A lifetime of singing, a lifetime of health.
Every phrase in singing is a breathing exercise. Beyond fueling the voice, singing breath offers wide-ranging health benefits, from calming the nervous system to supporting immunity and even building social connection. Research is showing that the act of singing is not only an artistic expression but also a whole-body wellness practice.
Breath and Stress Reduction
Breathing is one of the body’s most direct tools for managing stress. Research by Moore (2025) demonstrated that slow breathing, around six breaths per minute, increases vagal tone, improves heart rate variability, and activates the parasympathetic “relaxation response.” Singing naturally incorporates this rhythm: long, sustained exhalations and measured phrases mirror the benefits of guided biofeedback breathing.
James Nestor, in his book Breath, describes how cultures and athletes have long used slower, controlled breathing to build clarity, resilience, and calm. Singing engages these same principles, allowing performers to regulate stress in the very act of producing sound.
Mental Health, Immunity, and Connection
The benefits of singing extend beyond the lungs and nervous system. Rebechinni (2021) found that music-making supports both mental health and immune function, effects linked in part to the calming, regulated breathing that singing requires.
Singing also creates social benefits. Delius (2023) showed that choir members’ breathing patterns align during performance, a phenomenon known as “interpersonal synchrony.” Research has further demonstrated that this synchrony can extend to heart rhythms (Müller & Lindenberger, 2011; Vickhoff et al., 2013) and even to subtle postural movements. In other words, when voices blend, bodies literally fall into rhythm with one another across multiple systems. This shared physiological entrainment fosters feelings of connection and belonging, amplifying the individual health effects of singing.
Singing as Exercise
Although not the same as aerobic exercise, singing engages the respiratory muscles in a sustained way. Aliverti (2016) described how these muscles act like an “auxiliary heart” during exercise, aiding circulation. Singing trains this system, potentially improving respiratory endurance and contributing to cardiovascular resilience over time.
Actionable Tips for Singers
The Alexander Technique reminds singers that breathing is most effective when it is allowed, not forced. By maintaining awareness of posture and avoiding excess effort, singers can experience both musical and health benefits.
1. Stress-Relief Breathing (Ease in Exhalation)
Choose a comfortable pitch and hum while exhaling slowly for 6–8 seconds. Keep the neck and shoulders released, letting the breath flow out as a controlled release rather than a push. Pause briefly, then allow the next breath to enter naturally.
2. Singing Walk (Natural Coordination)
Take a relaxed walk and sing or hum in rhythm with your steps. Maintain an easy, upright posture, imagining the head balancing freely on the spine. This coordination encourages efficient breathing without strain and reinforces the calming, cardiovascular benefits of singing.
Closing Thought
Singing breath is far more than a vocal tool. It brings together healthy respiratory patterns in ways that reduce stress, strengthen the body, and build community. Through music, singers practice habits that nurture both artistry and overall health.
Jamea J. Sale, PhD
Director, Institute for Healthy Singing & Voice Research
Sing for a Lifetime
www.HealthySinging.org
“In the Alexander Technique, breathing is understood as something the body allows rather than forces. By cultivating awareness of posture, releasing unnecessary tension, and letting the breath enter naturally, singers can reduce effort and enhance both musical performance and overall wellbeing.”
References
Aliverti, A. (2016). The respiratory muscles during exercise. Breathe, 12(2), 165.
Delius, J. A., & Müller, V. (2023). Interpersonal synchrony when singing in a choir. Frontiers in Psychology, 13, 1087517.
Moore, E. C. (2025). Personalized Biofeedback for Stress Reduction: Modulating the Autonomic Nervous System through Slow breathing and Cardiovascular Monitoring. https://louis.uah.edu/honors-capstones/946
Müller, V., & Lindenberger, U. (2011). Cardiac and respiratory patterns synchronize between persons during choir singing. PLoS ONE, 6(9), e24893. https://doi.org/10.1371/journal.pone.0024893
Nestor, J. (2020). Breath: The new science of a lost art. Penguin.
