How to Use an Incentive Spirometer to Treat COPD

Treating COPD

Breathing exercises are an important part of COPD treatment, and experts recommend doing them regularly to keep your breathing muscles strong. They can also help you recover some of the breathing strength and function you lose after an illness or exacerbation weakens your lungs.

Unfortunately, practicing these techniques every day can be tedious, and it's easy to fall behind. It doesn't help that the benefits are usually subtle, and that they tend to happen so gradually that you might not notice them at all.

However, breathing exercises do help, which is why you can find special tools, known as incentive spirometers, to help you do them better. These devices are designed measure your breaths and give help you hone your breathing technique

Incentive spirometers give you real-time feedback as you breathe, allowing you to see and track your results in a way that's just not possible with unstructured breathing exercises. This can help motivate you to practice and strive for better results, whether you use it as part of your regular COPD treatment regimen or means to recover from a COPD exacerbation.

If you are interested in learning more about incentive spirometers and how they can help your lungs, then this post is for you. In the following sections, we'll explain everything you need to know about incentive spirometers and COPD, including what they are, how they work, and how to use them by following a simple step-by-step guide.

What is An Incentive Spirometer?

An incentive spirometer is a simple measurement and feedback device that can help you improve your breathing strength and ability over time. It does this by helping you practice taking long, slow, deep breaths (known in medical jargon as sustained maximal inspirations), and training you how to sustain those deep breaths for longer.

It's essentially a kind of lung exercise and recovery aid for people who struggle to breathe properly. That includes people suffering from lung injuries caused by surgery or pneumonia, and people with chronic lung diseases like asthma and COPD.

What an incentive spirometer essentially does is measure the speed and volume of the air that you inhale. It also has a simple visual mechanism that shows you exactly how quickly and deeply you are breathing in real time while you use it.

Using an incentive spirometer every day can help you strengthen your breathing muscles and improve how well your lungs function. It can increase lung capacity, reduce shortness of breath, and generally make it easier to breathe.

Incentive spirometers are particularly helpful for those who are recovering from a short-term illness like a lung infection or COPD exacerbation. These conditions often cause temporary lung function loss that can be recovered with treatment and time.

However, incentive spirometers do not necessarily work for everyone, and it's important to talk to your doctor if you are considering using one. Whether or not an incentive spirometer is right for you might depend on a variety of factors, including your specific respiratory condition, the severity of your symptoms, and the likelihood that your lung function can improve.

How Does an Incentive Spirometer Work?

There is more than one kind of incentive spirometer, but each type works in a very similar way. To help you get a better general idea of how they work, let's take a look at one of the most common incentive spirometer designs.

This type of incentive spirometer is a hand-held device made up of a handle and a mouthpiece attached to two differently-sized, clear plastic tubes. The large tube measures the volume of air you breathe in, while the smaller tube measures the air speed.

Each tube contains a movable plastic piece, called a “float,” that slides up and down as you breathe. Different spirometers have different types of floats; some look like balls, some look like small cylinders, and some have a flat, puck-like shape.

When you you inhale through the incentive spirometer, it creates an air current that blows the floats in each tube upward. How much they move depends on how fast and how deeply you inhale.

The purpose of these floats is to give you valuable visual feedback about your deep breathing technique so you can see your results and improvements. This helps you learn how to control your breathing better, and can also serve as incentive to practice and work toward better results. 


For the larger tube, your goal is to push the puck up as high as possible by taking in deeper breaths. The markings on the side of the tube indicate how much air (in volume) you inhale.

If you or your doctor wants to set a specific volume goal, you can do this by marking a specific point along this volume measurement tube. Then, you can use that point as a benchmark to measure your progress and to motivate you to push the float up to or beyond that personal goal.

The float in the smaller tube works differently; instead of trying to push it up as high as it will go, your goal is to keep the float within a certain middle range. You can do this by controlling the speed and steadiness of your breath: the faster you breathe in, the higher the float will go.

What are the Benefits of Using an Incentive Spirometer?

If you have COPD, then using an incentive spirometer has many of the same benefits as regular COPD breathing techniques and other inspiratory muscle training exercises. However, incentive spirometers specifically focus on honing deep breathing skills, which are particularly helpful for combating shallow breathing patterns that worsen shortness of breath.

When you practice with an incentive spirometer, you are essentially training your lungs to take longer and deeper breaths. This helps to increase your lung capacity—or how much air you can breathe in to your lungs at one time—which helps your lungs work more efficiently.

Practicing with an incentive spirometer also helps you exercise specific muscles in your abdomen and chest that you use to breathe. Making these muscles stronger not only makes it easier to breathe, but can also reduce chest muscle tightness, chest pain, and fatigue.

This is an important benefit for people with COPD, who experience shortness of breath at least in part due to respiratory muscle fatigue. Tired breathing muscles can trigger quick, shallow breathing which technically requires less effort, but is also less effective at getting you the oxygen you need.

Using an incentive spirometer can help you correct this breathing pattern by helping you build up the strength and skill you need to breathe more deeply instead. It also allows you to see your improvements over time and measure your progress toward personal breathing goals.

Unfortunately, while we know that incentive spirometers work, there have not been very many studies done on incentive spirometers and COPD in particular. Fortunately, what little research that has been done shows very promising results.

One study, for example, looked at the effects of incentive spirometers on patients with mild to severe COPD. It found that participants who used incentive spirometers experienced both an increase in exercise capacity and a decrease in shortness of breath.

