To Breathe or not to breathe: Suffering with COPD

Greetings Friends of Buddha, I need your help to understand a sort of catch 22 that has plagued me for many years. I, along with many others, have asthma in all of its glorious forms including allergic and exercise induced asthma. I also have COPD, but the labels are meaningless as all forms of this condition have the same effect which is the destabilization of my emotions.

Breath is the age old prescription for calming meditation, and the most effective way of finding peace and joy through the deep exploration of consciousness. Until recently I have always been able to find and employ enough breath to help me transcend my emotional turbulence. But lately due to a variety of causes I have been stressed out by my inability to maintain anything but the shallowest of breath.

So here is my question: if all of the suggestions for the discovery of deeper states of joy, and peace, and awareness involve breath meditation, and the very act of deep breathing causes myself and others to suffer in the process, how is a serious Buddhist to transcend this conundrum?

With Metta, as always.


Hi Rosie,

I’m sorry to hear about your recent medical trouble and I wish you a speedy recovery.

I too have been diagnosed with asthma (cough variant) and have had pneumonia several times in my life. While a deep, full breath feels wonderful, well do I know it isn’t always possible.

The good news is that it isn’t necessary for breath meditation. As the Ānāpānasati Sutta says: if your breath is long, simply know “this is a long breath” and if your breath is short, just know “this is a short breath.” That’s all. It’s the knowing (not the breathing) that makes the meditation :wink:

That said, sometimes — if we’re very ill or injured — the breath can be so painful that it’s not calming at all. Thankfully, there are other meditation objects that can be taken up at such times. If the pain really is too much, you can always do a body scan, repeat a mantra, spread loving kindness, or simply listen to the sounds around you.

But to truly “transcend this conundrum” once and for all: let go of the body.

Hope that helps!


I don’t think breaths need to be necessarily deep. The transition implied in the Anapanasati sutta is from a heavy to light breath, and as soon as possible one should train to be aware of how that conditions further the physical experience as a whole.

"When a mendicant has gone to a wilderness, or to the root of a tree, or to an empty hut. They sit down cross-legged, with their body straight, and establish mindfulness right there. Just mindful, they breathe in. Mindful, they breathe out.
When breathing in heavily they know: ‘I’m breathing in heavily.’
When breathing out heavily they know: ‘I’m breathing out heavily.’
When breathing in lightly they know: ‘I’m breathing in lightly.’
When breathing out lightly they know: ‘I’m breathing out lightly.’
They practice breathing in experiencing the whole body.
They practice breathing out experiencing the whole body.
They practice breathing in stilling the body’s motion.
They practice breathing out stilling the body’s motion.

The order of the words above imply to me that the light or shallow breathing that kicks in after a while defines the point at which one can broaden awareness to the body and witness how that lighter breathing calms the body itself.


Thank you so much for that illuminating reminder of How and why one should breathe in meditation. Perhaps I should be clearer: I find that when I am NOT meditating, and still trying to observe and detach from negative emotions that I consistently lose control. And when that happens-gasping for breathe during the lightest form of exertion I get stuck in my own misery, and feel destabilized, angry with my body, prone to irritable outbursts, and say things that I don’t always mean. I might shout “Just leave me alone!” or "I don’t need your help! which of course I do.

And I have found no remedy for this ongoing visceral anxiety based irritation. Meditating is actually the easier time to breathe. The rest is just a struggle.

Thank you again. :face_with_thermometer:


The good news is that there are a great many methods described in the early discourses, aside from breathing, for attaining deeper states of calm, joy, and peace. There is a very common “causal sequence” leading to samādhi (collectedness or unification of mind) in the suttas that follows this pattern:

[a certain practice] → gladness (pāmojja) → joy/delight (pīti) → calm/tranquility (passaddhi) →
pleasure (sukha) → collectedness/unification of mind (samādhi)

Here are the common methods or themes that go in the [certain practice] spot and that the suttas describe as leading to the rest of the causal sequence above:

