Asanaverse

COPD and Breathlessness

12 Week Breathing and Yoga Program for COPD

The distance you can walk before you have to stop has been getting shorter. Stairs need a plan. And the breathlessness itself has a way of speeding your breathing up, which empties the lungs less completely and makes the next breath harder still.

Our yoga teachers built this twelve week program around the finding that surprised everyone in this field: the breathing does most of the work. Twelve weeks to breathe out more completely, walk further before you stop, and have something to do when the breathlessness starts.

Three sessions a week plus a short daily one, four sequences, twelve weeks. Twelve is not a round number: every trial behind this program ran exactly that long.

Length

12 weeks

Practices

84 in total

Rhythm

Three sessions a week plus a short daily one

Made for

Adults with clinically stable COPD who can walk without oxygen at rest

What the research says

The single most useful result here comes from a trial that tested breathing on its own, with no poses at all. Forty people with moderate to severe COPD were taught one seated breathing technique in four short sessions and left to practise at home. They managed about twelve minutes a day rather than the thirty they were asked for. After twelve weeks the difference in six minute walking distance between them and the control group was 65 metres, well past what counts as clinically meaningful, and their quality of life scores improved too.

That fits what the pooled evidence says. A meta-analysis of 11 trials with 586 patients found yoga improved six minute walking distance by 25.5 metres and improved FEV1, both robust to how well the trials were run. Its authors were specific about the reason: the benefit tracked with the breathing-focused interventions rather than the pose-heavy ones. An earlier meta-analysis found the same direction, with 38.8 metres on the walking test and 123 mL on FEV1.

And it holds up against the standard of care. A trial of 150 people compared supervised yoga by video call against pulmonary rehabilitation by video call, five times a week for three months. Both groups improved substantially in walking distance, breathlessness, symptoms, quality of life, anxiety and depression, with no significant difference between them. That makes this a reasonable thing to do alongside your care. It does not make it a replacement for pulmonary rehabilitation.

See every study and guideline behind this program →

How the program works

3 phases, and you stay with the same practices for the whole of each one. That repetition is the plan rather than a shortage of ideas. A body changes when the same ask comes back often enough, and the trials this program follows repeated for weeks before they made anything harder.

Weeks 1 to 3MoveBelly breathing and pursed lip breathing, until both are automatic.Weeks 4 to 9BuildPractice on most days, plus two more breathing techniques and a little standing.Weeks 10 to 12IntegrateUse the breathing during exertion, not only during practice.

Each phase has one longer session three times a week and the same ten minute session on the other days. Open a session below to see every pose, its timing and the breathing that goes with it. Two things run through all twelve weeks: the breathing comes first in every session while you are freshest, and you never hold your breath in any of it.

Who this is for

  • ·Your COPD is clinically stable and you have not had a flare up in the last month or so.
  • ·You can walk on your own, even if you have to stop and rest.
  • ·You do not need oxygen while sitting still.
  • ·You want something to do about the breathlessness rather than only waiting it out.
  • ·You can find ten minutes most days and twenty minutes three times a week.

Before you start

This sits alongside your medical care and any pulmonary rehabilitation, not instead of either. Nothing here uses forced or rapid breathing, and nothing asks you to hold your breath. The practice guide has the rest, including what to do about oxygen saturation.

Read the full safety notes in the practice guide →

The practice

Two practices per phase. Open one to see every pose, its timing and the reason it sits where it does.

Move · Weeks 1 to 3

Two Techniques, Learned Properly

Belly breathing and pursed lip breathing, until both are automatic.

Three weeks on two techniques. Belly breathing gives the diaphragm its job back, and pursed lip breathing keeps a little pressure in the airways on the way out so the lungs empty more completely. Between them they are most of what this program is, and the rest of it is built on having them properly.

  1. 1.Easy Pose6 min
  2. 2.Staff Pose1 min
  3. 3.Seated Side Bend1 min each side
  4. 4.Revolved Easy Pose1 min each side
  5. 5.Bridge Pose45 sec, twice
  6. 6.Fish Pose1 min
  7. 7.Corpse Pose5 min
Open the full sequence →

Week by week

Week 1Find out where your breath currently sitsOne hand on the belly, one on the chest. If the upper hand is doing more, that is the pattern these three weeks are changing.
Week 2Get the pursed lip timing rightIn through the nose for two, out through gently pursed lips for four. Not forced, not blowing. Like cooling soup.
Week 3Use it on the stairs onceNot as an experiment in how far you can go. Just breathe out through pursed lips on the way up one flight and notice the difference.
← Back to the copd and breathlessness practice guide

Build · Weeks 4 to 9

Daily Practice, and Some Movement

Practice on most days, plus two more breathing techniques and a little standing.

