By Jessica Hamzelou
Deep breaths and forced coughs might help clear mucus but are unlikely to help people with a dry cough and mild cases of covid-19 – contrary to much advice circulating on social media.
Breathing exercises are an important part of managing some respiratory conditions, like chronic obstructive pulmonary disease. The main aims of such exercises are to clear the lungs of sticky mucus, co-ordinate your breathing with medication to deliver the optimal dose, and to keep the airways open, says Michael Niederman at Weill Cornell Medicine in New York.
These breathing exercises often involve taking deep breaths and coughing up sputum, and doctors may recommend devices that vibrate the airways to help with this. Could such techniques help those with covid-19?
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On the face of it, simple breathing exercises, such as those recommended by a UK doctor in a viral video shared widely on Twitter, make sense for people with covid-19, says Niederman. In the video, the doctor recommends taking a deep breath and holding your breath before releasing it. He suggests repeating this five times, before finishing a final round of breathing with a big cough.
The exercise is similar to others used in respiratory care, says Niederman. Deep breaths are generally a good idea, as they can encourage air into the depths of the lungs. If these pockets of the lung are not used, they can essentially close, and become at risk of infection, says Niederman. And deep breaths can increase the amount of oxygen getting into the body, and carbon dioxide leaving the body, adds Ema Swingwood, chair of the Association of Chartered Physiotherapists in Respiratory Care.
Dry coughs
But while deep breaths can be helpful, it’s generally not a good idea to inhale through your mouth while doing so, as the doctor in the video does. Sucking in a big gulp of air can irritate an existing dry cough. Breathing in through your nose is a better idea, says Swingwood. “The nose warms and moistens the air that you take in,” she says. “Breathing in dry air isn’t going to help you.”
A hard cough at the end of a breathing cycle would help clear out mucus, says Niederman. The problem is that most people who develop a cough with covid-19 have a dry cough, says Swingwood. For those people, hard coughs are unlikely to be helpful.
Advice on social media also recommends lying on your front once you have completed the breathing exercises. The idea is to take pressure off the lungs, which are located towards your back, behind the heart. In a hospital setting, turning a person over is thought to allow oxygen to reach other parts of the lungs.
“I do think that, if they are feeling a little short of breath, or oxygen levels are falling… I do recommend that people lie on their stomach,” says Niederman, although he cautions that this won’t be helpful for people with large bellies, including pregnant people.
But Swingwood isn’t convinced. The decision to turn hospitalised people over onto their fronts is only made after considering the person’s oxygen levels, heart rate, blood pressure, and breathing rate. And even then, doctors monitor how the person responds to the new position.
Monitor your symptoms
People who are managing more mild symptoms at home are unlikely to benefit at all, Swingwood says. “It’s more beneficial in sicker patients,” she says. “Lying on your front when you have covid at home probably won’t do anything.”
She also suggests some individuals with a shortness of breath, such as older people and those with underlying health disorders, might struggle to get in and out of the position.
Swingwood’s biggest concern is that people who are struggling to breathe attempt to manage their symptoms at home rather than seek medical help. “We want to make sure that people are reporting their symptoms and getting timely treatments,” she says.
“Keep hydrated,” advises Swingwood. “Monitor your symptoms and report them to a doctor – don’t try to self-manage with breathing exercises.”
Breathing exercises won’t stop people from getting covid-19, either. “I don’t think we know completely, but it’s unlikely to cause any extra benefit over going for a good old walk,” says Swingwood.
Personal hygiene and social distancing are much more likely to prevent a person from getting sick.
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