  1. Hearing the Dhamma (MN 7)
  2. Reflecting on the Dhamma (MN 7)
  3. Reciting the Dhamma (AN 5.26)
  4. Teaching the Dhamma (AN 5.26)
  5. Satipaṭṭhāna (DN 18)
  6. Seeing that the mind is currently free from unskillful thoughts/mind states (MN 40, DN 2)
  7. Recollection of the Buddha (AN 6.10)
  8. Recollection of the Dhamma (AN 6.10)
  9. Recollection of the monastic Sangha (AN 6.10)
  10. Recollection of one’s own generosity (AN 6.10)
  11. Recollection of one’s own moral conduct (sīla) (AN 6.10)
  12. Recollection of the devas and seeing the same qualities in oneself (AN 6.10)
  13. Radiation of the brahmavihāras (SN 42.13)
  14. Living in harmony with others, seeing them with kind eyes (AN 3.95)
  15. Focusing on a gladdening/inspiring theme (SN 47.10)

Perhaps this list might give you more options to choose from than the breath.


Lots of good study material there! This will take some time. Thanks very much!

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In such a situation the practitioner should understand that transgression is countered by knowledge of sila, the foundation of the path. They should therefore take the emphasis off meditation (the second stage), and focus on controlling their physical actions (speech).

“The Buddha teaches that the defilements are stratified into three layers: the stage of latent tendency, the stage of manifestation, and the stage of transgression. The most deeply grounded is the level of latent tendency (anusaya), where a defilement merely lies dormant without displaying any activity. The second level is the stage of manifestation (pariyutthana), where a defilement, through the impact of some stimulus, surges up in the form of unwholesome thoughts, emotions, and volitions. Then, at the third level, the defilement passes beyond a purely mental manifestation to motivate some unwholesome action of body or speech. Hence this level is called the stage of transgression (vitikkama). The three divisions of the Noble Eightfold Path provide the check against this threefold layering of the defilements. The first, the training in moral discipline, restrains unwholesome bodily and verbal activity and thus prevents defilements from reaching the stage of transgression.”—"The Noble Eightfold Path", Bikkhu Bodhi.

Moral action precedes meditation:

" One time, when a monk approached the Buddha
and asked for the training in brief, the Buddha told him: “First
establish yourself in the starting point of wholesome states, that
is, in purified moral discipline and in right view. Then, when
your moral discipline is purified and your view straight, you
should practice the four foundations of mindfulness” (SN 47:3)."

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Okay, straight to the point. I get it, and I have a lot of work to do. So if I hear you right, those defilements which arise under duress are a manifestation of unwholesome attitudes which I generally suppress…until they arise in response to physical suffering? I will continue to work on this. Thank you

If I may ask, do you smoke?

Something I find useful as a grounding method is what I call “feeling your weight”, which is just noticing the bodily sensations of pressure due to gravity/weight. Those sensations are continuously available, and can be used to re-establish mindfulness off the cushion.
As for on-the-cushion methods, have you considered kasina practice, eg using a coloured disc?
Some metta practice focused on the first stage (self) might also be useful, being kinder to yourself.

“If I may ask, do you smoke?”
Funny but that is almost always the first question people ask about COPD, but NO! That would be kinda counter productive. I quit about ten years ago. But I started life with childhood asthma.

Always good advice. Thanks!

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I confess my ignorance regarding a ‘color disc’. Could please explain or provide a reference?

Thanks again

I, along with many others, have asthma in all of its glorious forms including allergic and exercise induced asthma. I also have COPD, but the labels are meaningless as all forms of this condition have the same effect which is the destabilization of my emotions

That’s an object of meditation.

Breath is the age old prescription for calming meditation, and the most effective way of finding peace and joy through the deep exploration of consciousness>

You have assumed that, and as a consequence you feel frustrated. In the same way, those who assume that meditation can only be done sitting on the floor, and not having the physical condition to endure the posture they believe they cannot meditate.


