Breathing Techniques to Help Manage Breathlessness

How these techniques fit alongside your asthma treatment

Learning to breathe more calmly can genuinely help when your chest starts to tighten. But it is important to be clear about what breathing techniques can and cannot do. They are a self-management tool for mild breathlessness — the kind that creeps up when you are anxious, climbing stairs or recovering from a cold. They do not treat the inflammation in your airways, and they are no substitute for your preventer and reliever inhalers or your written asthma action plan.

If your breathlessness is moderate or severe, use your reliever inhaler as your action plan tells you and get help. Call 999 if you are too breathless to speak in full sentences, your lips or fingertips look blue or grey, or you are exhausted by the effort of breathing. Never delay emergency treatment to try a breathing exercise.

Pursed-lip breathing

Pursed-lip breathing slows your breathing rate and creates gentle back-pressure in your airways, which helps stop them collapsing as you breathe out. Many people find it eases that tight, air-trapped feeling.

• Sit upright if you can, with your shoulders relaxed and your jaw loose.
• Breathe in gently through your nose for a count of two.
• Purse your lips as if you were about to blow out a candle.
• Breathe out slowly through your pursed lips for a count of four — keep it gentle, as though you were making a candle flame flicker without blowing it out.
• Repeat for five to ten breaths, then return to normal breathing.

Your out-breath should always be longer than your in-breath. If you feel light-headed or dizzy, stop, breathe normally and try again later with a shorter count.

Diaphragmatic breathing

This one retrains you to use your diaphragm rather than the muscles at the top of your chest. Lots of people with asthma slip into upper-chest breathing without realising it, especially when they are worried.

• Sit comfortably, or lie down with your knees bent. Rest one hand on your chest and one on your tummy, just below your ribs.
• Breathe in through your nose for three to four seconds, feeling the lower hand rise. The upper hand should stay fairly still.
• Breathe out slowly through your nose or pursed lips for four to six seconds, feeling the lower hand fall.
• Aim for five to ten slow breaths, then rest.

It can feel awkward at first — that is normal. Don't force it or take huge breaths. Steady and quiet beats big and dramatic.

Practise when you feel well

This is the single most useful habit you can build. During a flare-up your breathing pattern changes and it is very hard to learn something new while you are struggling. Practising when your chest is settled makes the technique automatic, so it is there when you need it.

• Try five minutes, twice a day — perhaps with your morning inhaler and again before bed.
• Sit somewhere quiet, with your feet flat and your shoulders down.
• If counting feels fiddly, use the words "in" and "out", or simply make your out-breath twice as long as your in-breath.
• Stop if you feel dizzy, and pick it up again the next day.

Most people notice a difference within a couple of weeks. Be patient with yourself; it is a skill, like anything else.

Using them in everyday life

• Stairs and hills: pause at the top for three pursed-lip breaths before carrying on. It is far better than pushing through and ending up gasping.
• Cold air: breathe in through your nose and pull your scarf loosely over your nose and mouth. Warming the air makes a real difference on a frosty morning.
• Exercise: warm up gently for a few minutes, cool down slowly with pursed-lip breathing, and keep your reliever inhaler with you if you have been prescribed it before activity.
• Stress and panic: a long out-breath nudges your nervous system towards calm, which helps break the "I can't get my breath" spiral.
• Mild flare-ups: take your reliever inhaler first, then use pursed-lip breathing while you wait for it to work.

When to ask for help

Breathing techniques are for mild symptoms only. Contact your GP or asthma nurse if you are waking at night with breathlessness or a cough, needing your reliever inhaler more than twice a week, or feeling that your breathing is generally getting worse. Your preventer treatment may need reviewing.

Seek urgent help if your reliever inhaler is not lasting four hours, if you are struggling to walk or talk, or if you feel frightened by your breathing. An annual asthma review is also worth keeping up — it is a good chance to check your inhaler technique and refresh your action plan.

Used alongside good asthma care, these simple techniques give you something practical to do when breathlessness begins. That sense of control is often as valuable as the breathing itself.