Breathing for Singing, Voice and Public Speaking: Teaching Traditions and Evidence

Check first if something feels wrong

A voice that stays hoarse, hurts, or gives out, or breathing that is short or noisy when you speak or sing, is a reason to ask a clinician before trying exercises. Voice therapy for a medical problem is clinical care. If breathlessness is sudden or severe, call 911 (US) or your local emergency number. See when breathlessness needs medical care.

What "breath support" means

Singing and speech teachers often talk about breath support or breath control. One narrative review says diaphragmatic or "abdominal" breathing is taught as the foundation of singing and speech across virtually all vocal traditions. [1] It traces breath-support teaching to the Italian bel canto tradition, including the idea of appoggio, which that review summarizes as sustaining the inspiratory posture while exhaling. [1] Other traditions have their own terms, and we have not read sources on them.

That review is a narrative one, with no formal systematic protocol. [1] It argues that the voice is produced on the out-breath, with loudness and pitch governed by pressure below the vocal folds. [1] It also reports that singers' lung function is not superior to non-singers', and that singers' own descriptions of their breathing diverge markedly from measured mechanics. [1] Another review found that historic definitions of singing "support" seem incongruous but each pertains to a different part of the voice system. [2] In short, teaching language is not the same as measured physiology.

What research shows

1. Breathing exercises for voice disorders (systematic review, 23 of 650 articles)

   Insufficient evidence

   The review says many patients do not need extensive breath support for their voice demands, and current evidence does not support breathing exercises for all patients with voice disorders. [3]

2. Breathing-muscle strength training in trained singers (6 students)

   Insufficient evidence

   Muscle strength increased, but there were no consistent changes in airflow or voice measures. [4]

3. Singing groups for lung conditions: systematic review (6 studies)

   Promising but limited

   Singing may improve physical quality of life and anxiety; risk of bias is significant and studies are small. [5]

4. Singing for lung health in COPD (270 people)

   Promising but limited

   Non-inferior to standard exercise training for walking distance, with no significant between-group differences in quality of life, anxiety, lung function or breathlessness. [6]

5. Online singing for lung health in COPD (115 people)

   Promising but limited

   Physical but not mental health quality of life improved; the overall effect was modest compared with face-to-face groups. [7]

6. Singing-based program after COVID-19 (158 people, funded by Imperial College London)

   Promising but limited

   Mental health quality of life and breathlessness scores improved, physical quality of life did not. [8]

7. Singing and breathing program for long COVID (before-and-after pilot)

   Insufficient evidence

   Participants showed improvements in breathlessness symptoms, but only 21 of 27 recruited people who completed at least 10 classes were analyzed and the authors call for further study. [9]

8. Public speaking anxiety (two small trials)

   Insufficient evidence

   See below.

For the claim that voice-teacher breathing techniques improve vocal quality in healthy singers, Proper evidence not found. We searched PubMed for reviews on singing, voice pedagogy, breath support and respiratory kinematics, and found breathing exercises tested in people with voice disorders or in a small singer sample, not teaching methods in general. [3] [4]

Singing groups for lung conditions

Singing for lung health is described as an arts-based breathing control and movement intervention for people with long-term respiratory conditions. [7] A consensus group also discussed the core training and competencies group leaders need. [5] A literature review of 17 studies found trends of positive outcomes after singing lessons, regardless of statistical significance, and concluded singing can be used as an adjunctive treatment. [10] Singing does not replace inhalers, pulmonary rehabilitation or your care plan. See breathing exercises for COPD.

In the post-COVID trial, one participant had a minor dizziness event, which the authors linked to extended computer use. [8]

Public speaking nerves

In a randomized study of 76 nursing students, anxiety scores fell in both intervention groups, one receiving breathing therapy and one receiving emotional freedom techniques (EFT); EFT was reported as more effective. [11] The abstract does not describe a no-treatment group, so we cannot tell how much was due to the breathing therapy itself. In a pilot with 30 medical students, 15 minutes of alternate nostril breathing before a simulated speech showed only a trend toward lower anxiety, and the group effect was not statistically significant. [12] The authors call for a larger study. [12] Alternate nostril breathing comes from yoga; see Nadi Shodhana for its roots and cautions. For general stress breathing, see breathing exercises for anxiety.

Choosing a teacher

Voice and singing teachers, group leaders and speech coaches work in different settings with different training. How singing teachers are credentialed is not described in the sources we read. Ask about their training, whether they work with your condition, how they handle dizziness or breathlessness, and whether they ask you to check with your clinician first. We do not list or recommend teachers. See choosing a qualified practitioner.

Related pages

• Diaphragmatic breathing: what it is and the evidence
• Breathing exercises for shortness of breath
• Inspiratory muscle training