Who are these breathing techniques for?

Anyone With Asthma!

• • If you have asthma or breathing trouble, these exercises might help
  • Practicing these breathing exercises could even reduce your symptoms and improve your quality of life

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People with ‘Dysfunctional Breathing’

Some people with asthma also have what is called ‘dysfunctional breathing’. This means your normal breathing pattern is not working for you and can cause you to be short of breath for no apparent reason. Breathing exercises like these can help you retrain your breath to a normal, healthy pattern.

People who ‘Over Breathe’ or ‘Hyperventilate’

Some people with asthma have a breathing pattern where they breathe too fast. This is called ‘over breathing’. You might have heard this called ‘hyperventilating’. 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. Being breathless can make you feel anxious. Being anxious or scared can also make your shortness of breath worse. This is what is called the hyperventilation cycle.

People With Other Breathing Conditions

Some people with asthma have more than one lung disease. You might also have bronchiectasis, emphysema, chronic bronchitis, or chronic obstructive pulmonary disease (COPD) to name a few. If so, your doctor or physiotherapist might recommend extra exercises to help reduce your phlegm build up.

Nose Breathing

Do you have a habit of breathing through your mouth, rather than your nose?

Try to breathe through your nose all the time.

This may take practice if you usually mouth-breathe.

Your lungs like it better when you breathe through your nose because:

• Your nose filters the air before it gets to your lungs
  • This prevents some dust and bacteria reaching your lungs
• Your nose can warm and moisten the air you breathe in
  • Cold, dry air is very irritating to sensitive airways
• You are less likely to ‘over breathe”

Don’t put up with a blocked nose!

If hay fever, sinusitis, nasal polyps, or anything else is making you breathe through your mouth, don’t give up! There are many effective treatments available. See your doctor for the best treatment advice. If your nose blockage is severe, you might be referred to a specialist Ear Nose and Throat doctor or Allergy doctor.

Stomach Breathing

Have you ever found that taking a few deep breaths is enough to relieve your milder asthma symptoms?

Taking a few deep breaths using your stomach may help when you feel an attack of shortness of breath coming on. BUT – Don’t hesitate to use your reliever if you are experiencing asthma symptoms!

How to Practice:

1. Get comfortable. You might like to lie down while you are new to this.
   • This might be on your back with a cushion under your knees if you have lower back pain.
2. Close your mouth and breathe through your nose.
3. Relax your shoulders and chest.
4. Put one hand on your stomach and one on your chest.
5. Breathe in and out as normal
6. Now, as you breathe in gently, try to keep your chest still whilst allowing your stomach to rise.
7. As you breathe out, allow your stomach to fall gently – do not force it. It should be a slow, relaxed movement.

Slow Breathing

Are you someone who ‘over breathes’ or hyperventilates?

You could benefit from slowing down your breathing and take fewer breaths a minute.

You might like to have a clock or timer to help count your breathing or count in your head.

How to Practice:

1. Get comfortable. You might like to lie down while you are new to this.
2. Close your mouth and breathe through your nose.
3. Relax your shoulders and chest.
4. Practice breathing with your stomach
5. Now try to slow down your breathing
   • It can help to count in your head with your breathing (e.g. breathe in for a slow count of 2 and breathe out for a slow count of 3).
   • Try imagining or looking at a rectangle such as a window. Follow the short side with your eyes as you breathe in and the long side as you breathe out
6. To slow your breathing down more, add a short pause after you have fully breathed out before you take the next breath
   • Breathe in for a count of 2, breathe out for a count of 3, and then pause for another count of 2 to 3.
   • It is important not to pause so long that you feel faint!

Book a call with an asthma educator

Controlled Breath Holding

The aim of this breath holding technique is to practice holding your breath without needing to gasp for air afterwards. As you get used to breath holding you are less likely to feel breathless in your everyday life.

