Why Controlled Coughing Helps COPD and How to Do It Right

Woman coughing

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Controlled coughing is a technique that can help assist your body's natural mucus-clearing mechanisms. If you have chronic obstructive pulmonary disease (COPD), this can be helpful as your cough reflex may have been weakened by long-term exposure to an irritant (typically cigarette smoke), hampering your ability to clear your lungs.

Coughing serves a number of helpful purposes: In addition to keeping your airways clear, it's a defense mechanism against foreign or toxic substances that you may have breathed into your lungs from the environment. But coughing too much or too forcefully can cause the airways to spasm and possibly collapse, inhibiting expectoration. It can also fatigue you, making further coughing difficult.

When mucus is allowed to build up in the warm, moist environment of the lungs, it can become a hotbed for bacteria, leading to infection and increasing the risk of COPD exacerbation. Controlled coughing helps you effectively and safely mitigate these risks.

How to Perform a Controlled Cough

An effective cough is one that's controlled and that comes from deep within the lungs to loosen and mobilize mucus. It's something you can easily learn to do with practice. Once you've mastered the technique, you can call on it whenever you need it.

These steps from the Cleveland Clinic can help you get started. You may want to cough into a tissue and note the color, thickness, or overall appearance of what you bring up. If you notice any significant changes, let your doctor know.

  1. Sit upright in a chair or on the edge of a bed. Place your feet firmly on the ground, lean forward a bit, and take a few deep breaths to help your body to relax.
  2. Fold both arms across your abdomen and breathe in fully through your nose.
  3. As you exhale, lean forward a little more and press your arms against your abdomen. Open your mouth slightly and cough two or three times. Each cough should be short and sharp and you should feel your diaphragm move upward. The first cough loosens the mucus, while the second and third coughs are responsible for helping bring the mucus up and out of the airways.
  4. Breathe in slowly by gently sniffing throughout the entire inhalation. This will prevent mucus from being pushed back down into the airways.
  5. Rest and repeat if necessary.

When practicing a controlled cough, be careful not to cough too forcefully, or risk damaging your airways or lungs, which might be weakened or damaged due to the effects of COPD progression. Always use the least amount of force behind your cough as possible to safely clear your airways.

Tips for Perfecting Your Technique

To get the best results from controlled coughing, incorporate these simple tips:

  • Stay hydrated: Sticky mucus can be difficult to cough up. To help keep it thin and easy to expel, drink plenty of water throughout the day (at least eight glasses).
  • Use a bronchodilator before trying controlled coughing: This will relax your airways to allow mucus to move more easily.
  • Slow down your breathing: After coughing, keep your breaths slow and shallow. If you inhale sharply and quickly it can interfere with the movement of mucus out of the lungs—precisely the effect you want to avoid.

Risks and Considerations

As a general rule, people with COPD should avoid cough suppressant medications and homeopathic techniques, as having an effective, mucus-clearing cough is essential if you're battling COPD.

Patients with severe muscular wasting or other complications from COPD who may not be able to practice controlled coughing may need to seek help from a mechanical cough assist device, which is a tool that gently helps increase the force of a cough to clear the airways. Check with your doctor if you think this device may be helpful to you.

A Word From Verywell

The best way to practice controlled coughing is to work through the steps with your doctor first in the office, then carefully practice the routine at home. When used in a cautious manner, this technique can be very supportive for those with COPD, as it helps preserve energy and reserve oxygen.

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Article Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Cleveland Clinic. Controlled Coughing for COPD Patients. Published 2018.

  2. American Thoracic Society. Exacerbation of COPD: Information Series. Published 2018.

  3. Arcuri J, Abarshi E, Preston N, Brine J, Pires Di Lorenzo V. Benefits of interventions for respiratory secretion management in adult palliative care patients—a systematic review. BMC Palliat Care. 2016;15(1). doi:10.1186/s12904-016-0147-y

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