Breathing Treatments for Asthma: Which Works Best?

Under normal conditions, breathing is effortless. However, some people with respiratory illnesses need to undergo breathing treatments on a regular basis. 

Most breathing treatments deliver medication to the lungs in the form of a fine mist. Some breathing treatments are more effective than others, depending on the person and their illness. 

This article will discuss breathing treatments for asthma and other respiratory illnesses, including types, side effects, and alternatives.

Woman using an inhalation mask for a breathing treatment at home

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Breathing Treatments for Asthma

Asthma is a chronic medical condition that causes narrowing and inflammation of the airways in the lungs. Asthma symptoms include coughing, wheezing, and chest tightness. When asthma symptoms get worse, it is called an “asthma episode” or “asthma attack.” 

There are two main types of breathing treatments for asthma: controller medications and quick-relief medications. Controller medications, also called long-term medications, are used daily to prevent asthma attacks.

Quick-relief medications, often delivered through a rescue inhaler, are used on an as-needed basis during an asthma episode.

How Inhaled Corticosteroids Work

Inhaled corticosteroids, such as Flovent (fluticasone) and Pulmicort (budesonide), are often used as controller medications for asthma. 

People take inhaled corticosteroids by placing an inhaler directly into their mouth, pushing down on the canister, and taking a deep breath. When used on a daily basis, inhaled corticosteroids work to prevent asthma attacks by reducing inflammation in the airways.

The most common side effects include:

  • Oral thrush, a fungal infection in the mouth
  • Hoarseness
  • Sore throat
  • Sore mouth
  • Coughing

Nebulizer Treatment and Asthma

Nebulizers are “breathing machines” that use an air compressor to turn liquid medicine into a fine mist. The mist is breathed in through a mask or mouthpiece. 

The three main types of nebulizers are:

  • Jet nebulizers: Jet nebulizers usually consist of an air compressor, a tube, a cup, and a mouthpiece. Pressurized air travels through the tube to turn the liquid medicine in the cup into an aerosol spray. 
  • Ultrasonic nebulizers: Ultrasonic nebulizers use sound waves to convert liquid medicine into a mist. They are quieter than jet nebulizers, but they are also typically more expensive.
  • Mesh nebulizers: Mesh nebulizers use caps filled with small holes to convert liquid asthma medication into small droplets. Like ultrasonic nebulizers, they are quieter and more convenient than the classic jet nebulizers, but they tend to be more costly.

Some people with asthma prefer to use nebulizers because they’re easier to use. However, unlike inhalers, nebulizers have to be charged and disinfected regularly. They are also too large to bring with you wherever you go.

Inhalers and Asthma

Both controller medications and quick-relief medications for asthma are often delivered through an inhaler—a small medical device that delivers medicine directly to the lungs. The two main types of inhalers are:

  • Metered-dose inhalers: Also called “puffers,” metered-dose inhalers (MDI) deliver a fine mist of medicine to the lungs in a short burst. A spacer, which attaches to a mouthpiece and the end of your inhaler, can make it easier to use a metered-dose inhaler effectively.
  • Dry powder inhalers: Dry powder inhalers (DPI) are activated by your breath when you inhale. Some people find them easier to use than metered-dose inhalers. 

Controller inhalers are used on a long-term, preventive basis. They deliver inhaled corticosteroids and other controller medications. 

Rescue inhalers, such as Ventolin (albuterol) inhalers, are used only when asthma symptoms act up. They deliver medicines called bronchodilators (medications that act quickly to open up the airways to make it easier to breathe) to the lungs during asthma attacks.

Bronchodilators include both beta2-agonists, which relax airway muscles, and anticholinergics, which prevent airway muscles from tightening.

Other Asthma Treatments

In addition to nebulizers and inhalers, other asthma treatments are:

  • Oral corticosteroids: Oral or injectable steroids are used to treat asthma attacks to reduce inflammation in conjunction with a bronchodilator such as albuterol. In comparison to inhaled corticosteroids, oral corticosteroids typically have more severe side effects. These may include mood swings, high blood pressure, infections, and osteoporosis, among others.
  • Allergic asthma treatments: If you have persistent asthma symptoms due to seasonal allergies, anti-leukotriene drugs such as Singulair (montelukast) or injectable medications like Xolair (omalizumab) may help you breathe more easily. 
  • Bronchial thermoplasty: Bronchial thermoplasty uses a catheter and heat energy to open up the airways in the lungs and reduce their ability to constrict. The minimally invasive procedure has been approved by the Food and Drug Administration (FDA) to treat persistent asthma symptoms that don’t respond to other breathing treatments.
  • Home remedies: If your asthma symptoms are mild, you can try home remedies like inhaling steam or drinking warm liquids to reduce congestion and open your airways. Small amounts of caffeine can also help reduce asthma symptoms. 
  • Breathing techniques: Certain breathing exercises, such as deep belly breathing, may help to ease symptoms in people with mild to moderate asthma.

