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This leaflet will provide you with basic advice to help you manage your breathlessness. It is intended to act as a reminder following a physiotherapy session – please ask if you have any questions.

1 Coping with breathlessness

One of the most important things you can do to cope with breathlessness is slow down. This is also one of the most challenging things to do for many people. Use talking as a test. If you are moving at the right pace, you should be able to talk. If you can’t talk because of breathlessness, you need to stop and slow down the activity or introduce breaks in activity.

When doing repeated exercise such as climbing the stairs or walking, try pacing the exercise with your breathing allowing more steps for the outbreath. It can be helpful to breathe out as you step when going up or down stairs.

Using the space provided in this leaflet, write down some things which trigger your breathlessness and some strategies which you can try to reduce this, as explained by your physiotherapist. For instance, if you get breathless when showering, try wearing a towelling robe to dry yourself.

2 Recovering from breathlessness

Breathlessness is not harmful but it can be distressing and exhausting. If your breathing deteriorates so that you are struggling to talk:

  • stop any activity and find a comfortable forward leaning position to rest
  • focus on the ‘out breath’ and try to extend the length of the breath
  • use a fan if you find it helpful and
  • stay still for a minute after you have got your breath back before moving.

3 Panic

Panic is extreme breathlessness with anxiety. Panic can be prevented by pacing activity to prevent breathlessness escalating to the point of distress. It is important to be aware of increasing breathlessness and stop activity before it feels uncontrolled as this can trigger anxiety and a spiral of breathlessness.

If you do experience panic, use the above techniques to control your breathing. Try to practice the following breathing control techniques throughout the day when at rest and use relaxation once or twice a day.

4 Breathing exercises

Be still… be calm…
Drop the shoulders
Slowly sigh out… and out
Hear the sigh
Haaah… soft and quiet
Feel control returning
Peaceful and safe

Jenny Taylor, Head of Physiotherapy, St Christopher’s Hospice in End of Life Care Journal (2005)

It is common for patients who are breathless to use the neck and shoulder muscles to help with breathing. This can serve a purpose at times but can also become an unhelpful habit which, over time, can cause pain and stiffness in the neck and shoulders.

By practising controlled breathing and neck and shoulder stretches, you will use less energy to breathe and help to prevent this pain.

  • Sitting well supported in an upright chair, legs uncrossed, place one hand on your tummy, just above your belly button
  • Relax your shoulders and upper chest and rest your elbows by your side
  • Feel the movement of your tummy as you breathe in and out – try to relax your breathing and feel your upper chest and shoulders relax more as you continue to breathe
  • Do not try to take deep breaths.