Breathlessness is a subjective experience where a patient feels uncomfortably aware of their breathing. It’s a complex symptom involving physiological, psychological, environmental and functional factors.
Breathlessness can be acute and present as an emergency, or it can be chronic and gradually increase in severity. It can be continuous or it can come and go.
Breathlessness is closely linked to anxiety. Anxiety is an emotional response to breathlessness, but it can also make breathlessness worse. Treatment for breathlessness should always involve listening to and addressing the patient’s fears and concerns.
When breathlessness limits activities of daily living, patients can become more dependent on carers. It can also limit how able they are to have social interactions and engage in activities that are meaningful to them.
Managing breathlessness at home
Evidence suggests that how breathless you feel doesn’t always match up to the results of lung function tests and scans. This is because it’s not just lung function that affects how out of breath you feel. Breathlessness is also affected by the way you breathe, your lifestyle and how you think and feel about your breathing.
How you think and feel about your breathing is important. For example, a worrying thought can make you feel anxious and make you feel breathless. This could perhaps make you feel panicky and bring on physical symptoms such as a tight chest or fast breathing.
When you have a long-term lung condition, you can feel anxious. Because being anxious interacts with your physical symptoms and can increase your feelings of breathlessness. It’s important to talk to your health care professional about what help is available for you.
Unhelpful breathing habits will make you feel more out of breath.
When you’re out of breath, you may feel like you need more air. So you may start to take more air into your lungs or breathe faster. You might then not take the time to fully empty your lungs as you breathe out. This means you use the top of your chest more to breathe, instead of using your whole lungs. Breathing like this is more work – your muscles will get tired more quickly, and you’ll feel even more out of breath.
The good news is there are breathing techniques that you can use to breathe more efficiently and to feel in control of your breathing. If you practise these techniques and use them every day, they’ll help you when you’re active or if you suddenly feel short of breath.
To get used to breathing control, it helps to practice when you are sitting, relaxed and not out of breath.
Breathing control is about the best use of your main breathing muscle – your diaphragm. The focus is on reducing tension and using your shoulder and neck muscles to get into the best position for you to breathe easily. Your diaphragm contracts when you breathe. This pulls the lungs down, stretching and expanding them. It relaxes back – into a dome position – when you breathe out, reducing the amount of air in your lungs.
Try this at home
Get into a comfortable position, with your arms supported on arm rests or your lap. Relax your body and shoulders.
- Put 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. If you’re relaxed, the air will reach low in your lungs. Your stomach will 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. Imagine all the tension in your body leaving as you let the air out.
- Try to use as little effort as possible and make your breaths slow, relaxed and smooth. With every breath out, try to feel more relaxed. Gradually try to breathe more slowly.
When fully 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.