How Wheezing Is Treated

Wheezing is a high-pitched whistling sound produced during breathing that is caused by inflammation and narrowing of the bronchioles (airways). It can be chronic or acute and occur during inhalation or exhalation.

There is no single treatment for wheezing, as there are multiple potential causes, among them asthma, allergies, respiratory infection, and heart failure. In some cases, measures such as sipping hot tea or quitting smoking may be enough to alleviate wheezing. In others, prescription medications such as corticosteroids or bronchodilators may be necessary.

Home Remedies and Lifestyle

Home remedies are rarely sufficient as standalone treatments for wheezing, but most aren't likely to be harmful and may help to support more aggressive measures when necessary.

Hot Drinks

Wheezing can sometimes be relieved by sipping a hot beverage, which may help loosen chest congestion and make it easier to cough up phlegm. Beverages containing caffeine, such as coffee or tea, also may have a mild bronchodilating effect as well, meaning they help to relax and widen airways that become constricted.

According to a 2010 review in the Cochrane Database of Systematic Reviews, caffeine acts similarly to the drug theophylline and may improve airway function, albeit modestly, for up to four hours in people with asthma.

Steam Inhalation

Steam inhalation is an age-old remedy for chest congestion and wheezing. Warm, moist air works in much the same way as hot beverages—by relaxing the muscles of the airways and loosening congestion blocking airways.

However, steam inhalation, while comforting, has not been shown to control symptoms of acute respiratory infections and may, in fact, allow an infection to progress if it is used in place of antibiotics. Before breathing over a pot of steamy water or stepping into a hot shower, check with your healthcare provider to make sure you won't be doing more harm than good.

Breathing Exercises

Breathing exercises can benefit people with wheezing of any sort. There are two exercises in particular that may be helpful.

• Belly breathing: Also known as diaphragm breathing, this is done by allowing your stomach to expand while inhaling (pulling the diaphragm down), then sucking in your stomach while exhaling (pushing the diaphragm up). Belly breathing is said to allow for fuller expansion of the lungs than chest breathing.
• Pursed-lip breathing: This technique involves breathing in through the mouth and breathing out a steady flow of air through pursed lips. The technique is said to keep the airways open longer by slowing down the respiration rate and may help shortness of breath (dyspnea) that commonly occurs with wheezing.

A 2019 study in Respiratory Care reported that belly breathing and pursed-lip breathing are able to improve lung volume and slow the rate of breathing in people with COPD, but do not necessarily improve dyspnea.

Smoking Cessation

Smoking not only increases the risk of wheezing by triggering inflammation in the lungs but almost invariably prolongs and worsens acute symptoms. Even if you don't have COPD or another chronic respiratory disease, the bronchoconstrictive effects of cigarette smoke remain the same.

If you experience wheezing, kick the habit and make every effort to avoid secondhand smoke. If you have chronic or recurrent wheezing, speak with your healthcare provider about smoking cessation programs and aids, many of which are fully covered under the Affordable Care Act.

Vaping, marijuana smoking, and hookahs should also be avoided.

Avoiding Triggers

Wheezing with asthma, allergies, and COPD is often set off by environmental, chemical, or physiological factors that cause bronchoconstriction and bronchospasms. Some of the more common triggers of wheezing include:

• Cold, dry air
• Dust mites
• Cockroaches
• Exercise
• Food
• Fragrances and perfumes
• Medications
• Mold
• Pet dander
• Pollen
• Respiratory infections
• Smoke and fumes
• Stress

Identifying triggers can sometimes be difficult. To home in on those that may play a role in your wheezing, keep a symptom diary detailing the events or substances that you've been exposed to, along with the dates and details of any breathing problems you may have experienced.

Over time, patterns may develop that you can share with an allergist, who is specially trained to identify allergy and asthma triggers.

Humidifiers and Air Filters

Wheezing can be triggered and exacerbated by low humidity and airborne particles that cause constriction of the bronchioles. A humidifier adds moisture to the air, particularly during winter months, and can aid with sleep by reducing mouth and nasal dryness (even if you snore).

Some humidifiers are equipped with HEPA filters that can remove pollen, dust, and other irritants from the air. Alternatively, you can buy a separate multifilter air purifier equipped with both a HEPA filter and an activated charcoal filter.

