Understanding breathlessness in COPD

COPD, or Chronic Obstructive Pulmonary Disease, is a name for a group of long-term lung conditions including emphysema and chronic bronchitis.

COPD can cause breathlessness by damaging the lungs and airways.

  • Swelling and scarring from this damage can make airways less stretchy, and narrower.
  • Airways can fill with fluids like sputum/phlegm.
  • This makes breathing harder as it’s more difficult to get air out of the lungs.
  • As it’s harder to breathe out, old air gets left in the lungs. This means there is less space for new, fresh air.

That’s why it is important for the patient to focus on breathing out – to move old air out of the lungs and allow new, fresh air to get in.

Remember: not all of these causes of breathlessness will apply to everyone. Speak with your healthcare team if you have any questions about these.

There are other things that can trigger breathlessness and make it feel worse, such as stress or the weather for example. See Stress, panic and breathlessness for more information about these.

For more information about COPD you could visit the Patient.Info website.

Have you tried...?

Understand what breathlessness feels like

If you want to know what breathlessness feels like for the patient try doing the following:

  • Take a deep breath in and then breathe out half way. Then breathe in again. Now breathe at that level for a few more breaths.
  • Take a deep breath in and hold it as long as you can. What does it feel like?

Now imagine you had to go up some stairs breathing like that. This is what breathlessness can feel like.

The video below shows the steps described above so that carers can see what breathlessness might feel like.

What you can do to help the patient

Not all patients want help from carers when they are breathless. Some patients like to be given space to recover their breathing on their own. Other patients may benefit from the carer saying encouraging, reassuring things and reminding them of the following steps:

  • Pursed lip breathing is a useful way to help the patient focus on breathing out, creating space for the next breath in.
    Pursed lip breathing is easy to remember as:
    – Smell the rose (breathe in through the nose)
    – Flicker the flame of the candle (gently breathe out through pursed lips to flicker the flame).
  • The video clip below explains why breathing out is so important.
  • Using a handheld fan to cool the face can also help. See Ways to ease breathlessness for more information on using handheld fans.

It’s important to be aware that sometimes breathlessness can look worse to the carer than it feels for the patient.

  • Ask the patient to think back to a breathlessness episode and describe it to you. Then ask them to rate on a scale of 0-10 how breathlessness they felt (with 0 being “no breathlessness at all” and 10 being the “worst breathlessness”). Compare this with your experience of that same episode and how you would rate it. It may be that you each rated it differently, which often happens, and this can help you when agreeing what things work to manage breathlessness.

Some carers and patients find agreeing on some signals or hand signs helps to communicate what help the patient might need when they are out of breath and cannot speak.

Ways to ease breathlessness has a range of other useful ideas and advice too.

In the video below, Specialist Occupational Therapist, Julie Burkin, explains why carers should try to help the patient focus on breathing out when feeling breathless

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Page last reviewed: 08/05/2020