Breathing Practices With Asthma, COPD or Other Lung Conditions: Cautions

Urgent help first

If you or someone else is having difficulty breathing, MedlinePlus says to call 911 or your local emergency number right away.[1] Signs it lists include bluish lips, fingers or fingernails, and being unable to breathe lying down and needing to sit up.[1] It also advises helping the person use their prescribed medicine, such as an asthma inhaler.[1] The NHS (United Kingdom) describes an asthma attack as severe symptoms with difficulty breathing that can be life-threatening.[2] An asthma attack is not the time for a breathing exercise. Use your action plan and your reliever medicine, and get help.

Who this page is for

This page is for people with asthma, COPD (chronic obstructive pulmonary disease) or another long-term lung condition. It explains what is known, in plain language. It is information only and does not replace your care team. Please check with your clinician before starting a new breathing practice, and mention it at your next visit.

Techniques clinicians teach

In lung care, breathing techniques are usually learned with a clinician. The NHS says various breathing techniques are helpful for breathlessness for some people with COPD, and that you may be advised to join a pulmonary rehabilitation program, which includes a structured exercise plan tailored to your needs and ability.[3] Techniques it names include:

• breathing control: breathing gently with the least effort, with the shoulders supported;[3]
• pursed-lip breathing, as if whistling (listed among techniques for people who are more active);[3]
• paced breathing, using a rhythm in time with an activity such as climbing stairs.[3]

For a chesty cough with a lot of phlegm, the NHS says you may be taught a specific airway-clearing method called the active cycle breathing technique.[3] That method includes breathing control, chest expansion exercises and a forced breathing-out step,[4] so it is one to learn from a clinician, not from a web page. The NHS also advises speaking to a GP before starting a new exercise program if your symptoms are severe or you have not exercised in a while.[3]

For details of the methods themselves, see pursed-lip breathing for lung conditions and breathing exercises for COPD and pulmonary rehabilitation.

What research found

What these limits mean: you cannot blind a person to whether they are doing breathing exercises, so reported symptoms may be overestimated; the COPD review says so directly.[7] The asthma review did not look at side effects.[5] Findings for exercises taught in clinics do not automatically apply to apps, videos or classes.

Some methods in the asthma trials include nasal breathing and holding the breath.[5] This library does not teach breath-holding. See Buteyko for a critical look, and breathing exercises for asthma for the full evidence.

Proper evidence not found, in sources we could read, for gentle self-directed breathing practice in other lung conditions such as pulmonary fibrosis or other interstitial lung diseases. We searched PubMed for breathing exercises with interstitial lung disease, bronchiectasis and cystic fibrosis; the usable result was the airway-clearance review above. Ask your lung specialist.

Medicines and care plans stay in place

NHS guidance for asthma is to use your inhalers as recommended by your care team, and your team explains how and when to use your medicines.[2] Breathing exercises are at most an add-on. Do not stop, skip or reduce inhalers, oral medicines or oxygen because of a breathing practice. Our claim check on whether breathing exercises can replace asthma medicine covers that question.