Meet the group who get together to keep their lungs healthy by singing

Gunn is a member of The Warblers, a Lothians-based group of people with lung conditions including asthma, bronchiectasis and long Covid, who get together once a week to keep their lungs healthy by singing.

She said: “I was told I had COPD in 2015 and in 2016 I was going to pulmonary rehab where they encourage you to take more exercise, and you learn that sitting doing nothing is bad for your lung health. It was there someone told me about The Warblers.”

The group was established in 2016 for people with poor lung health. Each week, sessions are held in Musselburgh and Newton Grange.

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Dr James Robertson runs the Musselburgh sessions, which, he says, can be a ‘safe space’ for people coming to terms with the damage long covid has left in their lung tissue.

He said: “Lung disease is now the third most common cause of death in the UK and costs the NHS more than £9bn per year. And we find that lung function reduces from more than 1% a year from the age of 40.

“Research is being carried out on the benefits of singing on long covid,” he said.  “We do have members who have long covid and who are finding the sessions helpful. People feel the sessions to be a safe space, we’re not judging them.”

Dr Robertson taught music therapy at Queen Margaret College in Edinburgh and practised in a range of settings, working in forensic psychiatry, autism, palliative care and with children who have additional support needs.

He has led The Warblers, with colleague Esther Chuang, for a year, having discovered the science around the benefits of singing on lung health via The Musical Breath organisation which also uses singing to help people suffering from breathlessness.

Sessions are held in Musselburgh and Newton Grange (Image: Jon Davey Photography)

He said: “Phoene Cave, who runs Musical Breath, has pioneered a lot of work in the UK around singing for lung health and helps people understand the physicality of the voice and the anatomy, as well as ways of using singing to improve people’s health.

“The training that was offered for it inspired me, as it brought together my two interests - choirs and health and well being.”

For Gunn, the benefits are manifold.

“I didn’t get the right medication at first, and people would have to slow down for me when I was out,” she said. “Now I‘m on the right medication and I’m doing my breathing, and the singing is helping too.

“I was quite new to the condition when I joined The Warblers, and meeting other people who had the same condition, finding out how they coped, really helped me. I learned a lot in the first few sessions. It definitely helps both mentally and physically.

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“We kept going through Covid, and did the session online, because some of us were vulnerable. When we get together, nobody minds when you start coughing, nobody's looking at you thinking you have Covid. It’s relaxed, because people understand.”

In 2022, the charity Asthma + Lung UK reported that lung conditions kill more people in Britain annually than anywhere else in western Europe. In 2023, the Office for National Statistics reported almost 2 million cases of long covid in the UK, with Asthma + Lung UK claiming 38% suffer from breathlessness.

The science around the effects of singing on long covid patients is still in its early days. Last year, a project by the Imperial College London and English National Orchestra, worked with physiotherapists and speech and language teams on a six week programme aiming to help patients who had developed disordered patterns of breathing to return to more normal patterns. 

The study found that 80% of participants reported improvements in their breathing. Similar approaches are being taken in Europe with groups such as Germany’s voice teacher’s association BDG, which runs a programme called Durchatmen, which translates into English as breathe.

For Isobel Gunn and Dr Robertson, the effects go beyond the lungs.

The Warblers get together once a week to keep their lungs healthy by singing (Image: Jon Davey Photography)

Dr Robertson said: “It helps people physically in their breathing and their posture, it can help them emotionally in being valued by others. It brings people together.

“One of the things I have learned is about the importance of sustaining the exhale. We find even within a session that people might begin a session breathing in quite a high way rather than thinking of the abdomen and diaphragm, breathing lower and slower and focusing on sustaining the out breath for longer. Taking a big breath before singing can actually be counterproductive, because it creates tension in the upper part of the body and the neck.

He added: “We use songs whose phrasing is appropriate to all this. We sing things like Bridge Over Troubled Water by Simon and Garfunkell and the songs of Karine Polwart, which lend themselves well to what we’re doing, too. The groups have also written some of their own songs, too. We find that even after a single session people might focus differently on their breathing.

“It’s breathwork by stealth. Breathing is not the primary focus. We come to sing and as an outcome of that it enhances the breathing a great deal.”

The Warblers are now preparing to stage a concert in Edinburgh this spring, with fellow lung-health singing group The Cheyne Gang, and hope to engage with others who could benefit from singing with people living with debilitating lung conditions like bronchiectasis and asthma.

She said: “One of the first things some people say when they come along is, ‘I’m not a very good singer.’ But it’s not about being a good singer, it’s about the overall sense of well-being. My COPD hasn’t got too bad and I think it would have done had I just been sitting in the house.”