approach? Online group singing.
“Chronic breathlessness is a common and highly distressing symptom for people with chronic obstructive pulmonary disease and interstitial lung disease,” said study lead, Natasha Smallwood, MD, PhD, Professor and Director of Respiratory Medicine at The Alfred Hospital and Monash University School of Translational Medicine. “Yet there is a lack of safe, effective, and acceptable treatment options for managing this symptom.
“Group singing is increasingly used to manage symptoms and improve quality of life for people with neurological, mental health, and respiratory conditions, but we need more evidence to prove that this is beneficial, especially for people with interstitial lung disease.”
In a randomized controlled trial, named SINFONIA, the Italian word for symphony, 101 participants took part in a 90-minute online group singing session delivered via Zoom once a week for 12 weeks. Of the participants, 64 had COPD, and 37 had ILD. Roughly half (50) were allocated to the singing group, and the remainder (51) to a control group that received the usual care for their lung disease (for example, quitting smoking, inhalers and other medications, self-management education, and respiratory vaccines).
The group singing sessions, run by a registered music therapist, included relaxation and breathing warm-ups, breathing control and singing exercises, learning and performing songs, and social time for chatting and connection. Participants were also given CDs or recordings of songs and exercises to practice at home between sessions. The group sang songs such as “Can’t Help Falling in Love”, “Let It Be”, and “Pack Up Your Troubles”.
The main outcome was quality of life, which was measured by participants completing the SF-36 questionnaire. The tool measures health-related quality of life across eight sub-domains: physical functioning, how much physical health problems interfere with daily life, bodily pain, general health perceptions, vitality, social functioning, how much emotional problems affect daily life, and mental health. The raw scores for each domain are transformed into a standardized zero to 100 scale, where higher scores indicate better health. The researchers found that participants in the singing group reported an SF-36 score that was 7.4 points higher than those in the control group.
“Compared to usual care, taking part in the SINFONIA singing program led to improved quality of life for people with chronic obstructive pulmonary disease or interstitial lung disease with chronic breathlessness,” Smallwood said. “These effects were most pronounced amongst people who attended at least eight of the 12 sessions. We saw the greatest improvements in the domains that measures limitations due to physical health or emotional problems.”
The researchers also found evidence suggesting that women, people with anxiety and depression, and those who hadn’t previously completed lung rehabilitation – a structured program of exercise and education – experienced the greatest improvements in quality of life as a result of engaging in the singing program.
“The way in which group singing improves quality of life remains unclear and may vary for different participants,” said Smallwood. “But it could be due to better control of breathing, social connection, or mood improvements.”
The study findings were recently presented at the European Respiratory Society (ERS) Congress in Amsterdam.
Source: Monash University
