COPD GUIDE

Shortness of Breath in COPD: Why Does It Happen and How Can It Be Eased?

Prof. Dr. Yalçın Karakoca · Last updated: 25 September 2026

SHORT ANSWER

There are two main causes of shortness of breath in COPD. Air cannot get out of the narrowed airways well enough. And the air that builds up in the lungs leaves no room for a new breath. For immediate relief, pursed-lip breathing and sitting leaning forward help. A reliever inhaler also helps. For lasting relief, regular medication, exercise and stopping smoking are important. Using oxygen if needed and reducing anxiety are also important. If shortness of breath persists despite medication, the type of disease is assessed. Depending on this, balloon treatment or a lung valve is considered.

What causes shortness of breath?

Narrowing of the airways: A thickened airway wall and mucus slow down breathing out.
Air building up in the lungs: Air that cannot be breathed out stays inside. The diaphragm flattens, and more effort is needed to breathe in. The more you exert yourself, the more air builds up. This is why you get out of breath on the stairs.
Impaired oxygen transfer: In emphysema, oxygen cannot pass into the blood well enough.
Muscle weakness and loss of fitness: Inactivity weakens the muscles. Weakened muscles in turn increase shortness of breath.
Anxiety and panic: Fear of breathlessness speeds up breathing and makes the breathlessness worse.
Other causes: Heart failure or anaemia can also cause shortness of breath. A blood clot in the blood vessels of the lungs or pneumonia can also lead to it. If your shortness of breath has suddenly got worse, be sure to see a doctor.

Methods that bring immediate relief

Pursed-lip breathing: Breathe in through your nose for 2 seconds. Then purse your lips as if you were going to whistle and breathe out slowly over 4 seconds. This helps to empty the air that has built up in the lungs.
Sitting leaning forward: Rest your elbows on your knees or on a table. This relaxes your breathing muscles.
Reliever inhaler: This is your prescribed short-acting medicine. When used with the correct technique, it works within minutes.
Cool air: Direct a fan towards your face. Cool air reduces the feeling of breathlessness.
Using your energy sparingly: Doing tasks sitting down, taking frequent breaks, avoiding heavy meals.

If you cannot speak, your lips are turning blue or you are becoming confused, call 112 immediately.

For lasting relief

Method	Benefit
The right inhaler, used correctly	Reduces the air built up in the lungs and increases exercise capacity
Pulmonary rehabilitation	The most effective non-drug method for reducing shortness of breath and anxiety
Stopping smoking	Slows the progression of the disease and reduces cough and phlegm
Oxygen (in patients who need it)	In patients with a low blood oxygen level at rest, it prolongs life and increases exercise capacity
Weight and nutrition	Excess weight increases shortness of breath; being very underweight also weakens the muscles
Vaccines and a flare-up plan	Help to prevent permanent worsening after a flare-up
Coping with anxiety	Breaks the vicious circle between shortness of breath and panic

If shortness of breath persists despite medication

First, correct and regular use of the inhaler is reviewed. Coexisting conditions and the exercise programme are also looked at. Then the type of disease is assessed. If phlegm and airway narrowing predominate, balloon treatment is considered. If emphysema and air building up in the lungs predominate, a lung valve is considered. Suitability is determined with a chest CT scan and a breathing test.

PRELIMINARY ASSESSMENT

Is it suitable for you?

Book an appointment and bring your breathing test and chest CT scan reports. We decide together at the consultation. If you are coming from outside Istanbul, an online preliminary consultation can be held first.

Please bring: your breathing test, your chest CT scan report and images (CD/USB), your list of medicines and, if you have one, your blood gas test result.

HAVE A QUESTION?

Frequently asked questions

The questions our patients and their relatives ask most often, with answers. We discuss questions about your own situation together at the consultation.

What should I do to open up my airways?

First of all, treatments that open the narrowed bronchi are needed. The first step is regular treatment with medicines (inhalers). If shortness of breath persists despite medication, balloon bronchoplasty is considered in suitable patients. Depending on the state of the emphysema, valve treatment is also considered. When you are short of breath, three things bring immediate relief. These are pursed-lip breathing, sitting leaning forward and the reliever inhaler.

How do you get rid of shortness of breath in COPD?

It may not go away completely, but with the right treatment it can be markedly reduced. In selected patients whose symptoms persist despite medication, other options may also be considered. Balloon treatment or a lung valve are examples of these.

Is blowing up balloons good for COPD?

Blowing up balloons can exercise the breathing muscles. But it has nothing to do with “COPD balloon treatment”. Balloon treatment is a procedure carried out in hospital. It is done through the mouth, using a tube with a camera at its tip (bronchoscope).

What should a person do when they are short of breath?

They should stay calm, sit down, do pursed-lip breathing and use their medicine. If there is no improvement, they should go to the emergency department.

What should a COPD patient be careful about?

They should protect themselves from cigarette smoke, polluted air and infections. They should use their medicines regularly, exercise and have their vaccinations. It is also important to prepare a flare-up plan with their doctor.

APPOINTMENT

Book an appointment for a preliminary assessment

To find out whether you are suitable, book a preliminary assessment appointment. Bring your breathing test, chest CT scan report and list of medicines with you.

info@yalcinkarakoca.com · Rüzgarlıbahçe Mah. Cumhuriyet Cad. Hasoğlu Plaza Kat:3, Kavacık / Beykoz, İstanbul

REFERENCES

International COPD guideline (GOLD 2026 report); Turkish Thoracic Society COPD Diagnosis and Treatment Consensus Report.

This page is for general information purposes. It does not replace a medical examination or diagnosis. Treatment decisions are made during an examination, on an individual basis. In an emergency, call 112.

Medical content review: Prof. Dr. Yalçın Karakoca, Pulmonologist · Last updated: 25 September 2026

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