The Active Cycle of Breathing Technique

Respiratory Team, Physiotherapy Department, Colchester General Hospital, Turner Road, Colchester, CO4 5JL Tel: 01206 742550


This is gentle, normal breathing using the lower chest while relaxing the upper chest and shoulders.

It is important to return to this pattern of breathing to give ourself a rest between the more active techniques.

The emphasis is on breathing in. Breathing out should be gentle and relaxed.

At the end of breathing in you can hold the breath for 2-3 seconds or sniff 2-3 times to encourage the air to get behind the mucus and help clear it centrally when you breath out.

To huff, take a medium breath in (not a deep one) and then squeeze the air out using your stomach and chest muscles (like steaming up a mirror). The huff must be long enough to remove mucus from the small airways.

A period of breathing control (15-20 secs) must follow each set of huffs, to prevent the airways from tightening.

If you take any inhalers then co-ordinate your exercises with them as follows: 

1) take short acting bronchodilator eg Ventolin, Bricanyl or Combivent.

2) wait 20 minutes 

3) breathing exercises 

4) take steroid inhalers and/or long acting bronchodilators eg Becotide, Flixotide, Pulmicort, Serevent, Seretide, Oxis, Symbicort or Spiriva.

Step one – Breathing control (15 secs) Step two – Four deep breaths +/- inspiratory hold or sniff Step three – Breathing control (15 secs ) Step four – Two huffs Step five – Breathing control (15 secs) Step six – Cough

If no mucus is cleared after two or three coughs, repeat the cycle from step one.

The treatment is continued until you have cleared as much mucus as possible.

If you have any queries or concerns please contact your physiotherapist on the number on the front of this leaflet.

Please raise any concerns in the ward or department you are in. Ask to speak with the ward sister, matron or department manager. If your concerns cannot be resolved or you wish to make a formal complaint, please call PALS (Patient Advice & Liaison Service) on 0800 783 7328, or pick up a PALS leaflet.

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