Six weeks, and the longest phase for a reason: this is the stretch where the walking distance moves in the trials. Not through hard work, through doing it often. Two more techniques come in, both of which lengthen the out breath, and the sessions start with two minutes standing because breathing well upright is a different skill from breathing well on a cushion.

Week by week

Week 4Learn the two new techniquesAlternate nostril breathing and humming. Both feel odd for a few days. Humming is the easier one to keep, because it lengthens the exhalation without you having to try.
Week 5Two minutes standingStanding changes how the diaphragm works and makes the same breathing noticeably harder. Use the wall.
Week 6Find your own techniqueOne of the four will suit you better than the others. Give it more of the breathing block. They all pull the same lever.
Week 7Notice the walkingPick a route you know. This is around the point where people start noticing they stopped one lamppost later than they used to.
Week 8Keep the daily one goingThe long sessions matter less than the short ones. If something has to give in a busy week, drop a long session and keep the ten minutes.
Week 9Add a minute of standingThree minutes upright at the start instead of two, if that has been comfortable.
← Back to the copd and breathlessness practice guide

Integrate · Weeks 10 to 12

Breathing When You Need It

Use the breathing during exertion, not only during practice.

The last three weeks move the technique out of the session and into the day. Stairs, slopes, carrying things, the walk from the car park. The session is shorter and mostly upright, and the instruction is simply to keep the pattern while you move. Slowing down when it disappears is the whole skill.

Week by week

Week 10Breathe out on the effortOut through pursed lips on the step up, on the lift, on the stand. Not in. That single habit is most of what this phase teaches.
Week 11Reaching overheadArms above the head make breathing harder for almost everyone with COPD. Doing it slowly on purpose, with a long exhale, is how it gets easier.
Week 12Compare, then keep somethingThink about the route you picked in week seven, the stairs, and how often the breathlessness caught you out. Then keep the ten minute session most days and the fifteen minute one twice a week.
← Back to the copd and breathlessness practice guide

The 13 poses in this program

Every pose has its own page with alignment, common mistakes and the energetic effect. Look one up when a shape does not make sense in your body.

Easy PoseStaff PoseSeated Side BendRevolved Easy PoseBridge PoseFish PoseCorpse PoseCow PoseMountain PoseMountain Pose with Side BendCow Face PoseLegs Up the WallUpward Salute
Go to the Asana Lab →

The guide behind this program

Why these poses and not others

The COPD and Breathlessness practice guide explains what each pose does and why it belongs to this goal. It also carries the safety notes and every study this program is built on. Read it if you want the reasoning rather than the plan.

Read the guide →

Frequently Asked Questions

Does this replace pulmonary rehabilitation?

No. The trial that compared them found supervised yoga and pulmonary rehabilitation delivered by video call produced similar improvements in walking distance, breathlessness, symptoms and quality of life, with no significant difference between them. Similar is not the same as replacing, and pulmonary rehabilitation includes assessment and supervision that a program like this cannot.

Do I really only need ten minutes?

On most days, yes, and that is one of the better supported claims here. In the trial that tested breathing on its own, participants were asked for thirty minutes a day and actually managed about twelve, and still finished 65 metres ahead of the control group on the walking test.

What is pursed lip breathing doing?

Breathing out through gently pursed lips keeps a small back pressure in the airways, which stops the smaller ones collapsing early and lets the lungs empty more completely. That leaves more room for the next breath in. It is the single most useful thing in this program.

What about Kapalabhati and Bhastrika?

They are not here. Both use fast forced exhalation, and there is no evidence that this is safe in lungs that are already over-inflated. The techniques in this program are the slow ones, which is also where the evidence sits.

Is this suitable if my COPD is advanced?

This program is built for clinically stable COPD in people who can walk on their own and do not need oxygen at rest, because that is who was studied. The review that looked specifically at advanced disease with a high symptom burden did not find the same benefits, so if that describes you, this belongs in a conversation with your respiratory team rather than as a self-directed program.

What should I do about oxygen saturation?

If you use a pulse oximeter, agree a floor with your clinician and rest when you reach it, then start again once you have recovered. Symptoms count as much as the number: breathlessness at rest, dizziness or chest tightness mean stop, whatever the reading says.

Creator of this program

Manish Rana

Manish Rana

Founder of Asanaverse.de. Manish writes about yoga, Ayurveda and meditation, and owes his deep connection to yoga to his Indian roots. With over 1,000 hours of Yoga Alliance Teacher Training, he shares his knowledge with the community.

More about Manish →
Registered Experienced Yoga Teacher, E-RYT 500

Where to next

All programs

See the other programs

Every program here was built around one complaint and around the trials that studied it. Back, neck, knees, hips, sleep and stress, each one running for as long as the research says it takes.

Browse programs →