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Contemplating Change

I've been pondering - there have been a couple of post's and responses over the last few days about exercising with asthma and of course the fact that Dr Cath has just done the London marathon (wow!): It's all made me realise that I have given up totally on exercise and now just focus on trying to sleep rather than wheeze through the night and then make it through work.

Mmm, new goal's and more sleep needed and a definte need to remember what I used to be able to do - last spring I felt sooo much better!

Does anyone know any books or links to websites that take you through a gradual step by step guide to getting fit and knowing where to start? Also are there any inhalers that are meant to be better than others at getting rid of night time symptoms?

Any tips welcomed!

9 Replies

hi lee

I know what you mean about having significant symptoms at nighttime. I found singulair - also known as montalukast sodium very helpful once i started on it almost 13 years ago unfortunatly i no longer find it as helpful now but at the time when i started taking it it helped significantly with exercise induced symptoms and reduced my night time symptoms too. If your not taking it you may wanna discuss this with your doc or consultant.

Good luck and hope that helps lv kk Xx


When starting off on a new exercise routine, try breathing through your nose in and out for your exercises. Your nose (by virtue of its size) will limit the amount of exercise you can do on this amount of breath and should allow you to exercise within your lungs comfort zone thus minimising the exercise induced symptoms.

While this will slow your initial progress, if you maintain nasal breathing while exercising then you will be taking less chances with your asthma. Over time, the affect will diminish as your body gets used to nasal breathing while exercising.

If you cannot breathe through your nose, there are exercises to clear it.

When you breathe more (because of exercise) you directly inhale more triggers, particles, air pollution and irritants into your lungs. By nasal breathing when exercising, the amount is reduced and the air is both filtered (what your nose is meant to do) and slightly warmed which is better for your lungs.

I switched to nasal breathing six years ago and it had a big affect on my ability to play sport. Particularly indoor dusty sports which used to cause havoc with my asthma but now do not. I can even maintain regular (even competitive) exercise while suffering from a chest cold which previously kept me house-bound.


Thanks for the tips!

I'll try the nose thing but may be try on a long-ish flight of stairs first -as when I'm out of breath it's feels really hard to get enough air in through my mouth so the idea of just using my nose feels a bit scary, I will try tho.

Kit-Kat, I am on montelukast (coming to end of third month) but to be honest I havn't noticed a real change, also tried sleeping practically up right but without sucess. I've heard montelukast can take a while to work so maybe it will kick in. Fingers crossed we both get a good night's sleep soon!


hi lee

Montelukast can take a long while to start working i think its around 10-12weeks though i could be wrong!

Hopefully it'll kick in soon for you-it doesnt work for everyone though there is a slightly different drug of similar class called zurflukast (sp) which may work if montelukast doesnt! Bear it in mind if you really dont notice any difference with the montelukast!

Do you take your inhaler before you settle down for the evening? This may help with night time symptoms or give you a few hours before you wake at least! As for the exercise thing- i know nose breathing is supposed to help etc and its often suggested by alternative therapists in such techniques like that butakyo thing but in my experience i feel like im suffocating if i nose breath!

I also have a very large perforation in my nasal septum and it is always blocked on one side so this isnt helpful for me as when i do nose breath my oxygen saturations drop rather dramatically. So although its supposed to be better to nose breath if your finding it very difficult then i wouldnt beat yourself up about it too much!!

Good luck with the night symptoms and i hope things improve for you soon! As for sleeping in an upright position it can help but can be difficult to stay upright without a wedge or electric bed etc as you may find you slip down the pillows during sleep! If this happens you could try a wedge or you could put something underneath the legs of your bed at the head end just to tilt it up a bit etc.

Good luck lotsa lv Xx


Thanks for the reassurence about nose breathing Kit-Kat - definitely sounds like something you need to avoid doing!! I do take my reliever (and symbicort) before bed and norm get 2-3 hours sleep, it's that once I wake, taking the salbutamol only works for a short time before the cough and wheeze come back making staying asleep tricky. If I could convince my body that it was the afternoon (a good breathing time)at all times that would be fab!! Lungs are just wierd!


hi lee

Its frustrating when you struggle to get a decent nights sleep once you wake up in the small hours! Good luck with things stick with the montelukast but it does sound like your not very well controlled at the moment and could probably do with a visit to your doc or consultant to chat thro the situation with him/her!!

You ideally should get control enough of your asthma symptoms not to wake in the night or have significant symptoms during the day or night!

Good luck with things and keep us posted on how you get on. Lv kat Xx


take it very slowly and easy


If you wait until you are out of breath then of course suddenly switching to nasal breathing is almost impossible. (i know you actually said that when you get out of breath then you cant even get enough air in through your mouth. But if you never allow yourself to get out of breath through exercising slowly and carefully and ""asthma-friendly""ly then you will reduce the amount of times this happens.

