Puirsed Lip Breathing (PLB)

Two techniques can be beneficial to people with COPD and other some other chronic lung conditions:

What is PLB?
PLB is a technique that helps people gain control of breathing while exercising or while experiencing breathing distress. It helps increase oxygen levels in the blood. Regular use of PLB trains one to use the proper breathing muscles, and to exhale as much air a s possible before drawing in a new breath.

To do PLB, inhale through your nose, keeping your the mouth closed. Then merely purse your lips as if kissing or whistling and exhale softly against them. The key to PLB is to exhale at least twice as long as you inhale.

How does PLB work?
People with COPD commonly have a problem with air trapping in the lungs. Airways become floppier, and tend to collapse during exhalation, trapping the air in the air sacs (alveoli) at the end of the airways. When you breathe out against pursed lips, it builds a resistance in your airways. This resistance creates a back pressure extending down your airways, helping to keep them open during exhalation. By prolonging your exhalation at least twice as long as your inhalation, you help ensure that more air has a chance to escape the alveoli. More fully emptying your lungs means that, with the next inhalation, more oxygen will get into your lungs and your bloodstream.

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When should I use PLB?
PLB should be used anytime you feel short of breath. It should be used in conjunction with diaphragmatic breathing discussed next) when you exercise. Coordinating PLB with body movements will help you feel less short of breath exercising or when performing any activty (e.g. stair climbing) which causes you shortness of breath.

Diaphramic Breathing

What is diaphragmatic breathing?
Diaphragmatic breathing is an exercise to better use and to strengthen the diaphragm, the major and most efficient muscle of breathing. Regular practice of diaphragmatic breathing can help restore function to your diaphragm, and return you to a more efficient breathing pattern.

The diaphragm sits under the lungs and is dome-shaped if lungs are normal. During exhalation, the normally functioning diaphragm recoils upward, helping to expel air from the chest.

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Because of the air trapping that can occur in COPD, it becomes harder for the diaphragm to function, and it can become flattened and less useful in breathing. The flattened diaphragm forces more of the work of breathing onto other muscles in the chest. These other muscles are less suited for this task and have to work harder, burning more energy and tiring you out faster.

Practicing a deeper, diaphragmatic style of breathing can help ease the work of breathing and expel more stale air.

When starting to practice diaphragmatic breathing, it helps to lie down. Put one pillow under your head and another behind your knees. Place one hand on your upper chest, and the other on the center of your stomach, below the rib cage. The key to diaphragmatic breathing is to use your diaphragm for breathing, and not your upper chest muscles.

Inhale through your nose while expanding, or pushing out, your stomach muscles. Your upper chest should not move outward. When exhaling, exhale slowly through pursed lips while pulling in your stomach muscles. At first, you will have to force your abdomen to move in this way. But with practice and regular use, it should become more natural. If you can, work your way towards using diaphragmatic breathing all the time.