I have found no contradiction to this when it comes to inhaling but there are different views when it comes to exhaling. I am talking specifically about this as it relates to emphysema.
I have read that especially when we exhale through the nose, we breathe out slower than we do through the mouth and therefore we are able to absorb more oxygen into our lungs.
However, I have also read that "pursed lip" exhaling is best. Does anyone know more about this.
Hi I always used pursed lips it helps me breath so much better. Have a good night and take care 😊 Bernadette and Jack 🐕 xxxxxx
Hi and welcome. Pursed lip breathing out for a longer period that you inhale will get rid of as much trapped air as possible from your lungs which is important in emphysema.
While this seems to be what most articles I have read say about the trapped air in the lungs, I have also read that breathing through your nose gives the damaged alveoli more time to absorb the oxygen as you breathe out slower through your nose. Too bad that there is no consensus on this as it leaves one wondering what is the best thing to do. Thank you though for your reply.
I have emphysema and pursed lip breathing has been advised both at pulmonary rehab and by a physiotherapist. Pursed lip breathing can be done slowly.
Inhaling and exhaling through the nose is the best option generally. Pursed lip breathing used as needed when active, sob, walking etc. (you wouldn't normally use pursed lip breathing all the time).
I tend to agree with you but would like to be 100% sure and have googled this until I'm blue in the face (not really) but can't get a definite answer. Most seem to agree on pursed lip breathing but their is some info out there that makes a good case for nasal breathing. Still, all to often it's for COPD and emphysema is a little more involved when it comes to exercises and breathing in general, I have found.
Do you also have emphysema? Could you tell me where you got your information on this? My emphysema is bad and I don't want to make any mistakes that will make me worse. Thank you for responding.
Yes I have emphysema. Nose breathing through health education, see how the olfactory system works, your doctor can confirm the advantages of nose breathing. Pursed lip breathing, see BLF.org pages or check with any pulmonary /respiratory nurse to clarify both breathing options.
This is really a great place to visit with so many helpful and kind people. Right now, I am rather concerned about myself but hope that in the future I come to know all of you better and learn how you are coping with your own situations. I will do as you suggest and look up the olfactory system and the BLF. org pages. Thanks again.
Bit of a conundrum here for me as I agree with CDP104 and Bkin! I am naturally a nose breather and most of the time I find that's what I do. I use Pursed lip breathing for when sob after exercise but do find I have to really concentrate to do that when walking or active because it doesn't come naturally to me. I trained myself to be a nose breather years ago so sometimes struggle perhaps more than I need. Not a lot of help am I? Lol!
I thank everyone who replied to me but I still am no closer to knowing which is the better way to breathe. Each makes sense in their own way. You can't always rely on a doctor for the correct info either as some are surprisingly unknowledgeable about different breathing techniques. They are more likely to advocate the pursed lips breathing method but doesn't really mean there is no validity to nasal breathing. Do you have emphysema, by the way? They are kind of in a category of their own when it comes to these exercises and so forth. Anyway, thank you for your response.
One of my conditions is emphysema. Have you looked on You Tube - Pulmonary Rehabilitation exercises and breathing exercises - these are respiratory therapists who for the most part make the videos but also some specialist consultants. They know what they're about. Sorry couldn't help more - I only know what works for me.
Yes, I have watched some YouTube videos which is where I got the idea of nasal breathing to begin with, although it is my tendency anyway. However, the ones that I have seen tend to mix many things together for different conditions. You think that you have it right and then it turns out they are discussing Apnea etc. The basic theme is slower, smaller breaths but then there is more to it then that.
I even sent away for a book which I thought would be helpful. It was quite confusing really and half of the book warns about how careful you have to be when you have fragile lungs. When it comes to emphysema it devotes only a very small section to it which winds up being quite unclear as to what you should do. My lungs are quite damaged.
There are probably more videos out there that are more explicit and I will keep looking. I am also practicing diaphragm breathing which I know is good but just this one question plagues me.
By the way, are you referring to the Buteyko Method of Breathing? I believe that they have some good points but there are other things that I question. The Control Pause is one of them. Thank you for replying again. If you hear of anything else I would really like to hear from you. I hope that you are doing well.
Hi, I have copd and emphysema, for me I listen to my body. When I am relaxing, I generally am a nasal breather, however when I am walking or doing exercise a become a mouth breather, as I feel I can take in more oxygen, but when I become sob, I then practice pursed lip breathing to exhale and breath deeper. What also helps me is yogic diaphragm breathing which I practice daily and believes helps me improve lung capacity x
Can yoga breathing be either exhaled through the mouth or the nose?
You can do both, just be mindful of the breath.... and breath slowly inhaling and exhaling x
Yes it was the Buteyko method. I learned it before I even knew I had emphysema because I only breathed through an open mouth most of the time especially at night. I do find it beneficial and glad I did it, for a start my breathing is a lot calmer.
