COPD and Harmonicas: Music Therapy for Your Lungs

Medically Reviewed by Hansa D. Bhargava, MD on January 11, 2021
4 min read

Doug Martin lay in his hospital bed in 2015 as doctors and nurses treated him for a serious flare-up of chronic obstructive pulmonary disease (COPD). A hallmark symptom of COPD is shortness of breath, called dyspnea, that leaves Martin and other patients feeling as if they’re running out of air.

Martin, a retired carpenter from the Nashville area, regarded his condition as a “death sentence.” Indeed, COPD is the No. 4 cause of death in the U.S. Some 150,000 Americans die each year of emphysema, chronic bronchitis, and other forms of COPD, more than from strokes, Alzheimer’s, or diabetes.

Then Martin glanced up at the TV in his room and saw something that changed his life. A local news channel was airing a segment on “Harmonicas for Health,” a program from the COPD Foundation to teach people to breathe easier by practicing with the instrument.

“I thought, ‘I need to try this!'" says Martin, now 68.

Playing the harmonica mimics the pursed-lip breathing technique, which is “one of the best tools someone living with COPD can have in their toolbox,” says Stephanie Williams, a respiratory therapist and senior director of community education programs at the COPD Foundation.

With COPD, air tubes called bronchi get so narrow that you can’t force out enough air from the lungs despite effort. That can leave you gulping for new air even before you finish breathing it out. Or air sacs called alveoli, where oxygen gets swapped out for carbon dioxide, get damaged and trap stale air.

Pursed-lip breathing involves inhaling through your nose for two counts with your mouth closed. Then exhale for four counts through your lips, puckering or pursing them as if you’re about to whistle. A harmonica requires similar techniques.

Breathing exercises help boost lung capacity, or the maximum amount of air it can hold, as well as strengthen your diaphragm and other muscles you need to force air in and out. Exercises also may help you relax and slow your breathing rate.

The benefits can extend far beyond easing merely physical discomforts, says Mary Hart, director of research at the Allergy & Asthma Network, a patient advocacy group in Vienna, VA. People with COPD can become breathless just by standing up or taking the stairs. So they might avoid going shopping, attending social events, or anything that requires exertion.

“They may even isolate themselves more from family and friends due to this change in their ability to breathe,” Hart says.

Five years after his hospitalization, Martin not only still practices the harmonica, he also teaches a class for local seniors. More than anything, Martin says playing the harmonica has helped him to control and regulate his own breathing. 

“This helps during exacerbations because I know I can physically and consciously calm myself and breathe purposefully and correctly,” he says. A bonus: Making music is also fun. Martin’s favorite tune is “How Much Is That Doggie in the Window.”

Hart, of the Allergy & Asthma Network, has seen firsthand how harmonicas can help even those who rely on oxygen. But she couldn’t find any research that documented their effectiveness. So Hart convinced her former employer, Baylor Scott & White Health of Texas, to pay for a 12-week pilot study.

Fourteen people who were in pulmonary rehab attended 2-hour harmonica sessions weekly to learn one or two new songs. They also practiced at home 5 days a week for 30 minutes each time. Eleven participants completed all 12 sessions.

The goal of the pilot study was to see if playing the harmonica led to objective improvements in breathing, says Mark Millard, MD, a pulmonologist at Baylor University Medical Center in Dallas who was one of the researchers on the study.


The patients were assessed for breathing, muscle strength, and how far they could walk in 6 minutes, a standard test used for people with COPD. Healthy people can cover about 400-700 meters in that time. Before the study, the participants managed little more than 200 meters on average. After 12 weeks on the harmonica, they boosted their distance by about 50 meters, nearly double the distance that experts consider a meaningful improvement.

Millard says harmonica playing measurably strengthened the breathing muscles, “which translated into improved ability to walk.”

COPD has a high “misery index,” Millard says, that often turns into a self-fulfilling cycle.

“The less you do, the less you will be capable of doing, until getting up from a chair to go the bathroom or bedroom barely makes the effort worth it,” he says.

Breathing exercises can reverse that pattern and enable people to recapture their lost abilities. What’s more, Hart says playing the harmonica helped clear out the gunk from the airways.

“Many of our COPD patients coughed up secretions after about 10 minutes of playing,” she says.

Perhaps the biggest payoff from the instrument, Hart says, was how the people in the study blossomed socially.

“They were confident, happy, and more active.”