Aging often brings reduced lung capacity for many older adults, which can lead to respiratory-related conditions, such as chronic obstructive pulmonary disease (COPD), asthma and sleep apnea. The decrease in lung capacity also makes older adults vulnerable to serious complications from common respiratory illnesses such as bronchitis, pneumonia and, more recently, the COVID-19 virus.
This is why maintaining healthy lungs throughout our lifetimes is important. However, acute changes to mobility due to stroke, or even a particularly severe bout of pneumonia, can decrease lung capacity even in those with the best intentions. On top of that, natural, age-related changes decrease our lung capacity over time.
In fact, beginning at around age 35, we begin to see the following age-related changes to the respiratory system—changes that peak between 80 and 90 years of age:
- Bones reduce in size, and the rib cage loses mobility, leaving less room for your lungs to expand
- Muscles used for breathing, like the diaphragm, naturally weaken over time, decreasing the volume of air you’re able to exhale. The less air you exhale, the less room there is in your lungs for new oxygen. This leads to a buildup of carbon dioxide in your system, which leads to fatigue and shortness of breath.
- The portion of the brain that controls breathing may be impaired with age, and the nerves in your airway that trigger coughing may become desensitized, leaving your lungs vulnerable to harmful invaders such as germs. The coughing muscles may then weaken due to underuse.
So, in light of all of this, older adults need to increase and maintain their lung capacity, and thankfully several breathing exercises can help your loved one keep their lungs strong from the comfort of their own home.
Three breathing exercises to improve lung capacity and function
Respiratory experts recommend taking a moment to soften the shoulders, close the eyes, and relax before any breathing technique.
If your loved one starts to feel short of breath during an exercise (or any regular activity), remind them to follow these 3 steps (Stop, Reset, Continue):
- Stop the activity.
- Reset. Sit down. Relax the shoulders. Begin pursed-lips breathing to catch their breath.
- Once ready, resume the activity, but continue pursed-lips breathing as they go, slowing the pace if needed.
NOTE: As with all medical topics, we recommend you and your loved one talk to a doctor before starting any breathing exercise regimen to get instruction from a respiratory health care professional or physical therapist experienced in teaching breathing exercises.
Pursed-lips breathing
Pursed-lips breathing helps keep the airways open for longer, allowing more air to flow into and out of the lungs, thus increasing the chance for oxygen and carbon dioxide exchange, which lengthens the amount of time they can exercise. It also makes breathing easier in general, allowing the person to focus, slow their breathing, and stay calm.
The experts at the COPD Foundation recommend these four steps to practice pursed-lips breathing:
- Breathe in through the nose (as if smelling something) for about two seconds.
- Pucker the lips as if getting ready to blow out candles on a birthday cake.
- Breathe out very slowly through pursed lips, two to three times longer than you breathed in.
- Repeat.
Diaphragmatic breathing
The experts at the COPD Foundation also recommend diaphragmatic breathing. This technique is also called belly breathing or abdominal breathing because, when done correctly, the abdomen will rise during the inhale and lower during the exhale. The diaphragm is the main muscle that controls respiration, and age-related conditions (and aging in general) weaken this muscle over time. Belly breathing helps strengthen this muscle to take on the majority of the respiratory work, giving the neck, shoulders and back a break.
For first-timers, the COPD Foundation recommends trying this technique when your loved one is rested and relaxed, and practicing while seated or lying comfortably on their back:
- Place one hand on the abdomen. Place one hand on the upper chest.
- Focus on their breathing in their abdomen.
- As you breathe in, the hand on your abdomen should rise.
- As you breathe out, the hand on your abdomen should lower.
- Breathe in through the nose. Breathe out slowly through pursed lips.
They recommend practicing diaphragmatic breathing two to three times a day for five to 10 minutes, using a tiered approach: Your loved one should start by doing the technique while on their back, sitting and then standing. Then, have them try it while moving around doing an activity such as walking, showering, climbing stairs, or any daily activities.
An additional benefit of diaphragmatic breathing is stress and anxiety reduction. The vagus nerve, which passes through the diaphragm, is stimulated during diaphragmatic breathing. This activates the parasympathetic nervous system, which is our “rest-and-digest” part of our autonomic nervous system, the portion associated with decreased stress and anxiety.
Buteyko breathing for asthma
Scientists believe that the Buteyko breathing technique is especially helpful for those with asthma by normalizing carbon dioxide levels. In fact, some believe it can reverse or alleviate asthmatic symptoms. It also helps with anxiety or any condition where people tend to hyperventilate.
The Buteyko Breathing Association recommends hiring an instructor to teach you and your loved one the technique, and they recommend you practice 15-20 minutes three times a day for six weeks. Healthline provides the following helpful step-by-step guidance on its website. (As always, consult your loved one’s doctor before starting any breathing exercise regimen.)
Preparation
- Sit on the floor or on a chair.
- Elongate your spine to maintain an upright posture.
- Relax your respiration muscles.
- Breathe normally for a few minutes.
The Control Pause
- After a relaxed exhale, hold your breath.
- Use your index finger and thumb to plug your nose.
- Retain your breath until you feel the urge to breathe, which may include an involuntary movement of your diaphragm, and then inhale.
- Breathe normally for at least 10 seconds.
- Repeat several times.
The Maximum Pause
- After a relaxed exhale, hold your breath.
- Use your index finger and thumb to plug your nose.
- Retain your breath for as long as possible, which is usually twice the length of time of the Control Pause.
- Once you’ve reached the point of moderate discomfort, inhale.
- Breathe normally for at least 10 seconds.
- Repeat several times.
Buteyko breathing tips for beginners
- When practicing Buteyko breathing, always breathe in and out through your nose.
- If at any time you experience anxiety, shortness of breath, or intense discomfort, discontinue the practice and breathe normally.
- As you progress, you may be able to hold your breath for longer periods. Over time, you may be able to hold the Control Pause for one minute and the Maximum Pause for two minutes.