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MOD198 – Pursed Lip Breathing
Definition
Pursed Lip Breathing is a simple, yet effective breathing technique that involves inhaling slowly through the nose and exhaling in a controlled manner through pursed lips. It is designed to improve breathing efficiency, reduce shortness of breath, and enhance overall respiratory control, particularly beneficial for individuals with chronic obstructive pulmonary disease (COPD) and other respiratory conditions.
Explanation
Pursed Lip Breathing consists of:
- Relaxing the neck and shoulder muscles
- Inhaling slowly through the nose for about 2 seconds, allowing the belly to expand
- Pursing the lips as if about to whistle or gently blow out a candle
- Exhaling slowly and gently through the pursed lips for 4-6 seconds, ideally twice as long as the inhalation
- Repeating the process several times
This technique helps keep airways open longer, slows down the breathing rate, improves the exchange of oxygen and carbon dioxide in the lungs, and can provide a sense of control over breathing. It’s particularly useful during activities that might cause shortness of breath and can be practiced regularly to become second nature when needed.
Evidence to Efficacy
There is evidence from small-scale studies demonstrating the efficacy of Pursed Lip Breathing (PLB). They have shown its benefits to be:
Improved Gas Exchange and Reduced Dyspnoea: A study published in the journal Physiotherapy, conducted in London, UK, found that COPD patients who were taught PLB continued to use it long-term with positive effects. Nine out of 13 participants reported ongoing use of PLB, with eight reporting definite benefits. The study observed that PLB technique continued to reduce respiratory rate and increase oxygen saturation (SpO2) in these patients.
Enhanced Lung Function and COPD Management: The same UK study found that PLB helped patients manage their breathlessness during physical activity, with eight out of nine ongoing users reporting this benefit. Additionally, four out of nine users reported increased confidence and reduced panic when using PLB.
Stress Reduction: The study also revealed a novel finding that some patients (3 out of 9) used PLB at night, suggesting potential benefits for sleep and relaxation.
Long-term Efficacy: Importantly, this UK-based research demonstrated that the benefits of PLB persisted long-term, with patients reporting continued use and effectiveness 6 to 24 months after being taught the technique
Improved Quality of Life: While not specific to the UK, a broader review of PLB techniques indicates that it can help improve ventilation by moving old air (carbon dioxide) trapped in the lungs out and making room for fresh oxygen. This can lead to significant improvements in the quality of life for people with chronic lung conditions[3].
Physiological Benefits: Research has shown that PLB can help keep airways open longer, decreasing the work of breathing. It also improves ventilation and can relieve shortness of breath by slowing the breath rate.
These studies provide strong evidence for the efficacy of Pursed Lip Breathing, particularly for individuals with chronic obstructive pulmonary disease (COPD) and other respiratory conditions. The UK-based research is especially valuable as it demonstrates long-term benefits and patient adherence to the technique.
Neuroscience and Physiology
Pursed Lip Breathing optimises the physical mechanics of breathing by deliberately prolonging the exhalation phase through tightly pursed lips. This technique creates a gentle back pressure in the airways, known as positive expiratory pressure, which keeps small airways open longer and prevents their premature collapse. This enhanced airway patency improves the exchange of oxygen and carbon dioxide in the lungs, increasing overall breathing efficiency and reducing the energy needed for respiration.
From a neurological perspective, the slow, controlled exhalation activates the parasympathetic branch of the autonomic nervous system, often called the ‘rest and digest’ system. This activation promotes a calming effect on the body by lowering heart rate, reducing blood pressure, and decreasing levels of stress hormones such as cortisol. The rhythmic breathing pattern cultivates a state of relaxed alertness, improving the brain’s capacity to regulate stress and emotional responses.
Chemically, by extending the exhalation, PLB facilitates the effective removal of carbon dioxide, helping to maintain optimal blood pH and prevent respiratory acidosis—a condition where excess carbon dioxide causes the blood to become too acidic. Efficient carbon dioxide clearance supports oxygen delivery to tissues and optimises metabolic function, which is essential for overall cellular health and vitality.
Physiologically, PLB encourages proper engagement of the diaphragm—the large, dome-shaped muscle at the base of the lungs—while reducing reliance on accessory muscles in the neck and shoulders. This shift improves respiratory muscle strength and endurance, decreases fatigue, and supports better posture and body mechanics during breathing. Furthermore, PLB enhances proprioceptive awareness of the breath, helping individuals to consciously regulate their breathing patterns and respond more effectively to physical or emotional challenges.
