"Laughter as Medicine?" Metaanalytics: Laughter Therapy Reduces Anxiety and Increases Life Satisfaction in Adults

A major analysis of randomized studies of laughter therapy in adults was published in the Journal of Happiness Studies. The conclusions are simple and encouraging: laughter programs significantly reduce anxiety and improve life satisfaction. Laughter yoga has proven particularly effective. But the effect is not the same in all studies: strong heterogeneity and cultural differences mean that the method requires proper “translation to the locale.”

Background

• Why bother looking for “simple” methods against anxiety. Anxiety disorders are one of the most common mental health problems in adults. Pills and psychotherapy work, but they cost money, take time, have side effects, and are not available to everyone. Cheap, safe, and scalable supplements are needed.
• Laughter as a tool. Laughter is not only an emotion, but also a respiratory and muscular “release,” plus a powerful social glue. In groups, it quickly reduces tension, improves contact, and gives a sense of control — all of which potentially reduces anxiety and increases life satisfaction.
• Gaps before this review. There were dozens of small trials, but the results were disparate: different programs, “doses,” cultures, and assessment scales. Hence the questions: how stable is the effect on average? Which format “pulls” better? What about the quality of the studies?
• Why meta-analysis? To bring together all randomized studies, estimate the average effect size on anxiety and life satisfaction, and understand which laughter therapy options provide the greatest benefit and where the weaknesses (heterogeneity, risk of systematic errors) are hidden.
• Practical interest. If laughter therapy proves to be beneficial at least moderately, it can be built in as a low-risk module: in clinics, in corporate well-being programs, in universities and communities - where professional help is scarce and demand is high.

What exactly did they do?

The authors conducted a systematic review and meta-analysis of randomized clinical trials (PRISMA; protocol registered in PROSPERO: CRD42023475258). The analysis included 33 RCTs with quality assessment according to RoB2; in total, data were collected from adults 18+ with no upper age limit.

The main figures are in a “human” retelling

• Anxiety is reduced: standard effect size SMD = −0.83 (95% CI −1.12…−0.54) – this is approximately a medium to large effect by psychological standards.
• Life satisfaction increases: SMD = 0.98 (95% CI 0.18…1.79). There is an effect, but the confidence interval is wide — different programs provide different “profits”.
• Laughter yoga is in the lead: in the subgroups, it provided a greater reduction in anxiety (SMD = −1.02) and a greater increase in satisfaction (SMD = 1.28) compared to other techniques.

What is this "laughter therapy" anyway?

Under the umbrella of "laughter therapy" are laughter yoga, therapeutic sessions with provocation of sincere/conditional laughter, elements of humor interventions. Formats vary: from group sessions with breathing and game exercises to short inserts in rehabilitation and corporate programs. The range of methods is an important reason for the heterogeneity of results.

Why it works (likely mechanisms)

Laughter is not just “fun.” It activates breathing and muscle cycles, reduces tension, improves heart rate variability, provides a quick “social glue” in a group, and for some people, a sense of control and self-efficacy. The result is less subjective anxiety and a warmer assessment of one’s own life. The authors emphasize that context and culture can enhance or weaken the effect (not everyone values and understands the “same” humor).

Important caveats (without rose-colored glasses)

• High heterogeneity. Effects vary significantly between studies—different protocols, measures (anxiety/satisfaction scales), groups, and countries. This limits generalizability and calls for standardization.
• Wide CIs for satisfaction. There is benefit, but the effect size depends on the methodology and audience. Direct comparisons of formats and “doses” are needed.
• Not a panacea. Laughter is a complement to, not a replacement for, psychotherapy or medications for clinical disorders.

What does this mean in practice?

• For clinics and communities. Laughter therapy can be integrated as a low-risk module into mental health programs: 30-45 minute group sessions 1-2 times per week, especially for prevention and mild/moderate anxiety. Laughter yoga is a good candidate for the “default format.” (Protocol details have yet to be standardized.)
• For employers/universities. As an element of wellbeing initiatives, short regular sessions provide a “social charge” and subjective stress reduction. Voluntary participation and a safe atmosphere are important (not everyone is comfortable “laughing on command”).
• For researchers. The next step is direct RCT comparisons of different techniques, “dosage” (frequency/duration), cultural adaptation and common outcomes (including physiology: HRV, sleep). Protocol registration (as here in PROSPERO) is a must-have.

Conclusion

Laughter therapy is not a magic pill, but it is a really useful and accessible tool: it reduces anxiety and, most likely, makes people more satisfied with life. Laughter yoga seems to be the most “working” of the formats. It remains to put the protocols in order and understand where, for whom and in what dose laughter works best.