A melody a day keeps the doctor away? The proposed health benefits of singing

by Beth Cotter on February 21, 2013

Whether you are belting out a song in the shower, taking over the lead vocals to a hit on the radio, joining in exclaiming your alma matter after a football game, or performing a vigorously rehearsed performance of Handel’s Messiah, on a daily basis, the majority of us most frequently participate in the expression of music through singing. As some of us may be aware of the positive health effects of listening to music through music therapy, I wanted to examine whether any health benefits result from swapping roles from the number-one-groupie to the super-star vocalist. In other words, how does our health benefit from singing in our every day lives?

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Singing Can Boost Your Immunity

What doesn’t kill you makes you stronger – Kelly Clarkson

Wouldn’t it be fantastic if singing in the shower could improve our immune function? Well, some evidence suggests that it can. A study by Kreutz et al. in the Journal of Behavioral Medicine, looked at the levels of an important antibody in the immune system that is secreted during infection (Secretory IgA) in response to singing status amongst members in a choir. After comparing the antibody levels of singing choir members to the antibody levels of non-singing choir members, they found that the IgA levels were significantly higher amongst the singers than the listeners. This finding suggests that singing has a positive influence upon the immune system.

Not only does IgA respond to signals in the immune response but it is also understood that IgA levels can be associated with an individuals’ emotional state. Typically, when someone is in a happy or positive mood, they experience an increase in IgA. Therefore the positive emotional reaction amongst singing members of the choir could be serving as a major contributor to an enhanced immune response.

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Singing  Can Bring You and Your Loved One Closer Together

Love shack is a little old place where we can get together – B 52

A study by Grape et al. examined the beneficial effects of singing upon the overall well-being amongst trained and untrained singers. Although there were slight differences between the groups in terms of health outcomes, both groups of singers demonstrated an increase in oxytocin levels after singing. Oxytocin is typically referred to as the “cuddle hormone” since it is known to be released after a sensual encounter with a loved one, but it has also been associated with boosting feelings of trust, reducing anxiety and stress and promoting feelings of happiness. Have you ever gotten so fully involved in singing a song that you felt emotionally uplifted after it was done? Have you ever felt exhausted from the level of investment that you put into singing a song? Well, an emotional connection to a song or singing experience could be due to this release of oxytocin that, in turn, signals an improved sense of well-being.

Singing Can Help to Alleviate stress 

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I can see clearly now the rain is gone – Johnny Nash

Considering the fact that most of us have “that certain song” that we listen to in order to help us clam our nerves when we are  stressed or anxious, it is no surprise that by actively engaging in singing, we can reduce our levels of stress and anxiety. An exploratory study by Clift and Hancox collected information from students in a university choir about the perceived personal and health benefits that could result from participating in a choir. Eighty-seven percent of the students responded positively in believing that they benefited socially, 75% believed that they benefitted emotionally, 58% thought that they benefitted physically and 22% of the students believed that they experienced reduced stress and anxiety as a direct result of singing. In general, the study found that singing in a choir setting can influence relaxation and stress reduction amongst choir participants.

Singing Can Help You to Breathe More Easily

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Breathe, just breathe – Anna Nalick

A study performed by Gale et al. examined the quality of life and lung function of cancer survivors after participation in a choir that rehearsed for two hours a week. Although this study did not find that there was any signifiant change in their lung function after participation in the choir, they did find that the patients involved in the choir had a greater expiratory capacity than those people  not in the choir. Other studies have shown that patients with COPD (chronic obstructive pulmonary disease) who sang twice a week had better respiratory health than those who did not. These findings make sense considering the fact that singing utilizes muscles involved with breathing. By learning how to both regulate your breath and extend your expiratory time, singers are inherently increasing the strength of their lungs.

