What’s New About Breathlessness

Dr. Denis O’Donnell (Kingston, Ontario, Canada) and I wrote a review called Recent Advances in Dyspnea (medical word for breathlessness) in the January 2015 issue of the journal CHEST (pages 232-241). The review covered new research information about breathing difficulty over the past 4 years.

Here is information about how breathlessness affects daily life.

Dr. Denis O'Donnell, Professor of Medicine at Queen's University, in Kingston, Ontario, Canada

Dr. Denis O’Donnell, Professor of Medicine at Queen’s University, in Kingston, Ontario,

  1. Of 2,258 individuals with severe COPD, breathlessness was worse upon awakening in the morning.
  2. Most individuals reported that their breathing varied from day to day and from week to week.
  3. Treatment with a long-acting bronchodilator reduced the variability in breathing difficulty.
  4. Women generally report more breathlessness than men.
  5. In the United Kingdom, 20% of menopausal women reported breathing difficulty. This may be related to low levels of estrogen and progesterone which could affect mood.
  6. Obesity is associated with an increase in breathlessness.
  7. Anxiety and depression are more common in those with heart and lung diseases.
Here are some of the key findings about treatment.
  1. Most long-acting bronchodilators inhaled once or twice daily improve breathing difficulty in those with COPD.
  2. In general. the improvement in breathlessness is greater with two different bronchodilators in a single inhaler compared with one bronchodilator in an inhaler.
  3. Individuals with COPD reported less breathlessness related to anxiety after 8 weeks in a pulmonary rehabilitation program compared with “usual care.”
Here is information on new therapies not yet approved to relieve breathing difficulty. These therapies require more testing before use.
  1. Those with COPD had less breathlessness after acupuncture compared with a sham, or pretend, treatment.
  2. Placement of valves or coils into breathing tubes through a scope can deflate the lung and improve breathing difficulty.
  3. Using a breathing machine connected to plastic tubes in the nose (nasal cannula) to assist breathing during walking improves breathing by allowing the breathing muscles to work less.

Donald A. Mahler, M.D. is Emeritus Professor of Medicine at Geisel School of Medicine at Dartmouth in Hanover, New Hampshire. He works as a pulmonary physician at Valley Regional Hospital in Claremont, NH, where he is Director of Respiratory Services.