How to Use Pursed Lip Breathing to Alleviate COPD Symptoms

Quincy AdamCOPD Lifestyle

How to Use Pursed Lip Breathing to Alleviate COPD Symptoms

Shortness of breath or breathlessness, also known as dyspnea, is a serious symptom of chronic obstructive pulmonary disease (COPD). It is also one of the first symptoms you may notice in the early stages of the disease. Pursed lip breathing may help you deal with breathing problems.

Breathing techniques are an important part of your COPD treatment.They can provide relief any time you feel breathless, such as:

  • During normal daily activities, such as walking up a flight of stairs
  • When you feel an exacerbation or flare-up coming on
  • During physical activity
  • When environmental agents—including air pollution, cigarette smoke, dust or pollen—irritate your respiratory tract. In addition to using breathing techniques, also try to get away from the source of the irritation.

A physical therapist or healthcare professional can instruct you in pursed lip breathing to ease COPD-related shortness of breath.

Benefits of Pursed Lip Breathing for COPD Patients

  • When you struggle with shortness of breath, you’re probably having trouble taking in enough oxygen and expelling the carbon dioxide from your lungs. Pursed lip breathing can help you by creating back pressure inside your airways and preventing the collapse of your large air passageways.
  • Not only will pursed lip breathing help the COPD patient breathe deeper and draw in more oxygen, but the prolonged exhalation will make more room in the lungs and increase the amount of oxygen you can inhale.
  • Pursed lip breathing helps COPD patients slow their rate of breathing. You’ll feel more in control of your breathing, which can alleviate the tendency to panic and help you relax during an exacerbation or flare-up. Think of it as a rescue technique during a flare-up.
  • Furthermore, regular practice of pursed lip breathing may help COPD patients increase endurance during physical activity by as much as 25 percent.2 You’ll increase strength in your respiratory muscles—but you need to follow your doctor’s guidelines and practice your breathing exercise as advised.

Pursed lip breathing is the most basic and easiest breathing technique that your healthcare professional will teach you. And it’s part of virtually every pulmonary rehabilitation program—along with education and consultation. Diaphragm breathing is the second most common breathing exercise, and pursed lip breathing is part of that technique for COPD and asthma patients.

How to Use Pursed Lip Breathing as Part of COPD Treatment

While you cannot retrain or repair lungs, you can train your respiratory muscles to facilitate your breathing and ease breathlessness during a flare-up. There are two aspects to pursed lip breathing for the COPD patient.3

  • Exercise: Regularly practicing your breathing exercise will help build muscle strength. It also helps you develop muscle memory, which is important before a flare-up begins. Muscle memory makes the technique second nature and almost involuntary. As soon as you sense breathlessness, you’ll shift into pursed lip breathing practically without thinking.
  • Rescue: During an acute episode or flare-up, the first instinct is to panic because you feel as though you can’t breathe. The pursed lip breathing technique will help you relax and bring your breathing under control.

Sometimes called the “smell the rose and blow out the candle” exercise, pursed lip breathing is easy4

  • Find a comfortable position sitting, lying down or standing.
  • Let your head and shoulders drop forward.
  • Slowly breathe as deeply as you can through your nose. As you breathe in, mentally count to two or three.
  • Purse your lips as though you are going to whistle or blow out a candle. Breathe out slowly and evenly. Mentally count to four or six. The rule of thumb is the time you spend exhaling air should be about twice as long as the time you breathe in.

Talk with your healthcare professional about the duration and frequency of your exercises. Most will probably recommend practicing for five to ten minutes at a time and doing this four or five times a day. Also, if at any time you feel dizzy or light headed, stop the technique.

When to Use Pursed Lip Breathing as a COPD Rescue Technique

  • When you have a flare-up or when you are exercising particularly aggressively, use the pursed lip technique to ensure you are breathing in as much oxygen and expelling as much carbon dioxide as possible.
  • If you notice that your breathing is shallow, stop what you are doing and practice your pursed lip breathing. Also, if you see that your lips or fingernail beds look blue or gray, practice your pursed lip breathing.

Pursed lip breathing may improve the quality of life for you or a loved one with COPD5. Before starting any new breathing technique, talk with your doctor.


1 WebMD. Breathing with COPD. http://www.webmd.com/lung/copd/features/breathing-copd. Accessed 7.23.16.

Cabral LF1, D’Elia Tda C, Marins Dde S, Zin WA, Guimarães FS. Pursed lip breathing improves exercise tolerance in COPD: a randomized crossover study. 2015 Feb; 51(1):79-88. Epub 2014 Apr 2. http://www.ncbi.nlm.nih.gov/pubmed/24691248. Accessed 7.23.16.

3  NIH. How to breathe when you are short of breath. MedlinePlus. https://medlineplus.gov/ency/patientinstructions/000053.htm. Accessed 7.23.16.

4 Katherine Kam. Breathing With COPD. WebMD.

http://www.webmd.com/lung/copd/features/breathing-copd. Accessed 7.23.16.

5 Katherine Kam. Breathing With COPD. WebMD.

http://www.webmd.com/lung/copd/features/breathing-copd. Accessed 7.23.16.