Gerard J. Criner, MD, a professor of medicine and director of pulmonary and critical care medicine at Temple Lung Center at Temple University School of Medicine in Philadelphia. He is codirector of the Center for Inflammation, Translational and Clinical Lung Research.
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Simple ways to help yourself when you just can’t catch your breath…
If you can’t catch your breath, walking, climbing stairs or simply carrying on a conversation can be a challenge.
When breathing is a struggle, you wouldn’t think that exercise is the answer. But it can be a solution for people with chronic obstructive pulmonary disease (COPD) or heart failure or even for healthy people who occasionally become short of breath.*
Four better-breathing techniques that really help…
When you’re feeling short of breath, inhale through your nose for two seconds, then pucker your lips as if you were going to whistle or blow out a candle. Exhale through pursed lips for four seconds.
How it helps: It prolongs the respiratory cycle and gives you more time to empty your lungs. This is particularly important if you have emphysema. With emphysema, air gets trapped in the lungs. The trapped air causes the lungs to overinflate, which reduces the amount of force that they’re able to generate. This results in a buildup of carbon dioxide that makes it difficult to breathe.
You may need to do this only when you’re more active than usual and short of breath. Or you may breathe better when you do it often.
Simply changing how you stand or sit can improve breathing when you’re feeling winded.
How it helps: Certain positions help muscles around the diaphragm work more efficiently to promote easier breathing.
Examples: While sitting, lean your chest forward…rest your elbows on your knees…and relax your upper-body muscles. When standing, bend forward at the waist and rest your hands on a table or the back of a chair. Or back up to a wall…support yourself with your hips…and lean forward and put your hands on your thighs.
Your lungs produce excessive mucus when you have COPD. The congestion makes it harder to breathe. It also increases the risk for pneumonia and other lung infections. A normal, explosive cough is not effective at removing mucus. In fact, out-of-control coughing can cause airways to collapse and trap even more mucus. A controlled cough is more effective (and requires less oxygen and energy). You also can use this technique to help clear mucus from your lungs when you have a cold.
How to do it: Sit on a chair or the edge of your bed with both feet on the floor. Fold your arms around your midsection…breathe in slowly through your nose…then lean forward while pressing your arms against your abdomen. Lightly cough two or three times. Repeat as needed.
Important: Taking slow, gentle breaths through your nose while using this technique will prevent mucus from moving back into the airways.
This is a quick way to breathe better. When you are short of breath—or doing an activity that you know will lead to breathlessness, such as walking on a treadmill—position a fan so that it blows cool air on your face. You also can splash your face with cold water if you become short of breath.
How it helps: Cool air and water stimulate the trigeminal nerve in the face, which slows respiration and helps ease shortness of breath. That’s why the treadmills and exercise bikes used in respiratory-rehabilitation facilities often are equipped with small fans.
When to Get Breathing Help from a Professional
You can do many breathing exercises on your own without the help of a health professional. For the techniques below, however, it’s best to first consult a respiratory therapist (ask your doctor for a referral) to ensure that you know how to do the exercise properly. You can then continue on your own.
Paced breathing for endurance. This technique is useful for people who have COPD and/or heart failure, since it improves lung capacity and heart function.
How it helps: With practice, this technique can increase your cardio-respiratory endurance by 30% to 40%. To perform the exercise, a metronome is set at a rate that’s faster than your usual respiratory rate. Your therapist will encourage you to breathe as hard and as fast as you can for, say, about 15 minutes. (Beginners might do it for only a few minutes at a time.)
Example: The metronome may be set for 20 breaths per minute to start, and you may eventually work up to 40 breaths per minute.
You’ll notice that breathing becomes easier when you’re doing various activities—for instance, when you’re exercising, climbing stairs or taking brisk walks.
Inspiratory muscle training. Think of this as a workout for your breathing muscles. It is especially helpful for people with COPD or other lung diseases and those recovering from respiratory failure. People who strengthen these muscles can improve their breathing efficiency by 25% to 30%.
How it helps: For this breathing exercise, you’ll use a device known as an inspiratory muscle trainer, which includes a mouthpiece, a one-way valve and resistance settings. When you inhale, the one-way valve closes. You’re forced to use effort to breathe against resistance. Then the valve opens so that you can exhale normally. This breathing exercise is typically performed for 15 minutes twice a day. You can buy these devices online. Good choice: The Threshold Inspiratory Muscle Trainer, available at FitnessMart.com for $47.50.
*If you don’t have COPD, you should see a doctor if you have shortness of breath after only slight activity or while resting, or if shortness of breath wakes you up at night or requires you to sleep propped up to breathe.