Shortness of Breath and Panic

Many people experience feelings of panic or impending doom when they have an asthma attack. Even if you are already using a medical treatment for shortness of breath, breathing techniques may help you relax when symptoms act up.

Breathing Treatments for COPD

Chronic obstructive pulmonary disease (COPD) is a collection of diseases that affects 16 million Americans. Many people with COPD use breathing treatments to ease their symptoms and prevent complications.

What Is COPD?

The conditions grouped as COPD block airflow and create breathing problems. They are chronic and progressive. COPD includes chronic bronchitis and emphysema.

Symptoms of COPD include:

  • Chronic coughing
  • Shortness of breath
  • Color changes in the lips or fingernails (cyanosis)
  • Congestion
  • Wheezing
  • Fatigue
  • Frequent respiratory infections

People who smoke or used to smoke are most at risk of developing COPD. Other risk factors for COPD include:

  • Exposure to secondhand smoke
  • Exposure to pollution or chemicals, especially at home or at work
  • Childhood respiratory infections, such as pneumonia
  • A family history of COPD
  • Genetic alpha-1-antitrypsin deficiency (lacking an enzyme that helps lungs heal from minor damage)

There is currently no cure for COPD, but it can be effectively treated and managed.

Bronchodilators for COPD

Bronchodilators, including both beta-agonists and anticholinergics, can help to reduce excess mucus production and prevent chronic cough in people with COPD. 

Combination inhalers, which contain either two different bronchodilators or a combination of bronchodilators and corticosteroids, have been found to be most effective for people with COPD. Often, people with COPD take a combination of both short-acting and long-acting bronchodilators to stop symptoms in their tracks and prevent future complications.

Corticosteroids for COPD

Inhaled corticosteroids, which reduce airway inflammation, are often used in combination with bronchodilators to treat COPD symptoms. Research suggests that inhaled corticosteroids can prevent severe symptoms, reduce hospital visits, and improve overall quality of life in people with COPD.

Oxygen Therapy

Oxygen therapy is a treatment that provides supplemental oxygen for you to breathe. It may take place in a hospital setting or at home. Supplemental oxygen can help if you have trouble exercising, working, or engaging in daily activities because of your COPD symptoms.

Supplemental oxygen is usually delivered through tubes and a mask or nasal cannula. The main types of oxygen delivery devices are:

  • Oxygen concentrators: Oxygen concentrators are electrical devices that draw air directly from the room. They don’t need to be refilled.
  • Oxygen tanks: Oxygen tanks store compressed gas or liquid oxygen. They are either stationary or portable.

Oxygen therapy is usually safe. The most common side effects from oxygen therapy are nosebleeds, morning headaches, fatigue, and dry nose. Because oxygen is flammable, it’s important not to use it near flames or while smoking.

Your healthcare provider will be able to prescribe the correct type of oxygen therapy for you based on your medical history and the severity of your symptoms.

Pulmonary Rehabilitation Programs

If shortness of breath due to COPD is limiting your daily activities, a pulmonary rehabilitation program may help. 

Pulmonary rehabilitation programs are designed to help people with COPD and other chronic breathing conditions improve their quality of life. The programs often involve:

  • Learning how to exercise effectively
  • Developing a healthy eating plan
  • Participating in peer support groups
  • Developing a better awareness of respiratory health
  • Learning how to use oxygen therapy effectively

Pulmonary rehabilitation programs are usually delivered in an outpatient setting by a medical team of physicians, physical therapists, respiratory therapists, and other specialists. In some cases, your rehab team may be able to treat you at home.

Surgery

Some people with severe, persistent COPD symptoms may be eligible for lung surgery. The two types of surgery used to treat COPD are:

  • Lung volume reduction surgery (LVRS): LVRS is a procedure in which about one-third of the diseased part of the lung is removed. This allows the remaining healthy parts of the lung to function more normally. 
  • Bullectomy: During a bullectomy, large bullae (air pockets that crowd out healthy parts of the lung) are removed to help restore lung function.

In order to be considered as a candidate for lung surgery, you have to be healthy enough to undergo the procedure. You may not be eligible if you are a current smoker or if your lungs are severely damaged. 

If COPD symptoms have already extensively weakened the lungs, a lung transplant may be necessary.

