How Wheezing Is Treated

Wheezing is a high-pitched whistling sound made when you breathe that is caused by inflammation and narrowing of the airways. It can be chronic or acute and occur when inhaling or exhaling. There is no one drug or procedure that can alleviate wheezing in all people, as treatment depends on the cause of the wheezing, and the possibilities vary widely.

Why you are wheezing (e.g., asthma, allergies, respiratory infection, sleep apnea, heart failure, or another cause) will direct your doctor as to which treatments can provide effective relief of this frustrating and often debilitating breathing problem.

Home Remedies and Lifestyle

There are certain home remedies that may help reduce the severity or frequency wheezing, depending on the underlying cause. These are rarely used as standalone treatments and may be of no benefit in some cases.

Before embarking on any home remedy, it is important to speak with your doctor to ensure that it is appropriate and safe.

Hot Drinks

Wheezing can sometimes be relieved by sipping tea or other hot beverages. Even hot water can help loosen chest congestion and make it easier to cough up phlegm.

Interestingly, caffeinated beverages like coffee and black tea may also help relieve wheezing by having a mild bronchodilating effect.

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

Steam Inhalation

Steam inhalation is an age-old remedy used to treat chest congestion and symptoms of wheezing. The warm, moist air works similarly to hot beverages by relaxing the muscles of the airways and loosening any congestion that may be blocking airways. Even taking a steamy shower can help.

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 in the absence of appropriate antibiotic therapy.

Breathing Exercises

Breathing exercises can benefit people with wheezing of any sort.

Exercises of particular benefit include:

  • 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 increase the expansion of the lungs better 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.

Self-help breathing techniques are often used by people with chronic obstructive pulmonary disease (COPD), but studies are conflicted as to how effective such exercises are for this purpose and whether they are useful in all cases.

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, put out the cigarettes and make every effort to avoid secondhand smoke. If you have chronic or recurrent wheezing, speak with your doctor 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.

Identification and Avoidance of Triggers

Wheezing with asthma, allergies, and COPD are often set off by environmental, chemical, and physiological triggers that cause bronchoconstriction and bronchospasms. Some of the more common triggers 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 often be difficult. To narrow the causes, 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 both triggered and exacerbated by low humidity and airborne particles that induce bronchoconstriction. Having a humidifier adds much-needed 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 multi-filter air purifier equipped with both a HEPA filter and an activated charcoal filter.

Choose an air purifier that can service the size of your room and has a fine particle rating of 2.5 (PM 2.5), meaning that it can remove some of the finest airborne particles.

Over-the-Counter (OTC) Medications

There are several over-the-counter (OTC) medications that may help relieve wheezing in certain people. These include 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. (Note that prescription versions of these drugs also exist.)

OTC Bronchodilators

If you experience occasional mild asthma attacks, ask your doctor if non-prescription inhalers such as Asthmanefrin (racepinephrine) or Primatene Mist (epinephrine) are reasonable options for you. These drugs function as bronchodilators, opening, and relaxing narrowed airways.

While the inhalers are generally safe if used appropriately, they should never be used until asthma has been properly diagnosed by a pulmonologist. According to the U.S. 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 doctor.

Common side effects of OTC asthma inhalers include:

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

Asthmanefrin or Primatene Mist should never be used for any condition other than asthma. They cannot treat respiratory infections or COPD and can make a condition worse by delaying the appropriate treatment.

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: 

Antihistamines are particularly useful 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, whole-body allergy known as anaphylaxis which requires emergency treatment and an immediate injection of epinephrine.

OTC Anti-Inflammatory Pain Relievers

Respiratory infections are common causes of wheezing, most of which are caused by viruses like the respiratory syncytial virus (RSV), influenza viruses, and the various cold viruses (including adenovirus and coronavirus strains). The infection can lead to acute bronchitis in which the airway of the lungs become inflamed and start to constrict (narrow).

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

Never use aspirin to treat a viral infection or fever in children or teenagers as this can lead to Reye syndrome, a potentially severe condition that can cause swelling of the brain, liver damage, and even death.

Prescriptions

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

Severe bronchial infections may also benefit from the short-term use of bronchodilators as well as antibiotics to treat the underlying infection.

Rx 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

Rx Corticosteroids

Corticosteroids, also known as steroids, are oral and 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 even 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 symptoms and then gradually tapered off in favor of inhaled corticosteroids.

Rx 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 Rx 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

Asthma Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Woman

Special Therapies

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

These include:

Wheezing occurring with sleep apnea may be treated with a continuous positive airway pressure (CPAP) machine that you wear on your face to prevent gaps in respiration.

Wheezing is not generally treated with surgery. 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)

There are complementary treatments that alternative practitioners believe can relieve wheezing or prevent airway spasms and constriction that lead to acute respiratory symptoms.

Despite the popularity of many of these treatments, there is usually little scientific evidence to support their use. If you do decide to incorporate complementary medicine into your treatment plan, let your doctor know so that side effects can be tracked and drug interactions avoided.

Aromatherapy

Some say that aromatherapy, typically involving the inhalation of essential oils for therapeutic purposes, benefits 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:

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

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, involving the placement of needles on the body for therapeutic purposes, has not shown great efficacy in treating acute asthma symptoms. Still, 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.

According to a 2020 review in the Cochrane Database of Systematic Reviews, the use of Buteyko breathing or other alternative breathing practices (like pranayama) did not translate to improvements in people with asthma.

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 improves symptoms of asthma and other respiratory diseases.

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

A Word From Verywell

Chronic or recurrent wheezing should never be ignored or self-treated in the absence of a medical diagnosis. If you have new, persistent or worsening wheezing then 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.

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