# Positions to ease breathlessness: sitting, standing and lying

Source: https://breathingexercises.uk/exercises/positions-for-breathlessness/
Author: Nell Avery · Updated 2026-11-04

**Short answer:** Leaning forward with your arms supported is the most useful position when you are breathless. Sit with your forearms on your thighs or a table, or stand leaning on a wall or worktop. It lets your diaphragm and shoulder muscles work more easily. Then breathe out slowly through pursed lips until your breathing settles.

**Evidence grade:** Weak evidence. Small or short studies, surveys, or results that are mixed.

## Why does your position matter?

Your diaphragm works best when it is dome-shaped. In COPD, and whenever you are very breathless, your lungs stay over-full and push the diaphragm flat, so each contraction moves less air. You then lean on the muscles of your neck, shoulders and upper chest, which tire quickly.

The positions on this page help in two ways. Leaning forward lets your tummy press gently up under the diaphragm and restore some of its dome. Resting your arms on something steadies your shoulders, so the muscles that run from your shoulders to your ribs can lift the chest instead of lifting your arms. Many people with COPD find these positions on their own; you will often see someone leaning on a shopping trolley or a wall to get their breath back.

## When should you use them?

- **To recover** after walking, stairs, washing or dressing.
- **During a flare-up**, while you wait for your reliever or other medicines to work.
- **At night**, if lying down makes you breathless.
- **When you are out**: a wall, railing, bus shelter or trolley will do.

Once you are in position, slow your breathing with [pursed-lip breathing](/exercises/pursed-lip-breathing/) or gentle [diaphragmatic breathing](/exercises/diaphragmatic-breathing/).

## What the research shows

The idea goes back to physiology studies in the early 1980s, which found that many people with severe COPD were less breathless leaning forward, and that their diaphragms worked more efficiently in some positions than others.

A 2024 study measured the activity of the breathing muscles in 16 people with COPD across eight positions. Sitting and leaning forward, with forearms on the thighs or on a table, needed the least muscle effort. Lying flat on the back needed the most. Standing leaning forward, leaning back against a wall, sitting upright and lying propped up all came in between.

These are small studies that measured muscle effort over minutes, not trials of how people fared over months, so we grade the evidence as weak. But the positions are free, safe and standard NHS advice, and many people find them the quickest way to get their breath back.

## Common mistakes

- **Hunching your shoulders.** Let them drop away from your ears. If your shoulders are up, you are holding tension, not resting.
- **Gripping hard.** Rest your arms on the support; don't push down on it.
- **Lying flat.** Lying on your back usually makes breathlessness worse. Prop yourself up.
- **Only trying them in a crisis.** Practise each position when you are well, so you can use it without thinking.

## When breathlessness is an emergency

Call 999 if you are breathless and also have chest pain, blue or grey lips or skin, confusion or sudden drowsiness, or can't speak in full sentences, or if your breathing doesn't ease with rest and your usual medicines. See [breathlessness: when to get help](/conditions/breathlessness-when-to-get-help/).

## Frequently asked questions

### What is the best position for shortness of breath?

Sitting and leaning forward, with your forearms resting on your thighs or on a pillow on a table. In a study of 16 people with COPD, these two positions needed the least effort from the breathing muscles of all eight positions tested.

### Why does leaning forward help breathlessness?

Leaning forward lets your tummy push gently up under the diaphragm, giving it a better shape to work with. Resting your arms steadies your shoulders, so the muscles of your neck and chest can help pull air in.

### Is lying flat good for breathlessness?

Usually not. In the same study, lying flat on your back took the most effort of any position. If you need to lie down, prop yourself up on pillows or lie on your side with your head and shoulders raised.

## References

1. [Topcuoglu C et al. Neural respiratory drive during different dyspnea relief positions and breathing exercises in individuals with COPD. Respiratory Care, 2024.](https://pubmed.ncbi.nlm.nih.gov/38744480/)
2. [Sharp JT et al. Postural relief of dyspnea in severe chronic obstructive pulmonary disease. American Review of Respiratory Disease, 1980.](https://pubmed.ncbi.nlm.nih.gov/7416599/)
3. [Druz WS, Sharp JT. Electrical and mechanical activity of the diaphragm accompanying body position in severe chronic obstructive pulmonary disease. American Review of Respiratory Disease, 1982.](https://pubmed.ncbi.nlm.nih.gov/7065537/)
4. [Asthma + Lung UK. Breathlessness.](https://www.asthmaandlung.org.uk/symptoms-tests-treatments/symptoms/breathlessness)