Breathlessness

Most people associate breathlessness as common side effect of exerting yourself through physical activity, such as exercising. For those living with a lung disease or lung cancer, breathlessness can have a serious impact on your day-to-day life. However, there are simple steps you can take to help manage breathlessness throughout the day.

What is breathlessness?

Breathlessness (shortness of breath) normally indicates that the body needs more oxygen and energy when exerting itself. However, breathlessness (dyspnoea) is common in people with lung or heart conditions, as well as in people who are overweight or unfit. Those with lung diseases like Chronic Obstructive Pulmonary Disease (COPD) will experience breathlessness as the disease affects the breathing tubes or airways and the lungs. The feelings of breathlessness may increase as the disease progresses. 

This type of breathlessness is categorised into two types:

Chronic breathlessness

  • Chronic breathlessness  is the term used when people find themselves out of breath when participating in day-to-day activities while not physically exerting themselves. It’s common for people living with chronic breathlessness to unexpectedly find it difficult or uncomfortable to breatheDuring these times it may be difficult to regulate breathing.  

Acute breathlessness

  • If you get out of breath suddenly and unexpectedly for a short time, this is called acute breathlessnessAcute breathlessness can be a sign of an impending flare-up of symptoms for people living with a chronic lung conditionAcute breathlessness needs to be tested or treated straight away. The sooner you get treatment, the better you’ll recover. 

Tips to manage breathlessness

There are many treatment options and management strategies that can help you control or reduce your breathlessness. Make sure you communicate with your health professional when you start to have difficulty breathing so they can determine the cause quickly and efficiently and provide the best management options. 

Medicine 

Using your reliever and maintenance medicine can assist in controlling breathlessness. It is important that you understand the role of each of your medicines and your medicines are used correctly to ensure their effectiveness. Ask your GP to include any prescribed medication management recommendations to manage your breathlessness in your written Action Plan.  

If you don’t have an action plan, download a template and organise an appointment with your GP to work through it: 

Fitness

People who have chronic lung conditions are often less active, have reduced fitness and reduced muscle strength. People who exercise regularly can reduce their need for hospital admission. Increased fitness levels or improved tolerance to exercise will enable a decrease in the effort required to perform everyday activities and improve your quality of life.  

Before embarking upon an exercise program, it is important to speak to your GP or respiratory specialist to ensure you are medically clear to exercise. 

There are specialised exercise programs that are tailored to support people with lung disease to exercise in a safe and friendly environment. It is important to talk to your GPphysiotherapist, accredited exercise physiologist or Lung Foundation Australia about local programs. 

Pace yourself 

This is a very important skill and is often overlooked. If you have breathing problems and are noticing that you are shorter of breath than previously, you will need to slow down to get your tasks done. If you rush and try to beat the shortness of breath, you will spend longer trying to catch your breath.

If you go slowly and pace yourself, you will go a lot further before needing a rest. For example: While walking, try to establish a pattern of breathing that matches your steps and that you can maintain easily.

Do not hold your breath and rush through the task to ‘get it over with’ as this will only make you shorter of breath. Aim to find a rate of breathing that matches your effort. If you find an activity too hard to do, simply stop and recover before restarting the activity at a slower pace 

Recovery positions

Recover positions help you regain control of your breathing. Ensuring you have good posture bend over or leaforward, resting your arms on your thighs, furniture or wall. This position allows for better positioning of your organs which will improve your breathing 

Discuss the best recovery positions for you with your treating healthcare team.  

Relaxed breathing and control

People who have a progressive or chronic lung disease have more difficulty breathing out fully. The body’s normal reaction when breathlessness occurs is to breathe faster and shallower. However, fast and shallow breathing is not an effective way to regain control of your breathing. You could practice relaxed breathing any time you are trying to catch your breath.

Aim to breathe out slowly and without force. 

Manage your anxiety

Anxiety and depression are common in people with chronic physical illness. Learning how to manage or control your anxiety, or situations that cause your anxiety, can assist your breathing control.  

If you feel you are experiencing any of the signs or symptoms of depression or anxiety, need extra support or just need to talk to someone, it is important to discuss your thoughts and feelings with treating healthcare team or your GP to find out about your options.  

  • Progression of breathlessness in lung disease

    In mild forms of lung disease, breathlessness may occur when walking up hills or stairs. As the disease becomes more severe, breathlessness can occur on minimal exertion such as when walking slowly along flat ground or even at rest.  

    Daily activities become more difficult as the lung condition gets worse. For people living with a progressive disease it’s common to have feelings of anxiety, frustration and depression. It’s important to remember there are thingyou can do to make life easier and it’s important to stay as active as possible.  

  • Causes for breathlessness

    Shortness of breath is the most common challenge people living with lung cancer and other lung diseases face. It can be uncomfortable and scary to feel like you can’t get enough air into your lungs. The common causes of breathlessness include: 

    • A sign of a flare-up of your lung condition 
    • Infection such as a cold, flu or pneumonia 
    • Airway obstruction 
    • Anxiety or stress often causing more rapid breathing 
    • Fatigue 
    • Low red blood cells (anaemia) 
    • Lung cancer treatments. 
  • Severity of breathlessness

    The severity of breathlessness is dependent on how much oxygen your body requires. The breathing centre in your brain is constantly receiving signals from your body about the amount of oxygen that required 

    The oxygen requirements of your body will depend on many factors, such as: 

    1. The severity of your lung condition and the ability of oxygen to pass through your lungs into your blood stream for use by the body.  
    2. The level of activity you are currently doing will affect the amount of oxygen your body will need. For instance, when you are resting quietly, the oxygen demand is less than when performing strenuous activities, such as walking upstairs or hills.  
    3. Your fitness or conditioning will also affect your oxygen requirements during an activity. A person with a better fitness level will generally be more efficient in moving oxygen around their body, and their muscles will require less oxygen to do the same activity than a person who is unfit. 
    4. Stress or anxiety, or a low mood, can affect your breathing rate and make you focus on your breathlessness and more aware of your breathing.  
    5. If you are unwell more effort is required to breathe. 

Handheld Fan

Many people find using a battery-operated fan can help control breathlessness, and research has shown that a cool draft of air from a hand-held fan can be very effective. Hand-held fans are a great option because they are cheap, quiet and easily portable. A free-standing fan, a desktop fan or the breeze through an open door or window may also help.  

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