Breathing techniques to ease breathlessness (Leaflet 3)

The information given below is designed to help you manage your stable long-term breathlessness. If you feel your breathing is getting worse, or you are experiencing breathlessness as a new feeling, it is important to seek advice from your GP.

Muscles involved in breathing

The diaphragm

The main muscle of breathing is the diaphragm. This is a large flat sheet of muscle covering the base of your rib cage. As you breathe in, it moves down to help draw the air into your lungs, and your tummy rises. When you breathe out, it relaxes, returning to its natural dome shape, and allowing your tummy to rest back in. The diaphragm does not tire easily.

Breathing accessory muscles

There are many muscles around your neck, upper chest and shoulders with the role of moving your neck and arms. However, when you are breathless, these muscles can pull on your ribs to help with breathing. These muscles are therefore called breathing accessory muscles.

Breathing techniques

Relaxed tummy breathing

When to use

Relaxed tummy breathing may help you recover quicker from breathlessness after activity. It may also help your breathing to settle if you feel panicky. You may wish to use this breathing method with the hand-held fan and a position to ease breathlessness.

How it works

Relaxed tummy breathing is sometimes known as breathing control. The aim is to move from fast, upper chest breathing to relaxed, slow tummy breathing. This breathing technique helps to make your breathing as efficient as possible by focusing on breathing from your diaphragm, with the upper chest relaxed.

Breathing from the tummy often does not come naturally. You should therefore practise relaxed tummy breathing when you are not breathless for 10 minutes at a time, at least twice a day. This will help you master the technique.

Before practising, make sure you are in a comfortable position, with your head and back supported and your shoulders and upper chest relaxed. Place one hand on your tummy. Feel the tummy rise and expand as you breathe in and relax down as you breathe out. Breathe gently when practising; there should only be a slight movement of your tummy at rest.

‘Breathe low and slow, relax, let go’

If you have a tendency to breathe with small, fast breaths from the top of your chest you may find taking slower, deeper breaths from your tummy helps to ease breathlessness.

Breathe a rectangle

When practising relaxed tummy breathing some people like to imagine a wave, as pictured above. Other people may prefer the image of a rectangle. Wherever you are, there is often a rectangle to be seen, whether this is a book, a TV, computer or tablet screen, a door, window, table top, or even a picture on the wall.

Follow the sides of the rectangle with your eyes as you tummy breathe. Gradually slow the speed at which your eyes move around the edge of the shape to slow your breathing.

Recovery breathing

When to use

Use recovery breathing when you feel extremely breathless or panicky and you are unable to use relaxed tummy breathing.

How it works

Recovery breathing allows more time for the air to leave your lungs as you breathe out, therefore creating more room for the next breath in. The aim of recovery breathing is to calm your breathing until you can breathe smoothly and quietly from your tummy again. For further information on positions to ease breathlessness see Leaflet 4.

People with chronic obstructive pulmonary disease (COPD), emphysema or asthma may prefer long breaths out, perhaps through pursed lips. People with other conditions may find relaxed breaths out suit them better.

Pursed lips breathing

Some people find breathing in through the nose and out through narrowed lips helps to ease their breathlessness. This technique tends to help people who have conditions such as chronic obstructive pulmonary disease (COPD) or emphysema. People who find this technique beneficial often use it instinctively without realising they are doing it.

Pursed lips breathing helps to support the airways to open, therefore allowing the air to leave the lungs more easily. This creates more room for the next breath in. You can use pursed lips breathing at the same time as relaxed tummy breathing or recovery breathing.

General advice

Avoid breath holding during activities eg climbing stairs or bending.

• Try to ‘blow as you go’, which means breathing out on effort, eg blow out when bending, lifting, reaching or standing up from a chair
• Try to avoid rushing.
• Try pacing your breathing with your steps eg take a breath in and out on each step when climbing the stairs.

Further information

For further help or advice contact the Breathlessness Intervention Service on 01223 274404 09:00 (9am) to 17:00 (5pm) Monday to Friday.