Our recent online class ‘Breathing with Confidence’ was focussed on breathing exercises for people with asthma.
Some people with asthma also have what is called ‘dysfunctional breathing’. This means your normal breathing pattern can cause you to be short of breath for no apparent reason. Others have a breathing pattern where they breathe too fast. This means you take on more air than your body needs. Too much air is a problem because it can make you feel dizzy or more breathless. The exercises shown in the class can help improve your breathing if you have these problems.
In the event your question wasn’t answered on the night, you will find it here in our Breathing with Confidence Q&A.
We’ve kept this Q&A to questions to do with breathing exercises and breath retraining. If you had a question about asthma that wasn’t answered here, please call our Asthma Educators on 1800ASTHMA (1800 278 462).
If you would like to replay the class video or read more, see the links at the bottom of the page.
Does it matter if you breathe out with your mouth or your nose? Which would you recommend?
It depends on the person. If you’re very breathless and you have the ‘gas trapping’ Janet talked about, then it’s good to breathe out through your mouth. To slow things down and get the air out. You might imagine blowing out some candles through pursed lips. But if you’re just doing quiet breathing then try to breathe in and out through your nose.
When you say nose breathing, do we take deep breathing? When I take deep breath, I start to cough
It’s important to slow the breathing down. Deep breathing doesn’t necessarily mean big quick breathing. When we talk about deep, we’re talking about ‘low’ down, it doesn’t have to be a big breath but it’s a low breath. Often when you’re breathing in too quickly and too fast that can trigger that cough; that rush of air. So, slowing things down, and just thinking about nose and stomach, it doesn’t have to be big.
Is it normal to yawn when doing breathing exercises?
Yawning and sighing are often signs that you are over breathing so the slow breathing and those breath holds can help with those symptoms. But it’s usually because your body has this drive to breathe quicker, so as soon as you start to slow down you do a yawn or a big sigh. Gradually as you practice that it should get better but at the moment your body is sort of operating on that need to breathe a lot faster than you need to.
What do you need to do differently to make sure you are breathing with the stomach and not with the chest?
First of all, relax and ‘switch off’ all the muscles that don’t need to be on. You can lie down and put your hand below your collar bones and then put a small weight on your stomach like a wheat bag or bag of rice or pasta. You want to feel that you are completely still in your chest so there’s no muscle movement there and just breathing into your stomach. So, you’re lifting the weight you’ve got on your stomach and then bringing it down again, up, and down again. So that’s a good way to check that your chest is not moving, because you’ll feel it with your hands on your chest, and you’ll have that feeling of the weight on your stomach to help you use your stomach more to breathe.
I find it so hard to extend the external breath. I want to breath in longer than out. Not sure why. I’m an opera singer. I’ve done all this breathing…
Janet recommends practicing the controlled breath hold, but if you are finding it really hard to get that long breath out, that’s when it might be useful to try breathing out through your mouth. Think of a gentle breath out as if blowing out some candles.
Breathing exercises when you have asthma symptoms
Would it be recommended to practice these daily to help reduce asthma symptoms or is it that having practice helps when you get symptoms?
Absolutely its better to practice these exercises when you don’t have symptoms. Breathing exercises are really good to do when you’re well and stable. Every day if you can spend 10 minutes practicing your breathing exercises. The more you do it the more it becomes habitual so you don’t need to think about it, and you can start breathing properly. What that translates into is that when you’re having an attack you can feel a bit more on top of your breathing. So definitely practice when you are well.
What’s the best way to cope with a bad cough during an asthma attack?
- Try to take your reliever first of all and follow your Asthma Action Plan. When you have an asthma attack you usually have to breathe through your mouth. When you’re actually having an asthma attack is not the time to try and start your nose breathing, sometimes you just need to get air in. So often you’re breathing through your mouth so breathing in dry air through your mouth can irritate your airways and make you cough even more. So having some sips of water, trying to breathe through your nose (if you can) and relaxing your throat.
- Often it’s this sort of triggers (dry air) and inflammation and mucus which can lead to some of that coughing. We’ll be having another class looking at how to clear mucus coming up in winter
If I’m in hospital for an asthma emergency, can I use these breathing techniques?
- Yes, you can try. The slow breathing is really good, but it can be really difficult to get the nose and stomach breathing when you’re actually having an asthma attack. Trying to breathe out through pursed lips can be helpful. Really just trying to think about that long breath out. Often you have a sensation like you can’t get air in, but it’s often really because you haven’t been able to get the air out.
- I often explain to patients its kind of like a bag of apples. If you keep putting in 4 apples but only take out 2, at some point you cannot get any more in. So if you’ve got that sensation like you just cannot get anymore air in, it could be because you haven’t gotten the air out.
- So, if you’re in hospital with an asthma emergency, don’t worry about the nose, stomach, slow breathing, just focus on getting the air out with a nice slow, pursed lip, and that might help a little bit.
Breathing exercises when you have other conditions
Can reflux symptoms contribute to less diaphragm breathing and more chest breathing? Years of prednisolone has given me problems with reflux, and I notice stomach breathing exacerbates it.