Another study using the Respivol incentive spirometer also found a variety of positive results for people with COPD. Those who used the device regularly for 3-6 months showed a significant increase in certain lung function measures (maximal inspiratory pressure and maximal expiratory pressure), as well as reduced shortness of breath, increased exercise tolerance, and even an increase in quality of life.

However, it's important to realize that there is no known treatment, including incentive spirometers, that can reverse any of the permanent lung damage caused by COPD. They can, however, help you breathe more efficiently, and potentially even return back to baseline after temporary lung function loss caused by an illness or exacerbation.

Where to Get an Incentive Spirometer

If your doctor recommends or approves you to use an incentive spirometer, you have a few different choices of where to get one. In some cases, you can purchase one directly from your doctor, but that can be pricier than buying one yourself.

The easiest place to purchase an incentive spirometer on your own is to go to a medical supply store, either in person or online. You might also be able to find one at your local pharmacy or in the medical section of a general store like Walmart.

If you will be buying your incentive spirometer yourself, you might still want to ask your doctor to give you a prescription for the device. You can buy them over the counter, but you will need a prescription if you want it to go through your insurance and if you want to pay for it with your FSA or HSA account.

Luckily, incentive spirometers are surprisingly inexpensive, costing less than most fast food meals. You can buy them in most places for between $6 and $20, depending on the type and brand you buy.

How to Use Your Incentive Spirometer

As we mentioned before, incentive spirometers are not all the same and come in a variety of sizes and shapes. Because of this, there is no single set of instructions for how to use an incentive spirometer that will work perfectly with every type.

It's also important to note that, while text and video instructions can certainly help, nothing can substitute for a doctor's expertise. To ensure you use your incentive spirometer correctly, you should ask your doctor to demonstrate how to use it, and then practice in front of her so she can evaluate your technique.

Bearing these things in mind, let's take a closer look at how to use the basic dual-tube spirometer we described in a previous section. This is one of the most common incentive spirometer designs that you will find in most medical supply stores, from the brands Medline, Teleflex, SPIRO-BALL, and Respivol.

Before using your incentive spirometer, make sure to position your body upright in a position that makes it easier to breathe. Ideally, you should sit up straight in a chair or on the edge of your bed.

Avoid wearing tight clothes, belts, or anything else that could restrict your ability to breathe. You might also want to clear out your airways before you begin by practicing controlled coughing or other mucus clearance techniques.

Steps to Use an Incentive Spirometer:
While sitting in a relaxed, comfortable position, hold your incentive spirometer upright in front of you.
Seal your lips around the mouthpiece.
Inhale as slowly and deeply as possible, then hold your breath for as long as you can (at least 3-5 seconds).
While breathing in, watch the float in the smaller tube, and try to keep it within the marked range (this measures your breathing speed).
You can change the position of this float by adjusting how quickly you inhale.
Increasing the speed of your breath will move the float higher, while slowing it down will cause the float to fall down lower.
While breathing in, watch the float in the larger tube and try to push it as high as possible (this measures the volume of your breath).
Note which measurement mark the float reaches at it's highest point.
The deeper breath you take, the higher the float will go.
If your spirometer has a movable indicator on the outside of the tube, you can use this to mark the maximum height.
Record this measurement for future reference and to help you keep track of your progress.
Take a few moments to rest.
Repeat these steps for another 10 to 15 breaths in order to complete one full incentive spirometer session.

If at any point you start to feel dizzy or lightheaded, you should stop and take a break to breathe normally for awhile. Once you feel better, you can continue using your incentive spirometer again.

To see these steps in action, check out this video demonstration:

Continuing to Practice

Incentive spirometers are not a one-time or occasional treatment; they only work if you use them often over an extended period of time. How long that time is depends on your particular health condition and your reason for using the incentive spirometer.

If you are using an incentive spirometer for normal COPD maintenance, then your doctor may advise you to use it long-term or indefinitely. If you are using an incentive spirometer to help your lungs recover from an exacerbation, then you might be able to stop using your incentive spirometer after several weeks or months.

Either way, you will need to use your incentive spirometer every day in order for the treatment to be effective. Your doctor will tell you often you should use it during the day based on your health and treatment goals.

In a hospital setting, doctors often recommend using an incentive spirometer very frequently; usually once every 1-2 hours for patients recovering from serious lung infections and surgeries. However, this can differ from person to person, which is why you should always follow your doctor's specific advice.

It's also a good idea to keep records of your incentive spirometry results for you and your doctor to discuss and evaluate later. Simply write down your highest volume measurement you get from each incentive spirometer session, and then you'll be able to track any changes that happen over time.

Most importantly, don't give up on your incentive spirometer if you don't notice results right away. Real improvement takes time, so it's important to practice, persevere, keep working toward your personal incentive spirometry goals.

Managing COPD and lung function decline is tough, but there is a wide variety of tools and treatments available to help. Tools like incentive spirometers can help you keep up with certain aspects of treatment—like breathing exercises—by providing a simple and satisfying way to practice every day.

Incentive spirometry is safe, inexpensive, and has the potential to provide a variety of breathing and exercise benefits for people with COPD. It's easy to get the hang of and, if you stick with it long enough, it can make a noticeable difference in your symptoms.

If you or someone you love suffers from COPD, consider asking your doctor if she believes that an incentive spirometer would be a helpful addition to their home treatment regimen. While not every person will see significant improvements after using an incentive spirometer, many do, and it's well worth considering giving it a try.

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