Pursed-lip breathing

Pursed-lip breathing is the chief form of breathing control advocated for asthmatics. This technique is often taught to those with respiratory diseases such as chronic obstructive pulmonary disease (COPD). Pursed-lip breathing is designed to control shortness of breath by slowing the pace of breathing and increasing the effectiveness of each breath.

This technique is recommended during the difficult parts of any activity, such as bending, lifting or climbing stairs. Some also advocate using the technique to calm symptoms of an asthma attack. However, as with any recommendation, patients are urged to discuss the technique with their physician.

Pursed-lip breathing involves the following steps:

• Relax neck and shoulder muscles.
  

• Inhale slowly and normally (not deeply) through the nose for two counts, keeping the mouth closed.
  

• Pucker or purse lips, as during whistling or when blowing out a candle.
  

• Exhale slowly and gently (not forcefully) through pursed lips while counting to four. Exhalation should always take longer than inhalation.

Pursed-lip breathing acts as a "splint." It creates a back pressure that helps keep the airways open slightly longer to allow more stale air to escape so that more fresh air can replace it. The technique has the following benefits for those with breathing difficulties:

• Increases the amount of air taken in and let out of the lungs (vital capacity)
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• Releases trapped air from the lungs
  

• Extends time airways are open and makes breathing less work
  

• Lengthens exhalation time, which slows breathing
  

• Moves old air out of and new air into the lungs
  

• Improves gas exchange as more oxygen enters the body and carbon dioxide exits
  

• Relieves shortness of breath
  

• Improves posture
  

• Relaxes the body

Patients should practice the technique several times a day until it feels natural. It is important to create a rhythm of inhalation and exhalation, and not to hold the breath. Holding the breath locks up the diaphragm and tightens the muscles of the throat.

Many experts advocate pursed-lip breathing for asthmatics. During an asthma attack, less air reaches the lungs as the airways swell and produce excess mucus. This causes the person to work harder to breathe.

Pursed-lip breathing can make breathing more efficient, minimizing the effort necessary to breathe by emphasizing the use of the diaphragm and the muscles between the ribs instead of chest and neck muscles.

Advocates suggest asthmatics use the technique between two to four times a day. This can include once in the morning, during the late afternoon and at night just before sleep. Once an asthmatic has mastered pursed-lip breathing, it should be put into practice at the first hint of wheeze or when peak flow meter readings drop. Patients should continue to use pursed lip breathing until they no longer feel short of breath.

Patients who master the pursed-lip breathing technique may feel a greater sense of control over their respiratory disorder, according to advocates. This sense of confidence may help relax them during flare-ups, which in itself can lessen symptoms.

However, as with other breathing techniques, there is little hard data to support claims that pursed-lip breathing can improve a patient's asthma.