Article by Dr Raghuram Y.S. MD (Ay)
Dyspnoea depends on the disease or cause which is causing or triggering it. Management of those conditions or causes in the backdrop will take care of dyspnoea. Thus, prevention of dyspnoea can be achieved by preventing the primary conditions causing the shortness of breathe from recurrence and keeping away the causes which are responsible for dyspnoea.
Attend dyspnoea – Try to address breathlessness as soon as the distress becomes apparent. Do not wait until it gets well established. If neglected, symptoms may add up quickly.
Detect Cause – Try to find and establish a cause or causes of the dyspnoea. It may be a specific type of food allergy, pollen grains, pollution etc.
Dyspnoea due to psychological causes – Breathing difficulties may arise due to fear, anxiety, phobia etc. Talk to your doctor and get to know the cause. If anxiety is the reason, learn the tips to manage anxiety
Explore – Try to find out about the ongoing fears a patient has, like fears of suffocation, choking, dying in sleep etc.
Stay close – Staying close to an acutely distressed patient will help. One can use reassurance and distraction as tools for betterment of the patients.
Call bell – Make sure you have someone to call quickly. An attender’s presence during an attack of breathing difficulty will be very useful.
Positioning – Sitting upright with support is the most comfortable position for those suffering from dyspnoea
Room temperature – keep the room cool. It should neither be too cold nor be too warm. Asthma related dyspnoea may worsen if the room is too cold.
Move air – Moving air from a fan (hand-held or stationary) or open window helps provide psychological relief. Make sure that your home, especially your room has good ventilation.
Inhaler – people with asthma may use inhalers before going for an exercise or whenever they feel the early symtpoms.
Humidifier – is beneficial especially in winter. Dry air thickens mucus and can make breathing difficult.
Avoid warm rooms – Avoid sitting for long hours or sleeping in overly warm room. Warmth can worsen shortness of breath. Try changing your position to help relieve shortness of breath. Some positions are comfortable.
Rest – When you feel breathless, stop whatever you are doing, Rest until your breathing returns to normal.
Distract yourself – When you have dyspnoea, try to distract your mind and focus on something else instead of focussing on your breathing. This helps your subconscious mind take control of your breathing again.
Breathing exercises – The patients should be taught with breathing exercises and relaxation methods. They should be done by specialists. Breathing retraining, taught by physiotherapists or clinical nurse specialists come in handy. Try to learn Pranayama
Lifestyle modification – should be encouraged. Patients should be helped in knowing non-essential activities and in reducing them as far as possible. This should be achieved whilst trying to maintain mobility and independence as far as possible.
Encourage exertion – Exertion should be encouraged to the point of breathlessness to build tolerance and maintain fitness. Pulmonary rehabilitation appears to be well tolerated and to provide symptomatic relief in many patients with severe COPD.
Dietary modifications – should be done with small frequent drinks and meals being best tolerated.
Oral hygiene – Mouth breathing dries the mouth and oxygen will be very dry unless it has been humidified. So, attention to oral hygiene is important.
Complementary therapies – such as aromatherapy, hypnosis and acupuncture may be helpful to some patients
Diary or journal – keep a journal and write details about the episodes and timing of shortness of breath and also its quality. Also describe what makes it better and worse. This will help you and your doctor to take proper call on the management.
Sleep propped up – If you have difficulty sleeping, try to sleep propped up with many pillows or in a recliner. Try to lie on your side with a pillow between your legs and your head elevated with pillows.
Breaks – Take short breaks at regular intervals while doing strenuous activities to avoid shortness of breath.
Avoid chemicals and irritants – Avoid exposure to toxic chemicals at home or work. Also avoid any household or any work which is known to trigger your dyspnoea. Avoid all the known allergens which cause shortness of breath. Make a note if something suddenly causes dyspnoea.
Wholesome diet – Prefer taking a diet full of fruits and vegetables
Avoid stress and anxiety – stress, anxiety and panic attacks may cause or worsen shortness of breath. Therefore they should be kept away as far as possible.
Lose weight – obesity is one of the causes of shortness of breath. Loss of weight can cure shortness of breath. Proper diet, exercises and weight losing programs under guidance of qualified doctor will help to shed excess weight.
Hydration – drink plenty of water to keep your body hydrated. This helps thinning your mucus, making it easier to expel.
Do not – take any supplement or medicine without consulting your doctor.
Diaphragmatic breathing (abdominal breathing, deep breathing) –
This is useful especially in shortness of breath due to COPD (chronic obstructive pulmonary disease)
How to do?
- Lie down on your back
- Put your hands on your abdomen and relax your muscles
- Breathe in deeply through your nose, expanding your abdomen and then filling your lungs with air
- Hold your breath for couple of seconds
- Breathe out slowly through your mouth, empty your lungs completely
- Repeat this for 5-10 minutes
- Do this breathing exercise for 2-3 times a day
This technique quickly slows your pace of breathing. It also helps you to restore your normal breathing. It also helps relieve stress and anxiety.
How to do?
- Sit comfortably
- Relax your neck and shoulder muscles
- Keep your lips pressed together tightly, except at the centre
- Inhale through your nose for a couple of seconds
- Exhale slowly while counting to 4, through your pursed lips
- Continue to inhale and exhale for another 10 minutes
Smoking cigarette can cause dyspnoea and many other respiratory (breathing) problems. It also triggers the already persisting dyspnoea. It is immaterial if you are an active smoker or passive smoker. Therefore quitting smoking will help in getting rid of dyspnoea.
Quitting smoking also will reduce the risk of getting lung cancer.
Walking has immense benefits in curing shortness of breath. Dyspnoea or shortness of breath is common in overweight / obese people. Regular walking helps in weight reduction, improves stamina and reduces episodes of breathlessness.
Walking also will provide distractions of mind and help your subconscious mind restore your normal breathing. Walk for 30-60 minutes at a moderate pace, at least for 5 times a week. This boosts your metabolism, increases your stamina and helps get rid of dyspnoea.
Yoga and meditation are best relaxation therapies which help you deal with your breathing difficulties associated with dyspnoea. They help in enhancing blood and oxygen flow throughout the body. They can slow down your heart rate and helps in normal breathing. They help in reducing stress and anxiety.
If possible, try doing Yoga and meditation in an open area where you can breathe fresh and pure air.
Yoga and meditation should be done on a regular basis and in correct way, under the guidance of an expert to obtain optimum results.
Yoga for difficulty in breathing:
Ardha Matsyendrasana (Half Lord of the Fishes pose) –
Baddha Konasana (Butterfly pose) –
Padangushtasana (Big Toe Pose) –
Pranayama (Deep Breathing) –
This is essentially a breathing exercise which moves the breath in unique ways allowing for different effects on the nervous system. At night, practicing calm breathing, even breathing in a 1:1 ratio and then eventually building up to 1:2 allowing the exhale to lengthen more than the inhale. You can also try inhaling while blocking one nostril and alternating nostrils with each breathe, which can help calm the nervous system.
Uttanasana (Forward fold Yoga Pose) –
Balasana (Child pose) –
Bhujangasana – The Cobra pose
Ushtrasana – Camel
Purvottasana (Upward plank pose), video:
Utkatasana: chair pose
Sukhasana – The Easy Pose
Ekapadasana – One Foot Pose
Poorna Matsyendrasana – Full spinal twist pose