Media release

From: Monash University

Singing songs by the likes of Elvis and The Beatles can improve the quality of life of people with lung disease and help reduce their symptoms, new research has found.

The randomised-controlled trial was led by Professor Natasha Smallwood from Monash University and Alfred Health. It is unpublished but expected to be accepted by a major journal.

“Chronic breathlessness is a common and highly distressing symptom for people with chronic obstructive pulmonary disease and interstitial lung disease,” Professor Smallwood said. “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.”

Interstitial lung disease (ILD) is a general term for a large group of conditions that cause progressive scarring and inflammation of the lung tissue, affecting hundreds of thousands of people around the world. Chronic obstructive pulmonary disease (COPD) is a serious lung condition affecting around 400 million  people worldwide.

The SINFONIA study, recently presented at the European Respiratory Society Congress in Amsterdam [1], saw patients take part in a 90-minute online group singing session delivered once a week for 12 weeks over Zoom.

A registered music therapist developed and delivered the SINFONIA sessions, which included dedicated time for warmups, breathing exercises, song singing, and social check ins to foster group connection.

The program was delivered online to make it as easy as possible to take part, and patients were loaned iPads and given free data plans to help reduce barriers to participation. The group sang songs such as Can’t Help Falling In Love, Let It Be, and Pack Up Your Troubles.

Of the 101 participants, 50 were allocated to the singing sessions and 51 to a group who were given usual care (for example smoking cessation, respiratory vaccines, inhaler therapy, self-management education, and anti-fibrotic medications).

Sixty-four of the patients had chronic obstructive pulmonary disease (COPD), and 37 had interstitial lung disease (ILD).

Patients completed a questionnaire called the SF-36, which records their quality of life across eight sub domains (including pain, social functional, general health and fatigue). These domains are rated from 0 (worst quality of life) to 100 (best quality of life) and then averaged to give a total score.

SF-36 was 7.4 points higher in the singing group compared to 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,” Professor 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 measured limitations due to physical health or emotional problems.”

There was also some evidence to suggest that women, people with anxiety or depression, and those who have not previously completed pulmonary rehabilitation experienced the greatest improvements in quality of life as a result of the online group singing program.

“The way in which group singing improves quality of life remains unclear and may vary for different participants,” Professor Smallwood said. “But it could be due to better control of breathing, social connection, or mood improvements.”

Please acknowledge the European Respiratory Society Congress as a source in any articles:[1] Abstract no: RCT2291 “The SINFONIA study: a phase III randomised controlled trial of an online group singing intervention for people with COPD or ILD.”, by Natasha Smallwood et al; Presented in session, “ALERT 2: infections, lung cancer and respiratory symptoms management” at 15.30-17.00 CEST on Sunday 28 September 2025. [https://k4.ersnet.org/prod/v2/Front/Program/Session?e=685&session=19604]

Funding: This research received funding from the Windermere Foundation and the National Health and Research Medical Council in Australia. According to the UK Academy of Medical Science’s press release labelling system, this is a non-peer reviewed randomised controlled trial in people.