The trick (but it isnt a trick - its a great technique) is to start nasal breathing and limit your exercise so that you can maintain it. This may involve slowing down with your exercise or stopping if you must. All without even an atom of breath through your mouth! This is difficult to get used to, but once you do you get used to coughing or sneezing through your nose (with your mouth shut). If you practice when you are walking you will notice that your speed initially is much reduced. This is normal! Your speed quickly increases (this may take 6 weeks to get back to where you were- breathing through your mouth) as your body gets used to nasal breathing. Once you are breathing through your nose and slowing down when you need to, then you can exercise without causing an asthma flare. Its worth spending this time as we all have asthma for the rest of our lives! So, to go slowly for 6 weeks is only a little bit of ""going slowly time"" but allows you to develop a healthy and asthma-friendly way of exercising for the rest of your life.

Try it- you will be surprised. Always ensure that you stop (but try again next time) if you feel more than gentle discomfort. It is possible to build up this level of discomfort. It is scary and also counter intuitive - i was a 32 year mouth breather and my nose was blocked all the time but i have maintained breathing through one nostril for the last 6 years. This had had HUGE benefits for my asthma, my allergies, my fitness, my pulse, my sleeping (as this is when you need to breathe smaller- its very hard to sleep if your lungs are breathing like they are going for a walk/jog!). Watch other people when they are sleeping, their bodies are not heaving but relaxed and breathing lightly (and through their nose if the are good breathers). Sometimes when I am over-breathing (through my nose) then I mimic my partners breath rate- this helps.

Exercise is vitally important in improving your quality of life as an asthmatic. Its a catch 22 potentially as your asthma can limit the amount of exercise you can safely do.

By limiting this amount and slowly building up (through the only breathe through your nose technique slowing down to that rate allowable by your nose/lungs) you can rediscover the joys of exercise. Ideal to practice initially when walking slowly (and not chatting to anyone when walking – this is a major no-no for asthmatics!).

Do not be put off by how slow this means you will need to start. Be assured that this will build up to a decent level in time. Been there, done that.


nasal breathing

just thought i would make my own little contribution to this conversation.

last year i saw several times an osteopath who was using what is called the ""Gesret Method"", this involves movements and pressure on in certain places (chest, back, ribs...) in order to make the lungs and upper airways more free to move, this helps people with asthma and other problems. after a while people can learn to use these movements and apply the right pressure on their own (i haven't got that far yet, as my case is very severe).

this same osteopath also told me to do two other things every day:

the ""Afghan Walk"" (my Dad calls it the Aztec Shuffle, cos i go so slow, lol!) This involves a simple walk, using nasal breathing. also, getting a rythm to your breathing wich goes in time with your step. there are many different rythms that one can use for the Afghan Walk, it is a very personal matter, each case is different, i think. i use a 3 steps breathe in - 2 steps breathe out. last year as i got better, i also consequently used 3 steps breathe in - 3 steps breathe out, then 3 steps breathe in - 1 step holding breath - 2 steps breathe out, then 3 steps breathe in - 1 step hold breath - 3 steps breathe out. I started at 15 minutes of this walking, a day, in one go, and added on 5 minutes every so often (each week, every other week, when you feel ready for it, in other words). i did get up to 30 minutes of this walking a day, in one go (back down to 15 minutes now...) also, if you feel on some days, worse than usual, don't force yourself, if you are in pain, or having much difficulty breathing, it's ok to miss a day!...

he also told me to try using sea water in my nebulizer, once or twice a day (again, it depends on the person and the severity of their symptoms). i found you can buy packets of little glass phials of sea water in a chemist's, pharmacist's shop, as many people consider it healthy to drink this water. i used thes little glass phials to put in my nebulizer, alone, not with any other medicine or sterile water or anything, so this is an extra neb or two as well as the other things people would usually use in their nebulizer (what the doctor has prescribed for them). i found that this was extremely healthy in clearing up my lungs, using all the muck and mucus so that i couls cough it up, whereas without this, there was all this muck and mucus in my lungs, but i didn't even realise it or feel it most of the time, so there was no way i could cough it up.

this is just my experience, wich i share with you in the hope that it could help, but this method is well aware that each person is different. i also think i ought to say that before i saw this osteopath, i was one of these people who was very wary and ironical about any alternative methods (and i must say, it hasn't changed so much, i still think that many alternative methods are a pile of nonsense...!) but this has had such an amazing effect on me, it really helped me to live an almost normal life, as opposed to being completely housebound, and resting or in bed for most of that time anyway. i have had to go back to the start now, due to other health problems on my spinal cord etc.... but i am still confident that i can again recuperate some sort of fitness through this method.

Finally, i will leave you with a link to the english version of the website, in case this is of interest to anyone.


hugs and nebs to all, be careful, take care and stay well!!

Lots of Love



afghan walking

Hi HannahRose

If you try to do your breath-hold on your out-breath rather than on your in-breath as in to

Breathe in three steps breathe out three steps, hold breath one step with perhaps only a slight pause on the gap between breathing in and breathing out again

this could help to get you back up in terms of duration of activity/walking.

When singing, do you manage to do nasal breathing for the duration and at least ten minutes afterwards? I have found the benefits of always nasal breathing to be tremendous. Thanks for the afghan walking tip as i had never heard of it.

When you cough up all that gunk every day, can you cough through your nose?

When i repeatedly cough, this can bring on symptoms of asthma and is hard on my lungs. By coughing with my mouth closed, the tickle is reduced meaning that i cough less and need less repeat coughs.


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