Breath Stacking is a technique that some patients at our clinic find beneficial especially if started early. It is simple and can be done without any equipment. By fully and slowly breathing in and stacking one breath on top of another, you stretch lung muscles and pop open under-inflated air sacs. This provides more surface area for oxygen to defuse into your blood vessels. Well-oxygenated blood is then circulated to your muscles and organs.
After taking several of these stacked breaths and fully exhaling after each one, patients report that coughing and swallowing is improved. In addition many patients say they feel more calm and relaxed and their breathing is easier. These benefits may continue for several hours. The technique for simple breath stacking is described below and demonstrated in the video “Simple Breath Stacking” in the Video Gallery.


  1. Sit comfortably.
  2. Loosen restricting clothing or belts.
  3. Take in a full breath through your nose, allowing your stomach and lower ribcage to expand outward.
  4. Trap this breath by closing your vocal cords.
  5. Take in a smaller second breath and trap it.
  6. Take a third breath until your lungs are full.
  7. Hold your breath for 2 to 3 seconds. Let all the air out of your lungs through your mouth making a shushing sound.
  8. Rest for about a minute before repeating.
Do a series of 5 breaths 4 times a day.


Blowing up a Balloon: Take one big breath to open it up, then smaller breaths to make it bigger.

Watch a video of breath stacking

  1. Why do you recommend exhaling through the mouth rather than the nose?

    • Sara, thanks for your question. One can exhale through the nose as well as the mouth. However, I have found that a full exhalation is easier to accomplish through the mouth (similar to breath work that is integral to Yoga, Pilates or Qi Gong practice). People are more likely to engage their core and abdominal muscles to assist in exhalation when exhaling slowly through the mouth. In addition, if people have dysmotility of the oropharynx, floppy upper airway tissues, bulbar muscle weakness or airways that tend to collapse on exhalation (COPD, reactive airway disease) exhaling through the mouth with lips pursed or close together creates back pressure that can stint the airway and back of the throat open. Ultimately, what is most comfortable and effective for the patient is how you will coach them. Try both techniques yourself with the above scenarios
      in mind and see what feels right to you.