Breathing changes are one of the lesser-known challenges of Parkinson’s disease — yet they can have a real impact on daily life. Some patients notice a sense of chest tightness, shallow breathing, or shortness of breath that seems to come and go. Others find their cough feels weaker or their voice sounds softer over time.
These changes happen because Parkinson’s doesn’t just affect movement — it also influences the muscles and nerves that control breathing, swallowing, and speech. Researchers are uncovering effective ways to strengthen breathing, improve comfort, and reduce complications.
In this article, we’ll explore what science now tells us about breathing therapy in Parkinson’s — and share practical, research-based strategies that can help you breathe and live more easily.
For many years, doctors and researchers knew that people with Parkinson’s often struggled with shortness of breath or weak cough, but they didn’t fully understand why. That’s changing.
Recent studies have mapped out the mechanisms behind breathing problems — and just as importantly, have found specific, effective interventions.
We now understand the causes more clearly
Scientists now know that breathing issues in Parkinson’s aren’t simply caused by age or deconditioning. They happen because Parkinson’s affects the whole motor system, including the muscles that move the chest and diaphragm, and even the brainstem centers that control breathing rhythm.
When those signals slow down or become less coordinated, the chest wall becomes stiffer, breaths get shallower, and airflow can become less efficient.
Even small changes in posture — like the stooped position common in Parkinson’s — can make this worse by limiting how fully the lungs expand.
Importantly, researchers now confirm that these breathing problems are very common — estimates suggest between 40 and 60 percent of people with Parkinson’s experience some degree of respiratory involvement.
They’re also clinically meaningful: they can affect speech, swallowing, and overall stamina. Understanding that breathing changes are part of Parkinson’s — not “just anxiety” — is the first step toward getting help.
Strength training for breathing muscles can really help
One of the important breakthroughs in recent years is Expiratory Muscle Strength Training (EMST). This therapy uses a small handheld device that provides adjustable resistance when you blow into it — much like a “weight-training” tool for your breathing muscles.
You exhale forcefully through the device several times in a row, rest, and repeat. A typical program takes only five minutes a day, five days a week, for about four to six weeks.
How it helps:
- It strengthens the muscles that push air out of the lungs.
- It improves the force of coughing — essential for clearing mucus and preventing infection.
- It enhances swallowing safety by improving coordination of the muscles that protect the airway.
Clinical studies in Movement Disorders and Frontiers in Aging Neurosciences show that participants who complete EMST experience measurable improvements in breathing strength, cough, and swallowing within a month. Therapists often notice that people also report feeling more confident eating and speaking, and less short of breath during the day.
It’s a simple, low-risk, home-based therapy with high rewards — and it can easily be added to a regular Parkinson’s exercise plan.
Voice therapy can improve breath control too
Breathing and speaking are two sides of the same coin — every word we say depends on controlled exhalation. That’s why speech therapy programs designed for Parkinson’s, like LSVT LOUD®, often help with breathing as well.
LSVT LOUD® is an intensive four-week program where participants practice speaking loudly and clearly with the guidance of a speech-language pathologist.
By training the voice muscles to work more strongly and efficiently, the therapy also encourages deeper, more coordinated breaths.
Research published in the Journal of Speech, Language, and Hearing Research shows that people who complete LSVT LOUD® not only project their voice better, but also have more stable breathing patterns while talking.
Many report that they can speak longer before running out of air and that their voice sounds stronger and less breathy.
For anyone who’s noticed their voice fading or their breathing changing during speech, this therapy can make a real difference.
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Why this matters: preventing complications
Weak breathing and a weak cough don’t just affect comfort — they can have serious consequences. When the airway isn’t fully protected during swallowing, small bits of food or liquid can slip into the lungs, leading to aspiration pneumonia.
Pneumonia remains one of the leading causes of hospitalization and death among people with Parkinson’s. That’s why early recognition and intervention are so important.
Numerous studies in show that targeted therapies like EMST and LSVT LOUD® significantly improve airway protection and reduce pneumonia risk. These therapies also improve quality of life — giving people more energy, better sleep, and more confidence in daily activities.
What this means for you
Breathing can improve with practice and support. You don’t have to accept breathlessness or weak cough as “just part of Parkinson’s.”
Here are some practical, evidence-based steps to discuss with your healthcare team:
- Notice the patterns: Do breathing changes occur during “off” times or certain positions? Tracking this can help tailor your treatment.
- Ask about EMST: If you’ve had choking, coughing, or shortness of breath, EMST may strengthen your breathing muscles within weeks.
- Consider voice therapy: If your voice feels soft or breathy, an LSVT LOUD® program can help with both communication and breath support.
- Stay active: Gentle aerobic exercise — walking, swimming, cycling — helps maintain lung capacity.
- Work on posture: Upright sitting and stretching exercises open the chest and make breathing easier.
How to discuss breathing issues with your care team
Because breathing symptoms can be subtle, they’re often missed unless you mention them directly.
Here’s how to make sure they’re part of your next appointment:
1. Describe your symptoms clearly
Specific details help your doctor understand what’s happening. You might say:
- “I get out of breath when my medication wears off.”
- “My partner says I snore or stop breathing briefly at night.”
- “I can’t take a full breath, especially when I’m tired.”
Mention when the symptoms occur, what makes them better or worse, and how they affect your daily life.
2. Ask about testing
Your doctor may suggest a few simple tests to learn more:
- Pulmonary function tests (PFTs): measure airflow and lung volume.
- Maximal inspiratory and expiratory pressure tests (MIP/MEP): check breathing muscle strength.
- Sleep study (polysomnography): identifies breathing pauses or sleep apnea.
- Swallowing and cough assessments: often done by a speech-language pathologist (SLP) using imaging or endoscopy to see how safely you swallow.
These tests help determine whether your breathing changes come from muscle weakness, posture, medication timing, or something else.
3. Review your medication schedule
Sometimes shortness of breath worsens during “off” periods — when levodopa or other medications wear off. Adjusting timing or dosage may smooth out fluctuations.
Always talk to your neurologist before making any medication changes on your own.
4. Keep a simple diary
Write down brief notes each day — when you felt breathless, how strong your cough was, how you slept. Over time, patterns emerge that can guide your care team and show which strategies are helping.
Get Your Free Parkinson’s Medication Management Diary
Download your free printable diary to easily track your medications, symptoms, and doses.
Living better with awareness
Breathing problems in Parkinson’s aren’t just about air — they affect movement, speech, sleep, and confidence.
But awareness is powerful. Once you understand what’s happening, you can take action early and prevent small issues from becoming serious complications.
Simple daily habits can make a real difference:
- Sit tall and stretch to open your chest.
- Practice slow, steady breathing — in through your nose, out through pursed lips.
- Stay physically active within your ability.
- Do your EMST or voice exercises regularly.
- Keep your doctor updated on changes.
Caregivers can also help by watching for noisy breathing, shallow breaths, or coughing during meals. Early attention often leads to simple, effective interventions. Breathing may not be visible like tremor or stiffness, but it’s just as important. Addressing it helps protect health, comfort, and independence.
Key takeaway
Breathing changes in Parkinson’s are common, real, and — most importantly — treatable. Therapies like EMST and LSVT LOUD®, paired with mindful breathing habits and good communication with your care team, can make a lasting difference.
When you breathe better, you move better, speak better, and live better.
Every breath truly counts.
Disclaimer: The information shared here should not be taken as medical advice. The opinions presented here are not intended to treat any health conditions. For your specific medical problem, consult with your healthcare provider.