How to Practice:

1. Sit upright and well supported.
2. Breathe gently in and out through your nose.
3. Relax your shoulders and chest.
4. Take a normal relaxed breath in and gently breathe out, using your stomach breathing
5. At the end of the breath out, pinch your nose and hold your breath
6. Keep holding your breath until you feel a very slight urge to breathe in. Then let go of your nose and breathe normally.
7. Your next breath should be a relaxed breath, using your stomach breathing technique.
   • If you have to take a deep breath or gasp for air at this point, then you may have held your breath for too long. This is not dangerous. Next time you practice, try not to hold your breath for as long.

Airway Clearance Techniques

Do you have a lot of phlegm or sputum? Do you find yourself coughing up lots of “gunk”? Do you have another breathing condition like bronchiectasis or chronic obstructive pulmonary disease (COPD)?

Then you might benefit from more targeted breathing exercises. There are some breathing exercises that can help cough up that “gunk”. These are called ‘Airway clearance techniques’. It’s important to clear mucus and phlegm from your lungs so it doesn’t block airflow.

What are Airway Clearance Techniques?

• The ‘Active Cycle of Breathing’ technique
  • This incorporates the exercises on this page, plus ‘huffing’.
• Positive Expiratory Pressure
  • Where you breathe out against a resistance device.
• Oscillating Positive Expiratory Pressure
  • Where you breathe out against resistance through a device that vibrates.

Which One Should I Try?

The right exercise for you depends on:

• The severity of your lung condition.
• Your other medical conditions.
• Your lung capacity.
• The amount of daily phlegm production.

Because of all these factors, you need personalised instructions to start doing airway clearance.

So, Who Do You Ask?

A physiotherapist skilled in airway clearance techniques. Some specialise in this area and might be called ‘respiratory’ or ‘cardiorespiratory’ physiotherapists. They could also say they specialise in ‘pulmonary’ which
is another word for lungs. You might need to ask your doctor, nurse, or health worker to help you find someone who can help you in your local area. Or contact the Australian Physiotherapy Association at choose.physio/find-a-physico.

Huffing

Huffing is probably the most effective airway clearance technique. It forms part of most airway clearance exercises. Huffing helps move phlegm from the smaller to the larger airways towards the mouth. Then you can clear it more easily with a cough.

How to Practice:

Before you start: If huffing in the morning, make sure you take any morning asthma medicines first. If you choose to huff at night, make sure you take any evening asthma medicines first.

1. Sit upright
2. Take a medium breath in
3. breathe out through an open “O” shaped mouth with a mild-moderate force, keeping your mouth open.
   1. The breath you use when fogging up a mirror keeps your throat open. You may like to practice in front of the mirror the first few times.
   2. Don’t use too much force – trying to huff out too quickly and forcefully can collapse the airway.
   3. Use your stomach muscles to help squeeze the air out without causing a wheeze or cough.
   4. If you hear a wheeze on the breath out then the breath is too forced and you may need to breathe out slower.
4. Repeat the huff two more times and then follow with one strong cough to clear mucus from larger airways.
5. Always do some relaxed, slow breathing after huffing to help the airways relax.

Exercise

Your breathing doesn’t have to stop you being active. Did you know regular physical activity is recommended for people with asthma?

Exercise can:

• Improve your health and wellbeing
• Maintain your fitness
• Reduce symptoms such as breathlessness

Here are some tips for exercising when you have asthma

• Pick an activity you find fun! Exercise doesn’t need to be hard or gruelling.
• Always do a proper warm-up and cool-down.
• Practice breathing through your nose while you exercise.
• Try to keep your breath smooth, steady and controlled.
• Get as fit as possible – the fitter you are, the longer it should take for exercise to trigger your asthma.
• Avoid exercising where there are high levels of pollens, dusts, fumes or pollution.
• Choose the time of day that best suits your exercise. For example – avoid early mornings, if cold air is a trigger 
• Keep your reliever handy and be prepared if your asthma flares up
• Make sure your breathing reverts back to a good pattern once you’ve recovered.

Remember, any concerns you have with your breathing during or after exercise should be discussed with your doctor. 

Watch Recordings

If you’re interested in watching the Breathe Better Webinars (filmed in 2022), you can access the videos at the link below.

Learn More

More Breath Training Videos

For more information, watch the breath training video developed by our friends at The George Institute here.