Autogenic Drainage (AD)

This is gentle and safe to use even of you are coughing up some blood.

It involves breathing at different volumes and works by moving sputum from the smallest airways to the bigger ones like squeezing toothpaste along a toothpaste tube.

This may work best if you produce a lot of sputum.

The breath in

  • Should be moderate sized and gently through your nose so you do not hear the breath in; if it is too fast you will hear it.

  • Fully inflate your lungs and hold the breath for a couple of seconds if you can.

The breath out

  • Should be through a wide-open mouth and is a gentle sigh as if gently steaming a mirror or glasses

  • Should not be forced

  • Listen for the sound of sputum moving

Cough suppression

  • Try to supress your cough for as long as possible during this breathing exercise to make it more effective.

  • Fully inflate your lungs and hold the breath for a couple of seconds if you can.

Start with a test breath

Start with a test breath – this is a breath in and out as described above. You may need to do several until you start to hear the crackles of sputum moving.

  • If you hear loud crackles at the start of the breath out your sputum is high up – try to huff / cough and clear it.

  • If the crackles are quieter and towards the end of your breath out your sputum is further along towards the end of your airways.

Initially take a full AD style breath in then breathe all the air out through a wide mouth without forcing it (if this makes you wheezy then you are probably forcing it too much) then take a moderate breath in and breath all the air out again. Repeat this until the crackles become louder. As the crackles get louder gradually take a slightly bigger breath in and a moderate breath out (you don’t need to breathe all the way out as you take a bigger breath in) until you are taking a full breath in and a moderate breath out.

The 2nd link below has an AD leaflet which includes a diagram that shows the breathing at different levels.