3 Techniques to Clear Out Mucus in the Lungs

One of the hallmark symptoms of COPD is increased mucus production which, over time, can build up and obstruct the already narrowed airway. This pooling of mucus in the airways then becomes a breeding ground for bacteria which can lead to lung infections like pneumonia.

It's important to understand that learning how to clear mucus from the lungs takes time and may not produce immediate results. But airway clearance is an important part of COPD treatment, especially because it can help you breathe better.

In the end, practicing these techniques may not only help your disease but help you feel better, so you can enjoy life's comforts.

Here are three important yet simple airway clearance techniques:

1
Controlled Coughing

coughing
Coughing. Photo courtesy of istockphoto.com, user David Freund

Controlled coughing is the most effective means of airway clearance, unlike other forms of coughing like a hacking cough or simple clearing of the throat.

There are two controlled coughing techniques a person with COPD can use to clear mucus:

  • Deep cough technique
  • Huff cough technique

Deep Cough
While people with COPD often have great difficulty mustering up a strong, productive cough due, in part, to weakness and dyspnea, the upside is that using the deep cough technique actually helps a person conserve energy.

With this strategy, it's best to be seated comfortably on the edge of your bed or on a chair with your feet touching the ground. Then take a deep breath, hold it for two to three seconds, and, using your stomach muscles, forcefully release the air through pursed lips. Pressing your arms against your stomach may help you use your stomach muscles most effectively. 

Huff Cough
If you cannot clear mucus with a deep cough, you can try a huff cough. In this technique, first take a slightly deeper breath than usual, making sure to inhale slowly. Then, using your stomach muscles, make a series of three rapid exhalations with your mouth open. While doing this, make the sound "ha, ha, ha." Follow this by diaphragmatic breathing and a deep cough if you feel like the mucus is broken up and moving up your airway. 

2
Chest Physiotherapy and Postural Drainage

Upper Lobe Posterior Segments
Upper Lobe Posterior Segments. Copyright Deborah Leader

Chest physiotherapy (CPT) can be performed either manually, using chest percussion and vibration, or with an airway clearance device. Manual chest physiotherapy involves clapping on the chest and/or back to help loosen thick secretions. Airway clearance devices for home use are generally hand-held and can be an affordable alternative to manual CPT.

Often coupled with chest physiotherapy, postural drainage is an airway clearance technique that uses gravity to assist in the removal of secretions from the airways.

There are several different positions in which postural drainage is performed, depending upon which area of the lungs you are trying to concentrate on. For example, you can lie on your back or your stomach or on your side.

Overall, it's best to perform chest physiotherapy and postural drainage on an empty stomach, either before eating or a couple hours after. Have a partner or caregiver form a cup with his or her hand and clap (a popping or hollow sound should be heard) on your chest or back (depending on your position). The clap should not be painful. 

In addition to this clapping (called percussion), vibration can also be helpful. In this instance, your caregiver or partner should use a flat hand to gently shake your ribs, after you take a deep breath and exhale forcefully. 

After five minutes or so of percussion or vibration in each area of your chest, take a deep breath, cough, and spit out the mucus that was brought up.

3
Expectorant Therapy

Robitussin
Robitussin. Photo courtesy of Getty Images, user Scott Olson

An expectorant is a type of medicine that helps loosen the mucus in your lungs so you can more easily bring it up with coughing. It does this by stimulating the vagus nerve in the stomach, which increases airway secretions, thereby decreasing mucus thickness. Expectorants may also block the production and release of mucins, the main proteins found in mucus. 

A common over-the-counter expectorant (sometimes called a mucolytic) used in COPD is Robitussin or Mucinex (guaifenesin). However, according to the Global Initiative for Obstructive Lung Disease (GOLD), mucolytic drugs are not part of the current standard of care for COPD patients. This is because there is little scientific evidence to suggest they work to improve lung function in people with COPD.

Still, some doctors still recommend or prescribe them and many COPD patients feel that they work well. 

A Word From Verywell

Talk with your doctor about the best specific mucus clearing techniques for you. It's also a good idea to ensure you and your partner know how to do it properly, so consider attending a therapy session first before trying it at home. 

Sources:

Aboussouan LS. Role of mucoactive agents and secretion clearance techniques in COPD. In: UpToDate, Stoller JK (Ed), UpToDate, Waltham, MA.

Ides K, Vissers D, De Backer L, Leemans G, De Backer W. Airway clearance in COPD: need for a breath of fresh air? A systematic review. COPD. 2011 Jun;8(3):196-205.

Make BJ, Petrarche I. (2016). National Jewish Foundation. Techniques to Bring Up Mucus.

U.S. National Library of Medicine. (2016). Postural Drainage. 

Zhang T, Zhou X. Clinical application of expectorant therapy in chronic inflammatory airway disease. Exp Ther Med. 2014 Apr;7(4):763-67.

 

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