Monday Medical: Breathe in, breathe out |

Monday Medical: Breathe in, breathe out

Susan Cunningham/Steamboat Pilot & Today

Your respiratory system works hard, logging 20,000 breaths daily. But sometimes, issues arise.

“Respiratory muscles are working every minute of the day, every day of our lives,” said Dr. James Hoyt, a pulmonologist with UCHealth Pulmonology Clinic – Harmony Campus in Fort Collins, who also sees patients at UCHealth Pulmonology Clinic in Steamboat Springs. “Our respiratory muscles don’t have the luxury of being out of shape.”

Below, Hoyt gives insight to breathing basics, as well as common issues and how to deal with them.

How breathing works

To better understand your respiratory system, first picture a tree.

“The trachea, or windpipe, is like the trunk of the tree,” Hoyt said. “From there, the airways divide and divide, like branches of a tree. At the end of a tree’s branches are leaves; similarly, the ends of the bronchioles have alveoli also known as air sacs, where gas exchange takes place.”

In the air sacs, freshly inhaled oxygen is passed to the blood which is then pumped through the body; the air sacs also absorb carbon dioxide which is then removed from the body through exhalation.

The diaphragm, a thin muscle that separates the chest and abdominal cavities, tightens and pulls down as you breathe in, opening the chest cavity and allowing the lungs to expand. To breathe out, your diaphragm relaxes and moves upward, pushing air out.

Take a deep breath

Though it may feel unnatural to breathe deeply, the practice comes with various benefits. Deep breaths are more efficient: they allow your body to fully exchange incoming oxygen with outgoing carbon dioxide. They have also been shown to slow the heartbeat, lower or stabilize blood pressure and lower stress.

To experience deep breathing, find a comfortable place to sit or lie down. Breathe slowly and deeply through your nose, causing your stomach to rise and expand. Exhale fully.

“Breathing deep for a minute isn’t going to improve your lung capacity,” Hoyt said. “But deep breathing is a good way to reduce stress and relax.”

Common breathing issues

One common issue that affects the respiratory system is asthma, in which the airways narrow and produce extra mucus, making it difficult to move air through the lungs.

“With asthma, it’s harder for the air in your lungs to get out,” Hoyt said. “If you start breathing quickly, you’ll stack more air in the lungs. Then you can’t get a big breath in.”

First-line treatment is an inhaled steroid which reduces bronchial inflammation. Next, a long-acting bronchodilator can help by opening up the bronchial tubes.

Slow, deep breathing using a nebulizer, a device that produces a fine spray of medication that is inhaled, helps in two ways: the medication reduces inflammation, while the deep breathing removes excess air. “The medication helps, but breathing slow and deep is just as important,” Hoyt said.

With COPD, or chronic obstructive pulmonary disease, patients typically have two issues: chronic bronchitis, which inflames airways and results in wheezing, excessive coughing and phlegm production; and emphysema, in which the ‘leaves’ or alveoli of the lungs have been damaged, making it difficult to pass sufficient oxygen to the body.

Bronchodilators, inhaled steroids and other medications are used in treatment. Oxygen therapy may be necessary. About 95 percent of cases of COPD are attributed to smoking.

Finally, in pulmonary fibrosis, the alveoli become scarred. In most cases, doctors don’t know what causes the scarring. “Treatments have been disappointing, as there is nothing that reverses fibrosis,” Hoyt said. “But a few newer medications may slow the progression of scarring.”

To best care for your lungs, avoid smoking, embrace a healthy lifestyle and treat conditions that arise.

“Work with your doctor to address any concerns you have about breathing,” Hoyt said. “After all, breathing is critical to life.”

Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at

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