When you’re living with bronchiectasis, your primary goal in managing the condition is to reduce “exacerbations” — episodes in which you’re coughing, breathless, and making more phlegm — and to prevent the infections that lead to them, says Panagis Galiatsatos, MD, national spokesperson for the American Lung Association and assistant professor at the Johns Hopkins School of Medicine in Baltimore.
While your daily airway clearance routine remains the heart of your treatment plan, these additional lifestyle habits may further help reduce flares and keep your lungs as healthy as possible.
1. Make Exercise a Priority
Many people with bronchiectasis find that physical activity causes shortness of breath, so they exercise less, which then leads to poor conditioning and even more breathlessness. Dr. Galiatsatos says exercise is “100 percent overlooked” but essential for breaking this vicious cycle.
While exercise can’t reverse lung damage, it can help strengthen the healthy parts of your lungs, improve breathing, and reduce flare-ups. It can support your mental health as well.
Amit “Bobby” Mahajan, MD, national medical spokesperson for the American Lung Association and system chief of interventional pulmonology at Inova Health System in Virginia, recommends a two-phase approach: aerobic activity like walking for endurance, and resistance training with light weights to strengthen the upper chest. “Those are really what’s going to help you take deeper inspirations,” says Dr. Mahajan.
Always check with your healthcare provider before starting a new exercise routine. Ask how often you should exercise and if there are any specific exercises you should avoid.
2. Mind Your Environment
Air pollution is a significant trigger for bronchiectasis flares. Even small, daily increases in exposure to air pollutants, such as nitrogen dioxide from traffic or fine particles in the air, can increase your risk of an exacerbation by up to 11 percent.
To protect your lungs, make checking the air quality index part of your morning routine, just like you check the weather. “Anything greater than 100, I would really limit my time outdoors,” says Galiatsatos.
Paying attention to other triggers like allergies, including seasonal allergies, is also important. “Change your air filter in your heating, ventilation, and air-conditioning (HVAC) system a minimum of twice a year, and in areas of your home where you spend the most time, consider purchasing a HEPA filter to keep air quality as pristine as possible,” says Galiatsatos.
To avoid allergens like dust, mold, and pet dander that can cause inflammation, Galiatsatos recommends keeping your pet out of your bedroom, changing and washing your bed linens frequently, and wearing clean clothes to bed.
3. Stay Current on Your Vaccines
For someone with bronchiectasis, viral respiratory infections like the flu or COVID-19 are notorious for triggering severe flare-ups, causing the lungs to become more inflamed and making it harder to breathe and clear mucus. Staying current on your vaccinations can go a long way toward preventing infection and even hospitalization.
In addition to your annual flu and COVID-19 vaccines, talk to your doctor about the pneumonia, RSV (or respiratory syncytial virus), and shingles vaccines, says Mahajan.
If you’re taking the disease-modifying drug brensocatib (Brinsupri), discuss your health history and vaccine status with your doctor. They may recommend avoiding live attenuated vaccines, such as those for measles or certain flu sprays, to prevent potential interactions.
4. Practice ‘Infection Control’ in Your Social Life
Staying healthy and infection-free also requires taking steps to avoid the germs that cause respiratory illnesses. Practice good hand hygiene, and wear a face mask in crowded public spaces like grocery stores or airports, especially during peak viral seasons, says Galiatsatos.
Setting social boundaries is also key. If a holiday party or family gathering coincides with a known illness in the household or a surge in local flu cases, it’s okay to decline an invitation or ask for a raincheck. Think of it not as a snub to your friend or loved ones, but as a medical necessity to prevent infection and flare-ups.
5. Eat for Energy and Lung Strength
Food is the fuel your body needs for every activity, including breathing. While there isn’t one ideal diet for people with bronchiectasis, consuming the right balance of nutrients can help boost your energy levels and help you maintain a healthy weight. Since your body may use extra muscles just to breathe, maintaining your strength is a top priority.
Many people with bronchiectasis experience weight loss due to a loss of appetite. Mahajan warns that this unintentional weight loss can lead to muscle wasting, which makes it even harder to breathe. He recommends prioritizing high-protein foods to maintain the muscle mass your body needs to power through respiratory fatigue.
On the flip side, carrying too much weight around the abdomen can create excess pressure on your diaphragm and keep your lungs from fully expanding. If you find that large meals make you feel breathless, try eating smaller portions more often to prevent a full stomach from pressing against your lungs.
Beyond calories for energy, certain nutrients may help manage the underlying inflammation of the disease. Galiatsatos suggests prioritizing foods rich in omega-3 fatty acids for their anti-inflammatory properties, as well as foods rich in vitamin D to help keep your airways healthy. Ask your doctor about a meal plan that’s right for you, or whether a registered dietitian-nutritionist should be part of your care team.
6. Drink Plenty of Water
Talk to your doctor about how much water you should drink, especially if you have any underlying heart or kidney condition.
7. Prioritize Quality Sleep
Quality sleep helps keep your immune system strong, so it can fend off bacteria and tamper inflammation, resulting in fewer flare-ups. Feeling well rested also makes it easier to stay on top of your daily airway clearance routine and manage your medications effectively.
Your sleep position matters, too. Lying flat on your back makes it harder for your body to clear mucus, and sleeping on your stomach can often lead to neck and back pain. Most experts suggest the best way to get a good night’s rest is to sleep on your side or prop yourself up slightly with pillows.
8. Schedule Regular Wellness Checks
Chronic inflammation and long-term treatment for bronchiectasis can impact everything from your heart to your bones, so staying proactive with screenings is essential.
If you’re taking brensocatib, schedule regular dentist and dermatologist visits as well. Because this drug affects enzymes in your mouth and skin, your dentist becomes a key defender against gum disease, while a dermatologist can help you manage skin changes like thickening (hyperkeratosis) or rashes.
“Preventative care is essential, especially when you’re on any medication that’s going to affect your immune system,” says Mahajan.
The Takeaway
- Prioritizing exercise helps strengthen your lungs, while a high-protein, anti-inflammatory diet paired with proper hydration supports muscle mass and thins mucus for easier clearance, respectively.
- Reducing your exposure to air pollutants and allergens by monitoring the air quality index and using HEPA filters, along with preventing infection through good hand hygiene, masking, and setting social boundaries, can significantly lower your risk of flare-ups.
- Stay current on your vaccinations and attend regular wellness checks that assess your bone density, heart health, and mental well-being to help reduce the long-term impacts of chronic inflammation.
- Quality sleep supports a strong immune system and better disease management, so practice good sleep hygiene and utilize side-sleeping or elevated positions to assist with natural mucus clearance during the night.
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