Breathing Exercises and Yoga Asanas for Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease (COPD) is a group of progressive lung diseases that include chronic bronchitis, emphysema, and non-reversible asthma. COPD affects about 24 million people in the U.S., and nearly half of those people are unaware they have the disease.

In this article, you will learn about specific breathing exercises for COPD, including deep breathing, pursed-lip breathing, diaphragmatic breathing, and more. We will also discuss how yoga asanas (poses) and pranayama (breathing) and other exercises like tai chi can help with COPD.

So how will you know if you’re suffering from COPD?

In the case of chronic bronchitis, there is inflammation and narrowing of your bronchial tubes, and this leads mucus to build up within them. With emphysema, the tiny air sacs in your lungs are damaged, and this interferes with airflow. With non-reversible asthma, you do not respond to asthma medications, which cannot reverse the tightening and swelling of your airways.

Any form of COPD makes breathing more difficult, and common symptoms include shortness of breath, chronic coughing, chest tightness, wheezing, blue lips or fingernail beds, fatigue, and unintended weight loss.

The most common cause of COPD is smoking cigarettes, and it can still be diagnosed decades after you’ve stopped smoking. Another cause of COPD is long-term exposure to chemical fumes, air pollution, and dust.

When left untreated, COPD can worsen respiratory infections and also lead to heart problems. That is why it is important to treat COPD right away, and performing breathing exercises can provide some relief until you see your doctor.

Breathing Exercises for COPD

Breathing can indeed worsen with time in COPD patients, but fortunately there are a number of effective breathing exercises for COPD. When you practice breathing exercises on a regular basis, this can help you exert yourself less during your daily activities. It will also give you more energy to exercise, which is difficult for those with COPD.

COPD exercises for breathing include pursed-lip breathing, deep breathing, the huff cough technique, coordinated breathing, and diaphragmatic breathing. Read on to learn about these breathing exercises in more detail.

1. Pursed-Lip Breathing

Breathing through pursed lips helps promote relaxation, focus, calmness, and the slowing of the breath. This makes it easier to breathe while releasing air trapped in the lungs.

This breathing exercise should be done during and after exercise, and up to four or five times daily. You can use the exercise whenever you feel short of breath, such as when performing strenuous activities like climbing stairs.

How do you perform pursed-lip breathing? You will begin by breathing in through your nostrils, similar to a deep sniff, for about two seconds. You’ll then breathe out slowly without forcing air out.

Breathe out with puckered, pursed lips, as you would when blowing out a candle on a birthday cake. You will also breathe out two to three times longer than when breathing in. You will exhale for about five to seven seconds.

Repeat this breathing technique until breathing feels comfortable.

2. Deep Breathing

Deep breathing helps you breathe in fresh air and prevents air from being trapped in the lungs, which causes shortness of breath. Deep breathing is similar to pursed lips breathing; however, between inhalation and exhalation, you will hold your breath for about five seconds.

Deep breathing can be performed with other breathing exercises, and you can do them for 10 minutes at a time, and three or four times daily.

How do you perform this deep breathing exercise?

Begin by standing or sitting with your elbows slightly back, and allow your chest to expand fully. Inhale through your nose for about two seconds, and once fully inhaled, hold your breath for one to five seconds.

Pucker your lips, and exhale in a controlled manner for about five to seven seconds. During your exhalation, release the air slowly and deeply through the nose until all of the inhaled air has been released. You can repeat deep breathing until your breathing is comfortable.

3. Coordinated Breathing

Feeling short of breath can lead to anxiety, which in turn leads to holding your breath. You can prevent shortness of breath with coordinated breathing, by coordinating your breath with intervals of relaxation and tension when anxious or during exercise or a strenuous activity.

How do you perform coordinated breathing? When performing an exercise movement like standing up during a squat or lifting a dumbbell during a bicep curl, exhale through pursed lips. In the relaxation part of the exercise, you will inhale through your nose.

4. Huff Cough

Mucus can build up easily in your lungs when you have COPD. A huff cough is a breathing technique that allows you to cough up and remove mucus from your lungs during a COPD attack.

This breathing technique helps you get enough air behind the mucus, so you’ll have the momentum to bring it up. This makes a huff cough less tiring than a traditional cough and keeps you from feeling worn out when you cough up mucus.

How do you perform a huff cough? Begin by sitting in a comfortable position. Then, inhale through your mouth, taking in a slightly deeper breath than normal. Activate your stomach muscles to exhale the air in three breaths while making the sounds, “ha, ha, ha.”

