Benefits of Laughing: What the Trials Actually Measured

Published on 12 November, 2026

Laughter has been tested properly more often than you would expect, and the most striking trial is also the strangest. A randomized non-inferiority study in the British Medical Journal found that laughter exercise was not inferior to 0.1 percent sodium hyaluronic acid eye drops for ocular surface discomfort in dry eye disease.

That is a real clinical comparison against an active treatment, and it is the clearest signal in a field where most claims rest on small studies and enthusiasm. Here is what holds up and what does not.

What Laughter Does to the Body

A genuine laugh is a respiratory event before it is anything else. It produces rapid, forced exhalations against a partly closed glottis, recruits the diaphragm and the abdominal muscles, briefly raises heart rate and blood pressure, and is followed by a period in which both fall below where they started.

That post-laughter drop is the physiological basis for most of the relaxation claims, and it is the same pattern produced by other brief exertions. Laughter is not unique in causing it; it is simply the most enjoyable way most people will get there.

The muscular involvement is substantial enough that sustained laughing leaves the abdominal muscles sore, which is a familiar experience and a reasonable indication that something physical is happening.

The Dry Eye Trial

The study randomized people with dry eye disease to either laughter exercise or sodium hyaluronic acid drops, the standard lubricating treatment, and tested whether laughter was non-inferior on ocular surface discomfort, and that is what it found.

A non-inferiority design is worth understanding, because it does not claim laughter is better. It claims the difference between the two is small enough to fall inside a pre-specified margin, meaning laughter did not perform meaningfully worse than an established treatment.

The proposed mechanism is mechanical. Laughing produces repeated forceful blinking and stimulates the lacrimal and meibomian glands, which is plausible and testable rather than mystical.

Stress Relief: Where the Evidence Sits

Laughter yoga, a structured practice combining voluntary laughter with breathing exercises, has been tested in several randomized controlled trials across different populations, including people with Parkinson disease and adolescents with intellectual disability.

These trials generally report improvements in anxiety, mood and loneliness. They are also small, they cannot be blinded, and the comparison is usually against no intervention rather than against another group activity. Any pleasant structured session with other people improves mood on a questionnaire.

Laughter-based interventions appear to help mood and anxiety modestly, the effect is unlikely to be specific to laughter, and the activity is free of side effects. For a cheap group intervention, that is a reasonable risk-benefit position without being strong evidence.

Claims That Outrun the Data

Laughter burns significant calories. It raises energy expenditure slightly. The commonly quoted figures would require laughing continuously for an hour, which nobody does.
Laughter boosts the immune system. Small studies report changes in immune markers after laughter. No trial shows people who laugh more falling ill less often, which is the claim that would matter.
Laughter is the best medicine. It is an agreeable phrase and not a finding. The dry eye trial compared it with eye drops, not with medicine generally.
Fake laughter works as well as real laughter. This is the central premise of laughter yoga and it has not been properly tested against genuine amusement.
Laughter adds years to your life. Observational associations exist between positive affect and longevity, and they cannot separate laughing from being well enough to laugh.

Laughter Therapy, in Practice

Laughter therapy and laughter yoga sessions typically combine voluntary laughter exercises, clapping, chanting and breathing, usually in a group, for 20 to 45 minutes. The premise is that the body does not distinguish simulated from spontaneous laughter.

What makes these sessions work, to the extent they do, is probably the combination: controlled breathing, light physical activity, group participation and the social permission to behave foolishly. Each of those has its own evidence base.

A free intervention with no side effects that reliably lifts mood for an hour is worth having, and understanding why it works prevents the claim being oversold.

How to Get More of It

Build it into something social. Laughter is roughly thirty times more likely in company than alone, which is the most robust finding in the whole field.
Treat a laughter yoga class as a group exercise session rather than a treatment, and judge it on whether you feel better afterwards.
Watch comedy deliberately rather than scrolling, since sustained attention produces more genuine laughter than short clips.
Avoid using it as a substitute for treatment of depression or anxiety, where the evidence supports therapy and medication rather than this.
Notice that laughing with people and laughing at them produce different social outcomes, which matters more for wellbeing than the physiology does.