On a subtle energetic level, Pursed Lip Breathing aligns with principles recognised in emerging fields such as quantum biology and energy medicine. The breath serves as a bridge between the physical body and subtle energy systems, influencing the flow of life force or ‘prana.’ This conscious modulation of breath can harmonise the body’s energetic field, facilitating greater mind-body coherence and promoting holistic wellbeing. While quantum physics is still exploring the precise mechanisms behind this interplay, the breath’s capacity to shift consciousness and energy is widely acknowledged across ancient and modern healing traditions.
Together, these respiratory, neurological, chemical, physiological, and energetic aspects make Pursed Lip Breathing a highly effective, accessible technique for improving lung function, enhancing relaxation, and supporting overall health.
Governing Body
There is no specific governing body for Pursed Lip Breathing. However, it’s widely recognized and taught by respiratory therapists, physiotherapists, and organizations like the American Lung Association.
What Good Looks Like
Good Pursed Lip Breathing feels controlled and deliberate, allowing you to maximise oxygen exchange while reducing the effort of breathing. You can expect:
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You inhale gently and quietly through your nose, filling your lungs fully without tension or haste.
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You exhale slowly and steadily through tightly pursed lips, like gently blowing out a candle, which creates a slight resistance that keeps your airways open longer.
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You notice a marked reduction in breathlessness as this technique helps regulate airflow and improves carbon dioxide release.
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You experience a calming effect on your nervous system, as the slow exhalation encourages relaxation and decreases respiratory muscle fatigue.
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You maintain a relaxed posture throughout, avoiding unnecessary chest and shoulder tension, allowing the diaphragm to work more efficiently.
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You find the rhythm easy to follow, enabling you to use the technique during daily activities or episodes of breathlessness to regain control and composure.
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You receive clear cues on timing — typically, exhaling should last about twice as long as inhaling — ensuring optimal breathing efficiency.
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You develop an increased awareness of your breath’s quality and rhythm, helping you anticipate and manage symptoms of respiratory distress.
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You are guided with practical feedback to embed this technique naturally into your breathing habits, enhancing your overall respiratory health.
Good Pursed Lip Breathing is a straightforward but powerful tool that improves your breathing control and efficiency. It supports lung function and eases symptoms associated with respiratory challenges, empowering you to breathe easier and maintain calm even in difficult moments.
What to Ask a Practitioner
For Pursed Lip Breathing (PLB), a specific practitioner is not always necessary, as it’s a technique that can be self-taught.
If you wish to seek guidance from a practitioner, here are some questions to ask:
How do you typically teach Pursed Lip Breathing to patients?
Desired answer: A clear, step-by-step explanation of the technique, including proper posture and breathing rhythm.
What specific conditions do you use Pursed Lip Breathing for in your practice?
Desired answer: Mention of conditions like COPD, asthma, or other respiratory disorders.
Can you describe how you would progress a patient from learning PLB at rest to using it during activities?
Desired answer: A gradual, structured approach to incorporating PLB into daily life.
What potential challenges might I face when learning Pursed Lip Breathing, and how would you address them?
Desired answer: Awareness of common issues like dizziness or difficulty maintaining the technique, with specific strategies to overcome them.
Self Study Resources
British Lung Foundation: Offers guidance on breathing techniques, including PLB.
Asthma UK: Offers resources on breathing exercises for asthma management.
European Lung Foundation: Provides patient-friendly information on various breathing techniques.
These resources can provide valuable information on PLB technique, its benefits, and how to incorporate it into daily life. However, for individuals with severe respiratory conditions, it’s advisable to consult with a respiratory therapist or physiotherapist before starting any new breathing technique.
Related Therapies
Diaphragmatic Breathing (MOD195): A deep breathing technique focusing on engaging the diaphragm.
Box Breathing (MOD194): A technique involving equal counts for inhaling, holding, exhaling, and holding again.
Yoga Breathing (Pranayama)(MOD190): Various yogic breathing techniques for controlling the breath.
Conscious Connected Breath (MOD192): A transformative breathwork practice using continuous, connected breathing to promote emotional release, increased awareness, and holistic healing.
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