Breathlessness

What is breathlessness?

Being short of breath, struggling to breathe, or feeling chest tightness or chest pain are common symptoms of a lot of chest and heart conditions, including:

• Stroke
• Heart failure
• COPD
• Asthma
• Angina
• Long Covid
• Anxiety

Breathlessness is also called dyspnoea (pronounced disp-knee-ah). It can come on suddenly, or it can get steadily worse over time.
Breathlessness can feel like:

• Tightness in your chest
• Difficulty filling your lungs
• Gasping for air or finding it hard to catch your breath
• Exhaustion
• Feeling anxious or panicked

It is normal to be short of breath sometimes – for example, when you run for a bus or climb a long staircase – but sometimes this breathlessness can become part of your daily life.

Breathlessness can be emotionally and physically difficult to cope with, but it can also be managed and improved over time. You can learn to avoid or manage periods of breathlessness.

How is breathlessness treated?

Depending on what is causing your breathlessness, you may be able to treat the cause directly with medication. For example, people with asthma may be given medicine which relaxes the airways, and people with COPD may be given steroids or antibiotics to deal with flare-ups.

You may be given equipment like an inhaler, spacer, or nebuliser to deliver this medication. It is important to know how to use this equipment correctly – talk to your nurse, doctor, pharmacist or physiotherapist to make sure you are using it right. You can find more information on using inhalers at www.mylungsmylife.org

Alongside medication, you can make changes to your lifestyle to help with breathlessness. A healthy diet, appropriate exercise, and avoiding breathlessness triggers like smoking or allergies can make your breathlessness much more manageable. You can also learn techniques like breathing exercises and chest clearing exercises to help you to deal with your symptoms.

You may be referred to pulmonary rehabilitation, a programme which teaches a range of management techniques for breathlessness. Find out more about pulmonary rehabilitation in our booklet on the subject.

Breathing positions

If you are having trouble breathing, you may find it helpful to sit or stand in positions which open your airways and make it easier to breathe. What works best will depend on who you are, what causes your breathlessness, what you are doing, and where you are.

Ask your physiotherapist, occupational therapist, or other health professional for advice on useful breathing positions. Some positions which may help are:

• Sitting down, leaning forwards with both arms on your thighs. Relax your hands and wrists and let your head fall forwards if necessary.
• Sit upright with your back against the back of your chair. Rest both hands on your thighs, with hands and wrists relaxed.
• Standing up, lean forwards with your arms resting on a ledge at chest height – for example, a chair back or windowsill.
• Standing up, lean your back against a wall. Relax your shoulders, letting your arms rest at your sides. If it feels comfortable, move your feet about 30cm away from the wall, slightly apart.

Breathing exercises

There are two main types of breathing exercise that may be helpful:

1. Breathing control techniques – exercises which help you to breathe consciously and get control over the muscles you use to breathe
2. Chest–clearing exercises – exercises which clear phlegm (sticky mucus) from your airways, keeping it from building up in your lungs.

Ask your physiotherapist or other health professional for what exercises you might find helpful. You can also find more detail about these exercises on www.mylungsmylife.org, or by looking at our booklet on Breathlessness.

Managing activities

Breathlessness can affect what activities you do and how you do them. This is a very personal thing, and the only certain way to know what works for you is by trying.

You can still be active and do physical exercise, while dealing with breathlessness. However, you might need to change what exercise you do, or build in more rest breaks. It can help to take things slow – avoid high-impact exercise that makes you breathless, and consider whether you can shift towards lower-impact exercises like: walking, gentle stretches, pilates or yoga, or careful swimming.

You may also need to consider your breathlessness when you plan day-to-day activities. For example:

• Consider whether you can do certain tasks (such as cooking) while sitting instead of standing.
• Make sure you leave yourself enough time to recover if you do have breathlessness.
• Try to build up your activity slowly when you are ready to increase how much you do.
• Some people find it helpful to have company when they are doing activities which may trigger their breathlessness – this can be an important source of support and comfort.

Often, you may find that you have triggers. These are things that happen around you which make breathlessness more likely. For example: pollen, pollution, certain weather conditions, or smoke. By doing your best to avoid these situations, you may find your breathlessness affects your life less. You can check air quality – a common trigger for breathlessness – by texting WEATHER to 66777 to receive a free “Air Quality and Weather” text message from our Advice Line.

Recognising anxiety

One of the common difficulties with breathlessness is that it can be very anxiety-provoking. It can also feel a lot like an anxiety attack – and, in fact, anxiety does often cause breathlessness. This can mean that, when you are experiencing breathlessness, you become anxious, and this can make the breathlessness worse.

To avoid this vicious cycle, it is important to try and stay calm while breathless. Remember that breathlessness, while unpleasant, is rarely dangerous. Try to be aware of how you feel and what, if anything, is causing you additional stress. Breathe slowly and deeply. Try to be aware of your surroundings and how your body feels.

For more information on anxiety and how to manage it, look at our page on Mental Wellbeing.