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Breathe easier

Learning to control your breathing will help ease breathlessness and reduce the feelings of panic and anxiety that can come with shortness of breath.

Watch a video on Managing Breathlessness using Pursed-Lip breathing


Using this method, you breathe out for twice as long as you breathe in. You should practice this method several times a day so it becomes natural to you when you are breathless.

  • Breathe in slowly. This should be a normal breath. Inhale through your nose, with your mouth closed. As you inhale, count 1, 2.
  • Purse your lips in a whistling position. This is pursed lips.
  • Breathe out slowly. Exhale for twice as long as you inhaled. As you exhale count 1,2,3,4,
  • Relax and keep breathing steady.
  • Repeat these steps until you no longer feel breathless. If you get dizzy, rest for a few breaths and then begin again

Diaphragmatic Breathing

People with COPD may have to work harder to breathe and tend to use the muscles in their upper chest, rather than the lower chest muscles, the main muscle being the diaphragm. You should practice this method daily. The more often you do it the easier it becomes and your diaphragm will become stronger. A stronger diaphragm decreases your breathlessness, strengthens your cough and helps removes mucus.

Diaphragmatic Breathing

  • Place one hand on your tummy between lower ribs and navel. Place the other hand on your chest. Your upper chest and shoulders should be relaxed.
  • Breathe in through your nose, you should feel your tummy move out as you breathe in. Keep your upper chest relaxed. The hand on your chest should not move or move very little.
  • Breathe out gently through your lips, your tummy will move in as you breathe out. “Sigh” out gently.
  • Ensure shoulders remain relaxed.
  • Over a few seconds gradually increase the depth of breathing while maintaining relaxation.
  • Practice first when sitting and relaxed so that it is automatic when you really need it. Then begin to practice while you are walking.


Active Cycle of Breathing Techniques (ACTB)

Watch a video on ACTB techniques


ACBT is a technique which uses breathing exercises to remove phlegm from your lungs. ACBT can be performed in sitting, lying or side-lying positions. Initially you should start in a sitting position until you are comfortable and confident to try different ones.

ACBT uses an alternating depth of breathing to move phlegm from the small airways at the bottom of your lungs to the larger airways near the top where they can be cleared more easily with huffing/coughing.

General rules

  • Try to maintain a good breathing pattern with relaxed shoulders and neck.
  • Try to breathe in through your nose and out through your mouth. Breathing should be slow, like “sighing out”. This can help minimise any wheezing.
  • Try to remember the principles of Diaphragmatic breathing.

Deep Breathing Exercise

  • Take 3-4 deep breaths in allowing the lower rib cage to expand.
  • Try to ensure your neck and shoulders remain relaxed.
  • At the end of the breath in, hold the air in your lungs for 3 seconds (This is an inspiratory hold).
  • Let the air out gently.

Forced Expiratory Technique

  • 1 or 2 “huffs” combined with diaphragmatic breathing.
  • Take half a breath in and blow the air out quickly through an open mouth.
  • Follow this with diaphragmatic breathing.
  • Repeat.
  • As the phlegm moves into the larger airways take a deep breath in and blow it out again through an open mouth, “huff” which should help clear the phlegm out of the back of your throat.
  • A typical cycle of ACBT consist of:
    • Diaphragmatic breathing
    • 4 deep breaths (+/- 3 second inspiratory hold)
    • Diaphragmatic breathing4 deep breaths (+/- 3 second inspiratory hold)
    • Diaphragmatic breathing
    • Forced expiratory technique

Active Cycle of Breathing Technique.


Active Cycle of Breathing Techniques (ACTB)

Controlling Breathlessness at Night

Some people with COPD may suffer from breathing difficulties at night. This can be very frightening and the anxiety can then make your breathlessness worse. Sleeping upright using 4 – 5 pillows can make you feel more comfortable and less breathless. Being prepared for breathlessness at night can also reassure you and help you cope.


  • If you wake breathless, sit up and lean forward e.g. sit at the edge of bed and lean on bed table.
  • Use pursed – lip breathing technique
  • Relax shoulders and neck muscles
  • Keep your reliever inhalers beside your bed and use if required.
  • Keep a fan beside you and turn on if breathless.

Watch a video on Relaxation


Clearing Mucus (phlegm) from your lungs

Some people with COPD produce a lot of mucus in their lungs and may find it hard to get it up which can cause an extra distress and breathlessness.
Changes in colour may indicate infection and you should contact your doctor

Tips on Clearing Mucus:

  • Drinks lots of fluids to keep mucus loose.
  • Use reliever inhaler before trying to clear phlegm
  • Do diaphragmatic breathing