COPD makes you feel more breathless. This is because it takes much more effort to get air in and out through narrowed airways. In most cases it is not due to a lack of oxygen. Your lungs are huge and can cope for some time with the damage that has happened without us noticing any difference. 

With shortness of breath your breathing rate increases. This results in each breath becoming faster and shallower. As your breathing becomes faster you will likely feel less in control of your breathing. 

Sometimes we all have to be more aware of our breathing, like where breath comes from and goes to. Think of how we have to change our breathing when using an inhaler. It is important to know what ‘normal’ breathing is to be able to aim for this. Even the highest level athletes have to concentrate on breathing patterns to achieve their goal. 

The environment we are in may also make a difference to breathing: 

  • Make it smoke free
  • Have moving air through fans or open windows
  • Keep it free from perfumes or pets that may irritate
  • Control the temperature where possible 

The following instructions are recommended to help you to:

  • slow your breathing down
  • breathe more efficiently
  • regain control of your breathing

In this way you will begin to make more effective use of your breathing.

Remember: The lungs are the fuel tanks of your body. We need to fill them properly.

The Upper Chest 

The upper chest is not designed for constant use. At rest and during moderate activity the lower

part of your chest is by far the most efficient. The upper part is only expected to help out when the activity level increases. For this reason the upper chest is really just a reserve to fall back on when a little more is needed. 

The chest muscles that enable us to breathe into this upper part are only meant to be used from time to time. Their main function is to support the head. Overuse will cause these muscles to tire and use more energy than is needed. This makes the job of breathing even more difficult and tiring.

When you are short of breath the upper part of your chest will be working very hard. You should be able to see this in a mirror. Your upper chest will rise as you breathe in then fall as you breathe out. 

It is very important that you try to relax the upper chest. This will be easier if you make yourself comfortable, with your head and shoulders supported.

This will reduce the workload on your muscles. It will also make it easier for them to relax before trying to move your breathing down to the lower part of the chest. Place a hand on your tummy and try to feel the expansion when you fill the lower part of your lungs with air. Your physiotherapist will tell you how to do this. Try to keep your upper chest absolutely still. 

Remember: This is the way we are naturally programmed to breathe. However, we can get into bad habits. Think about watching the breathing of a new baby. The chest stays completely still but the tummy rapidly rises and falls 

Breathing In   

You should try to breathe in through your nose. The passageways behind your nose are designed to slow the air down. This gives it time to warm up and collect humidity before it reaches your lungs. 

Breathing through your mouth allows cold, dry air to enter your lungs which can irritate them. Also other irritants in the air (like dust or pollen), which are normally filtered out by the fine hairs in your nose, can enter your lungs through your mouth.

The breath in should be unforced and as quiet as possible. If you can hear the air entering, then too much effort is being used and you should try to relax your breathing a little more. 

At the end of the breath in there should be a little break before breathing out. This is the point at which the oxygen that you have taken in is absorbed into the body.

When you become breathless, and your breathing becomes faster, you will notice that the break at the end of the breath in usually disappears. 

This means that some of the oxygen that you have taken in will be expelled when you breathe out before it has had a chance to be absorbed. 

At first try to put the little break into just the occasional breath. As you become more used to this you can add it to a few more breaths. Soon you should be able to manage several breaths in a row. In this way you can build up the control gradually. 

Breathing Out 

A normal breath out lasts about 3 seconds. This allows your muscles that do the work to breathe in to have a rest. 

It takes longer to empty your lungs that it does to fill them. When you are breathless you will find that the breath out is shorter. Sometimes it may last only 1 second. This makes it difficult to clear all the old air out of your lungs. Your muscles that should be having a rest now have to work to push the air out your lungs. This increases your body’s demand for oxygen and leaves you feeling tired.

This retained air will restrict the amount of new, oxygenated air that can be taken in with the next breath, increasing the shortness of breath. This can become apparent during exercise. 

Try to lengthen an occasional breath at first and build it up gradually. Sometimes pursing the lips can help slow and lengthen the breath. 

It is important not to force the air out. Breathing out is normally achieved by the elastic recoil of the lungs and needs no muscle activity. Try to let the air out as quietly and gently as you can. 

Abdominal Breathing 

With a hand resting on your tummy, try to expand the lower part of your chest. You should feel your hand being gently pushed away as you breathe in, and sinking in again as you breathe out. 

At first it will be useful to practice your breathing control several times a day. Try a few breaths every time you sit down with a cup of tea. Practice again when you get into bed at night or before you get out of bed in the morning. 

Practice in different positions from sitting, to lying in bed, to standing still. Just stop what you are doing to drop your shoulders and be aware of a few abdominal breaths.

As you adjust to this relaxed breathing control, it is best to adopt this pattern of breathing when doing daily activities that normally leave you breathless like walking and climbing stairs. This helps to try to keep a sense of control over your breathing. At higher level activities intermittent nose or diaphragm breaths may help you keep a sense of control over your breath.

Practice over a few months to help you to retrain your brain to breathe more efficiently. You may already be doing this automatically.

Top Breathing Techniques  

Make sure you are in control of your breathing, not the breathing in control of you.

For instance when going from point A to B always keep control at every stage. Do not rush and end up at Point B gasping. Stop and start, rest half way or slow down to keep that control. 

‘Blow as you go’. Breathe out when you are making a big effort such as: 

  • Stretching your arms above your head
  • Reaching for something on a shelf
  • Bending down
  • Going up a step or stairs 

Forward Leaning.

Positions your diaphragm to take a good effective breath to help during activity and recovery. Sometimes mobility aids such as sticks or walkers are used for this purpose. 

Pursed Lip Breathing.

Breathe out with your lips pursed as if you are whistling. This slows your breath down. It also allows old stale air that can become trapped in the lungs to escape. This can be particularly useful during exercise.

If in doubt breathe out.

Quite often we concentrate so much on trying to get the air into the lungs that we forget about breathing out. This often happens when we are anxious or panicky. Sometimes a prolonged breath out can help lower lung volumes to be able to actually take a deeper breath in. 

Contact:

The Coppice, Carleton Clinic, Carlisle, CA1 3SX

Telephone: 01228 602036

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