What Is Pursed Lip Breathing?

Did you know breathing out can relax you faster than breathing in and help you combat stress?

Read on to learn about the mechanism of controlled exhalation technique, ways to perform it and its importance.

Pursed lip breathing?

Pursed Lip Breathing is a type of breathing exercise which involves a deep inhalation through the nose and exhaling slowly through pursed lips. This method improves breathing efficiency and manages respiratory conditions like COPD, asthma, etc. The exhalation phase is prolonged than inhalation as it helps to keep the airways open and facilitates better gaseous exchange reducing shortness of breath. The controlled exhalation decreases the work of breathing and promotes relaxation.

Importance of breathing techniques

Breathing techniques promote physical and mental well-being by harnessing the power of conscious breathing. Breathing techniques can help:

• Manage stress and anxiety
• Reduces the heart rate
• Facilitates better oxygen intake and calms the mind
• Improve overall respiratory function

These techniques can be easily incorporated into daily routines as self-care practices for a healthier and more balanced lifestyle.

Overview of the respiratory system

The vital components such as the oesophagus, ribs, nose, pharynx, larynx, bronchi, trachea, lungs, sinuses, diaphragm, and epiglottis contribute to the respiratory system for a smooth breathing process.

The process of breathing facilitates gaseous exchange between oxygen and carbon dioxide. The oxygen moves into the lungs and moves through the organs and tissues.

When you inhale, the diaphragm (important muscle for respiration) contracts and moves downwards creating a negative intrathoracic pressure allowing the air to enter the lungs. This inhaled oxygen gets absorbed into the bloodstream through alveoli (tiny air sacs) present in the lungs removing carbon dioxide¹ during exhalation.

With the exhalation, your diaphragm relaxes and the chest cavity gets smaller just like how air releases from a balloon.² Breathing is an involuntary process and requires no effort but it can be a tedious task in respiratory conditions.

Normal breathing vs. abnormal breathing

Normal breathing is the involuntary, effortless, rhythmic pattern of inspiratory expansion and expiratory contraction where the body receives an adequate supply of oxygen releasing carbon dioxide and maintaining a steady acid-base status.  Normal breathing has a relatively constant inspiratory volume that constitutes the normal respiratory rhythm.³

Abnormal breathing refers to irregular breathing rhythms where the normal respiratory rate (15-20 rpm) is altered and the person uses his accessory respiratory muscles like sternocleidomastoid, scalene and intercostals. Abnormal breathing patterns can be due to underlying health issues like respiratory disorders, neurological conditions, anxiety, etc.

Abnormal respiration patterns include:

• Dyspnea
• Paroxysmal nocturnal dyspnea
• Orthopnea 
• Cheyne-Stokes- a crescendo-decrescendo respiratory pattern followed by a period of apnea. Bradypnea.
• Tachypnea
• Hyperpnea in increased volume with or without an increased rate of breathing. Blood gases are normal.
• Agonal breathing- slow, shallow respirations that result from anoxic brain injury. 
• Apnea is the absence of breathing and a life-threatening situation.
• Hyperventilation and Hypoventilation.⁴

Benefits of pursed lip breathing

Improved Oxygenation⁵ Pursed lip Breathing improves oxygenation by facilitating an efficient gaseous exchange in the lungs. The expiratory phase is prolonged compared to the inspiratory phase in exhalation, causing a back pressure called PEEP (Positive End Expiratory Pressure). PEEP decreases the work of breathing by increasing surface area and recruiting more alveoli to participate in the exchange of gases.

Reduced Shortness of Breath: Pursed lip Breathing reduces shortness of breath by opening the airways and releasing carbon dioxide. Prolonging exhalation through pursed lips prevents the collapse of the small air sacs in the lungs and reduces the work of breathing in respiratory conditions such as COPD, asthma, pulmonary fibrosis, etc.

Pursed lip breathing enhances respiratory endurance and promotes relaxation and stress reduction.

When should you practice pursed lip breathing?

Pursed lip breathing is one of the chest exercises given during chest physiotherapy to patients suffering from obstructive lung conditions such as:

Chronic Obstructive Pulmonary Disease (COPD): COPD restricts airflow, causing the building up of CO2 inside the lungs. Pursed lip breathing can improve oxygenation and help in releasing the trapped CO2.⁶

Anxiety and Stress: Practicing this exercise during stress or anxiety can calm your mind and provide good relaxation to your body.

Asthma: Pursed Lip Breathing exercises during asthma attacks promote better airway function and decrease the intensity of breathing difficulties one faces.

Bronchiectasis: this is also an obstructive lung disorder where the airways that carry air get damaged. Expiratory exercises along with airway and mucus clearance.⁷

Physical Exertion and panic attacks: Pursed Lip Breathing during high-intensity physical exercises can enhance endurance and prevent symptoms like chest pain, breathlessness, etc. This breathing exercise can turn into a more controllable breathing pattern during panic attacks.

Incorporating Pursed Lip Breathing, you can effectively manage various respiratory conditions and reduce breathing discomfort by promoting a greater sense of well-being and improved overall respiratory function.

How to perform pursed-lip breathing?

• Sit in a comfortable position.
• Inhale gently through your nose (don’t take large deep breathes)
• Exhale through your mouth and maintain a pursed lip like you are about to whistle or pout.
• Repeat this 8-10 times in 1 set.
• Suppose you are unable to perform this set of pursed lip breathing. You can blow any sheet of paper that will help you get started. Hold a sheet of paper in one of your hands, inhale gently and gradually blow the paper.

Other Breathing Techniques include Diaphragmatic breathing, deep breathing exercises, stacked inspiration, spirometers, etc.

Summary

To conclude, pursed lip breathing is a breathing technique that can benefit people with respiratory conditions, such as COPD, pulmonary fibrosis, asthma, and other lung conditions. By implementing this simple yet effective breathing exercise, an individual can enhance his respiratory efficiency, reduce shortness of breath, and promote a sense of relaxation, thereby improving overall well-being.

Pursed lip breathing can encourage individuals to take control of their breathing patterns, make it more rhythmic and thereby improve their quality of life, allowing them to perform daily activities with greater ease and comfort. Incorporating pursed lip breathing along with other chest exercises can contribute to better symptom management and an improved overall outlook for individuals living with chronic respiratory disorders.