Over-the-Counter Medications

Among the over-the-counter (OTC) medications that may help relieve wheezing for certain people are bronchodilators used to treat asthma, antihistamines to treat mild respiratory symptoms caused by an allergy, and anti-inflammatory drugs to help ease symptoms of bronchitis related to a respiratory infection. Prescription versions of these drugs also exist.

OTC Bronchodilators

If you experience occasional mild asthma attacks, a non-prescription inhaler such as Asthmanefrin (racepinephrine) or Primatene Mist (epinephrine) may be a reasonable option for you. These drugs work by opening and relaxing narrowed airways.

While OTC bronchodilators generally are safe, you should not use one unless you have been diagnosed with asthma by a pulmonologist. According to the Food and Drug Administration (FDA), as many as 20% of Primatene Mist users should instead be on prescription asthma medications and under the care of a healthcare provider.

Common side effects of OTC asthma inhalers include:

• Anxiety
• Dizziness
• Headache
• Insomnia
• Jitteriness
• Loss of appetite
• Nausea
• Sinus pain
• Sore throat
• Tremor
• Vomiting

OTC Antihistamines

It is not uncommon to develop sneezing, nasal congestion, coughing, and even wheezing due to an allergy, particularly seasonal allergies caused by tree and grass pollens. OTC antihistamines are often the first-line defense for uncomplicated mild to moderate allergies. They help block the action of histamine, a chemical released by the body that triggers allergy symptoms.

Newer-generation antihistamines available over the counter are less sedating and can usually provide relief within 30 minutes. These include: 

• Allegra (fexofenadine)
• Claritin (loratadine)
• Zyrtec (cetirizine)

Antihistamines are particularly effective in reducing the frequency or severity of wheezing and shortness of breath in people with allergic asthma.

Allergy-related wheezing should never be ignored or minimized, particularly if accompanied by hives or rash, shortness of breath, dizziness, irregular heartbeat, or swelling of the face, tongue, or throat. These are all symptoms of a potentially deadly, systemic allergic reaction known as anaphylaxis, which requires emergency treatment and an immediate injection of epinephrine.

OTC Anti-Inflammatory Pain Relievers

Wheezing is a common symptom of respiratory infections, most of which are caused by viruses like the respiratory syncytial virus (RSV), influenza, and the various cold viruses (including adenovirus and coronavirus strains). Such an infection can lead to acute bronchitis, a condition in which the airways become inflamed and start to constrict.

For mild uncomplicated bronchitis caused by RSV and other respiratory viruses, a nonsteroidal anti-inflammatory drug (NSAID) like Advil (ibuprofen) or Aleve (naproxen) or even aspirin may help ease inflammation and the associated fever and body aches. Tylenol (acetaminophen), another type of pain reliever, may also help.

Prescriptions

Wheezing associated with asthma and COPD are commonly treated with prescription inhaled and oral bronchodilators, corticosteroids, and, in some cases, antihistamines.

Short-term use of bronchodilators as well as antibiotics to treat the underlying infection may also effectively treat bronchial infections and relieve symptoms.

Bronchodilators

Bronchodilators deliver medications either directly to the lungs or into the bloodstream to open and relax narrowed airways. There are two types:

• Short-acting bronchodilators, also known as rescue inhalers, that stop an asthma attack or COPD exacerbation when it occurs
• Long-acting bronchodilators (inhaled or oral forms), which are used on an ongoing basis to reduce airway hypersensitivity and provide longer-term control of asthma or COPD symptoms

Corticosteroids

Corticosteroids, also known as steroids, are oral or inhaled drugs commonly used to relieve chronic lung inflammation. The drugs work by tempering the immune overreaction that triggers bronchospasms.

Inhaled corticosteroids are often taken with long-acting inhaled bronchodilators to provide better control of COPD or asthma symptoms. There are also inhalers like Advair Diskus that combine corticosteroids, like fluticasone, with a long-acting bronchodilator, like salmeterol, for people with moderate to severe COPD.

Oral corticosteroids are used for the short-term control of severe COPD and asthma symptoms and then gradually tapered off in favor of inhaled corticosteroids.

Antihistamines

For people with severe or chronic allergy symptoms, allergists will often prescribe antihistamines that are stronger or longer-lasting than their OTC counterparts.

These include:

• Clarinex (desloratadine)
• Palgic (carbinoxamine)
• Periactin (cyproheptadine)
• Vistaril (hydroxyzine)
• Xyzal (levocetirizine)

The first-generation antihistamines (Palgic, Periactin, and Vistaril) can make you drowsy and are preferred if an allergy is keeping you up at night. The second-generation antihistamines (Clarinex and Xyzal) are less sedating and can be used during the day.