Singing Can Facilitate a Sense of Community

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Oh I get by with a little help from my friends -The Beatles

Having grown up in a relatively musical family, it seems like whenever we all get together we find a way to incorporate singing. From Christmas caroling around the neighborhood, to performing duets from musical theatre productions, or attempting to create a five-part harmony, it seems that no matter what type of music is produced it always brings my family closer together. Because of this, I fully appreciate the idea that singing could play a role in facilitating community, an idea supported by Gale et al. The researchers of this study recognized that it could be very difficult to fully separate the direct health effects of singing versus the health effects of having a social support system (via a choir), yet still found it valuable to acknowledge the social and community benefits that choirs can provide. Considering that the population in this study consisted of cancer survivors, the findings are particularly relevant to that specified population, but I think that the positive influence of singing in a “community” can be translated to external populations.

Does level of singing expertise effect the magnitude of the health benefit?
No! In fact studies demonstrate that professional and amateur singers receive distinct health benefits from singing! While as you might expect, professional singers are more physiologically fit for singing and are more tuned into the details of musical performance, they experience greater stimulation from singing than amateurs. But, in terms of health benefits, it appears that amateur singers are able to utilize singing to better release emotional tensions and experience a greater  sense of well-being than professional singers. Therefore, whether you sing in the car or perform on Broadway, health benefits can result from anyone who takes time to sing!

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Need for Further Investigation:

While the health benefits of singing appear to be slightly diffuse, the success that has been discovered in observational studies, surveys, and experimental studies sheds a positive light upon future discoveries. As with any body of research, caution should be taken when translating the findings of one study to an entire population, but the significant effects of singing upon the health outcomes of choir groups, surviving cancer patients and COPD patients establishes a promising future for further investigation.

 

He who sings scares away his woes – Miguel de Cervantes

 

[Updated: 02/27/13]

Lola February 21, 2013 at 10:53 am

Beth,
Great post! I like that you made me think about a topic that I had not considered before. And I like the personal connection about your musical family. Further, I think the placement of appropriate quotes/lyrics was a really nice touch.

One thought–I feel like I remember secretory IgA being associated primarily with mucous membranes. Do you think that the air flow through the nasal and oral cavities during singing and subsequent increase in mucus and saliva production might be responsible for the increased presence of IgA??? Just curious.

Beth February 21, 2013 at 4:56 pm

Thank you for the comment, Lola! You are correct in that secretory IgA is primarily located in mucous membranes, but it appears that it is commonly used as an indicator of mood and stress becuase of its easily accessible and measurable presence in saliva. IgA is an interesting marker for stress because it initially increases immediately after stress and then decreases with a few days after a stressful event. Therefore, it is curious that Kreutz et al. found immediate increases in IgA in saliva after singing.

More in realtion to your question, I could not find any reserach regarding if the mechanical action of air flow through the naval and oral cavaties has an influence upon IgA secretion, or if an increase in the quantity of saliva would inherently result in an increase in salivary IgA. Kreutz et al. mentions that the autonomic nervous system effects the immune system, and that the secretion of IgA is controlled by the sympathetic nervous system (“fight or flight response”). The effect between singing and increased IgA could be explained by the possibilitly of an interaction between singing and the sympathetic nervous system, but that is a conclusion that could probably use some more research!

http://link.springer.com/article/10.1007%2FBF02931243?LI=true#
http://link.springer.com/article/10.1007%2Fs10865-004-0006-9

Brian Clegg February 21, 2013 at 10:56 am

Nice post, though if there is any danger of belting out “Handle’s” Messiah, it may be the case that singing has a negative effect on the ability to spell.

Beth Cotter February 21, 2013 at 12:29 pm

Considering the fact that some studies have shown that learning how to read music could be associated with enhanced overall cognitive function (maybe a future post?…), I think that this error may just have been a simple personal mistake. Either way, thank you for pointing it out. It was not my intention to misrepresent such a historic composer.

http://dx.doi.org/doi:10.2307/3345521
http://jrm.sagepub.com/content/52/1/6.short

Anthony February 21, 2013 at 9:53 pm

Interesting post. Did you come across any information in your research that suggests that singing sad songs can actually make your immune system more vulnerable? Is it just the act of singing, regardless of content, that strengthens the immune system? Also, did you come across any reference to the spoken word – such as reciting uplifting poetry, or were the benefits to the immune solely based upon the act of singing?

