If you have pulmonary fibrosis, you may experience breathing difficulty from an inability to fully expand the lungs and fill them with air due to scar tissue buildup. However, there are breathing techniques that can strengthen certain muscles to help reduce breathlessness and related anxiety and fatigue.

The diaphragm and belly breathing

Belly, or diaphragmatic, breathing can be an effective tool for helping you live better with chronic lung disease.

A patient article by the Cleveland Clinic explains that the diaphragm is a large, dome-shaped muscle just beneath the lungs and is the most efficient breathing muscle. In lung diseases like pulmonary fibrosis and chronic obstructive pulmonary disorder (COPD), the diaphragm can become weakened.*

Belly breathing is meant to correctly utilize the diaphragm during breathing and make it stronger, which can allow for:

• less breathing effort,
• reduced breathing rate,
• decreased oxygen need, and
• greater energy.

Belly breathing while lying down

Positioning:

• Lie face-up in bed or on another flat surface with knees bent
• Support your head and (if desired) knees, as with pillows
• To feel the diaphragm during breathing, put one hand at the top of your chest and the other just below the ribs

Performance:

• Slowly inhale through your nose with the stomach expanding outward against your hand
• Slowly exhale through pursed lips (see pursed lips breathing) as you tighten your abdominal muscles and let your stomach go back down
• Keep the hand on your chest as still as possible throughout the exercise
• Focus on feeling the belly move in and out 

Belly breathing while sitting

As you become more proficient at belly breathing, you can advance to a seated position.

Positioning:

• Sit comfortably in a chair with relaxed head, neck, and shoulders

Performance (same as lying):

• Slowly inhale through your nose with the stomach expanding outward against your hand
• Slowly exhale through pursed lips as you tighten your abdominal muscles and let your stomach go back down
• Keep the hand on your chest as still as possible throughout the exercise
• Focus on feeling the belly move in and out 

Practice makes perfect

Cleveland Clinic advises beginners to practice belly breathing exercise for 5-10 minutes 3-4 times a day. As with any exercise, you can increase the duration and intensity to keep getting stronger:

• You can gradually increase the time spent belly breathing.
• Once at 10 minutes 3-4 times per day (lying down), you can increase the difficulty of the exercise by placing a progressively larger book on your belly.

You may become tired while doing the exercise, as it requires some effort to perform correctly, but readers are encouraged to “keep at it.” Performed properly and consistently, belly breathing will become easier and automatic, helping you breathe deeper and feel more relaxed.

*Cleveland Clinic. (2018, September 14). Diaphragmatic breathing. https://my.clevelandclinic.org/health/articles/9445-diaphragmatic-breathing