Version July 2025
| Mild dyspnea | Moderate dyspnea | Severe dyspnea |
| Treat underlying disease* Treat psychosocial factors¶ | Treat underlying disease Treat psychosocial factors Pulmonary rehabilitationΔ Consider anxiolytic§ | Treat underlying disease Treat psychosocial factors Pulmonary rehabilitation Facial cooling (by use of fan) Opioids◊ Anxiolytics§ Noninvasive ventilation |
* Treat underlying disease includes anemia, pleural effusions, congestive heart failure, reversible airway obstruction, hypoxemia, main stem bronchial compression or obstruction.
¶ Treat psychosocial factors: For anxiety, use relaxation techniques, distraction, activity modifications, behavior modifications, and breathing strategies. For depression, use cognitive therapy, antidepressants, or a combination of both.
Δ Pulmonary rehabilitation includes exercise training, psychosocial support, nutritional therapy, and self-management education, including breathing strategies, use of supplemental oxygen, pharmacologic therapy (to relieve airways obstruction), and panic control.
◊ Evidence indicates that they do not cause premature death in end-of-life patients when titrated to relieve pain or dyspnea.
§ UpToDate authors suggest that anxiolytics be considered for dyspnea-related anxiety, but note that there is no evidence that anxiolytics alone reduce dyspnea.