Individuals with lung disease often feel they can’t exercise because they’re short of breath. But exercise is one of the best ways to help you breathe easier. The key is learning how to control your breathing. Coordinated breathing helps you match your breathing to the activity you’re doing. You can control how deeply and quickly you breathe with techniques like pursed-lip breathing and diaphragmatic breathing. Read on for more on the do’s and don’ts of coordinated breathing.
Breathing is something that we all take for granted. It is an activity that is performed at an unconscious level; it occurs automatically. Nevertheless, for a person with chronic lung disease, successful participation in daily activities and exercise requires that you coordinate your breathing with the pattern of your movements, so that you can perform these activities without experiencing breathlessness.
When you’re short of breath, it feels as if you just can’t get enough oxygen in your lungs. This often makes you want to breathe more rapidly in an attempt to get the oxygen you feel you need. In reality, in contrast to your instincts, it is prolonged exhalation that is needed, not more breaths. In a person with obstructive lung disease, increasing your breathing rate results in an inability to adequately empty the lungs of air before the next breath and, as a result, increases breathlessness. This phenomenon is called “breath stacking” and leads to air trapping, a condition that can be modified by pursed lip breathing and changing the pattern of your breathing during activities.
What Aspects of Breathing Can You Control?
1. Depth of the breath
Sometimes people breathe with only the upper part of their chest, and don’t really use the diaphragm at all. This means that air doesn’t get down into the lower lobes of your lungs, where more gas exchange will take place.
2. Pace of breath
You can also control how fast you breathe. Sometimes you may take short, shallow pants, inhaling and exhaling so fast that the gas never really gets into the lower lobes of the lungs.
3. Tension in the respiratory muscles
Holding your shoulders very tight and tightening your abdomen makes it harder to breathe. You can learn to relax these muscles by breathing deeply and evenly, in a more relaxed fashion.
Techniques for Coordinated Breathing
The use of coordinated breathing minimizes shortness of breath and assists in delivering adequate oxygen and eliminating carbon dioxide from the working muscles. Mastering coordinated breathing takes time, effort, and practice. Understanding how, why, and when to apply pursed-lip breathing will enhance your success and desire to master the process.
Pursed-lip breathing is putting your lips into a position much like puckering for a kiss and then exhaling through your puckered lips to increase the backpressure required in exhaling. This technique forces the airways to stay open during the entire length of exhalation and allows a more complete emptying of the air in the lungs. Here are some instructions that you can practice on your own.
Pursed-lip Breathing
Why is this technique effective?
- Decreases respiratory rate
- Keeps airway open longer during exhalation
- Increases tidal volume
- Improves gas exchange
- Reduces the work of breathing (decreases the use of accessory muscles)
- Increases exercise tolerance
How do you do pursed-lip breathe?
- Inhale through the nostrils (if possible)
- Exhale slowly (do not force the air out)
- Exhale through slightly pursed lips (as if to whistle or blow out a candle)
- Exhale two to three times longer than inhalation
When should you use this technique?
Pursed-lip breathing should be utilized during and following exercise, and with any activity that causes you to experience breathlessness
Coordinated Breathing During Activities of Daily Living
Many common activities and daily tasks may increase your breathlessness and pose a challenge to you at home. By practicing a few simple techniques that coordinate your breathing to the task, you can significantly impact your ability to live and work with less breathlessness. You should always:
- Avoid prolonged constriction of the abdominal muscles
- Avoid bending positions that make breathing more difficult
When carrying objects:
- Try to avoid carrying things next to your chest
- Use plastic grocery sacks that allow your shoulders to absorb the weight
- Consider using a cart or a luggage carrier
- If you don’t have back problems, use a backpack
Bending will put pressure on your diaphragm, causing you to feel more short of breath. Keep objects that you use frequently within easy reach. When bending, keep your back straight and lower yourself with your legs. Exhale while you are doing it.
Crouching also presents a problem because it restricts the movement of your diaphragm. Your legs push against your chest, making breathing more difficult. Try to avoid this position. It is better to sit down, or use an “all fours” position, if the task you are performing is for a prolonged period of time.
Leaning forward while sitting is very different from crouching. Crouching interferes with your breathing by pushing your legs against your chest. Leaning forward assists with your breathing, because it places your diaphragm on a diagonal stretch between your ribs and spine. This gives it a bit more elasticity for breathing. This is a recommended posture when you need to recover from a severe episode of dyspnea.
Climbing stairs is a demanding activity that may cause shortness of breath. Slowly pace yourself, resting every few steps, or every step, as needed. Breathe out when you take a step up, inhale at rest. Try to breathe evenly and smoothly. Find a pattern that is comfortable for you.
Stooping and reaching: As you lean forward, exhale. As you straighten up, inhale. Set up an even rhythm of leaning and standing as you breathe evenly. You may also want to consider a long-handled “reacher” for use in tasks that involve bending, stooping, and crouching. These devices are available in pharmacies and medical supply stores. They can serve as an energy-saving device. They can be used while doing laundry, in the kitchen, in the garage or in the yard.
Lifting: Exhale on exertion; exhale as you lift. Avoid holding your breath. Divide the load into smaller portions and use the stronger leg muscles while lifting to avoid straining your back.
Pushing and pulling: Coordinate your breathing with your movements. For example, when vacuuming, exhale as you push, then inhale as you pull back.
Using the arms and hands vigorously: Stabilize the trunk of your body against a wall, or in a chair with a back you can lean against. This allows you to relax the accessory breathing muscles while using your arms. Support your elbows on the table or desk edge while using your arms.
Recovery breathing: If you notice that you are breathing fast or shallow; STOP and concentrate on getting your breathing back to a comfortable pattern before continuing
WHEN ON THE BRINK…THINK
When you become short of breath, don’t panic, follow the technique below to help regain control of your breathing.
S.O.S. for S.O.B. (Shortness of Breath)
- Stop and rest in a comfortable position
- Get your head down
- Get your shoulders down
- Breathe in through your mouth
- Blow out through your mouth
- Breathe in and blow out as fast as is necessary
- Begin to blow out longer but not forcibly
- Begin to slow your breathing
- Begin to breathe through your nose
- Begin diaphragmatic (deep) breathing
- Stay in position for 5 minutes or longer
Adapted from the American Lung Association
Source: https://subscriber.alphanet.org/s/article/6-10-7-the-art-and-work-of-breathing