Breath Cycle – the impact of singing on cystic fibrosis

Scottish Opera and Gartnavel Hospital created Breath Cycle – a music making project with 17 young Cystic Fibrosis (CF) patients which saw work being created virtually on-line. The project ran for almost a whole year (May 2013 – January 2014).

The project set out to measure the impact of singing on the lung function of people with CF.  We wanted to take residence at Gartnavel’s respiratory unit and work with their patients and staff to create vocal exercises and songs; solos, duets and little pieces each written especially for, and sung by, people with fragile voices because of their condition.

We wanted to create beautiful music whilst measuring if singing increased lung function and could be used as an alternative to physiotherapy treatment (typically unpopular with patients).

The project had a huge impact on the 17 participating patients, none of whom had any previous experience of opera or performing. The medical staff at the Respiratory Unit and our team of artists were also strongly affected by the project: it was an entirely new experience for them too.

Scottish Opera’s Composer in Residence Dr Gareth Williams led the project with our partner, Lead Consultant at the Respiratory Unit, Dr Gordon McGregor. One of Scottish Opera’s Emerging Artists Marie Claire Breen devised and delivered all the work in the Unit, with the support of our repetiteur Laura Baxter, and we worked with librettist David Brock who co-conceived and co-created the project with Gareth.

This was the first long term residency Scottish Opera had ever undertaken in a health setting; and moreover, in an acute ward. We were creating work especially for fragile, limited voices – work that was taking us, Scottish Opera, into new areas.

Innovative Thinking

The project was the first of its kind – creating artistic projects with, and for, people with CF.  Previously, projects with people with lung problems such as COPD have been choirs where participants sing along.  In this project, the participants worked with our artists to create their own music. We also used the internet in a new way: to rehearse with the patients (who cannot be in the same room together) and to broadcast their singing.

The project greatly developed the creativity of the participants.  There was a very low interest level in the arts prior to the project and a subsequent low awareness of their own innate creativity or confidence in their creative skills. Breath Cycle also developed the creative practice of all artists and gave them the experience of working in an acute hospital setting.

The participants were encouraged to take a leap of faith into the unknown.  They were encouraged to do this by the medical staff who were well known to them as well as by our artists who visited the Unit regularly.

The vocal exercises were designed to be done regularly: the patients are used to physiotherapy treatment demands but compliance can be very poor.  The one-on-one attention the patients received with the vocal coach meant that their engagement levels remained consistently high.  They were encouraged and nurtured by Scottish Opera’s artists but they were also tested and pushed.  Each of the participants met the high expectations placed upon them.


Medically, the participants benefitted hugely from the project.  Physiotherapists supporting the project noted that participants had increased breath size, more controlled expiration, occasional expectorating after singing as well as improved physical fitness post singing practice.

Lead consultant at Gartnavel’s respiratory unit, Dr MacGregor and his team were greatly encouraged by the psychosocial benefits of the bringing people with CF together.  Usually segregated to prevent cross infection, this project encouraged peer interaction and support.

A more tangible benefit of the project was the increase in lung function as measured in FEV testing; measuring the amount of air a person can force out in one second.  During this project, the participants enjoyed a 13% increase.  Dr MacGregor cites this as one of the best results of the project and cites the project as a whole as an incredibly positive intervention. These medical results are all evidenced through clinical research.

The artistic impact of the project is evidenced in the interviews and qualitative tools used and displayed on the website. The project’s reach is due to be expanded as co-conceiver Dr Gareth Williams has been appointed as Research Fellow at the University of Edinburgh to further pursue the work.

All the participants said the project created amongst them, a sense of community.  CF patients must be isolated from each other top prevent cross infection.  We created a project structure which meant that the participants worked together on-line.  This proved to be incredibly successful and participants have maintained this new community post project, supporting each other and enjoying music beyond the life span of the project.

This website hosts all the information about the project as well as songs performed by the participants.

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