Pursed Lip Breathing: Pucker Up and Breathe Easier
You would think that breathing would be as easy as inhaling and exhaling, requiring no thought at all. But for people with COPD, breathing can sometimes be very difficult - sometimes seeming almost impossible. Today we’re going to begin to talk about proper breathing techniques with COPD. Some of these techniques can be used with other pulmonary disorders as well, but as always, check with your doctor or respiratory health care professional before starting to use any new technique or exercise.
We talk a lot here about knowing what’s going on in your lungs, and when it comes to breathing techniques, this is no exception. Remember, we’re here to help take away some of the mystery - and the confusion - about why in the heck it can be so hard to breathe
Here are some key terms and abbreviations:
COPD - Chronic Obstructive Pulmonary Disease
SOB - Shortness of Breath (also called dyspnea - disp ´-nee-uh)
PLB - Pursed Lips Breathing
DB - Diaphragmatic Breathing
CO2 - Carbon Dioxide (the waste product of breathing - the air you have to get rid of)
O2 - Oxygen
Let’s start with a little review. COPD is a combination of emphysema, chronic bronchitis and asthma. When you have COPD, especially with a significant component of emphysema, your lungs are hyper-inflated, or stretched out. Remember in my first blog (Asking Questions, Getting Answers and Moving Forward) we talked about the balloon that wasn’t as elastic as it used to be. If your lungs have been damaged by cigarette smoking or some other hazard in the air, that’s how they can get, making them inefficient at moving the air. So, your lungs are actually too big, they’re crowded inside your chest and they don’t have a lot of room for movement. In short, over-inflated lungs can cause you a whole lot of work with not a whole lot of results. So, that’s why breathing can be so hard.
Also in COPD, the inside walls of your airways, the tubes inside your lungs that the air travels through, can become weak and collapse. I don’t have to tell you that if your airways collapse, that’s a problem and can make breathing even harder.
There are two main breathing techniques: Pursed Lips Breathing (PLB) and Diaphragmatic Breathing (DB), (also called abdominal or belly breathing. Today we’re going to talk about PLB (pursed lips breathing). Look this information over and check with your doc about working on it over the next two weeks. Then in my next blog we’ll tackle Diaphragmatic Breathing, which is also very important, but somewhat more difficult.
Some of the following information was graciously shared by Phil Cable, a pulmonary patient who had extremely low lung function (about 10%!). He lived for a long time with COPD and did a lot to help others learn how they could breathe better. He’s since passed on, but I’m sure he’d be happy to know that in a way he’s still out there helping.
"What is Pursed Lip Breathing (PLB)?
PLB is the first line of defense used by most COPD-ers when trying to recover from shortness of breath. It involves breathing in through the nose and exhaling with the lips pursed as if you were going to whistle. How hard do you blow out? I find that blowing out with the same force that you would use to cool hot soup on a spoon to be the perfect force. Blow hard enough to cool it, but not hard enough to blow it off the spoon."
How does PLB help?
When we PLB properly we create a ‘back pressure’ on the inside walls of the airways…and this back pressure actually holds the airways open.
“When we huff and puff, we tend to breathe out too hard and this collapses the airways and makes it harder to breathe. Also when we huff and puff we don’t expel enough air and we build up CO2 in our lungs as well as trapping air. This CO2 build-up triggers our body to breathe harder to expel it.”
Disclaimer: The information is not to be substituted for medical advice. Always consult with your doctor before starting any new exercise or technique. These breathing techniques should be demonstrated and taught by a pulmonary health care professional, and when beginning, should be practiced for a just a few minutes at a time, a few times a day. This is for your information only. Feel free to bring this information to your doctor and ask him or her if working with these breathing retraining techniques would be appropriate for you.
Here is a start on learning Pursed Lips Breathinelax Your Shoulders
Begin by relaxing your shoulders, and while still sitting up straight, letting them fall as low as you can. For people with chronic lung disease, it is very common to have a lot of upper body tension. You will not be able to do this breathing retraining effectively if your shoulders are up high and tense.
1. Inhale slowly through your nose.
2. Purse your lips, or pucker them gently, as if you were going to whistle.
3. Breathe out slowly while keeping your lips pursed.
4. Take twice as long to breathe out as you do to breathe in. For example, if you breathe in for a count of two seconds, breathe out for four seconds.
5. Never force your air out. Just let it flow out through your pursed lips.
Pursed-lips breathing will help you:
- Slow down your breathing
- Get rid of more of the stale, trapped air, and carbon dioxide (CO2).
- Be in control of your breathing, instead of your breathing controlling you!
And here are some last reminders for today -
- Don’t ever, ever hold your breath unless you are performing a lung function test and the technician is instructing you to do so.
- Keep your shoulders down and as relaxed as possible.
- When you exhale, think about all the bad stale air leaving your lungs to make room for good fresh air filled with oxygen.
- Practice this when you are sitting still and relaxed, and then be sure to use this technique whenever you exert. If you practice it, it will come naturally after a while.
If done properly, using the right breathing techniques really will make a positive difference in helping you control your breathing and move more air without working so hard. Happy Breathing, my friends, and don’t forget to “pucker up!”
Respiratory Therapist, COPD educator and author