Shortness of Breath and Cough
Difficulty breathing or breathlessness, sometimes called dyspnoea, can be a frightening and debilitating symptom but it can often be improved with treatment. It is important to discuss any feelings of breathlessness with your doctor.
Pain can reduce your ability to take deep breaths and to cough. As a result, secretions may gather in your chest and this can increase your breathlessness. Good pain control is helpful in managing breathlessness.
For more information on Shortness of Breath or Cough, please see the list of topics below.
Medicines for breathlessness
The painkiller morphine can be used to treat breathlessness. It can be taken in tablet or liquid form, or by injection under the skin. Drugs that help you relax can also help relieve the anxiety and panic that breathlessness can cause. If swallowing medicines is difficult, painkillers, sedatives and other drugs can be given by constant infusion under the skin using a syringe driver. Drugs called bronchodilators widen the air passages, increasing airflow. These can be given as tablets or as a fine spray with an inhaler. They can also be given through a mask called a nebuliser.
This is where oxygen is given using a face mask, or through small tubes that sit under the nostrils. Using a fan or sitting by an open window may give you the same benefit. Oxygen therapy is only suitable for some people and your doctor will let you know if it is right for you; if you need oxygen at home they can arrange this for you.
Tips for managing breathlessness
- Sit down to carry out everyday tasks like washing, dressing and preparing food.
- Cool air blowing directly onto or across your face can help you breathe more easily. Try sitting by an open window or using a small handheld fan.
- Arrange your kitchen with frequently used items stored at waist-height, rather than having to bend or stretch to reach cupboards and shelves.
- Wear loose-fitting clothes, especially around your waist and chest. Sit down when dressing and bring your feet up to put on socks, tights and shoes, as bending can make you breathless. Slip-on shoes are easier to get on and off than shoes with laces.
- Using a telephone extension cord or a cordless or mobile phone, will mean that you don’t have to rush to answer a call.
- A baby monitor is a good way of talking to someone in another room without having to shout or get up, especially at night.
- Concentrate on your OUT breath – slow sighs. This is more helpful and effective than emphasising taking breaths in and easier to do
Controlled breathing and relaxation
Breathlessness can cause you to breathe with your upper chest and shoulders in a rapid and shallow way. This can use up a lot of energy and tire you out. Learning a technique called controlled breathing can help you to relax and breathe gently and more effectively using your lower chest and tummy muscles. A physiotherapist or specialist nurse can teach you these techniques. Being breathless can cause you to feel anxious, frustrated and panicky. These emotions can cause rapid, shallow breathing, which can make you even more breathless. Understanding your emotional responses to breathlessness and learning to control them can help you manage your condition. Relaxation techniques can help you control anxiety and improve breathlessness.
Coughing can be helpful because it helps to clear our airways, but it can also be uncomfortable, embarrassing and affect our ability to sleep, rest and eat. If you’re coughing up green or dark yellow phlegm (sputum), you may have an infection and need to take antibiotics. Some people need physiotherapy to help them clear their airways. Sometimes steam inhalations or saline given as a fine spray through a nebuliser are helpful. If you have a dry irritable cough, your doctor may prescribe a cough mixture to help. If your cough is persistent then painkillers like codeine or morphine can be helpful.
Occasionally people cough up blood. It’s important to let your doctor know if this happens or if the symptom gets worse. It can be caused by a chest infection, by a blood clot in the lung, by bleeding from small blood vessels in the lungs or from a tumour in the lungs. The treatment will depend on the cause, so you may need tests to find out what that is. Antibiotics can help treat a chest infection, or your doctor may prescribe a drug called tranexamic acid, which encourages blood to clot and reduces bleeding. Radiotherapy can often be helpful when the cause is a tumour in the lung.
When to call for help
- If there are signs of an infection present (e.g. high temperature, sweating, dirty sputum). Call your GP as you may need antibiotics.
- If the breathlessness persists and you are concerned, then seek help.