1. In this randomized control trial, a single laughter yoga session resulted in an attenuated cortisol stress response as compared to individuals who did relaxation breathing as well as controls
2. There was no difference in subjective stress rating, salivary cortisol, or salivary amylase between the groups
Evidence Rating Level: 1 (Excellent)
Stress has a deleterious impact on both mental and physical health. Early intervention may reduce the risk of developing associated illness by reducing the physiological response to stress. Cortisol is widely recognized as a ‘stress hormone’ and is seen to be elevated in individuals who experience high levels of stress. Yoga and laughter are both associated with decreases in perceived stress, and laughter yoga (LY) may represent a means of decreasing cortisol stress response. However, evidence for beneficial effects of LY are scarce.
This randomized control trial compared a single 30-minute session of LY to relaxation breathing as well as a control group. The primary outcomes assessed were salivary cortisol, salivary alpha amylase, subjective stress, and cortisol response after a standardized psychosocial stress test [Trier Social Stress Test for Groups (TSST-G)]. Twenty serial measurements were made throughout TSST-G. Individuals were included who were over the age of 18 and able to give informed consent. Exclusion criteria included BMI under 19 or over 27, consumption of more than 10 drinks/week, smoking, traumatic brain injury, substance use disorder, regular medications that involve the hypothalamic-pituitary-adrenal axis, personal or family history of psychiatric disorder, and use of hormonal contraceptives.
A total of 35 participants were included and randomly allocated to either the LY (n=11), relaxation breathing (n=12), or control (n=12) groups. Participants in the LY group demonstrated a significant decrease in cortisol response during the TSST-G. No significant differences were observed between groups for salivary cortisol, salivary amylase, or subjective stress. The study limitations included limited sample size, impacts of menstrual cycle on cortisol response, and age differences between groups. Nonetheless, the outcomes of this study suggest that LY may help reduce stress response, even after a single session.
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