Rebecchini, L. (2021). Music, mental health, and immunity. Brain, behavior, & immunity-health, 18, 100374.
Vickhoff, B., Malmgren, H., Åström, R., Nyberg, G., Ekström, S. R., Engwall, M., Snygg, J., Nilsson, M., & Jörnsten, R. (2013). Music structure determines heart rate variability of singers. Frontiers in Psychology, 4, 334. https://doi.org/10.3389/fpsyg.2013.00334
How Breathing for Singing Supports Posture, Digestion, and Vocal Freedom: The Health Benefits of Respiration in Singing - Part 1
Breath is often described as the “fuel” of singing, but it is also a whole-body health practice. While singers may think primarily of sustaining tone, science shows that the way breath is managed during singing supports posture, digestion, and overall physiological balance.
The Physiology of Singing Breath
Singing requires more than simply filling the lungs with air. The breathing system operates as a coordinated unit involving the diaphragm, rib cage, abdominal muscles, and the pelvic floor. Classic studies by Gould (1971) and Hixon (1973) revealed that posture and respiratory support directly influence how freely the vocal folds vibrate and how efficiently airflow is managed for sustained sound.
The pelvic floor plays a surprising role in this coordination. Research has shown that the pelvic floor contracts and releases in cooperation with the diaphragm to regulate intra-abdominal pressure, stabilizing the trunk and supporting airflow (Hodges, 2007; Park, 2015; Talasz, 2022). This makes core engagement and posture not simply supportive extras, but integral to healthy breath management.
Breath and Digestion
Recent studies also highlight how breathing influences digestion. As the diaphragm moves with each inhale and exhale, it creates gentle pressure changes in the abdominal cavity. This rhythmic movement acts as a kind of “massage” for the intestines, stimulating peristalsis, improving blood flow to abdominal organs, and promoting more efficient digestion (Peiqi & Lei, 2024). Singing breath, therefore, not only energizes the voice but also contributes to digestive health.
Actionable Tips for Singers
Breathing for singing may sound complex, but small adjustments can build awareness and efficiency. The Alexander Technique frames breathing as an allowing process rather than a forced one, emphasizing posture, release of unnecessary tension, and whole-body coordination.
1. Body Scan Breath (Release First)
Before inhaling, pause to release your jaw, neck, and shoulders. Then place one hand on the sides of your lower rib cage and the other on your lower abdomen. Allow the breath to enter naturally, noticing how the rib cage expands, the abdomen softens, and the pelvic floor gently releases. As you exhale, sense the recoil of the ribs and abdominals and the natural upward lift of the pelvic floor without pushing.
2. Singer’s Stretch Breathing (Lengthen and Widen)
Stand with an upright and buoyant relaxed posture. Allow one hand to rest gently around your neck, and notice whether there’s activity under your palm as you inhale. If so, there may be tension you can release. Inhale again and imagine your torso lengthening upward and your ribs widening outward and backward as you inhale. Think of the breath “arriving” rather than being pulled in. This activity reduces chest and neck tension and fosters a freer, more efficient breath.
Closing Thought
From vocal fold efficiency to intestinal health, singing breath demonstrates how closely interconnected the body’s systems are. Each phrase sung draws on healthy respiratory patterns and, in the process, supports balance, posture, and overall well-being.
In my next post, I will explore how singing breath impacts stress reduction, immunity, and even social connection in ways that extend far beyond the practice room.
Jamea J. Sale, PhD
Director, Institute for Healthy Singing & Voice Research
Sing for a Lifetime
www.HealthySinging.org
“The Alexander Technique is a method of mind-body
re-education that teaches awareness of posture, movement, and breathing. It frames breathing as an allowing process rather than a forced one, emphasizing release of unnecessary tension and natural coordination of the whole body. Many singers use it to develop ease, efficiency, and vocal freedom.”
References
Gould, W. J. (1971). Effect of respiratory and postural mechanisms upon action of the vocal cords. Folia Phoniatrica et Logopaedica, 23(4), 211-224.