Picture yourself blowing onto a mirror, and this will lead it to steam.

5. Diaphragmatic Breathing

Diaphragmatic breathing is also called abdominal or belly breathing. Your diaphragm is an important muscle involved in breathing. People with COPD often rely on accessory muscles of the back, neck, and shoulders for breathing instead of the diaphragm.

Yet diaphragmatic breathing will help you retrain the diaphragm muscle to help it work more effectively.

Diaphragmatic breathing can be more complicated than other breathing exercises; therefore, this technique requires a little more practice. It is also a good idea to get instruction from a physical therapist or respiratory healthcare professional. As you become comfortable with this technique, you can reduce shortness of breath and other symptoms of COPD.

How do you perform diaphragmatic breathing?

While lying down or sitting with relaxed shoulders, place one hand on your upper chest and the other on your abdomen. Focus on breathing with the abdominal muscles, and take a breath in through the nose for about two seconds.

You will feel your stomach move outward. When doing this correctly, your stomach will move more than your chest.

Breathe out slowly through your mouth with pursed lips, and press lightly on your stomach. This enhances your diaphragm’s ability to release air.

Practice diaphragmatic breathing two or three times daily for five to 10 minutes each time. Start this technique when lying on your back, and then try it when sitting, standing, and doing an activity.

Yoga Pranayam and Other Asanas for COPD

In yoga, pranayam, or pranayama, is the practice of controlling your breath. The breath is the source of prana—also called vital life force.

In a study published in Integrative Medicine: A Clinician’s Journal in 2014, researchers concluded that pranayam is a useful adjunct treatment, and can be an effective part of a rehabilitation program for COPD patients.

For the study, participants performed pranayam with four asanas, including the single nostril breath, the alternate breathing technique, the bee breathing technique, and the breath of fire, or the kapalbhati breathing.

In this section, we will take a deeper look at yoga pranayam breathing exercises as well as specific COPD yoga postures you can try at home to help maintain flexibility and build strength.

Single-Nostril Breath (Surya Bhedana and Chandra Bhedana)

In this breathing technique, you close your left nostril using your ring and little fingers from the right hand, and inhale slowly and deeply through the right nostril. Then, close the right nostril with the right thumb, and exhale slowly and deeply with the left nostril.

Exhalation is longer than your inhalation. In surya bhedana, you block your left nostril and inhale with the right, and close the right and exhale through the left. In chandra bhedana, you inhale through your left nostril, and exhale through the right.

This technique is done for one to three minutes.

Alternate Breathing Technique (Nadi Shuddhi or Nadi Shodhana)

In the alternate breathing technique, you will sit comfortably with your spine erect and shoulders relaxed. Next, close your right nostril with your right thumb and exhale completely with your left nostril, and then inhale deeply through the same nostril.

Then, close your left nostril with the ring and little fingers of your right hand, and exhale slowly and completely through your right nostril.
Repeat this technique using alternate nostrils, where you breathe in from the right nostril and exhale from the left. Continue the inhalation and exhalation from alternate nostrils.

Bee Breathing Technique (Bhramari)

In the bee breathing technique, you will inhale deeply and exhale to produce a low-pitched sound similar to the humming of a bee—where a vibration is felt throughout your entire head.

You will close your eyes and breathe deeply, and close your ear lids with your thumbs. Place your index finger above your eyebrows, and rest your fingers over your eyes with your middle fingers.

Gently apply pressure on the side of your nose, and concentrate between your eyebrows. Keep your mouth closed and breathe out slowly, and make the humming sound with your nose.

Repeat this technique five times.

Breath of Fire or Skull Shining Breathing (Kapalbhati)

In this technique, you will breathe rapidly through your nostrils with a passive inhalation and an active and forceful exhalation. You will sit comfortably, and exhale with your stomach pulled in and your navel pulled back toward your spine.

Keep your right hand on your stomach to feel your abdominal muscles contract. When you relax your abdomen and navel, your breath automatically flows into your lungs.

Complete up to 20 breaths for one round of skull shining breathing. After completing the round, relax with your eyes closed. Complete two more rounds of this breathing technique.

Standing Mountain Pose (Tadasana)

In standing mountain pose, you will stand tall and open up your chest with your arms at your sides or raised. With your big toes touching and your heels placed slightly apart, lift yourself onto the balls of your feet and spread your toes. Also, move your shoulders back and away from your ears.

