For individuals with chronic lung diseases like asthma, and especially obstructive disorders such as Chronic Obstructive Pulmonary Disease (COPD), proper breathing techniques are critical for quality of life, and should be learned and practiced for maximum effectiveness.
Chronic lung disease can often set off a vicious cycle that can severely impair normal day-to-day life. If you have shortness of breath due to COPD, you may tend to avoid activities that increase your respiratory rate and heart rate and cause even more breathlessness. This leads to a decrease in physical activity and a weakening of the muscles, which leads to more breathlessness, inactivity and, in many cases, isolation and depression.
With regular practice of breathing techniques, individuals can break this cycle and breathe better. Knowing what to do – and what not to do – can not only be empowering during times of stress, but also provide a better quality of life overall.
- practice pursed-lips breathing
- use diaphragmatic (abdominal/belly) breathing and minimize use of accessory muscles
- seek pulmonary rehabilitation
- ignore early warning signs of an acute exacerbation
- use supplemental oxygen less than directed by your doctor
- give into increased inactivity due to shortness of breath
Pursed-lip breathing helps you breathe easier by slowing your breathing down and keeping airways open longer so you can get rid of more stale, trapped air. Using PLB will help move the air in and out of your lungs without making you work so hard to breathe. It’s normal to hold your shoulders tense and high. Before starting to practice of any breathing technique, take a minute to drop your shoulders down, close your eyes and relax. The steps of purse-lip breathing are:
- Inhale through your nose in for two counts. Inhale slowly, as if you’re smelling a flower.
- Pucker your lips in the same way you get ready to blow out candles on a birthday cake.
- Breathe out very slowly, for about four counts. In pursed-lips breathing, exhaling should be twice as long as breathing in. “In – 1-2. Out – 1-2-3-4.”
- Practice this so it becomes second nature and comes automatically when you exert.
Diaphragmatic breathing is not as easy to do as pursed-lips breathing. It is recommended that you work with a respiratory healthcare professional or physical therapist experienced in teaching it.
It helps to know that the diaphragm is meant to be the main muscle of breathing. In a person with healthy lungs, the diaphragm is dome-shaped. When you breathe in, it flattens, pulling down on the bottoms of your lungs so the air can come in easily. When you breathe out, the diaphragm returns to a dome-shape, pushing up on the lungs, helping expel the air. But in COPD, the lungs are stretched. They become too big, the diaphragm is flattened, and doesn’t work as well.
Even so, you can improve the function of the diaphragm.
- Relax your shoulders and the muscles in your neck and upper chest (accessory breathing muscles).
- Place one hand on your chest and the other on your belly.
- Inhale through your nose. Concentrate on your belly moving outward. The hand on your belly should move more than the hand on your chest.
- Slowly exhale through pursed lips, gently pushing your belly in.
- Repeat as much as is comfortable.
Pulmonary rehabilitation is a program of exercise, education and support that helps you learn how to breathe—and function—at the highest level possible. Your rehabilitation team will take a complete health history, talk with you about your current level of activity, and help you set goals for what is most important to you.
In addition to exercising at your own rate, in a program individualized for you, you will learn about breathing techniques, medications, nutrition, relaxation, oxygen, travel, how to do everyday tasks with less shortness of breath, how to cope with chronic lung disease and how to stay healthy.
Exercise can often change the way you feel, breathe and function. At first, your exercise routine should be slow and easy. Even if you think you can do more, take it slow. Your exercise time and effort should gradually increase over time. When you’ve reached the point that you’re feeling better and breathing better, don’t stop. Keep it up. If your lung health professional has told you to use oxygen with activity, do so.
An acute exacerbation is a flare-up or episode when your breathing gets worse than usual and you become sick. It is often linked to an infection. Exacerbations can be serious, leading to hospitalization.
Early warning signs include:
- Wheezing, or more wheezing than normal for you
- Coughing more than usual
- Shortness of breath that is worse than usual
- An increase in the amount of mucus
- Change in the color of your mucus to yellow, green, tan or bloody
- Shallow or rapid breathing, more than normal for you
- Confusion or excessive sleepiness
- Swelling in your feet or ankles
Even if you already have a chronic lung disease, don’t ever stop trying to quit smoking. While quitting won’t cure or reverse COPD, it can slow down the disease’s progression. It’s also important to live and work in an environment that is free of smoke and respiratory hazards. There are many options available to help you quit smoking, including gums, patches and prescription medicine.
We all need oxygen to live, but if you require supplemental oxygen, follow the recommendations of your doctor. Some people feel self-conscious about being seen with oxygen in public. But oxygen helps maintain the function of your heart and brain. Keep in mind that today oxygen is smaller, lighter and easier to carry. Your body can’t store oxygen – if you wear it at night, this will not help you have a higher oxygen level during the day.
It might seem impossible to exercise if you are short of breath, but the health care professionals at pulmonary rehabilitation are experts at working with individuals with very severe shortness of breath and physical limitations. They will design a program especially for you and take the time to help you learn to live and breathe as well as possible.
Having a chronic lung disease makes it harder to breathe. And when it’s hard to breathe, you may tend to decrease physical activity and become deconditioned, leading to more breathlessness, inactivity and, in many cases, isolation and depression. Avoid this vicious cycle. Ask your lung health professional about helpful breathing techniques, pulmonary rehabilitation and exercise.