Hey guys.
This week's update comes straight from a conversation with one of you.
I recently received a thoughtful message from a follower living with chronic obstructive pulmonary disease,
Alongside some significant heart challenges.
She was keen to discuss breathwork as an adjunct to help manage her condition.
Her openness and the care she clearly takes in listening to her own body prompted me to put together a few thoughts that I hope will help others in a similar position.
First,
The most important thing.
.
.
Nothing I share here is a replacement for your respiratory doctors or specialists.
Your medical team,
Your prescribed medications,
Your pulmonary rehab,
Those come first,
Always.
What I offer sits alongside that care as a bonus,
A set of simple gentle tools that can help COPD patients feel a little more in control of their breathing day to day.
Think of it as an adjunct,
Never a substitute.
With that said,
Here's what the work and the research points to.
Breathe through the nose wherever possible.
For someone with COPD,
This matters more than most people realise.
The nose warms,
Humidifies and filters air before it reaches the lungs,
So you take in cleaner,
Gentler air.
Mouth breathing,
By contrast,
Sends cold,
Dry,
Unfiltered air straight down,
Which tends to increase irritation in airways that are already working hard.
Nitric oxide,
The nose's hidden bonus.
As you breathe in through the nose,
The nasal passages and sinuses release nitric oxide,
A gas that helps open the airways.
You don't get this through the mouth,
So nasal breathing effectively carries it down towards the lungs,
A small,
Free advantage available with every breath.
Let the exhale lead and lengthen.
For COPD patients,
The hard part is usually getting air out,
Not in.
A gentle rhythm of a shorter inhale and a longer,
Relaxed exhale,
Often around 1 to 2 ratio,
Roughly 2 seconds in,
4 seconds out,
Helps more stale air release before the next breath.
This is the essence of pursed lip breathing,
One of the most consistently recommended techniques in COPD care.
Keep it light and unforced.
The whole approach is calm,
Quiet,
Low effort breathing.
Never straining,
Gasping or forcing big breaths.
If anything ever brings on breathlessness or dizziness,
That's the signal to soften or stop,
Not to push through.
What the research says.
For those who like the evidence,
A large 2024 systemic review in the European Respiratory Review found that breathing techniques probably improve breathlessness in people with COPD and consistently improved quality of life with pursed lip and diaphragmatic breathing having the most evidence behind them.
A 2019 COPD trial comparing Bottego breathing with purslip breathing found both effective.
With measurable improvements in lung function tests and other studies have shown pursed lip breathing can improve exercise tolerance and oxygen levels during activity.
To the follower who reached out.
Thank you for trusting me with your story.
And for the reminder that the best of this work happens in conversation.
To everyone else navigating COPD,
Please keep your specialists at the centre and treat these gentle practices as a helpful bonus that sits alongside their care.
See you next week.