Beth February 21, 2013 at 11:01 pm

I’ll start with your last question first, about if there are any discovered immune benefits associated with the spoken word. I did not come across any studies relating the spoken word to enhanced immune function, but I have seen a few studies that have incorporated poetry and creative writing as potential therapeutic devices for people with mental health issues and have found that they are beneficial for improving the physiological and psychological conditions of the patients. Unfortunately, more research needs to be done to determine whether or not these types of therapies impact a persons’ overall health status. That is a very interesting point though, because it starts to touch upon the mechanism through which our bodies connect (potentially differently) with either the spoken word and the “melodic” word.

In regards to your first question, Grape et al. (as referenced in the blog post) touches briefly upon data that could be interpreted to answer whether the lyrics or melodies of a song (whether they be happy, sad, upbeat or slow) have different impacts upon immune function. When you dig a little more deeply into the study you find that, while singing music led to an increase in positive mood and an increase in the immune component IgA, solely listening to music lead to an increase in negative mood and had NO effect on IgA secretion. It is interesting that the immune system was “boosted” with a positive mood and not effected by a negative mood. Considering that this particular study was not designed to test the interaction between mood (as a result from singing) and IgA, we may not be able to draw the conclusion that singing songs that put us in a “bad mood” can impede our immune systems. That being said, there are some studies that have been found a relationship between mood and immune function, but I did not come across any others that relate the act of singing to immune function.

This same study briefly touched upon the differing impacts of listening to music and singing music upon cortisol levels (a hormone that is released in response to stress within the body). We would predict that cortisol levels could potentially decrease after both singing music and listening to music (as a person becomes less stressed), but the study found that cortisol levels were only decreased after listening to music. Putting together the ideas that “listeners” reported negative moods and had decreased cortisol levels could suggest that the expressions of negative emotions (sadness, grief) are experienced as relaxing or soothing. Therefore, considering that negative moods are not associated with a change (for better or for worse) in immune function, and that negative moods could be influence by sad music, I am tempted to make the conclusion that songs that induce sadness may not have an effect on the immune system! Hopefully future research can help to shed light on these relationships!

http://dx.doi.org/doi:10.1046/j.1351-0126.2001.00428.x

Mary February 21, 2013 at 10:08 pm

Words of wisdom from a great singer – Perry Como.
http://www.youtube.com/watch?v=lyOk-GMYsCU

Beth February 21, 2013 at 11:04 pm

“Don’t worry that it’s not good enough for anyone else to hear – Sing, sing a song.”

Thanks for sharing!

Virginia February 22, 2013 at 10:06 am

I also liked the personal reference to family singing together. You will treasure this memory forever. At eighty six I remember playing the pump organ when I was a teenager and my grandmother and I would joyfully belt out songs.
Typo in last sentence of eighth paragraph? Thanks for a pleasant and informative blog.

Beth Cotter February 22, 2013 at 10:52 am

I will definitely cherish the “jam sessions” that my family and I have together! It is so much fun during the holidays because my sisters and I love to sing, my dad plays the drums and my cousin is an amazing guitarist! I’m not sure how we would be received by the public, but my extended family makes for a very loving audience.
Thank you for your comment and the keen “spell-checking” eye.

Loon February 25, 2013 at 5:25 pm

Interesting. However, I am confused at “musical therapy” being described as listening to music. In the musical therapy used here in Germany as part of the therapy for various mental illnesses, the production of music, whether with instruments or through singing, is usually the focus. Then again, language and culture differences might mean that we’re talking about two completely different things.

