Why am I short of breath?

It is very common for people with a respiratory illness for example Covid, to feel breathless both during the acute phase of the illness and whilst recovering. Breathlessness can occur for lots of reasons but it can often make people feel scared, anxious or start to panic and may limit your daily activities.

What does breathlessness look like in everyday life?

Getting short of breath when walking up and down the stairs.

Finding it difficult to go for a walk, and keep having to stop to ‘catch’ your breath.

Feeling that breathing is really hard work and your shoulders are going up and down as you breathe.

You may find yourself getting tense and gripping things to help yourself feel less breathless.

You may feel like you have tightness in your chest.

What can I do to help get my breath at rest and during exercise?

It’s important to remember:

• We all get breathless with exercise that is challenging for us.
• Getting short of breath with exercise is normal (see Getting Moving Again).

There are a number of approaches you can use to help manage your breathlessness, including:

• Pace and planning your activities, try not to rush or do things rapidly. Try and conserve your energy and get a balance between activity and rest.
• Choose the best time of the day to do certain activities and plan ahead, thinking about what you might need to do the task. (see Fatigue)
• You may be able to break individual tasks down into smaller ones that are more manageable. It may be possible to spread the activities throughout the day or week and alternate lighter tasks with heavier ones.
• Take rests before, during and after completing a task, frequent short rest periods are better than a few longer ones. The practice of resting before you become tired/ exhausted is very effective in helping to conserve your energy.
• Do not overestimate what you can do. Try short bouts of exercise or tasks first and gradually build the frequency. It is easy to think you are fitter than you are and then overdo it.
• Do not stop doing the things that are making you feel breathless. This can make the problem worse because your muscles will get weaker from not being used so you will then feel more breathless.
• If you are using a walking aid, such as a stick or a frame, lean forward on it when you feel breathless. This can reduce the work of the upper body and help you recover your breath quicker.

Top Tip

• Try wiping a cool wet flannel on your nose and upper cheeks of your face as cooling the face especially around the nose, can often help reduce the feeling of breathlessness. Using a fan is not recommended during the Covid outbreak due to the risk of spreading infection.
• Be kind to yourself. You should expect to have some days that are better than, or worse than others. You will not always experience progress in a consistent manner. Do not compare today’s results to that of yesterday, or to how you were prior to your illness, or to other people.

Techniques to help control your breathing

• Using a breathing technique called Breathing control. This helps you to breathe gently with the least amount of effort and can help control your breathing whilst moving around and help recovery after activity.
• Practice whilst you are sitting down to master the technique;
  • Put one hand on your chest and the other on your abdomen.
  • Slowly breathe in and out through your nose, with your mouth closed. If this is too hard, breathe in through your nose and out through your mouth. If you’re relaxed, the air will reach low in your lungs. Your abdomen will move out against your hand. If your breathing is controlled, the hand on your chest will hardly move.
  • When you breathe out, your abdomen will fall gently. Imagine all the tension in your body leaving as you let the air out.
  • With every breath out, try to feel more relaxed and calm. Gradually try to breathe more slowly.

  When you are able to do this easily whilst sitting down, try and then use this technique when you are active.

• Relaxation, try to give yourself time to relax and rest. By being able to relax it can give you a sense of control over runaway feelings or symptoms such as breathlessness. Other relaxation techniques are discussed in the Fatigue section.
• Breathing rectangle technique can help control your breathing and also help you to relax. This should be done in a seated, upright comfortable position, resting your hands in your lap. Look around for a rectangle e.g. a door, window, picture or book. Now follow the sides of the rectangle with your eyes as you breathe following the diagram below, gradually slow the speed that your eyes move round the triangle, pausing at the corners to slow your breathing.

  

If I get really breathless with everyday activities what can I do straightaway?

• Choose a position to reduce breathlessness, this is important to reduce your work of breathing and effort (see pictures below).
• Try and support your arms rather than grip or tense them.
• When you feel breathless, try to stay calm, stop, drop your shoulders and try to use the breathing control technique above. When walking, sometimes putting your hands in your pockets, tucking your thumbs into your belt loop or resting your hands on your handbag can help keep your shoulders from tensing and rising up.