Kasina practice is detailed in the Vissudhimagga, Chapter 5 I think. It includes using colours and elements as objects of concentration, as an alternative to the breath. Traditionally you use a coloured disc for the colour kasina. I have a blue one, about 10" diameter - you could make one easily using coloured card.
Alternatively you could just try watching a lighted candle, which would be a version of the fire element kasina.
Working with an object other than the breath for a while might help? I have mild COPD, so I understand why this could be an issue.

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For years, I have experienced sleep apnea (stoppage of breath during sleep, either from physical obstruction or nervous system causes). I came to consider this as one of the most fortunate, instructive experiences in this life. For me, it seemed to eventually allow for two distinct beneficial practices:

  • Confronted again and again with the panic of the body during what seemed to be life termination episodes, I tried to observe closely. The mind can imo get bored with the panic of the body! Panic itself can be broken down by repeated observation. And beyond panic, interesting observations can occur.
  • Metta meditation for one’s body and its parts & processes, and for all life, both during these episodes and during other parts of time, can be cultivated. In my experience, it can be of immediate benefit to interrupt the feedback loops of mind & body panic. This seems to be a skill or state of mind which improves with practice.

:slight_smile: There is opportunity, regarding mental behavior at least, in human life; in maybe all of it? In planned retreats, and in the asthma/apnea attacks; in mealtime(s), and the day to day; in whatever each life gets, the highs, lows, and ordinary! Irritation in some ways is just a view; I suggest you get bored with it (edit maybe that is already occurring?), and let irritation go, no matter episodes or non-episodes; interrupt irritation!

Use if helpful. :slight_smile: Ignore if not. May you and I and all be happy, peaceful, and ultimately free.


Hi, and thanks so much for your intelligent response.

Terribly sorry to hear about your personal form of physical suffering. And thanks for sharing. Knowing that others people suffer takes me out of my own, and reminds me to be compassionate for us all.

This is a very interesting observation as it gets down to the ‘nuts and bolts’ of what really happens emotionally during states of extreme discomfort. Maybe panic is what I feel, but more than that I seem to become irrationally angry. Strange because it comes as if on its own volition, though I suppose somewhere in the EBT’s that there is some description of the formation behind it?

Great idea! But I am as of yet unable to establish any form of control over my emotions at the point of gasping for breath. Anger simply rises in response. I intend to do more research on the biochemical/emotional effects of low blood oxygen levels, and may return with the results. For now I try to maintain by reminding myself not to get shot with the same arrow twice!

Of course your comments were helpful. May we all be relieved of suffering. Metta

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My understanding is that breath meditation only involves watching the breath, not altering it.
You are doing unaltered breathing all of the time, so if you can learn to just watch, without interfering you should be okay.


More great advice. My problem is that I do not know how to merely watch it without being overcome with anger and sadness. In the midst of a low oxygen event, I seem to have no control over my anger. I will continue to practice. Thanks.

2 Likes of O2 availability within the central nervous system, secondary to high altitude exposure induces a variety of neuropsychological impairments (Winget and DeRoshia, 1986; Hornbein, 2001) including alterations in cognition, mood, behavior and sleep indices. Other symptoms that are manifest during hypoxic exposure include impairments of coordination, vision, cognitive function, alertness, vigor, etc. (Acevedo and Ekkekakis, 2001; Virués-Ortega et al., 2004). Importantly, these symptoms are commonly complemented by increases of negative psychological and emotional responses and a decrease of the positive psychological profile elements (Yeung, 1996; Ishizaki et al., 2002; Lipnicki and Gunga, 2009). It has to be noted, however, that significant inter-individual differences in neuropsychological changes at high altitude have been reported (Hornbein et al., 1989; Hornbein, 2001). Indeed, large inter-individual differences might lead to different cognitive responses to various situations and consequently modulate an individuals’ ability to adapt to adverse environments (Bahrke and Shukitt-Hale, 1993; Acevedo and Ekkekakis, 2001). Moreover, a moderating role of personality characteristics has also been suggested to influence the measured outcomes (Virués-Ortega et al., 2004).Biological impact of hypoxia

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Thus the potential for Buddhism to mediate the attendant suffering?

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