Other Prescription Drugs

Depending on the underlying cause of wheezing, other drugs may be used to prevent or control symptoms.

These include:

• Antibiotics to treat bacterial lung infections
• Anticholinergics to help control acute asthma or COPD symptoms
• Biologic immunomodulators to treat chronic inflammatory lung disorders
• Leukotriene modifiers for people with mild persistent asthma
• Mast cell stabilizers to better control asthma or COPD symptoms
• PDE4 inhibitors to reduce lung inflammation

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Special Therapies

Wheezing associated with the chronic respiratory diseases COPD, cystic fibrosis, and bronchiectasis often benefit from manual or mechanical therapies to ease breathing obstruction.

These include:

• Oxygen therapy, either short-term or ongoing, may be used if breathing restriction is causing low blood oxygen (hypoxia).
• Airway clearance, performed at home or by a physical therapist, is used to clear the lungs of accumulated mucus using mucolytics, manual percussion, or oscillating or vibrating devices.
• Pulmonary rehabilitation, overseen by a respiratory care practitioner, is used to improve lung function with exercise, nutrition, emotional support, and breathing retraining.

Surgery is rarely a treatment for wheezing. Even in instances where there is a structural defect, like vocal cord dysfunction, surgery is only considered after all other non-surgical options have failed to provide relief.

Complementary and Alternative Medicine (CAM)

Alternative medicine practitioners may turn to any of several approaches to relieve wheezing or prevent spasms and constriction of the airways that lead to acute respiratory symptoms.

It's important to note that most have little scientific evidence to support their use. If you decide to incorporate complementary medicine into your treatment plan, let your healthcare provider know so they can track any side effects and prevent drug interactions.

Aromatherapy

Aromatherapy, typically involving the inhalation of essential oils for therapeutic purposes, is thought by some CAM practitioners to benefit people with certain respiratory diseases. Among the oils said to relieve wheezing and other acute respiratory symptoms due to their anti-inflammatory and antibacterial effects are:

• Anise oil
• Eucalyptus oil
• Peppermint oil
• Tea tree oil
• Thyme oil

But despite the purported benefits, the inhalation of certain essential oils can worsen rather than improve respiratory symptoms in some people.

A 2018 study in the Journal of Asthma and Allergy found that inhalation of eucalyptus and other oils containing pinene may increase airway inflammation, reduce the peak expiratory flow, and increase nasal congestion.

Acupuncture

Acupuncture, which involves inserting slender needles into key points on the body for therapeutic purposes, has not been found to successfully relieve acute asthma symptoms. Even so, the perceived benefit of acupuncture has led many to explore this alternative therapy.

According to a 2011 study in the New England Journal of Medicine, simulated "sham" acupuncture reduced the perception of chest tightness and breathing difficulty in people with asthma due to a placebo effect but did nothing to improve lung function or provide better asthma control.

Buteyko Breathing

Buteyko breathing is an alternative therapy used primarily to treat asthma and other respiratory conditions. It is based on the idea that respiratory problems are caused by chronic hyperventilation, which differs from the basis for breathing exercises endorsed by pulmonologists and physical therapists.

The technique involves various steps including nasal breathing, reduced breathing (consciously reducing either the breathing rate or volume), and relaxation.

Although a 2013 study from the Philippines concluded that Buteyko breathing reduced the need for inhaled corticosteroids in people with asthma, the study was small (16 people) and used subjective questionnaires rather than lung function tests.

Speleotherapy

Speleotherapy, an alternative therapy used in Central and Eastern Europe, is based on the hypothesis that the ongoing inhalation of salty air in caves and other subterranean environments can remodel airways and improve symptoms of asthma and other respiratory diseases.

Beyond the impracticality of the approach, little more than generalized claims currently support the use of speleotherapy for any medical condition.

A Word From Verywell

Chronic or recurrent wheezing should never be ignored or self-treated without a medical diagnosis. If you have new, persistent, or worsening wheezing, you should see a medical professional for appropriate evaluation and treatment. Ignoring symptoms like these can allow a respiratory condition to progress and worsen. With diseases like COPD, this can lead to irreversible lung damage and an increased risk of premature death.

Getting the correct diagnosis and treatment can go a long way toward protecting your lungs as well as your general health and well-being.