Breathlessness can be a difficult symptom to live with, but there are ways you can reduce its impact on your life. Learning some breathing techniques can help.

If possible, it may be more helpful to practice these breathing techniques for the first time when you’re not feeling too breathless. That way you’ll become familiar with the techniques and will know how to use them during episodes of breathlessness. Knowing that there are things you can do when you feel breathless will also give you a sense of control. It might be helpful for someone to read the information to you when you practice the exercises for the first time.

Get into a comfortable position

When you feel breathless, it can help to be in a comfortable position that supports your upper chest muscles and allows your diaphragm and tummy to expand.

We describe four comfortable sitting and standing positions below. You can also see photos of the positions below. 

If you are in bed, make sure you are sitting in an upright position with your back supported by pillows so that you can expand and open your chest area. Allow your head to rest back gently on the pillow so you can feel a release of tension in your neck. Rest your arms against your sides, supported by pillows if this is more comfortable.

Position 1

• Sit in a chair in an upright position, with your back supported, legs uncrossed and feet resting comfortably on the floor.
• Let your shoulders drop and feel heavy, with your arms resting softly in your lap.
• Keep your head upright.

Position 2

• Sit in a chair and lean forward with your upper body.
• Have your legs uncrossed and feet on the floor.
• Relax your shoulders.
• Slowly move forward a little so that your elbows and lower arms are resting on your thighs, supporting your upper body.
• Keep your knees shoulder-width apart and let your chest relax when you lean forward.

Position 3

• Stand and lean forward on to a secure surface.
• Let your arms and elbows rest on the surface, so that you’re supporting the weight of your upper body.
• Keep your shoulders and chest relaxed by letting your forearms remain shoulder-width apart.

Position 4

• Stand in an upright position and lean back against a secure surface. A wall is best.
• Let your arms drop to your sides and make your shoulders heavy and relaxed.

Breathlessness can cause you to breathe with your upper chest and shoulder muscles rather than your diaphragm and lower chest. This causes fast and shallow breathing, which can use up a lot of energy and tire you out.

An important part of managing breathlessness is learning a technique called controlled breathing, which uses your diaphragm and lower chest muscles. Controlled breathing can help you breathe more gently and effectively. It can also help you relax.

If you practise this when you’re not too short of breath, you will become familiar with it and so be able to use it to help you when you’re more breathless.

• Sit comfortably with your neck, shoulders and back well-supported – an upright chair is ideal (see the photo of position 1 above).
• Relax your shoulders.
• Breathe in gently, through your nose if possible. Try to use your lower chest to breathe so when you inhale it is your tummy area that expands, rather than your upper chest.
• Breathe out slowly and watch your tummy sink back down.

How to check whether you are breathing from the lower chest:

Place your hands on your tummy, just below your ribcage. As you breathe in, you should feel your hands rising. As you breathe out, your hands will sink back down and in. Your upper chest and shoulders shouldn’t move very much at all.

Once you’re in a comfortable position, try breathing in through your nose and out gently through your mouth. Some people find it helpful to breathe out through pursed lips – as if blowing out a candle.

If you find breathing in through your nose difficult, you can breathe through your mouth instead.

When you breathe out, feel your shoulders and upper chest relax. As you breathe in gently, keep your shoulders relaxed. If this is hard to do, ask someone to press down gently on your shoulders to help relieve some of the tension.

Breathe in slowly and out gently, feeling your upper chest muscles relax more and more with each breath out.

Try to remember this during day-to-day life. Gradually, you’ll be able to adjust your breathing so it’s more effective and relaxed.

It can take a bit of time to get used to these exercises. Try not to force the exercises or expect instant results. Aim for a gradual change from breathlessness to controlled breathing.

Using a handheld fan is a simple but important way of easing breathlessness. It can help you recover more quickly when you experience breathlessness. You may also find a floor-standing fan or desktop fan effective.

Carry a fan with you to help you whenever you need it. Fans are small and light and easily fit into a handbag or pocket.

When using a fan:

• get into a comfortable position (see examples above) – if you’re uncertain about positioning, ask a doctor, nurse or physiotherapist at the hospital
• hold the fan yourself if possible – about 15cm (6in) away from your face
• let the cool air blow towards the upper and central part of your face, always including your nose and mouth.

Sitting in front of an open window with the cool air blowing over your face can also be helpful. Some people find putting a cool flannel on their face effective.

Cambridge University Hospitals have a video on how to use a handheld fan the correct way. This video has been made by the Breathlessness Intervention Service of Cambridge University Hospitals.