Decreasing Shortness of Breath

How to Decrease Your Shortness of Breath and Increase Your Oxygen Levels

Whether you have a restrictive pulmonary problem like interstitial lung disease (ILD), an obstructive problem like chronic obstructive pulmonary disease (COPD), or shortness of breath with episodes of asthma, you can relieve your shortness of breath with these techniques. In fact, these techniques can also help those without a pulmonary problem who get short of breath when walking fast, and even for your children to try when they are running about or hiking.

In addition, done properly, these techniques can increase the oxygen levels in your blood and lower carbon dioxide retention for those with this problem. While it is easier to learn in a pulmonary rehabilitation class, or with the aid of a “pulse oximeter.” A pulse oximeter is a probe, usually placed on your fingertip, which measures blood oxygen levels, termed oxygen saturation. Oxygen saturation is measured as a percentage – 95% or above is about average for a healthy person resting at sea level. However, the breathing techniques we are introducing here are not too hard to learn on your own, and cost nothing!

Pursed-lip Breathing for Chronic Obstructive Pulmonary Disease

Let’s start with COPD. If you have COPD, it is very important to breathe in slowly through your nose, and breathe out slowly through slightly pursed lips, always breathing out longer than you breathe in. Using good pursed-lip (PLB) with your slower breathing can make the difference between normal blood oxygen levels and abnormally low levels of blood oxygen. Another advantage, discovered by PERF board member Dr. Brian Tiep, is that good PLB will also help to lower your carbon dioxide level! PLB makes your breathing even more efficient, and help to reduce symptoms of breathlessness.

Pursed-lip Breathing for Interstitial Lung Disease

If you have a form of restrictive lung disease like ILD, you may find that your oxygen levels plummet with even very light activity, which can make you short of breath. It is very important to pace yourself, slow down, and practice your good breathing techniques. Your oximeter may be used to give you feedback to guide how well using PLB is increasing your oxygen saturation. Start by slowing your rate of breathing. Inhale through your nose and exhale through your mouth with pursed lips. Smell the roses, then blow the candle just enough to cause it to flicker. As you are watching your oximeter, remember that it takes about 30 seconds for the information from your chest to get down to your finger. So, be patient as you take that delay into account. Dr. Tiep tells us that PLB is actually even more beneficial for people with a restrictive lung disease, such as fibrosis than it is for those with COPD whom it helps so much!

Increasing your Blood Oxygen Saturation using Pursed-lip Breathing

The normal saturation of oxygen at sea level is usually above 95%. If you are at high altitude, normal oxygen saturation may be lower (e.g., 90%); this is discussed in another article in this series. Unless your oxygen saturation goes down to 88% most of the time, you are not a candidate to need a supplemental oxygen tank or oxygen concentrator. Most physicians like you to stay between 93% to 94%. The lower your oxygen saturation, the easier it is to “blow those oxygen numbers up” using pursed-lip breathing! The closer your saturation is to normal, the better your technique needs to be in order to increase your saturation numbers. There are lots of patients with low oxygen saturations who are quickly able to increase their saturations up to 93% with good PLB technique. We’ve seen superstars get all the way up to 98% saturation – that is higher than the saturation they had when they were using supplemental oxygen at 2 liters per minute!

WARNING! If you work too hard and too forcefully at your breathing, you will see on your oximeter that you may actually lower your saturations! Good PLB should be comfortable and easy to do. If you get lightheaded, that means you are breathing too hard, too fast, and blowing off too much carbon dioxide. If this happens, stop, relax, and don’t try to be an overachiever! Good PLB is not hard work!

Why would you want to use PLB to increase your oxygen levels if you have oxygen prescribed for this very reason? For peace of mind! If you have confidence in your ability to keep your oxygen saturation at a safe level with your own breathing techniques, you should not need to panic if you temporarily run out of oxygen! Also, proper breathing techniques, which include a slower rate of breathing, will enable you to better utilize your prescribed oxygen, and perhaps allow a lower liter flow. This means your oxygen will last longer. During the big 2011 earthquake and tsunami in Japan, patients ran out of oxygen, some of them for many days. Not one pulmonary patient who had been through a pulmonary rehabilitation program and learned PLB and panic control, panicked or needed hospitalization! We were told by our friends in Japan that all those without this training needed hospitalization! You can understand why the Japanese are now so supportive of pulmonary rehabilitation programs.

And yes, these breathing techniques may also be of help for those of you without pulmonary problems when you become short of breath with activity or at higher altitudes. Teach these techniques to your children before the next time they go on a hike!

Remember that each person is different! Please be sure to discuss your breathing problems with your doctor and keep doing that PLB.

If you are interested, here is a video by Dr. Tiep that explains pulse oximetry:

Mary Burns, RN, BS and Brian Tiep, MD