Why is it important to clear sputum?

Sputum can be a problem for some people with respiratory conditions. In some respiratory diseases, the body's normal sputum clearance mechanism does not work effectively, so it is important to do as much as possible to help keep your chest clear.

There is no evidence to show that clearing sputum will significantly improve lung function. However:

• uncleared sputum can increase the risk of infections
• repeated infections can cause further airway damage
• uncleared sputum can increase breathlessness
• uncleared sputum can be unpleasant and uncomfortable.

For these reasons, it is important to keep your lungs as clear as possible.

Clearing your lungs in public can sometimes feel embarrassing. You may find it helpful to clear your lungs before going out or to find a place where you feel comfortable.

You may notice changes in the colour, consistency or amount of sputum when you have an infection or an exacerbation of your condition.

If this happens, contact the Community Respiratory Team.

Medications

If you have difficulty clearing secretions, you may benefit from a trial of medication to help clear sputum from your lungs.

This will need to be discussed and agreed with your GP.

Physical exercise

Physical exercise, such as walking, can help loosen trapped secretions in the lungs, making them easier to cough up and clear.

Try to exercise at a level that makes you slightly short of breath but still able to speak in full sentences.

Hydration and humidification

Drinking fluids helps maintain hydration within the lungs.

If the body becomes dehydrated, sputum can become thick, sticky and more difficult to clear.

You can help stay hydrated by drinking plenty of water and other clear fluids.

Your fluid requirements may increase during hot weather or when you have a raised temperature.

Staying hydrated can also help you feel more alert and improve your general wellbeing.

Active cycle of breathing technique

The active cycle of breathing technique is a breathing cycle that combines relaxed breathing, deep breathing and huffing.

It can help loosen and clear sputum that is difficult to bring up.

Step one – breathing control

• sit comfortably, or in the position recommended by your physiotherapist
• relax your shoulders
• breathe gently at your normal rate
• feel your stomach rise as you breathe
• continue for about one minute.

Step two – deep breaths

• take three deep breaths
• hold each breath for three seconds if possible
• breathe normally between breaths if needed
• your physiotherapist may ask you to add a sniff at the end of the breath
• return to breathing control.

Step three – huff

• take a medium-sized breath in
• perform a huff
• a small cough should help clear your phlegm
• return to breathing control.

If you cannot clear your sputum the first time, return to the beginning of the cycle and repeat until your lungs feel clear.

If you cough during the cycle, return to breathing control and continue the cycle until your lungs feel clear.

Breathing cycle summary