Is it too late to improve my breathing?

No. Respiratory muscle strength responds to training at any age, and the randomised trials of inspiratory muscle training that produced the largest blood-pressure effects were done in midlife and older adults specifically.

Should I do breath holds or the Control Pause?

Not as a starting point, and not at all with heart disease, uncontrolled blood pressure, glaucoma or a stroke history. Slow continuous breathing has all the benefit and none of the pressure spike.

It loads the breathing muscles, trains breath support, and singing groups have good evidence for wellbeing and for breathlessness in lung conditions. It is one of the more enjoyable ways to do this work.

Breathing exercises in later life: strength, balance and blood pressure

You get breathless on stairs that used to be nothing. Your voice does not carry as it did. You would like to do something useful and specific rather than being told to take it easy.

Do this now

Slow breathing, seated, ten minutes

10 minutes

Sit in a firm chair with your feet flat and your back supported. Do not do this standing at first.
Mouth closed. In through the nose for about five seconds, out for about five. No holds.
Keep it comfortable — you should be able to hold a conversation afterwards without being winded.
Ten minutes. If you feel light-headed, stop, sit still and breathe normally.
Once this is easy, ask a clinician or physiotherapist about inspiratory muscle training, which is the version with the better numbers.

Run it with a timer

What changes with age

Respiratory muscle strength declines with age, the chest wall becomes stiffer, and lung elastic recoil reduces — so the same activity costs more breathing work. Reduced respiratory muscle strength is associated with poorer functional capacity and, in cohort studies, with mortality. It is also trainable, which is the useful half of that sentence.

Inspiratory muscle training is the standout

Training the inspiratory muscles against resistance — a few minutes a day with a handheld device — improves respiratory muscle strength in older adults, and high-resistance protocols have lowered systolic blood pressure substantially in midlife and older adults in randomised trials. It is one of the better-evidenced small interventions available in later life, and it needs a device and preferably a clinician's guidance to set the resistance.

What to be careful about

Breath holds and Valsalva-type efforts carry more risk with age and with cardiovascular conditions, so the Control Pause and breath-hold training are not the place to start. Practise seated rather than standing until you know how you respond, because light-headedness and falls are a worse outcome than a missed session. And if there is breathlessness on exertion that is new or worsening, that is an assessment rather than a training question.

What changes it, over a week

Daily, ten minutes
Slow nasal breathing at about six breaths a minute, seated. Consistency is the whole mechanism.
Most days
Walking, and something that involves standing up from a chair repeatedly. Breathing work does not replace strength and balance work.
Speak and sing
Reading aloud, singing or a wind instrument all load the breathing muscles pleasantly. Singing groups have good data on wellbeing as well.
Ask about
Inspiratory muscle training with a device, and a blood-pressure check. Both are specific, cheap and under-used.

When this is not a breathing pattern

See a clinician — promptly, and before assuming any of this applies to you — if any of these describe you:

New or worsening breathlessness on exertion, or breathlessness at rest or lying flat — needs assessment
Chest pain, palpitations, or fainting and near-fainting — urgent assessment
Ankle swelling, or waking at night breathless
Avoid breath holds and straining if you have heart disease, uncontrolled blood pressure, glaucoma or a history of stroke
Any fall, or new unsteadiness — that needs review rather than more exercise alone

This page is education, not medical advice, and no part of it is a diagnosis. Full disclaimer.

Questions people ask

Is it too late to improve my breathing?: No. Respiratory muscle strength responds to training at any age, and the randomised trials of inspiratory muscle training that produced the largest blood-pressure effects were done in midlife and older adults specifically.
Should I do breath holds or the Control Pause?: Not as a starting point, and not at all with heart disease, uncontrolled blood pressure, glaucoma or a stroke history. Slow continuous breathing has all the benefit and none of the pressure spike.
Does singing count?: It loads the breathing muscles, trains breath support, and singing groups have good evidence for wellbeing and for breathlessness in lung conditions. It is one of the more enjoyable ways to do this work.

What this page is built on

— Craighead et al., 2021, Journal of the American Heart Association — high-resistance inspiratory muscle strength training and blood pressure
— Rodrigues et al., 2017, and respiratory ageing reviews — respiratory muscle strength decline and functional consequences
— Sclauser Pessoa et al., 2014, Brazilian Journal of Physical Therapy — inspiratory muscle training in older adults

Named by author and year. The DOIs live in the journal.

Put a number on it

Most of what is on this page tracks one measurement: the Control Pause. It takes sixty seconds, needs no account, and it is the thing that tells you whether any of this is working.