Pursed Lip Breathing and Diaphragmatic Breathing

Simple breathing exercises

When it’s difficult to breathe, it’s normal to get anxious. However, this can make you even more short of breath.

There are two breathing techniques that help you get the air you need without working so hard to breathe. These techniques are called pursed lip breathing and diaphragmatic breathing.

Before starting any breathing technique, make sure to relax. Take a minute to drop your shoulders and close your eyes.

You need to avoid the harmful cycle of breathlessness:

You feel breathless > You avoid activities that make you feel breathless > You do less > Your muscles weaken > You get more breathless > You feel depressed

Pursed lip breathing

Pursed lip breathing (PLB) benefits:

Slows down your breathing.
Keeps airways open longer so your lungs can get rid of old trapped air.
Reduces the amount of work required for breathing.
Increases the amount of time you can exercise or be active.
Improves the exchange of oxygen and carbon dioxide in your lungs.

PLB can be particularly useful for patients with chronic obstructive pulmonary disease (COPD), which is a very common lung
disease. The increased pressure created by exhaling through pursed lips will help prevent the large airways from collapsing.
This may also help open up airways to release more air.

PLB instructions:

Breathe in through your nose for several seconds, keeping your mouth closed.
Pucker your lips like you are blowing out a candle.
Breathe out very slowly through puckered lips and try to exhale 2-3 times longer than your inhale.
Repeat for several minutes, or until your breathing is controlled once more.

Diaphragmatic breathing (belly or abdominal breathing)

The diaphragm is the main muscle used for breathing and is designed to do most of the work. When you have COPD or other
lung diseases, the diaphragm doesn’t work well and your neck muscles, shoulders and back are used. These “accessory”
muscles are not as effective in moving air in and out. Training the diaphragm to do the majority of the work again can help you feel much better.

Diaphragmatic breathing is more difficult to perform compared to PLB. Make sure to get instructions on the technique from a qualified healthcare provider.

This technique is best used when you feel rested and relaxed. Try lying on your back or sitting in a relaxed position.

Diaphragmatic breathing instructions:

Relax your shoulders.
Place one hand on your chest and the other on your belly.
Inhale through your nose with your mouth closed for about two seconds.
As you inhale, you should feel your belly move outward. Your belly should move more than your chest
Exhale in one long, slow breath through pursed lips. While exhaling, gently press on your belly and concentrate on allowing your belly to sink in. This will push up your diaphragm to help release air.
Repeat steps one through five about five times.

Other useful information

Physiologic benefits of breathing deeply:

Moves air to the bottom of the lungs, utilizing full lung capacity.
Opens air passages allowing mucous to move out more effectively
Helps the blood and oxygen supply to your lungs, improving circulation.
Lowers the risk of lung complications, such as pneumonia and infections.

Dealing with shortness of breath during activity:

When you feel short of breath during exercise or activity, first stop your activity. Sit down, relax your shoulders, and perform PLB until you catch your breath.
Resume the exercise or activity, performing PLB or diaphragmatic breathing as you go. Continue your activity at a slower pace if needed

Breathing exercises after chest surgery (heart or lung):

Your lung tissues are made up of many small air sacs. These sacs are fully expanded during normal breathing.
After surgery, it is common for you to take shallow breaths because of pain or limited mobility. This can cause secretions(phlegm/mucus) to stay in your lungs and collapse the air sacs. This is called atelectasis.
For these reasons, it is very important to perform deep breathing exercises. It is also important to cough strongly to help lower your risk of complications after your surgery, such as pneumonia or infections.
If your healthcare provider has given you an incentive spirometer to use, use it regularly as recommended.
Until you are walking, these breathing exercises should be done every hour while you are awake. Ask your healthcare provider for pain medications if you are too sore to perform the breathing exercises.

This information is provided by Cleveland Clinic Abu Dhabi, part of Mubadala Healthcare, and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.