Stretch and elongate your spine. Rock side to side, and back and forth. Reduce swaying, and come to a standstill. You will also keep relaxed with
slow and deep breathing. Hold the pose for about a minute.

Standing Back Bend (Anuvittasana)

Standing back bend opens up your chest muscles; nonetheless, you should practice this method carefully to avoid breathlessness and a muscle strain.

From the mountain pose, you will place your palms on your lower back and sacrum with your fingers pointed down. Press into your feet, and squeeze your buttocks and thighs. Use your arms to support your weight, and keep your buttocks and legs engaged.

Take three to seven breaths. To release this posture, inhale, release your arms to your sides, and let your head and neck come up last.

Seated Forward Bend (Paschimottanasana)

A seated forward bend will help strengthen your respiratory system. In this posture, sit with your legs straight out in front of you. Your knees should be slightly bent. You can also sit on a folded blanket or a cushion.

Inhale, and then lift up your arms and extend forward and rest your hands on your body or the floor. Hold seated forward bend for about five minutes.

Standing Side Bend (Parsva Urdhva Hastasana)

A standing side bend will help strengthen your diaphragm and improve the flexibility of your rib cage. From the mountain pose, interlace your fingers and point your index finger over your head while pressing your feet into the floor.

Exhale and press your right hip to the side, and arch to the left. Reach up and out through your fingers and the crown of your head. Breathe and hold for two to six breaths.

Inhale and press into your feet, and reach your fingers toward the ceiling. Repeat this yoga posture on the other side with the left hip to the side, and arch to the right.

Other Exercises and Activities That Help Chronic Obstructive Pulmonary Disease

Additional exercises and activities can help treat COPD, including tai chi and singing classes. Let’s take a look at both of these below:

1. Tai Chi

Tai chi is a type of qigong exercise that combines controlled breathing, martial arts, and Eastern and traditional Chinese medicine philosophies. The practice is known to increase flexibility, improve and maintain balance, and improve muscle strength.

Tai chi can benefit people with a variety of health conditions, including COPD. In a randomized controlled study published in the journal Respiratory Care in 2010, researchers found that tai chi is a safe alternative treatment for people with moderate to severe COPD.

2. Singing Classes

There is also some evidence that suggests singing lessons can benefit COPD patients.

A randomized controlled study published in the journal BMC Pulmonary Medicine in 2012 found that singing classes have a positive impact on physical well-being, and when combined with other studies, the researchers concluded that singing lessons may be a useful treatment in COPD patients.

For this study, patients were randomized to a film club or singing class for an eight-week period.

Precautions When Doing Breathing Exercises or Yoga

Breathing exercises can help ease shortness of breath and improve quality of life and exercise capacity. But when you feel short of breath during exercise, stop all activity immediately, sit down, relax your shoulders, and perform pursed-lip breathing until you can catch your breath. Then, continue your activity, and breathe through pursed lips as you go along. Slow your pace when needed.

There are similar precautions to take when practicing yoga. You should also stop yoga immediately when you experience shortness of breath. Rest until you feel well enough to begin your yoga practice again.

Not all exercise is safe for COPD patients. You should avoid push-ups; sit-ups; walking up steep hills; heavy lifting; outdoor exercises when the weather is cold, hot, or humid; and chores like shoveling the snow and mowing or raking the lawn.

Consult your doctor immediately if you experience symptoms such as weakness; nausea; dizziness; severe shortness of breath; an irregular or rapid heartbeat; or pain in your shoulder, arm, chest, jaw, or neck. You doctor should also tell you whether exercise is safe when you have COPD.

Final Thoughts on Breathing Exercises and Yoga for COPD

Chronic obstructive pulmonary disease includes the lung diseases emphysema, chronic bronchitis, and non-reversible asthma. If left untreated, these conditions can worsen your breathing. However, breathing exercises for COPD can help.

The breathing exercises mentioned in the article include deep breathing, pursed lips breathing, coordinated breathing, huff cough, and diaphragmatic breathing.

There are also a number of yoga pranayam breathing exercises you can try, such as single nostril breathing, alternate breathing, bee breathing, and skull shining breathing. Specific COPD yoga postures include standing mountain pose, standing back bend, seated forward bend, and standing side bend.

Tai chi and singing classes can also help with COPD.

Breathing exercises and yoga are great for shortness of breath and other COPD symptoms. Just remember to always stop when you experience shortness of breath during exercise. Moreover, consult your doctor to see if it is safe to exercise in general.