What can I do to manage my breathlessness?
Evidence suggests that how breathless you feel doesn’t always match up with how well you’re getting air into your lungs. This is because it’s not just lung function that affects how out of breath you feel.
Breathlessness is also affected by how you breathe, your lifestyle and how you think and feel about your breathing.
On this page:
- Breathing habits
- Breathing control
- Breathing techniques
- Positions to help you recover from breathlessness
- Obstructive and restrictive lung conditions
Unhelpful breathing habits can make you feel more out of breath.
When you’re out of breath, you may feel like you need more air. So you may start to take more air into your lungs or breathe faster. You might then not take the time to fully empty your lungs as you breathe out. This means you use the top of your chest more to breathe, instead of using your whole lungs. Breathing like this is more work – your muscles will get tired more quickly, and you’ll feel even more out of breath.
The good news is there are breathing techniques you can use to breathe more efficiently and to feel in control of your breathing. If you practise these techniques and use them every day, they’ll help you when you’re active or if you suddenly feel short of breath.
Talk to a physiotherapist to find the best techniques for you. If you don’t already have one, ask your doctor to refer you.
Breathing control means breathing gently, using the least effort. It will help when you’re short of breath or feeling anxious. This type of breathing is commonly used in yoga.
To get used to breathing control, it helps to practise when you’re sitting, are relaxed and not out of breath.
Breathing control is about the best use of your main breathing muscle, your diaphragm. The focus is on reducing tension, using your shoulder and neck muscles to get into the best position for you to breathe easily. Your diaphragm contracts when you breathe, so pulling the lungs down, stretching and expanding them. It relaxes back – into a dome position – when you breathe out, reducing the amount of air in your lungs.
Get into a comfortable position, with your arms supported. Let your shoulders and body be relaxed and loose.
- Put one hand on your chest and the other on your abdomen
- Close your eyes to help you relax and focus on your breathing
- Slowly breathe in through your nose, with your mouth closed. If you’re relaxed, the air will reach low in your lungs. Your abdomen will move out against your hand. If your breathing is controlled, the hand on your chest will hardly move
- Breathe out through your mouth. Your abdomen will fall gently. Imagine all the tension in your body leaving as you let the air out
- Try to use as little effort as possible and make your breaths slow, relaxed and smooth. With every breath out, try to feel more relaxed and calm. Gradually try to breathe more slowly
When fully in control of your breathing, your out breath should be longer than your in breath. There should be a natural pause at the end of your outbreath.
Use breathing control combined with any of these breathing techniques:
Blow-as-you-go helps make tasks and activities easier. Use it while you’re doing something that makes you breathless. You can use it with pursed-lips breathing.
How do I do it?
Breathe in before you make the effort. Then breathe out while you’re making the effort. For example, when standing up, breathe in before you stand up, and then blow out as you stand up. Try using pursed-lips as you blow out.
Paced breathing is useful when you are active, for example, walking or climbing stairs. You pace your steps to your breathing. You can use it at the same time as pursed-lips breathing and blow-as-you-go.
How do I do it?
Count to yourself as you walk or move. For example, breathe in for one step and then take either one or two steps as you breathe out.
Take more steps as you breathe in or as you breathe out, if that feels better for you. Try different combinations to find what works best for you - for example, one step in, two steps out.
Pursed-lips breathing can be used at any time to help you control your breathing. This helps to empty all the air out of your lungs and is particularly useful for people with COPD as the narrowed airways can trap air in the lungs.
How do I do it?
Breathe in gently through your nose, then purse your lips as though you’re going to blow out a candle. Blow out with your lips in this pursed position. Imagine blowing out a candle when you breathe out. Blow out only for as long as is comfortable – don’t force your lungs to empty.
Use these positions to help you practise your breathing control, or to recover your breath when you get breathless.
Stand leaning backwards or sideways against a wall
Have your feet slightly apart, about one foot or 30cms away from the wall. Relax your hands down by your sides. If you prefer, rest your hands or thumbs in your waistband or belt loops, or across the shoulder strap of your handbag.
This position can be helpful for most people with a lung condition. Other helpful positions vary depending on whether you have an obstructive or a restrictive lung condition.
Obstructive and restrictive lung diseases both cause breathlessness but they result from different processes in your lungs:
- obstruction refers to how quickly you can move air in and out
- restriction refers to the total amount of air you can get into your lungs
If a healthy person takes a big breath in and then blows out as hard, they will be able to get over 70% of the air out of their lungs in one second.
Obstructive lung diseases
In obstructive lung disease, such as COPD, asthma or bronchiectasis it takes longer to empty your lungs. The airflow is slower because the disease makes airways narrower or lungs less elastic. Because breathing out is slower, the person may need to breathe in again before they have emptied their lungs. This makes breathing uncomfortable.
Restrictive lung diseases
In restrictive lung disease, you cannot fill your lungs with air because your lungs are restricted from fully expanding. This happens when the lungs themselves are stiff or because there is a problem with the chest wall or the breathing muscles.
The most common restrictive lung conditions are interstitial lung disease, such as IPF, others are obesity or a curved spine.
Some people find it difficult to breathe because they have lots of phlegm in their airways. This happens with lung conditions such as bronchiectasis. If you have lots of sputum, clearing your sputum may help you to feel less out of breath.
There’s more detail in patient information leaflets developed by the Association of Chartered Physiotherapists in Respiratory Care.
Positions for obstructive lung conditions
In obstructive lung disease, it takes longer to empty your lungs. Try our suggestions to reduce your breathlessness
Positions for restrictive lung conditions
In restrictive lung disease, you cannot fill your lungs with air because your lungs are restricted from fully expanding. Try our suggestions to help reduce your breathlessness