Absolutely. Reflux can make you more breathless and make you cough more. It could also contribute to mucus in your chest. Your diaphragm is really important because when it contracts it also tightens up the oesophagus a nit which helps stop some of that reflux from coming up. It’s a bit of a catch 22 because reflux does impact on your ability to do diaphragmatic breathing, but if you can practice it, diaphragmatic breathing can actually help some of the reflux symptoms. Always see your doctor if you have reflux because it is more than just your diaphragm. Reflux can irritate the airways and vocal chords, make you more breathless and potentially contribute to more inflammation and mucus as well.
Does vocal chord dysfunction contribute to disordered breathing, or the other way around?
The evidence isn’t clear on this yet. We know that they are definitely associated, be we don’t know which one causes which. We know that people with disordered breathing often have vocal chord dysfunction and vice versa. It could be that when you are breathing with your upper chest too much you use a lot of accessory muscles which can put strain around your vocal chords but there are also other causes of vocal chord dysfunction as well.
How can you practice slow nose breathing with chronic difficult to treat sinus problems? Is it ok to use your mouth to breathe slowly and achieve similar benefits?
It’s not as good to use your mouth but chronic sinus problems can be horrendous! Make sure you’ve tried all the things your doctor recommends like sinus rinsing, sprays, seeing an Ear, Nose and Throat specialist if you need to. But even if you can just slow your breathing down and use your stomach, that will still be helpful. And of course, treating the sinuses as best as you can.
Does wearing a CPAP mask when sleeping at night change the way I breathe?
CPAP or BiPAP are machines with masks worn at night to help people with sleep apnoea. Some people find that wearing their CPAP mask slows their breathing down compared to their usual. However, the way CPAP works is it improves breathing by reducing apnoea’s (not changing your pattern). It also helps prevents upper airway collapse during sleep.
I suffer anxiety would these breathing techniques help.
Yes! These breathing techniques can help to reduce anxiety and panic – especially slow breathing
I sneeze a lot. Like several times rather loudly. Can exercises help this?
- Sneezing usually occurs from irritation to your nose, I’m not sure these exercises would help specifically with sneezing – best to try and identify the triggers and then avoid them!
- Sneezing is also one of the main symptoms in hay fever, so check out our information on that here: https://asthma.org.au/about-asthma/triggers/hay-fever/treatment/
Can you please explain huffing technique for mucous plugs?
- We will be covering huffing and other airway clearance techniques in our next Breathe Better class: Breathing in cold weather. You can register your interest here: https://asthma.org.au/what-we-do/learn
- In the meantime, we have included huffing directions in our Breathe Better booklet which you can access here: https://asthma.org.au/wp-content/uploads/2022/03/AA2022_Breathe-Better-A4_v7.pdf
Other breathing exercises
Is there a difference between these exercises and the Buteyko breathing method?
All of these breathing techniques including Buteyko, Papworth, yoga breathing are very similar. The premise behind them is all about slowing your breathing down, using your nose and using your diaphragm. Buteyko can get a bit ‘extreme’ for some people but the premise behind all of these techniques is very similar. So that’s why we’ve gone through these 4 techniques today because you see them in any sort of breathing program and they’re the ones that we know work.
What are your thoughts on Wim Hof’s breathing techniques? Hyperventilation followed by breath holds.
The purpose of a lot of Wim Hof’s breathing techniques is a little different, they’re more for psychological wellness rather than symptom control which is what we’re looking at when we talk about breathing exercises for people with asthma. Wim Hof does a lot of purposeful hyperventilation, followed by some slower breathing and things like that. There have not been any studies in this method for people with asthma, so the research is not as strong, and overall focusses more on the psychological symptoms than the four techniques we have taught in our class.
Can you explain why it seems harder to breathe when it is humid?
It depends because some patients find it much easier to breathe in the humidity! People who have a lot of excess mucus can find humidity quite useful and that it can help clear their sinuses and clear their chest, but otherwise it can often feel quite ‘heavy’. It does add more hydration to the airways, so sometimes more hydration can make it feel harder to breathe.
Is it good to use a fan on face to help with breathing?
- Yes definitely! There’s lots of good evidence around using a handheld fan or just having some air flowing around your face. It’s really effective in breathlessness so if you’ve done some exercise or you’ve done something that has made you very breathless having that flow of air around your nose and jawline sends a message to your brain that you’re getting enough air, things are ok, so can help to dampen that sensation of breathlessness
- We will talk about this in our Spring Breathe Better Class: Breathing during exercise. You can register for updates here: https://asthma.org.au/what-we-do/learn
If chest muscles are sore during breathing at night, is this mostly a sign of muscular fatigue due to disordered breathing, or could it be something else that needs investigation?
It would be best to see your GP and get some investigations done. Breathing exercises may still help, but it is important to rule out anything else that may be contributing to these issues.
Is there a good app that has the exercises demonstrated?
- We don’t have an app, but we do have the exercises written out step by step along with short video clips demonstrating them on our website.
- You can choose to view them in your internet browser here: https://asthma.org.au/treatment-diagnosis/live-with-asthma/would-you-like-to-breathe-better/
or download the booklet here: https://asthma.org.au/wp-content/uploads/2022/03/AA2022_Breathe-Better-A4_v7.pdf
Need More Information?
We’ve limited this Q&A to questions to do with breathing exercises and breath retraining. If you had another question about asthma that wasn’t answered here, please call our Asthma Educators on 1800ASTHMA (1800 278 462) who can help you find an answer.
Register for our second webinar in this series Breathing in Cold Weather below