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Breathlessness Management Guide

Breathing Techniques

Different things work for different people. Therefore it is recommended that the following techniques are practiced to determine what works for you.

Relaxed, slow deep breathing

Breathe in gently through the nose and breathe out through your mouth.

Pursed Lip Breathing

• Relax your neck and shoulder muscles
• Breathe in for 2 seconds through your nose, keeping your mouth closed
• Breathe out for 4 seconds through pursed lips. If this is too long for you, simply breathe out twice as long as you breathe in.

Blow as you go

Use this when you are doing something that makes you breathless, such as standing up.
Breathe in before you make and effort and then breathe out when making the effort. Try using pursed lips while you breathe out.

Paced breathing

This can be useful when you are doing something active, such as climbing stairs.
You pace your steps to your breathing. For example, breathing in when on the stair/step and breathing out as you go up one stair/step.

Managing your daily activities and coping with breathlessness. Follow the 5P’s:

Prioritise

  • Consider which activities are important to you each day and prioritise those activities for which you would like to conserve your energy.

Top tip – try to cut out unnecessary tasks in order to conserve your energy and spread out activities through your diaries and timetable. Look at your day in terms of a bank balance. Do a bit and rest.

Plan

  • Organise your activities as effectively as possible in order to conserve as much energy as possible.
  • Consider which times of day are best for you to be active or at rest.
  • Try not to do too much in any one day and plan your activities for the week if at all possible.

Top tip – avoid using the stairs too many times in one day. If possible, use them once in the morning and once in the evening.

Pace

  • It is important to balance periods of activity with periods of rest.

Top Tip – Take your time when walking and take frequent rests if you need to, especially when walking up slopes.

Position

  • Work out a position that is comfortable for you when you feel breathless and practise this so that you can help yourself. Have a go at these:

High Side Lying

  • Make sure your head and chest are supported
  • Bend your top leg up
  • Put your lower arm under the pillows

Relaxed Sitting Position

  • Sit on a chair
  • Rest your elbows on your thighs
  • Relax your hands and wrists

Relaxed Standing

  • Lean against a wall, keep a comfortable distance.
  • Relax your hands, wrists and neck

Forward Lean Standing

  • Lean against a bannister or a chair
  • Relax your shoulders arms and neck

Permission

Give yourself permission NOT to do activities which result in your becoming tired and breathless. Instead of thinking along the lines of ‘I must’, and ‘I ought’, try to change the way you think about things and instead say to yourself, ‘I choose to do…….’, ‘I wish to do……’ .

Videos to Support Written Breathlessness Management information

Progressive Muscle Relaxation

Progressive Muscle Relaxation

Breathing techniques

5 minute guided relaxation

Seated Exercises

Toe Taps -front

Purpose

This will increase heart and breathing rates, benefiting the cardio-respiratory system. It will also help to mobilise the ankle joints

Instructions

  • Step with your left foot to the front, tapping the ball of the foot onto the floor.
  • Return to the starting position and repeat with the right foot.
  • Continue alternating left and right toe taps to the front

Toe Taps- side

Purpose

This will increase heart and breathing rates, benefiting the cardio-respiratory system. It will also help to mobilise the ankle joints

Instructions

  • Step with your left foot out to the side, tapping the ball of the foot onto the floor.
  • Return to the starting position and repeat on the right side.
  • Continue alternating left and right toe taps to the side

Heel to Toe

Purpose

This will increase heart and breathing rates, benefiting the cardio-respiratory system. It will also help to mobilise the ankle joints

Instructions

  • Hold onto the seat of the chair, and keep the right foot flat on the floor throughout.
  • Place the heel of the left foot onto the floor, raising your toes up as you do so.
  • Then lift the left heel off the floor and press the ball of that foot into the floor.
  • Repeat this sequence, and then perform using the right foot.

Leg Marching

Purpose

This will increase heart and breathing rates, benefiting the cardio-respiratory system. It will also mobilise the hip joints

Instructions

  • Perform a marching action by lifting the left knee (thereby raising the left foot off the floor), placing it down, and then repeating with the right foot.