Why Laughter Is Mostly Social

The most robust finding in laughter research has nothing to do with health. People laugh roughly thirty times more often in company than alone, and most laughter follows ordinary conversation rather than anything funny. It is a social signal first and a response to humor second.

Telling someone to laugh more is close to meaningless; arranging to spend time with people reliably produces it. The intervention that works is company, and laughter is the measurable by-product.

It also explains why laughter yoga is run in groups rather than sold as a solo practice. The format is doing a great deal of the work that the laughter gets credited with.

Who Should Take Care

Anyone with a recent abdominal or chest surgery, where the muscular effort is genuinely uncomfortable and sometimes inadvisable.
People with severe asthma or chronic lung disease, since laughter is a recognized trigger for bronchoconstriction in some.
Anyone with a hernia or recent eye surgery, where repeated pressure increases are a consideration.
People with cataplexy, in whom laughter can trigger sudden loss of muscle tone.
Anyone with uncontrolled high blood pressure, where the transient rise is worth mentioning to a doctor before joining an intensive session.

A Fair Position

One properly designed trial against an active treatment for dry eye, several small positive trials for mood and anxiety, and a long list of claims about immunity, calories and longevity that the evidence does not carry.

Laughing more is free, enjoyable and almost certainly good for you in ways that are hard to measure. It is not a treatment, and it does not need to be one to be worth doing.

Book Your Wellness Journey at YO1

The Depression and Stress Management program at YO1 combines naturopathic therapies, yoga and meditation with a vegetarian kitchen, and a Health Counselor conducts a pulse assessment on arrival to determine your mind and body type and shape the program around it. Meals are chef-prepared and locally sourced.

To plan a stay built around what you have come for, visit yo1.com.

FAQs

Q: What are the health benefits of laughing?

A: The best-evidenced is a randomized non-inferiority trial in which laughter exercise matched sodium hyaluronic acid eye drops for ocular surface discomfort in dry eye disease. Laughter-based interventions also show modest improvements in mood and anxiety in small trials.

Q: Does laughter reduce stress?

A: Laughing briefly raises heart rate and blood pressure and is followed by a fall below baseline, which is the physiological basis for the claim. Trials of laughter yoga report improvements in anxiety and mood, though they are small and cannot be blinded.

Q: Is laughter yoga actually effective?

A: Randomized trials in several populations report improvements in anxiety, mood and loneliness. The effect is probably not specific to laughter, since the sessions also involve breathing, light exercise and group participation, each with its own evidence.

Q: Does laughing burn calories?

A: It burns only a marginal amount. Energy expenditure rises slightly during laughter, and the figures quoted in popular articles would require laughing continuously for an hour, which does not happen.

Q: Can laughter boost your immune system?

A: Small studies report short-term changes in immune markers after laughter. No trial has shown that people who laugh more fall ill less often, which is the claim that would actually matter.

Q: Does fake laughter work as well as real laughter?

A: This is the founding premise of laughter yoga and it has not been properly tested against genuine amusement. The physiological events are similar, and whether the psychological effect matches is unresolved.

Q: How much should I laugh a day?

A: No trial supports a dose. The most reliable finding in the field is that laughter is roughly thirty times more likely in company than alone, which makes company the practical lever rather than a target number.

Q: Can laughing be bad for you?

A: Rarely, and worth knowing. Laughter can trigger bronchoconstriction in severe asthma, cataplexy in people who have it, and discomfort after abdominal or chest surgery or with a hernia.

Q: Is laughter the best medicine?

A: It is a phrase rather than a finding. The one trial comparing it with an active treatment tested eye drops for dry eye, and laughter was not inferior in that specific comparison.

Q: Can laughter help with depression?

A: It should not replace treatment. Trials of laughter interventions report modest improvements in mood, and the evidence for therapy and medication in diagnosed depression is far stronger.

Sources

Li J, et al. Effect of laughter exercise versus 0.1% sodium hyaluronic acid on ocular surface discomfort in dry eye disease: non-inferiority randomised controlled trial. BMJ. 2024. PMID: 39260878

Get in Touch

Please take a moment to fill out the form below with your contact information. A YO1 Longevity & Health Resorts representative will reach out to you with additional information.

Press Coverage

Connect with Us, Start Your Journey

Take part in customized health programs that are best suited to meet your individual needs.

Book Your Stay