Pursed-lip breathing: how and when to use it
Pursed-lip breathing is a simple way to slow your breathing down and make each breath out longer. It is widely taught to people with lung disease, and anyone can use it when breathing feels hard work.
In short
- Breathe in through your nose for about 2 seconds, then breathe out slowly through pursed lips for 4 seconds or longer.
- It slows your breathing and keeps the airways open for longer, so trapped air can get out.
- Use it during the hardest part of an activity, such as climbing stairs, and practise it when you are calm.
- In COPD it reliably slows breathing; its effect on breathlessness varies from person to person. It does not treat lung disease.
- Sudden or severe breathlessness, or chest pain, needs urgent medical help.
How to do it
- Sit down and relax your neck and shoulders.
- Breathe in through your nose for about 2 seconds. It does not need to be a deep breath.
- Purse your lips, as if you were about to whistle or blow out a candle.
- Breathe out slowly through your lips for 4 seconds or longer. Do not force the air out.
- Repeat for a few minutes.
The American Lung Association puts it simply: breathe out at least twice as long as you breathe in.
Why it helps
Breathing out slowly through pursed lips keeps the airways open for longer, so air that would otherwise stay trapped in the lungs can get out. It also slows your breathing down and reduces how many breaths you take. Together this can ease breathlessness and make breathing feel like less work.
When to use it
- During effort. Use it during the hardest part of an activity: bending, lifting, climbing stairs or exercising. Breathe out through pursed lips while you make the effort.
- When you feel out of breath. It can ease the feeling of breathlessness and the effort of breathing.
- With hyperventilation or panic. Breathing out slowly through pursed lips is also one of the things that helps when you are breathing too fast. More in breathing for anxiety and panic.
Practise it at calm moments too, so that it comes naturally when you need it. Cleveland Clinic suggests 4 to 5 times a day for at least 5 to 10 minutes; the American Lung Association suggests 5 to 10 minutes a day.
What the research shows
Most research is in people with chronic obstructive pulmonary disease (COPD):
- A 2019 review of 19 trials with 745 people with COPD found that pursed-lip breathing slowed breathing and made breaths deeper. It did not significantly reduce breathlessness or improve walking distance compared with the control groups. Most trials lasted only a day or two.
- An older Cochrane review found that one study of 60 people saw them walk on average 50 metres further in six minutes, but effects on breathlessness and quality of life were inconsistent.
- In a lab study of 8 people with COPD, pursed lips gave a slower, deeper breathing pattern, but whether it eased breathlessness during exercise differed from person to person.
In short: it reliably slows your breathing, and many people find it makes breathlessness easier to manage, but it does not treat lung disease.
Safety
Stop if you feel dizzy, lightheaded or very tired. Call your local emergency number (112 anywhere in the EU) if you:
- are gasping, choking or cannot get your words out;
- have chest tightness or pain that spreads to your arms, back, neck or jaw;
- have blue, grey or very pale lips or skin, or sudden confusion.
Get medical advice soon if you are more breathless than usual, if breathlessness gets worse with normal activity or when lying down, or if it comes with swollen ankles or a cough that has lasted three weeks or more.
Common mistakes
- Forcing the air out. Let it flow out gently through your lips.
- Taking a big, deep breath in. A normal breath in through your nose is enough.
- Waiting until you are badly out of breath to learn it. Practise when you are calm.
- Using it to cope with breathlessness that is new, sudden or getting worse, instead of seeing a doctor.
Try it
Hold My Chaos guides you through it with a calm visual and gentle haptics. Coming soon to iPhone.
More guides
- Alternate nostril breathing: how to do it
- Belly breathing: how to do diaphragmatic breathing
- Humming breath (bhramari): how to do it, what is known
Sources
- Cleveland Clinic: Pursed lip breathing
- American Lung Association: Breathing exercises
- Ubolnuar et al. (2019): Effects of breathing exercises in patients with COPD: systematic review and meta-analysis. Annals of Rehabilitation Medicine
- Holland et al. (2012): Breathing exercises for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews
- Spahija et al. (2005): Effects of imposed pursed-lips breathing on respiratory mechanics and dyspnea at rest and during exercise in COPD. Chest
- MedlinePlus (NIH): Hyperventilation
- NHS: Shortness of breath
These guides explain, they do not diagnose or treat. If your symptoms are new, severe or worrying, talk to a doctor. In an emergency, call your local emergency number (112 anywhere in the EU).