Could laughter be the best medicine for bronchiectasis?

It’s well established that laughing can improve our mental wellbeing, but there is a real lack of research into how it could benefit those with physical health conditions. Dr Arietta Spinou at King’s College London is researching how it could improve the lives of people with bronchiectasis.

Bronchiectasis is a long-term lung condition which causes the airways to become damaged and widened. Thick mucus (phlegm) can build up in them which increases the risk of getting an infection. The main symptoms are a cough that brings up phlegm, breathlessness and fatigue. 

Why do we need new treatments for bronchiectasis?

One of the main ways we treat bronchiectasis is by helping people get rid of mucus sitting in their airways. This can help improve their symptoms and reduce infections. People with bronchiectasis are given advice on techniques to do this but they can be hard to learn and take time. If they’re not done correctly, they are not effective. 

Another treatment that can help is pulmonary rehabilitation (PR). This is a programme of exercise and education, such as learning about techniques to manage breathlessness. However, not everyone is offered PR and some are not able to take it up or complete the sessions.

How does laughter affect our lungs?

It’s important we find ways to help people clear their airways and use ways that they find easy to do and stick to. We know that laughing moves our lungs  and it could potentially cause vibrations in our airways that can loosen mucus and help people breathe more easily. So, through the SPLASH Project (Social Prescribing of LAughter claSses for people with broncHiectasis), I’m exploring whether laughter-based activities could support people living with bronchiectasis. 

People with bronchiectasis take part in a six-week programme with weekly sessions of laughter yoga and education twice a week. Laughter yoga within the programme combines exercises to make you laugh with breathing exercises, but nothing is forced (and people follow at their own pace). Education is tailored to people with bronchiectasis and participants are feeding into the topics of our discussions.

Do people experience laughter in the same way?

We wanted to make sure that this programme was really meeting the needs of the people we wanted to help. We held a Laughter Lab and other activities, where we brought together people living with lung conditions, carers and relatives, clinicians, researchers, and creative practitioners. Through creative activities, discussion, and a laughter yoga taster session, we explored experiences of laughter and invited participants to shape the design of the event itself.

One important thing that came out from our work is that people experience laughter in different ways. For many of us, it’s associated with joy, connection and wellbeing, but for others it means self-consciousness, coughing, breathlessness, embarrassment, or concerns about laughing in public. So, we needed to make sure that there were different ways for people to take part and that people feel comfortable throughout. 

Can we make treatment for bronchiectasis fun and enjoyable?

Early feedback from SPLASH participants has been very encouraging - people have told us that they understand their condition more, they’ve been able to clear their airways better and they’ve seen positive effects on their daily activities and wellbeing. The project has also helped raise awareness of bronchiectasis which is really important as it’s often overlooked. 

We’re hoping that this can become a low-cost, scalable intervention that can be accessed by many. Currently, we have little to offer in the way of treatment for bronchiectasis, but this is a simple way that people could help improve their symptoms in a fun, enjoyable and easy way. This could greatly improve wellbeing and quality of life for people living with bronchiectasis, just through something simple that we’re all able to do. If successful, similar approaches could be adapted for other long-term lung conditions. 

I am delighted to see laughter emerging as a serious area of scientific research, and I am proud to lead its development in respiratory conditions. As a natural respiratory manoeuvre, its potential benefits have been largely overlooked. Our early work suggests that laughter may offer benefits beyond its psychological effects, with potential implications for respiratory health and function.