I have a cousin whose daughter is a respiratory therapist who works in a veterans hospital in the USA, I 'll ask her what she has been taught about breathing g with emphysema. I'll get back to you.
Hi.
I will try to explain things, I tend not to be a good teacher, others here are more eloquent so bare with me. Firstly you need to understand Emphysema, I have very severe Emphysema and a low lung function of 28%.
1. With Emphysema and being a past smoker, the destruction of the alveoli is usually at the upper parts of the lobes.
2. The lungs are normally elastic, stretch with inhale and shrink on exhale. With Emphysema the lungs lose that elasticity and remain stretched. This makes for the difficulty in breathing out, hence hyper-inflated lungs.
3. Imagine a balloon that has been blown up a few times and it has been over stretched, let the air out and it collapses in on itself full of wrinkles creating folds leaving trapped air pockets. This what your lungs will be like. Those trapped air pockets in your lungs will actually be co2; co2 retention is a notorious complication with Emphysema.
4. By using 'Pursed Lip Breathing' you not only slow down your breathing but create a slight back-pressure in your lungs thus holding them open, preventing the lungs from collapsing and causing 'air trapping' (retaining co2).
I hope that makes sense to you and realise that "sniff the roses and blow out the candle" is the best and more efficient way of breathing with Emphysema.
Over time it can become second nature, I even get told off for blowing in my partners face, in bed whilst asleep. Incidentally, I still do not need supplementary oxygen.
That's great 2 greys, I thought of you earlier and knew you would be able to explain. I remember you talking about this in the past. I just find I have to remind myself to do it when moving etc and by the time I've remembered it's too late and I'm sob!
Yes, thank you for that explanation. I am becoming more dependent on oxygen all the time. My blood oxygen saturation levels can be fine when I'm sitting and not moving around much but even then they can go lower. Most of the time when I get up and start moving they can go down to as low as 82. In fact, I've even had a reading of 70. However, it quickly goes up if I rest again. Still, it's serious.
Before shielding because of Covid, was still working full time as a production engineer, on my feet all day and went sailing, skippering cruising yachts on holidays. I am 70 years old.
I most certainly hope that you will be able to resume doing as you did before Covid. You sound like a very strong person. Before Covid I was in better shape. I was able to take the bus and was more active. I only used oxygen at night occasionally. Then I became housebound, more or less, and like you was shielding in place. That's how it's been for close to a year now. I am a 75 year old woman and the lack of activity in my life seems to have been the catalyst that's made my emphysema much worse. Perhaps, it would have happened anyway - I can't be sure.
Also have a look at free reading and resources page at themusicalbreath.com
I definitely will do that. There is much to learn from out there if one has the motivation and doesn't give up.
On this occasion a very good teacher. The analogy with a balloon made perfect sense and explains the reason for pursed lip breathing very clearly. 👍
What a great explanation! I'm new to diagnosis of emph and Bronchiectasis-both mild and want to keep it that way. Due to covid my first appt with Resp doc is February so self managing meantime. GP useless!Ive got emergency ABs and bought Shaker classic for getting rid of mucus along with ABC from YouTube. All learnt from this forum.
Thank you and everyone! If there's anything else I should do please let me know. Best wishes Stay Safe
Excellent explanation 2G especially No. 4 in relation to pursed lip breathing. The back pressure is crucial as it acts as a splint to keep the lungs from collapsing.
Thank you so very much. Please, when you have some time, could you tell me the basics that Buteyko taught you. I don't expect you to go into a lot of detail. Are you for example, practicing on a daily, regular and sustainable basis slower and smaller breaths? How often did you do the Control Pause throughout the day? Which were the main exercises that you did? I have practiced the "little mouse" exercise for one. Then finally, do you do a maintenance program and what does that involve doing?
I hope that I am not asking too much of you but I really need some help in putting this method into some proper perspective as the book is so poorly written and the videos that they show are not necessarily in a step by step order. I can't afford the program as a paying customer and would not do well over video anyway. It has, however, given me some hope for the first time. Not only do I have emphysema but asbestosis and scarring from a severe case of pneumonia that I had many years ago - plus I smoked for years. Not very smart of me, was it?
Firstly, my person from the USA said they advocate pursed-lip breathing for severe emphysema with the same explanation as that of "2greys" post.
Secondly, I learned the Buteyko method years ago so I would say that now I don't religiously carry out the exercises every day at all but that I am a fully committed nose breather and on resting breathe slow and smaller breaths. As I said I took up with the method to cure myself of open-mouthed breathing because I had a dry mouth all the time - I didn't know at the time that I had anything else wrong with me. I found the control pause feature a bit fraught at times and I didn't get on with that too well. I just taught myself to keep my mouth shut even at night, I learned how to stifle a sigh and control a yawn - both these two help me a lot now. I guess you can say in my case I took from it what I needed. I find that now I don't have blocked up nose at all so it has been beneficial. I bought Patrick Mckeowns 'Close your Mouth' and found it to be very straightforward and watched some of his You Tube videos.
