Shortness of breath

Shortness of breath is common in people with advanced disease. Shortness of breath or breathlessness is when you are having a hard time breathing or feel like you cannot get enough air.

Feeling like you cannot breathe can be very upsetting and can make you feel worried which can make your symptoms worse. Remember that you know best how your breathing feels and you may not look like you’re short of breath, but that doesn’t mean that you don’t feel short of breath.

Shortness of breath may come on with activities such as walking or climbing stairs. Sometimes it seems like it comes on for no reason at all. Some causes of shortness of breath include:

  • Chronic conditions: Some chronic conditions such as lung disease, lung cancer, heart failure or kidney disease can cause extra fluid buildup in the body or lungs.
  • Treatments: Like chemotherapy.
  • Other symptoms/conditions: Like anxiety, low iron levels or a sudden lung problem like an infection (e.g. pneumonia).

Managing shortness of breath works best when you play an active role:

  • Try to figure out if there is a cause for your shortness of breath.
  • Is it better or worse at different times?
  • What helps or makes it worse?

You may want to use a symptom diary to record information about your constipation. Tracking this information will help you talk to healthcare team about your shortness of breath.

Physical steps you can try:

  • Medication: If you take medication for your breathing, take it as prescribed so your symptom doesn’t get too bad. Try taking it before an activity that makes you feel short of breath.
  • Taking ‘water pills’: Too much fluid in your body can lead to shortness of breath. If you are prescribed a “water pill” to remove fluid, be sure that you are taking it.
  • Pace yourself: Break larger jobs into small jobs or save the harder jobs for when you feel less short of breath.
  • If you feel winded, stop and rest: Wait until your breathing goes back to how it was when you started. Then, start the activity again, if you can. Use a walking aid if that helps.
  • Wear loose clothing: Clothing that is tight around your neck or waist can make shortness of breath worse.
  • Sit and sleep more upright: Using pillows to support your back may help. Sleeping in a recliner may help.
  • Small handheld fan: Try using a small fan to blow air gently across your face. Sit near to an open window and keep the air around you humidified and not dry, if possible.
  • ‘Pursed lip’ breathing: Ask your healthcare team to show you. If it doesn’t feel natural or it doesn’t help, don’t do it.
  • Follow a low-salt diet: Salt affects the amount of fluid in your body. If you need more help with this, you could ask to speak with a dietitian.

Mental activities you can try:

  • Think positively: Positive thinking may ease shortness of breath.
  • Distract yourself: Do something that you enjoy to try and keep yourself mentally busy. For example, crossword puzzles, Sudoku, needlework or video games.
  • Relax: Try meditation, mindfulness or relaxation therapy. Learning to relax and to change the way you think may help you cope with your shortness of breath.

Relaxation techniques you can try at home:

Ask if someone on your healthcare team can help you get started. You can also learn some on your own. Some techniques include:

  • Progressive muscle relaxation: Focus on slowly tensing and then relaxing each muscle group.
  • Deep breathing exercises: Slow your breathing to the point where you are as relaxed in your breathing as possible. Breaths should be deep and fill your lungs.
  • Meditation: Sit or lie in a comfortable position for 20 minutes. Be aware of your breathing, your sensations (including your pain), your thoughts and feelings.
  • Guided Imagery: Form mental images to take a visual journey to a peaceful, calming place or situation.
  • Yoga: Can relax your breathing, ease muscle tension, and energize your mind and body.
  • Hydrotherapy: It uses flowing water to relax muscles.
  • Music and art therapy: Listening, playing music, drawing and painting can help you to relax.

Speak with your healthcare team if shortness of breath is a problem for you. Your worries and questions are important to you and them. Your healthcare team may speak to you about the different medications you can take.

  • Let your healthcare team know if a medication is working for you or if you’re having side effects. You may have to try a few different ones to know what works best for you. If you have homecare, they may be able to help you with your shortness of breath at home.
  • Talk to them before taking over-the-counter medication, including vitamins and herbal remedies.

Tips on sharing your symptoms with your healthcare team:

  • Make some notes about your shortness of breath symptoms and tell your healthcare team about them.
  • Has there been a change in your shortness of breath?
  • What does your shortness of breath feel like? How bad is it?
  • When does it happen and how long does it last?
  • What makes it better or worse? What have you tried already?
  • Make a list of all the medications you are taking including over the counter medications.

Sometimes when you’re very short of breath, it can feel like an emergency. Plan ahead and have a list of who you can phone and what medication (including oxygen) you can take to help your breathing.

If you have a diagnosis of COPD and have a COPD Action Plan, please refer to your Action Plan if your symptoms are getting worse.