One other thing: wouldn’t the production of oxytocin be related both with the stress reduction and the community building effect?

Tarin Towers February 26, 2013 at 2:51 am

I enjoyed reading this, but I echo the previous commenter: Music therapy (I’ve never heard it referred to as “musical therapy”) usually involves creating music; music therapy where listening is the primary intervention is the exception, not the rule.

I also hope that it is with sly irony that you’re using Kelly Clarkson as the author of the first quote. Otherwise, I despair for our culture’s future, song-filled or no.

Jillian February 27, 2013 at 10:44 am

Thank you for your article. Here’s a great book published by the Music Therapy department at Beth Israel Medical Center:

Music, the Breath and Health: Advances in Integrative Music Therapy
Edited by Ronit Azoulay and Joanne V. Loewy $35.00
The breath affects multiple dimensions of our health. Scientific research is increasingly demonstrating the influence of breath on emotion, physical health, resilience and vitality. Music offers a unique contribution to breathing function: Listening to music can impact breathing rhythms; live music entrained to breathing rhythms may support interpersonal connection; and active music-making using the breath directly (e.g., wind instrument playing and/or singing) can support optimal respiration. Integrative music therapy incorporates clinical interventions using music and breath within a holistic view of the patient and healthcare delivery. In this book, contributors from music therapy, medicine and related healthcare professions offer clinical methods and research on music, the breath and health across a variety of populations including pulmonary medicine, mechanical ventilation, coma, pain management, procedural support, childbirth, neonatal intensive care, oncology, end of life, psychotherapy and wellness.

http://www.musicandmedicine.org/

Beth Cotter February 27, 2013 at 11:33 am

Thank you for your posts and raising questions based upon the definitions of music therapy. While simply listening to music may have been a generalized representation of of the methods that are used to implement music therapy, listening to music can be effective based upon the needs of the patient.

The American Cancer Society defines music therapy as an intervention where, “Music therapists design music sessions for individuals and groups based on their needs and tastes. Some aspects of music therapy include making music, listening to music, writing songs, and talking about lyrics. Music therapy may also involve imagery and learning through music. It can be done in different places such as hospitals, cancer centers, hospices, at home, or anywhere people can benefit from its calming or stimulating effects. The patient does not need to have any musical ability to benefit from music therapy.”

In continuation of Jillian’s comment, it appears that there are many different clinical utilizations of music therapy, which could provide great information for another blog post.

Sara D. February 28, 2013 at 9:13 am

I am very inspired by the thought of singing in a community brings everyone closer. I completely agree with that observation. I did not know singing could boost you immunity, now that I think about it, I always feel great after singing. Me and my family organize a caroling party every Christmas and it’s been a tradition for several years now. I look forward to it every year, and it brought me and my neighbors closer, now they organize it and we enjoy watching all the little kids sing as we look on from our doorway. I was wondering if in the future, would professional artists benefit more from singing than normal people? For example would they live longer? Would they be much healthier? Thanks #SPX9

Seun March 1, 2013 at 9:16 am

I am very surprised at how much music impacts. I never knew that music affects your immune system. I love music and will continue to listening to it. What is the best kind of music to listen to?? #SPX9

Beth March 1, 2013 at 11:11 am

Thank you for your comment, Seun! Isn’t it interesting to think that there may be some connections between singing and your health?!

According to the studies presented in the post, it appears that singing music that is purposeful (whether that be music that you are working hard at to learn, music that excites you, music that calms your nerves or you mood) to the singer facilitates the greatest health benefits.

Angela March 3, 2013 at 7:17 pm

I wonder whether making music in general has this effect. Obviously, singing seems to be a much more visceral thing that, let’s say, playing the piano or the guitar, but I have noticed that after a serious operation, after every time I made music (whether with or without singing), I made (or felt I made) significant healing progress (physically and mentally). Expressed in musical quotes, I’d put that as ‘Free your mind and your ass will follow. –Funkadelic’.

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