Breathing exercises
Breathlessness may be one of the possible symptoms experienced by patients with pulmonary fibrosis
Pulmonary fibrosis causes scarring of the lungs, makes them stiffer and less elastic. It can become harder to breathe in deeply as the lungs are less able to expand properly. This leads to less oxygen in the blood and can make you feel breathless.1
It can be frustrating when routine daily tasks that were once manageable start to become more challenging. If you feel anxious, your breathlessness can become worse and you may begin to hyperventilate (when you start breathing very fast without control).
Breathing exercises can control your breathing and help you to strengthen your lungs.2 If you start to feel breathless, try your best to stay calm and breathe slowly.
Below are five simple breathing exercises that can help prevent breathlessness and settle your breathing.
QUICK TIP
Try to master these breathing exercises by working through the techniques with the support of a family member or friend. You can also speak to your treatment team- they will be able to guide you through them
Pursed-lips breathing3
Pursed-lips breathing can help you to control your breathlessness and return your breathing to normal if you are beginning to hyperventilate. It may also help reduce any fear and anxiety you may be experiencing.
How do I do it?
1. Breathe in through your nose
(As if you are smelling something) for about 2 seconds
2. Pucker your lips
Like you’re getting ready to blow out candles on a birthday cake.
3. Breathe out very slowly
Through pursed lips for about 4 seconds
4. Repeat
Steps 1 to 3 until you’re feeling relaxed
Belly breathing, also known as diaphragmatic breathing2
Belly breathing is an exercise that engages your diaphragm (the flat muscle at the bottom of the rib cage that controls your breathing). Belly breathing is best done when you’re feeling rested and relaxed, while sitting back or lying down, in a position that allows your chest and shoulders to relax.
How do I do it?
1. Place one hand on your chest and the other on your belly
When you begin to breathe, you should feel the hand on your belly move, but the hand on your chest should remain as still as possible
2. Breathe in slowly through your nose
Your belly should move out toward your hand
3. As you breathe out slowly through pursed lips
Gently press on your belly, this will push up on your diaphragm to help get air out of your lungs
4. Repeat
Steps 1 to 3 until you’re feeling relaxed
Blow-as-you-go4
Blow-as-you-go is useful for helping you carry out daily activities that make you feel breathless.
How do I do it?
Breathe in before you start the activity, and then exhale as you perform the activity.
For example, when lifting heavy items, breathe in before you lift the item and then breathe out as you lift. This method can be used as you perform any activity no matter how big or small. You may also try combining blow-as-you-go with the pursed-lips breathing exercise.
Paced breathing4
Pacing your breathing can be useful while you are active, for instance, while you are walking, climbing stairs or when performing any activity that makes you breathless.
Paced breathing means matching your breath with your physical steps. Try matching your steps to your rate of breathing. You can combine this method with the pursed-lips breathing exercise if it helps.
How do I do it?
-
Count to yourself as you walk
-
Try breathing in as you slowly count to 1 whilst taking a single step
-
Then take another one or two steps as you breathe out over 2 or 3 seconds
-
Adjust the number of steps you take while you breathe in and out to a pace that feels comfortable for you
Paced breathing is also useful when climbing stairs. Try to slowly breathe in and out over the course of 1-3 seconds as you gradually make your way up one step at a time. If you are feeling comfortable, you can try to increase the number of steps you take in a single breath.
Relaxed slow and deep breathing4
Deep breathing isn’t just for yoga or meditation - it can be very useful while you’re active too. Use it as soon as you begin an activity, whether that be during small activities around the home or when you go out walking.
How do I do it?
Whilst keeping active, try to slow your breathing and inhale through your nose as deeply as possible.
Take your time doing and learning these breathing exercises. Don’t try to take on too much at once.
While these exercises are useful, they are not to be used alone for managing your health while living with pulmonary fibrosis. Read the other advice in this section for more information on how to take care of yourself while living with pulmonary fibrosis.
Make sure that you have spoken to your treatment team and agreed on a full plan of care with them. The plan should include all the appropriate medications, pulmonary rehabilitation exercises, emotional support and lifestyle changes.
Key takeaways
Breathing exercises can help you cope with breathlessness
Pursed-lip and belly breathing are simple and effective exercises to try
Doing breathing exercises can help reduce anxiety as well as making everyday activities easier
Pulmonary Fibrosis Foundation. Pulmonary Fibrosis patient information guide. 2015. Available at: http://www.pulmonaryfibrosis.org/docs/default-source/patient-information- guides/patient_info_guide_eng_2013.pdf?sfvrsn=2. [Accessed April 2019].
Borge CR, Hagen KB, Mengshoel AM, et al. Effects of controlled breathing exercises and respiratory muscle training in people with chronic obstructive pulmonary disease: results from evaluating the quality of evidence in systematic reviews. BMC Pulm Med. 2014;14:184.
Swigris JJ, Brown KK, Make BJ, Wamboldt FS. Pulmonary rehabilitation in idiopathic pulmonary fibrosis: A call for continued investigation. Respir Med. 2008;102:1675–1680.
Association of Chartered Physiotherapists in Respiratory Care. How to Cope with Being Short of Breath - Breathing Exercises. 2011. Available at: https://www.acprc.org.uk/Data/Publication_Downloads/GL-02HowtocopewithbeingSOB-breathingex.pdf. [Accessed April 2019].
Also in this section
“When I am resting normally, things are practically fine. As soon as I do a more physical activity - climbing stairs - then that begins to trouble me”