Online laughter yoga beat in-person for nurses' sleep

Nurses working shift-based, high-demand clinical roles are a group in which poor sleep and burnout are persistent problems, and low-cost complementary approaches are often proposed to help. Laughter yoga is one such approach, but most of the interest has focused on whether it works at all rather than how it is best delivered. Since the shift to remote sessions, workplace wellbeing programmes are increasingly run over video, and it is not obvious that a group activity built on shared laughter survives that translation. The authors note that evidence comparing different delivery formats remains limited, which is the gap this pilot set out to probe.

This was a three-group pilot randomised controlled trial run at a public hospital between April 2024 and February 2025. A total of 47 nurses were randomly assigned to a face-to-face laughter yoga group, an online laughter yoga group, or a control group. The intervention was identical in content across the two active arms: four laughter yoga sessions delivered over a two-week period. Outcomes were collected at baseline and immediately after the intervention using the Perceived Stress Scale, the Jenkins Sleep Scale and the Maslach Burnout Inventory. Analysis used repeated-measures analysis of variance, paired-samples t-tests and effect size calculations.

On perceived stress — one of the headline targets — there were no significant differences, either between the groups or within them over time. The online group did show significant improvements in sleep quality, emotional exhaustion and personal accomplishment, and the authors report large effect sizes for these changes. No significant changes were found in either the face-to-face group or the control group, meaning the in-person version of the same four sessions did not separate from doing nothing. The pattern is therefore mixed rather than uniformly positive, with the stress null sitting alongside the sleep and burnout signals.

This is a feasibility-oriented pilot, and the authors frame the findings as preliminary rather than conclusive. The result runs against the intuitive assumption that a shared, physically co-located laughter session would be the stronger format, though with roughly a dozen or so participants per arm the comparison is fragile and could easily reverse on replication. The researchers also flag practical obstacles specific to the online format, including internet access and connectivity issues, that would need to be reduced in any larger trial. Open questions include whether the benefits persist beyond the two-week window and why perceived stress was unmoved when burnout scores shifted.

The reasonable takeaway is that a remotely delivered group laughter session is at least worth taking seriously as a format, rather than dismissing it as a diluted version of the in-person thing. It is not evidence that laughter yoga reliably fixes burnout or sleep, and the absence of any effect on perceived stress is a useful reminder that self-reported wellbeing measures do not all move together. For anyone in shift work weighing up low-cost wellbeing options, this is a reason to think format may matter less than expected, not a reason to expect a specific result. Replication in larger and more varied workforces is what would turn this into something firmer.