Breathlessness is difficult, laboured breathing that can make people feel uncomfortably aware of their breathing. It is a complex symptom involving physical, psychological, environmental and functional factors. 

Breathlessness can be severe and short in duration, or it can be ongoing and gradually increase in severity. It can be continuous, or it can come and go.

Watch our video on how to live well with breathlessness:

Your diaphragm

The primary muscle of breathing is the diaphragm. It is a large flat sheet of muscle covering the base of your ribs. It moves down to help draw air into your lungs, and as you breathe out, it relaxes, moving upwards.

Your Accessory Muscles

Some of the muscles around your shoulders and neck can further help to draw air into your lungs when you become breathless. These are known as accessory muscles.
It is normal to use these muscles for short periods when very breathless, however, they are not designed to help with breathing for long periods. Overuse can make them stiff painful.

Positions that help your breathing

When short of breath, you may find it helpful to get into a comfortable position with your arms supported. These positions help your diaphragm to expand and encourage your accessory muscles to relax.

When using these positions, try to keep your back straight but let your head drop so that your neck is relaxed. Also, try to relax your shoulders and arms, including your wrists.

Techniques that help your breathing

Breathing Control

Breathlessness can make you breathe with your upper chest and shoulder muscles rather than your diaphragm and lower chest. Its causes fast and shallow breathing, which uses more energy and makes you tired. Breathing control is the most efficient way of breathing. It helps you to only take in the air that you need and to avoid unnecessary effort.  It will help you when you are short of breath or feeling anxious, but it is good to practise this when you are sitting, relaxed and not feeling breathless.

Get into a comfortable position, with your arms supported on armrests or your lap. Your shoulders and body must be relaxed and as loose as possible. You may also find it helpful to place a small cushion in the small of your back.

  • Place one hand on your chest and the other on your stomach.
  • Close your eyes to help you relax and focus on your breathing.
  • Slowly breathe in through your nose, with your mouth closed. You should be able to feel your stomach move out against your hand. If your breathing is controlled, the hand on your chest will hardly move.
  • Breathe out through your nose. Your stomach will fall gently.
  • Try to use as little effort as possible and make your breaths slow, relaxed and smooth. With every breath out, try to feel relaxed. Gradually try to breathe more slowly.

When entirely in control of your breathing, your out-breath should take longer than your in-breath. There should be a natural pause at the end of your out-breath.

Pursed Lip Breathing

Pursed lip breathing is a technique that can help people when they experience shortness of breath by providing a quick and easy way to slow your pace of breathing and make each breath more effective. The technique helps keep airways open longer so that you can remove the air trapped in your lungs.

To practise pursed-lip breathing:

  • Sit down in a chair and relax your neck and shoulder muscles.
  • Breathe in slowly through your nose, then " Pucker, or "purse" your lips as if you were going to whistle or gently blow out a candle.
  • Breathe out all of the air in your lungs through your mouth slowly and gently through your pursed lips.

Try breathing out longer than your inhale, but only for as long as is comfortable – don’t force your lungs to empty.

Blow As You Go

Blow-as-you-go helps make tasks and activities easier. It is a useful technique to help when doing anything physical, which makes you breathless.

  • Breathe in before you make the effort
  • Exhale while you’re making the effort. You can also breathe out using pursed lips if this helps.

For example, when standing up, breathe in before you step or stand up, and then blow out as you stand up. Or, when lifting a heavy bag, breathe in before you lift the bag and then breathe out as you lift the bag.

Anxiety Related to Breathlessness

Breathlessness is closely linked to anxiety. Anxiety is an emotional response to breathlessness, but it can also make breathlessness worse.   See the page on managing anxiety by clicking here.

Watch our video on Living with anxiety here:

The spiral of inactivity

Sometimes, because feeling breathless is unpleasant and makes you feel anxious, you may avoid activities that you know will make you feel out of breath. 

If you avoid these activities, your muscles become weaker. Weaker muscles need more oxygen to work, and so over time, you will become more breathless. This is called the cycle of inactivity.

It is possible to break this cycle of inactivity. By becoming more active, you can make your muscles stronger, including your breathing muscles. Its will help you feel less out of breath when you do everyday tasks.

Go to the page on physical activity