An incentive spirometer is a handheld breathing device that helps you take slow, deep breaths to keep your lungs fully expanded. You’ll typically receive one after surgery, especially chest or abdominal procedures, to prevent small air sacs in your lungs from collapsing. The technique is simple once you understand it, but doing it correctly makes a real difference in how well it works.
How the Device Works
The spirometer has a large chamber with a piston or ball that rises as you inhale through a mouthpiece connected by flexible tubing. The harder and deeper you breathe in, the higher the indicator rises. A numbered scale on the side measures the volume of air you’re pulling into your lungs in milliliters. Most devices also have a smaller second chamber with a separate ball or indicator that tells you whether you’re breathing at the right speed.
The goal is sustained, slow inhalation. When you breathe in slowly and steadily, air reaches the deepest parts of your lungs, opening up tiny air sacs that tend to deflate after surgery, during bed rest, or with shallow breathing caused by pain. This is what prevents a condition called atelectasis, where portions of the lung partially collapse.
Step-by-Step Instructions
Sit upright on the edge of your bed or in a chair with your feet flat on the floor. Sitting up straight gives your lungs the most room to expand. Holding the spirometer upright in front of you (tilting it changes how the indicator moves and gives inaccurate readings), follow these steps:
- Breathe out normally. Before placing the mouthpiece in your mouth, exhale gently until your lungs feel comfortably empty. Don’t force all the air out.
- Seal your lips around the mouthpiece. A tight seal prevents air from leaking around the sides, which would reduce the volume your breath registers on the device.
- Inhale slowly and deeply. Breathe in through the mouthpiece as slowly as you can while still raising the piston. Watch the speed indicator: the ball in the smaller chamber should float in the middle of its range. If it shoots to the top, you’re inhaling too fast. If it stays at the bottom, you need a bit more effort.
- Try to reach your volume goal. Your care team will set a target volume marked on the device. Pull the piston as high as you can toward that mark, but don’t sacrifice slow speed for a higher number.
- Hold your breath for 3 to 5 seconds. Once you’ve inhaled as deeply as possible, remove the mouthpiece and hold the air in your lungs. This sustained inflation is the most important part of the exercise because it gives air time to reach collapsed areas.
- Exhale slowly. Let the air out through your mouth at a relaxed pace. Rest for a few normal breaths before repeating.
Repeat this cycle 10 times per session. Most post-surgical guidelines recommend doing a session every 1 to 2 hours while you’re awake. That sounds like a lot, but each session takes only a few minutes.
Getting the Speed Right
The most common mistake is breathing in too fast. It’s natural to want to see the piston climb quickly, but a fast inhale fills mostly your upper airways without reaching the deep lung tissue that needs the exercise. Think of it like sipping air through a straw rather than gasping. The speed indicator ball should stay floating in the middle of its chamber throughout your entire inhale. If you hear a rushing sound or the ball slams to the top, slow down.
Breathing too slowly is less common but also reduces effectiveness. If the piston barely moves, try a slightly stronger, steadier pull. The sweet spot feels like a long, controlled breath in, not a gasp and not a trickle.
What Your Volume Goal Means
Your target volume depends on your age, height, sex, and lung health before surgery. A respiratory therapist or nurse typically sets this number for you. Right after surgery, you may only reach 500 to 750 mL, and that’s fine. The goal is progressive: each day you should try to increase your volume slightly. Many patients work their way up to 1,500 mL or higher within a few days, though your personal target may differ.
If you weren’t given a specific number, a reasonable starting approach is to note the highest volume you can comfortably reach during your first session and aim to improve by about 10 to 15 percent every day or two. Write down your best volume after each session so you can track progress.
Clearing Mucus After Each Session
Deep breathing loosens secretions in your airways, so you may feel the urge to cough after using the spirometer. That’s a good sign. If you’ve had chest or abdominal surgery, a regular forceful cough can be painful. A technique called huff coughing is gentler on healing incisions while still moving mucus out.
To huff cough, take a slow breath until your lungs are about three-quarters full. Hold for two to three seconds to let air settle behind the mucus. Then exhale firmly but steadily with your mouth open, as if you’re fogging a mirror. This “huff” moves mucus from smaller airways into larger ones. Repeat one or two more times, then follow with a single strong cough to clear everything out. If you’ve had abdominal surgery, pressing a pillow firmly against your incision while you cough (called splinting) reduces the pain significantly.
Cleaning and Replacing the Device
At the end of every day, remove the mouthpiece and tubing from the main chamber and wash them in warm, soapy water. Let all parts air dry completely before reassembling. Do not use a dishwasher, boiling water, or bleach, as these can warp or degrade the plastic components.
Incentive spirometers are designed for single-patient use and have a limited lifespan. Most manufacturers recommend replacing the device after 30 days or 1,000 uses, whichever comes first. After that point, the piston may not move as smoothly, and bacterial buildup becomes harder to manage with basic cleaning.
When the Spirometer Won’t Work Well
Not everyone can use an incentive spirometer effectively. The device requires you to understand the instructions, cooperate with the technique, and generate enough breathing force to move the piston. People who are heavily sedated, confused, or very young children may not be able to use it properly. It’s also not appropriate if severe pain, diaphragm weakness, or strong pain medication prevents you from taking a deep breath. In those situations, your care team will use alternative methods to keep your lungs expanded, such as positive pressure breathing devices or more aggressive pain management so you can breathe more deeply.
If using the spirometer causes dizziness, that usually means you’re breathing too fast or doing too many breaths without resting in between. Take two or three normal breaths between each spirometer breath, and the lightheadedness should resolve. Mild discomfort at a surgical site during deep inhalation is expected and not a reason to stop, though sharp or worsening pain is worth reporting to your care team.