Hixon, T. J. (1987). Respiratory function in speech and song. (No Title).
Hodges, P. W., Sapsford, R., & Pengel, L. H. (2007). Postural and respiratory functions of the pelvic floor muscles. Neurourology and urodynamics, 26(3), 362-371.
Park, H., & Han, D. (2015). The effect of the correlation between the contraction of the pelvic floor muscles and diaphragmatic motion during breathing. Journal of physical therapy science, 27(7), 2113-2115.
Peiqi, L., & Lei, S. (2024) The Interaction Between the Respiratory System and The Digestive System: A Preliminary Study.
Wood, A. C. (2025). The Feasibility of a Hybrid Telehealth Respiratory Muscle Strengthening and Coordination Program on Chronic Constipation Outcomes (Doctoral dissertation, University of Miami).
Vaping and Your Voice: Hidden Risks for Singers
Based on Research by Madison, et al., The Laryngoscope (2022)
In recent years, vaping has often been marketed as a safer alternative to traditional smoking. However, research shows it can harm not only your lungs but also your voice. For singers, educators, and other professional voice users, vaping’s effects on airway health, tissue hydration, and vocal fold function can undermine both breathing efficiency and healthy sound production.
How Vaping Harms the Lungs, Airway, and Voice
A 2022 study in The Laryngoscope examined the short-term effects of e-cigarette use on vocal fold physiology and respiratory function. Results showed that even brief exposure to vaping aerosol can cause airway inflammation, increase mucus viscosity, and impair mucociliary clearance, the airway’s natural cleaning mechanism. These changes make it harder for the vocal folds to vibrate freely. They can raise the phonation threshold pressure, the amount of air pressure needed to start and sustain sound.
Research on small particle lung health and vaping shows that e-liquids produce ultrafine particles that can penetrate deep into lung tissue, triggering inflammatory responses similar to those seen in chronic bronchitis. Johns Hopkins Medicine also reports that certain vaping liquids contain propylene glycol, glycerin, and flavoring agents that can dehydrate the airway lining, leading to vocal dryness, fatigue, and irritation.
Healthy singing depends on efficient breath support and vocal fold vibration. Inflammation, dehydration, and thickened mucus from vaping create extra resistance, requiring more effort from the respiratory system and laryngeal muscles. Over time, this can lead to compensatory vocal behaviors such as pushing, straining, or constricting, which increase the risk of long-term vocal injury.
If you vape, be aware that its effects are not limited to lung health; they can directly interfere with your ability to sing with ease.
Lung health matters for breath control. Inflammation, irritation, or reduced lung capacity from vaping or second-hand aerosol can limit how much air you can inhale and how steadily you can release it. This makes it harder to sustain phrases, manage dynamics, and maintain vocal stability.
Recovery from vaping-related irritation involves complete cessation, consistent hydration, and sometimes voice therapy under a qualified specialist.
Even occasional vaping before a performance can impact your stamina and vocal quality. Treat your vocal tract with the same care an athlete gives their body, avoiding harmful agents whenever possible.
The Takeaway for Your Voice: Vaping may seem less harmful than smoking, but for singers, the science tells another story.
Protect your breath, protect your voice; your artistry depends on it.
Jamea J. Sale, PhD
Director, Institute for Healthy Singing & Voice Research
Sing for a Lifetime
www.HealthySinging.org
References
Madison, T. M., Gartner-Schmidt, J., Sataloff, R. T., & Heman-Ackah, Y. D. (2022). Acute Effects of Electronic Cigarette Aerosol on Laryngeal and Respiratory Physiology. The Laryngoscope, 132(11), 2179–2185. https://doi.org/10.1002/lary.32469
Johns Hopkins Medicine. (n.d.). What Does Vaping Do to Your Lungs? Retrieved August 2025 from https://www.hopkinsmedicine.org/health/wellness-and-prevention/what-does-vaping-do-to-your-lungs
Hodes, R. (2021). The Role of Small Particle Lung Health in Vaping-Related Respiratory Effects (Master’s thesis).
