A patient with COPD has a respiratory rate of 30 breaths per minute and uses the upper trapezius and sternocleidomastoid during inspiration. Which breathing technique is most appropriate to slow the respiration?

• A. Incentive spirometry
• B. Segmental breathing
• C. Glossopharyngeal breathing
• D. Pursed-lip breathing

Answer: (D)

Slowing rapid breathing in COPD is best achieved with pursed-lip breathing because it directly influences the way air leaves the lungs. In COPD, air trapping and dynamic hyperinflation make quick, shallow breaths energy costly and exacerbate dyspnea. Pursed-lip breathing creates a small resistance during exhalation, generating positive airway pressure that keeps airways from collapsing too soon. This prolongs exhalation, reduces the work of breathing, lowers the respiratory rate, and improves gas exchange.

To use it, inhale gently through the nose for a short count, then exhale slowly and steadily through pursed lips for longer than the inhalation (often about twice as long). The goal is a calm, controlled pace rather than forceful breathing.

Incentive spirometry focuses on deep inspirations to prevent atelectasis and is not aimed at slowing the rate in COPD. Segmental breathing targets regional expansion and not necessarily overall rate control. Glossopharyngeal breathing can increase expiratory effort in some settings but is not the standard method for reducing tachypnea in COPD.