Pucker for a better breathing: Pursed Lip Breathing
Posted Sep 29 2008 4:09pm
Patients with advanced COPD look for a more complete exhalation leading to more room for breathing. That’s the reason why they breath out slowly and their lips pursed. This technique, naturally adopted by advanced COPD patients, can also be adopted by less severe COPD patients to take more of the benefits of better breathing.
The cause for Pursed Lip Breathing
When the lung airways are obstructed due to brochoconstriction (contraction of smooth muscles bands wrapping the airway), the air is trapped inside the lungs and leads to less area for exchange of oxygen to the blood. As a result patients require more time to exhale that trapped air; making lung areas available for gas exchange.
Extending the airway and keeping it open
What represents the patient’s intention to pucker their lips is the extension of the airway at the mouth level. Now the air has more way to run and this requires time, prolonging the exhalation. It also maintain the airways open during more time. The sensation for the patient is more comfortable than shortening the airway.
Pursed Lip Breathing in the Healthy
The interesting issue of this natural defense against air trapping is that healthy people do it when exhausted or during exercise workouts. It allows a better timing for using the benefit of breathing.
It has been recommended to practice the technique at least 5 minutes every day to become familiar with it. It doesn’t have to be preceded by a deep-deep breath in but by a normal inspiration. It may be practiced early morning or before going to bed (also making of it a moment of relaxation and/or meditation).
What to do?
Seated or in standing position, the patient should look ahead and relax the neck. This is followed by a normal inspiration (breath in) through the nose (closed mouth). Pucker the lips and start the breath out (through the mouth) as if the intention was to whistle. Take your time until you feel you don’t need to exhale more room. Start again. Remember: no deep breath or it may lead to dizziness.
COPD patients have the feeling of wellness after practicing the “pursed lip breathing” technique. That’s what we all are looking for. Our patients require some time to be instructed about the benefits of this breathing technique (it’s not a pure breathing exercise). It helps patient and put into practice principles of physics and physiology in the lung ventilation. Talking to patients about it may make a huge difference in the office conversation also.