Why Your Voice Needs Water (and What Kind!)
You’ve probably heard it before: “Drink more water!” But when it comes to vocal health, that advice is more than just a wellness cliché. Research shows that hydration—both internal and surface-level—is key to keeping your voice working efficiently and comfortably.
What Does Hydration Actually Do for the Voice?
Hydration keeps the vocal fold tissues supple. When we’re dehydrated, those tissues become more viscous (thicker), which increases what’s called phonation threshold pressure—the minimum effort needed to start vocal fold vibration. More pressure = more effort. That means your voice tires out faster and may sound strained, rough, or inconsistent.
A 2002 study (Verdolini et al.) found that even 1% loss of body weight from dehydration was enough to raise the effort level for vocalizing, especially at high pitches. Another study using computational modeling showed that even short periods of speaking or singing can dry out the vocal folds at the tissue level, especially when vocal fold vibration is vigorous.
In other words, dehydration can sneak in faster than you think, and your voice is often the first to notice.
The Two Types of Vocal Hydration
1. Systemic Hydration: This is what you get from drinking water. It supports hydration at the tissue level, but it’s slow. It may take hours for what you drink to reach your vocal folds.
2. Surface (Superficial) Hydration: This refers to the thin layer of moisture that coats the vocal folds. It plays a key role in vibration and impact protection. You can improve this layer more directly and quickly using steam or nebulized saline mist.
Should Singers Use a Nebulizer?
Yes, especially if you speak or sing in dry environments, have allergies, or are recovering from illness. Studies show that nebulizing with isotonic saline (0.9% sodium chloride) can lower vocal effort, improve vocal quality, and support mucosal wave function.
A mesh nebulizer with sterile saline is an affordable and portable tool to add to your vocal health routine. It’s not a substitute for rest or professional care. Still, it can be a game-changer for managing daily vocal fatigue.
Bottom line for singers?
Hydrate early. Hydrate often. And consider both what you drink and what you breathe.
Jamea J. Sale, PhD
Director, Institute for Healthy Singing & Voice Research
Sing for a Lifetime
www.HealthySinging.org
Performance = Potential – Interference: What Singers Can Learn from The Inner Game of Tennis
As a voice scientist and specialist in rehabilitating singing voices, I have observed a common pattern in my students, especially those recovering from vocal injury or who self-identify as perfectionists: they tend to “should” on themselves.
“I should already know this.”
“I should sound better by now.”
“I should be able to sing like [insert artist].”
Sound familiar?
This mindset traps singers in what W. Timothy Gallwey in The Inner Game of Tennis calls the paradox of the “two selves.” Self 1 is the analytical, judging voice (“Come on, you’re off-pitch again!”), while Self 2 is the unconscious mind-body system—the part of you that already knows how to sing when given the chance.
Gallwey’s insight is critical for vocalists: performance = potential – interference. That is,
P = p – i
We often work so hard to get it “right” that we disrupt what our bodies already know how to do. In Gallwey’s words:
“Every time I get near match point... I get so nervous I lose concentration. I’m my own worst enemy.” (The Inner Game of Tennis, p. 6)
In singing, that “match point” might be the high note, the audition, the solo moment. And in trying to control every detail, Self 1 tightens the muscles, clouds the mind with judgment, and causes the very interference that throws us off balance.
Here’s the shift: stop “trying” and start allowing. Let Self 2—your wise, experienced, adaptive body—do what it has been trained to do. Instead of commanding your voice to perform, simply notice. Observe without judgment. Allow the sound to emerge.
This is the essence of relaxed concentration—what Gallwey calls the master skill for excellence in any field. And yes, even singing.
If you’re a singer prone to perfectionism, consider this your invitation to stop battling yourself. Trade judgment for awareness. Trust your body. Let it sing.
Your best voice isn’t forced—it’s freed.
Jamea J. Sale, PhD
Director, Institute for Healthy Singing & Voice Research
Sing for a Lifetime
www.HealthySinging.org