An incentive spirometer is a handheld device that helps your lungs recover after a surgery or lung illness. Your lungs can become weak after prolonged disuse. Using a spirometer helps keep them active and free of fluid.

When you breathe from an incentive spirometer, a piston rises inside the device and measures the volume of your breath. A healthcare provider can set a target breath volume for you to hit.

Spirometers are commonly used at hospitals after surgeries or prolonged illnesses that lead to extended bed rest. Your doctor or surgeon may also give you a take-home spirometer after surgery.

In this article, we’re going to look at who can potentially benefit from using an incentive spirometer, and break down how spirometers work and how to interpret the results.

Breathing slowly with a spirometer allows your lungs to inflate fully. These breaths help break up fluid in the lungs that can lead to pneumonia if it isn’t cleared.

An incentive spirometer is often given to people who’ve recently had surgery, people with lung disease, or people with conditions that fill their lungs with fluid.

Here’s more information:

  • After surgery. An incentive spirometer can keep the lungs active during bed rest. Keeping the lungs active with a spirometer is thought to lower the risk of developing complications like atelectasis, pneumonia, bronchospasms, and respiratory failure.
  • Pneumonia. Incentive spirometry is commonly used to break up fluid that builds up in the lungs in people with pneumonia.
  • Chronic obstuctive pulmonary disease (COPD). COPD is a group of respiratory disorders that are most commonly caused by smoking. There’s no current cure, but quitting smoking, using a spirometer, and following an exercise plan can help manage symptoms.
  • Cystic fibrosis. People with cystic fibrosis might benefit from using an incentive spirometer to clear fluid buildup. A 2015 study found that spirometry has the potential to reduce pressure in the chest cavity and lower the chance of central airway collapse.
  • Other conditions. A doctor may also recommend an incentive spirometer for people with sickle cell anemia, asthma, or atelectasis.

Research has found conflicting results on the effectiveness of using an incentive spirometer compared with other lung strengthening techniques.

Many of the studies looking at potential benefits were poorly designed and not well organized. However, there’s at least some evidence it may help with:

  • improving lung function
  • reducing mucus buildup
  • strengthening lungs during extended rest
  • lowering the chance of developing lung infections

Your doctor, surgeon, or nurse will likely give you specific instructions on how to use your incentive spirometer. The following is the general protocol:

  1. Sit at the edge of your bed. If you can’t sit up completely, sit up as far as you can.
  2. Hold your incentive spirometer upright.
  3. Cover the mouthpiece tightly with your lips to create a seal.
  4. Slowly breathe in as deep as you can until the piston in the central column reaches the goal set by your healthcare provider.
  5. Hold your breath for at least 5 seconds, then exhale until the piston falls to the bottom of the spirometer.
  6. Rest for several seconds and repeat at least 10 times per hour.

After each set of 10 breaths, it’s a good idea to cough to cleanse your lungs of any fluid buildup.

You can also clear your lungs throughout the day with relaxed breathing exercises:

  1. Relax your face, shoulders, and neck, and put one hand on your stomach.
  2. Exhale as slowly as possible through your mouth.
  3. Breathe in slowly and deeply while keeping your shoulders relaxed.
  4. Repeat four or five times per day.
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Example of an incentive spirometer. To use, place mouth around mouthpiece, breath out slowly, and then inhale slowly only through your mouth as deeply as you can. Try to get the piston as high as you can while keeping the indicator between the arrows, and then hold your breath for 10 seconds. You can place your marker at the highest point you were able to get the piston so you have a goal for the next time you use it. Illustration by Diego Sabogal

Setting incentive spirometer goals

Next to the central chamber of your spirometer is a slider. This slider can be used to set a target breath volume. Your doctor will help you set an appropriate goal based on your age, health, and condition.

You can write down your score each time you use your spirometer. This can help you track your progress over time and also help your doctor understand your progress.

Contact your doctor if you’re consistently missing your target.

The main column of your incentive spirometer has a grid with numbers. These numbers are usually expressed in millimeters and measure the total volume of your breath.

The piston in the main chamber of the spirometer rises upward along the grid as you breathe in. The deeper your breath, the higher the piston rises. Next to the main chamber is an indicator that your doctor can set as a target.

There’s a smaller chamber on your spirometer that measures the speed of your breath. This chamber contains a ball or piston that bobs up and down as the speed of your breath changes.

The ball will go to the top of the chamber if you’re breathing in too quickly and will go to the bottom if you’re breathing too slowly.

Many spirometers have a line on this chamber to indicate the optimal speed.

Normal values for spirometry vary. Your age, height, and sex all play a role in determining what’s normal for you.

Your doctor will take these factors into account when setting a goal for you. Consistently hitting a result higher than the goal set by your doctor is a positive sign.

The Centers for Disease Control and Prevention has a reference calculator you can use to get an idea of the normal values for your demographic.

However, this calculator isn’t meant for clinical use. Don’t use it as a replacement for your doctor’s analysis.

You may feel dizzy or lightheaded when breathing from your spirometer. If you feel like you’re going to faint, stop and take several normal breaths before continuing. If symptoms persist, contact your doctor.

You may want to call your doctor if you’re unable to achieve the goal, or if you have pain when you breathe deeply. Aggressive use of an incentive spirometer can lead to lung damage, such as collapsed lungs.

The hospital may give a take-home incentive spirometer if you’ve recently had surgery.

You can also get a spirometer at some pharmacies, rural health clinics, and federally qualified health centers. Some insurance companies may cover the cost of a spirometer.

One study found the per-patient cost of using an incentive spirometer is between $65.30 and $240.96 for an average 9-day hospital stay in an intermediate care unit.

An incentive spirometer is a device that can help you strengthen your lungs.

Your doctor might give you a spirometer to take home after leaving the hospital after surgery. People with conditions that affect the lungs, like COPD, may also use an incentive spirometer to keep their lungs fluid-free and active.

Along with using an incentive spirometer, following good pulmonary hygiene may help you clear your lungs of mucus and other fluids.