Breathing Treatments for Pneumonia

Pneumonia is an infection in one or both lungs that causes symptoms like coughing, fever, muscle pain, weakness, chills, and shortness of breath. It may be bacterial, viral, or fungal. People with asthma and/or COPD are more at risk of developing pneumonia.

Some cases of pneumonia can be treated with antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), fluids, and rest. Inhaling steam or sleeping in a room with a humidifier may provide relief. 

More severe cases of pneumonia may require hospitalization, intravenous fluids, and breathing assistance from oxygen therapy or a ventilator.

Pneumonia and Inhaled Corticosteroids

Chronic use of inhaled corticosteroids, especially for asthma or COPD, has been linked to an increased risk of pneumonia. If you are concerned about developing pneumonia, talk to your healthcare provider about reducing your risk as much as possible.

Choosing a Breathing Treatment

There are several factors to keep in mind when it comes to choosing a breathing treatment. Talk to your healthcare provider about the side effects, maintenance, and effectiveness of each type of treatment.

Side Effects

It’s important to keep potential side effects in mind when considering a possible breathing treatment. Many of the first-line treatments for respiratory illnesses (such as inhaled corticosteroids for asthma) became popular because they do not come with serious side effects for most people.

After you start a new breathing treatment, monitor your progress. Talk to your healthcare provider about any side effects you experience. They may be able to lower your dose or recommend an alternative. 

If your symptoms get worse or you start to show signs of an allergic reaction, seek medical help right away.

Maintenance

When you’re considering a breathing treatment, consider how much effort, time, and money it will take to use it regularly. 

For example, some people find that nebulizers are easier to use than inhalers. However, they have to be cleaned and disinfected on a regular basis in order to be effective. If you don’t have the time or ability to clean your nebulizer, you might want to consider other options.

Effectiveness

Ask your healthcare provider about the effectiveness of a breathing treatment for someone with your symptoms, medical history, and condition. What works for one person with a respiratory illness may not be as effective for someone else. 

For example, people with COPD usually need to use combination inhalers to control their symptoms. Someone with asthma may only have to take one type of medication to prevent an asthma attack.

Summary

Breathing treatments deliver medication directly into the lungs. They are used by people with respiratory illnesses, such as asthma and chronic obstructive pulmonary disease (COPD), to make it easier to breathe. 

The most common breathing treatments for asthma include inhaled corticosteroids and bronchodilators, usually delivered through an inhaler or nebulizer. Other asthma treatments include bronchial thermoplasty, injectable prescription drugs, oral corticosteroids, anti-leukotriene medications, and natural remedies, such as breathing techniques.

The most common breathing treatments for COPD are corticosteroids, bronchodilators, oxygen therapy, pulmonary rehabilitation, and surgery.

Breathing treatments for pneumonia may include bronchodilators, antibiotics, and humidifiers. In severe cases, someone with pneumonia may need breathing assistance from a ventilator.

When considering a potential breathing treatment, it’s important to keep side effects, maintenance, and effectiveness in mind. Your healthcare provider can help you choose the best breathing treatment for your particular needs.

A Word From Verywell

If you or a loved one has difficulty breathing it can be concerning or even frightening. Chronic conditions that interfere with breathing can limit your activities. There are many different kinds of breathing treatments for asthma and other respiratory conditions. Talk to your healthcare provider about which one might work best for you.

Frequently Asked Questions

  • How do you get rid of asthma without an inhaler?

    If you find it difficult to use an inhaler, there are many other options for treating asthma symptoms. Nebulizers may be easier to use. You can also take oral corticosteroids to reduce inflammation in the airways. Injectable drugs, such as omalizumab (Xolair), may help with persistent symptoms that do not respond to other treatments.

  • What are some treatments for asthma?

    Inhaled corticosteroids, which reduce inflammation in the airways, are often the first choice of treatment for asthma.

    Also, bronchodilators are often used intermittently when asthma symptoms get worse. These medications are delivered directly into the lungs with devices like inhalers or nebulizers.

    Other options include injectable medications, bronchial thermoplasty, and oral corticosteroids. Natural remedies, such as breathing techniques, can also be tried.

  • Does steam help asthma?

    Steam can help loosen mucus and soothe airways for some people with asthma. A hot shower or vaporizer can sometimes be helpful in easing mild asthma symptoms. However, heat can be an asthma trigger for some people.

  • What does a nebulizer do to your lungs?

    A nebulizer turns liquid medicine into a fine mist that can be breathed in with a mouthpiece or mask. Nebulizers offer quick relief from asthma symptoms because the medication is delivered directly into the lungs. They can open up airways and reduce inflammation, making it easier to breathe.

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