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Don’t Breathe In – Breathe out

Like many with very severe emphysema, a component of COPD, my worse moments often occur soon after waking. Today was no exception. It is the moment when my long acting inhalers are done with until the next dose. When my body, and lungs has frozen from a night of little movement – leaving me extremely breathless on rising.

We feel we do not have enough breath and struggle to breathe, so instinct tells us to suck in harder. The problem is, try as hard as we might, more air into our lungs is not coming. Indeed, sometimes we cannot seem to suck in more air at all and it feels as though we are suffocating. Which for some causes panic. Worsening an already grim situation. This is where we need to know a little about emphysema and how our lungs work.

Think of your lungs as a balloon full of air. But now no more air can enter your balloon as it is full to bursting point. Now imagine that balloon is know longer elastic, so unable to contract to allow air out anymore, even when you let go the opening of the balloon. Normally you let go of the balloon and there is a whoosh as it whizzes around the room letting the air out. But no longer does this happen. Instead you have to squeeze that balloon to let some of the air out to allow you to blow more air into it. That is a simple way to explain your lungs when you feel you are breathless and unable to get more air into your lungs. Your lungs are over inflated. Very large. Full of air. And unable to take in anymore until some has left your body. Your lungs have lost much of their elastic quality and you have to sometimes consciously concentrate more to do what used to be a natural function.

The key is to learn to breathe in a more efficient way. Forget about working hard to draw air into your lungs, instead concentrate on getting air out of those over-inflated lungs. This will then let out some of the stale air, giving room to suck in fresh, oxygen laden air. Incredible as it may seem to you, taking more time to exhale than inhale is the answer. This can be achieved by using pursed lip breathing.

Pursed-lip breathing involves shaping your mouth as though you are whistling, and blowing out gently and slowly. A bit like blowing out a candle very softly. To be effective you need to breathe out twice as long as inhaling. How long you can suck in and breathe out is different for each of us. And you will need to find what you are comfortable with. To practice, sit comfortably, place both hands on your stomach. Many of us breathe from the top of our chest, a bad habit as we are not moving enough air out of our lungs, leaving us ever more breathless. By instead allowing our tummy to rise and fall we will allow more fresh oxygen laden air in and stale air out. Try to breathe in through your nose to the count of three, then blow out gently and slowly through pursed lips, don’t forget to shape your lips like a whistle, slowly to the count of six. Then repeat. To start with, you could practice this for a few minutes several times a day. And if you are feeling breathless try it then also to relieve your breathlessness. When you get used to this, increase the count to four in and eight out if you can. Don’t worry if you cannot manage three though, go for two in and four out instead.

This does take practice as we are learning something new. But once mastered, you will find you are purse lip breathing automatically. It will help you in all situations. When walking, when plain breathless, or doing jobs around your home. If you have an oximeter, take a reading before and during practicing purse lips breathing. And watch them oxygen blood saturation levels rise. I have found the results can be amazing.

Of course there is much more to emphysema, as much of the lungs including the alveoli is damaged and unable to exchange gases as they used to. But for now, to enable you to breathe better the above analogy will be helpful to help you breathe a little easier.

If, like me, you have great difficulty in that first half hour after rising in the morning, take your rescue inhaler to bed with you. When you rise take a couple of sucks of your rescue inhaler before you get out of bed. Then if need be purse lip until you are able to take your long acting inhalers and they start to work.

I hope this article has been of use to you. Until I write again remember to be kind to yourself. And most of all, Breathe Easy.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • cbpitts
    3 years ago

    Thank you Derek. I knew this but we all just forget sometimes. Thanks for the reminder!!!!!

  • Derek Cummings author
    3 years ago

    My pleasure cbpitts. Always pleased to hear my articles have helped.

  • 8ei647
    4 years ago

    Finding your blogs and stories so helpful and interesting – finding it also helpful that you are so positive about everything – striving to be like you !!!

  • Derek Cummings author
    4 years ago

    Everything is easier when we are positive Patsy. Life is at times difficult. But there are lots of others in a worse place than us. I am glad my blogs are helpful and helping you. Many thanks for your comments. 🙂

  • Jenn Patel
    4 years ago

    Thanks so much for your comment, and for being part of our community! We agree that Derek’s writing is interesting and inspiring. 🙂

    Please feel free to come by any time you’d like to get some information and/or support. There are many people in the community who can understand what you’re going through – you’re not alone here!

    Jenn (Community Manager,

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