There's a lot of great help from those who have posted and perhaps the best way forward would be to concentrate on one type of breathing at a time and see how You feel. I'm no expert unlike some on this forum who have sadly got great personal expertise, but the general consensus of opinion it seems to me is that you should do what gives you the most comfort and effect. Good luck with your research.
I took up Buteyko a month or two before I was diagnosed with copd (in 2000). I did it for the asthma I'd had since my 20s - 74 now. I had a very expensive instructor and was doing well - my control pause went from around 9 to 28 as I remember. This was over about 2-3 weeks and I was thrilled.
Then I started noticing that when I took my pulse it was missing beats - quite a few. And the control pause started going backwards. I was working in the NHS at the time and my team consultant told me this would be the carbon dioxide building up. I have since read many respiratory practitioners saying that people with copd should not do Buteyko precisely because the potential CO2 build-up is dangerous.
Closing your mouth, though, whenever you can manage is very helpful and something positive to take from the Buteyko method. But when you think that some of us become CO2 retainers and how awful that is especially as you are not then able to use oxygen as I understand it, you can see why it might not work for us. I did once see a book with an adaptation of the method specifically for emphysema but Ive never managed to find it again.
I know primarily this method was for Asthma and as I said I found using the control pause a bit fraught at times and I'm now wondering if that was what was happening to me with C02. I do think though that if this method was really good for COPD, wouldn't more consultants have taken this on board and advocated the practice of it?
I have gained some benefits from learning and using it so I'm not knocking it, but mine wasn't really for the breathing benefits at all, which was why I deliberately didn't mention the name of the method in my original answer to the poster.
I may buy Patrick Mckeown's book, as well, to sort of guide me along. The book that I bought was written by the top guy, whatever his title is. Artour Rakimov, I think is his name or something close to it. Anyway, it was really not well written and with too many charts that needed more explanation then was given.
Also, I want to make a plan that I can adhere to. I want to develop what I do know about nasal breathing and use the pursed lip technique when I'm doing certain things, like perhaps housework etc.
Well, it certainly has been a nice surprise to run into such a nice and helpful group of people. You have been particularly generous with your time. I hope to chat with you again. May you keep your health up and good luck to you also.
2greys explanation is spot on. I have emphysema and lung function of 20%. I was told by my Consultant to inhale through the nose and breath out through the mouth for twice as long to get rid of as much CO2 as possible. Keep safe. John
Hi I have had emphysema for nearly 30 years. I am a nose breather and use pursed lip breathing when I’m SOB. There are many advantages to breathing through the nose. See below:-
When we breathe through our noses, we are better protecting our respiratory system by priming the air for respiration. Our nasal passageway warms and humidifies inhaled air before it goes further down the respiratory tract. This ensures that the inhaled air does not damage the airway or the lungs. Alternatively, breathing in dry, cold air - as happens when we mouth breathe - can irritate the airway and lungs, leading to wheezing, coughing and shortness of breath. It is especially a problem for those with asthma, COPD or bronchitis.
Along these lines, an additional nose breathing benefit is that our nasal passageways also filter airborne particles. Mucus and nose hairs catch potentially harmful bacteria before it enters the respiratory tract, which can protect us from illnesses such as pneumonia.
However I would suggest that you breath whichever way is most comfortable for you. Barbs x
ok Danker you have had some good info from people.Write it down and try each one individually see how you go
Try not to worry onward and upward my friend
I was taught by a very good physio. Nose breathing is best but if you are struggling with nose breathing having a cold ect then pursed lip breathing is the way to go. 😷
I have emphysema, and find I can control my exhalations better with pursed lip method . But maybe that's just me . 🤔
Yes - nose breathing better on inhale as moistens & warms the air - exhale doesn’t really matter hugely - best not to overthink it - you obviously have to breathe out through your mouth when speaking! pursed lip breathing the way to go if you feel breathless - the added resistance at lips helps to splint open airways ie helps keep the small airways open for longer on exhale so you can get the air out & avoid breath stacking (ie hyper inflated lungs) hope that helps
I like your thinking! I tend to get very anxious through over thinking things whatever they are and I know I've sometimes felt I'm failing myself when I don't quite get my pursed lip breathing right quickly enough and tend to panic a bit.
Why singing good as it adds resistance at vocal fold level too & gives you some feedback you can hear (& it doesn’t matter what you sound like) just choose songs with long phrases like “can’t help falling in love” or similar ballad if you have an obstructive condition such as copd as you want to extend outbreath to reduce breath stacking - moving gently while you sing helps with anxiety too - maybe try one of the online groups (the musical breath.com)
A very Happy Christmas, to each and everyone of you. You all have such great attitudes in spite of your own individual health problems and thank you so much for helping me to sort out mine. Godelieve Danker
I believe nose breathing is very important.
Purse lip breathing is good for breathlessness and mouth breathing during strenuous exercise
Good information to know. Will watch all of the videos later this evening.
Relvar/trelegy 
Hello from Chom 🐕
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