Breathing Strategies for COPD

Reviewed by: HU Medical Review Board | Last reviewed: October 2021 | Last updated: August 2023

People with chronic obstructive pulmonary disease (COPD) often have trouble breathing. Fortunately, there are exercises and strategies that can help make breathing easier.1

How do breathing strategies help people with COPD?

COPD causes obstructive airflow from the lungs that gets worse over time. In COPD, the lining of the bronchial tubes, which carry air from the air sacs (alveoli) of the lungs, becomes inflamed and narrowed. In addition, the lungs create more mucus, which can further block the airways.2

The elastic walls of the air sacs are damaged and destroyed in COPD as well. This causes them to collapse when exhaling. This leads to trapped airflow within the lungs, which worsens breathing.2

Breathing exercises are designed to help people with COPD breathe more efficiently and effectively. They can help clear out the stale air in the lungs and fully engage your breathing muscles. The 2 breathing exercises that are most beneficial for those with COPD are pursed-lip breathing and abdominal (belly) breathing.1,3,4

Pursed-lip breathing

Pursed-lip breathing helps those with COPD in several ways. First, it can help release trapped air in the lungs by keeping the airways open longer during breathing.1,3

Pursed-lip breathing can also help lower the number of breaths you take by extending the exhalation phase of breathing. Breathing slower can help you improve your breathing pattern, easing shortness of breath and anxiety.1,3

Pursed-lip breathing can be used during or after exercising, or during any activity that makes you feel out of breath.1

To do pursed-lip breathing:1,3

  • Close your mouth and breathe in slowly through your nose for 2 seconds.
  • Purse your lips like you are going to blow out candles on a cake.
  • Breathe out slowly, aiming to breathe out 2 to 3 times longer than you inhale.

Abdominal (belly) breathing

Abdominal breathing is sometimes called belly breathing or diaphragmatic breathing. It may take a bit more practice than pursed-lip breathing. But with practice – or if you have a health professional to teach you – you can master it in no time.1,3

The goal of abdominal breathing is to practice engaging your diaphragm while breathing. This helps you take deeper breaths and fully empty your lungs when you exhale.1,3

The diaphragm is the main muscle in our chest that controls breathing. People with COPD sometimes rely on their neck or back muscles to breathe, but these do not work as effectively.1,3

When practicing abdominal breathing, the goal is to feel your stomach move as you breathe. Here are the basic steps for abdominal breathing:1,3

  • Lay on your back in a comfortable setting.
  • Relax your muscles, especially in your neck and shoulders.
  • Place 1 hand on your chest and 1 hand on your stomach.
  • Slowly breathe in through your nose.
  • Focus on using your stomach to breathe. You should feel the hand on your stomach rise as you inhale.
  • Slowly breathe out through your mouth. You should feel the hand on your stomach lower. The hand on your chest should not move at any point.

As you get better at abdominal breathing, you can practice doing it standing up. Eventually, you should be able to use abdominal breathing even while doing regular day-to-day activities.1,3

Other strategies for people with COPD

There are other strategies that can help those with COPD. Those include:5,6

  • Huff coughing
  • Conserving energy

Huff coughing

Huff coughing helps to clear mucus from the airways. This technique involves taking a deep breath and then forcefully exhaling with an open mouth, creating a "huff" sound. To perform the huff cough:5

  • Sit in a comfortable position.
  • Take a deep breath and hold it for 3 seconds.
  • Breathe out as quickly as you can. Hold your mouth as you would if you were fogging a mirror and say "huff" as you breathe out.
  • Repeat 4 to 5 times.

Conserving energy

People with COPD can often get tired while performing normal tasks. Conserving energy can help with this. Tips for conserving energy include:1

  • Move slowly
  • Take seated breaks often
  • Practice pursed-lip breathing during breaks

A word of caution

If you are new to these breathing exercises, do not practice them when you are out of breath. Instead, practice them when you are breathing normally and feel comfortable. Later, when you have had practice, you can use these strategies when you are feeling out of breath.3

Talk with your doctor about any questions you may have about doing breathing exercises to help with your COPD.

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