against a wall, resting their head on raised arms or leaning over a banister. Breathing exercises and sputum clearance Specific breathing exercises can be highly beneficial for patients with chronic dyspnoea. Controlled breathing techniques should be taught to patients while they are not breathless, and they should be encouraged to practise them regularly. When they become breathless, they should be able to use these techniques to control their respiratory rate and reduce their discomfort. Removing sputum can reduce dyspnoea, and patients should be encouraged to expectorate and dispose of sputum in a tissue or sputum pot. In hospitals, sputum pots should be changed at least daily to reduce the risk of cross-infection. Hygiene As it can take patients who are breathless several hours to wash, it is useful to discuss coping strategies and additional help that they may require. Some may need oxygen during washing and bathing. Oral hygiene The nose provides natural humidification to inspired air. Breathing through the mouth at an increased respiratory rate can result in a drying effect on the oral mucous membranes, and can be very uncomfortable. Fluids should be encouraged, along with regular mouth care. Oral candidiasis is a common side-effect from inhaled corticosteroids, although this can easily be corrected with good oral hygiene. Rinsing the mouth after using an inhaler should be encouraged. Eating and drinking It is not uncommon for patients with dyspnoea to find it difficult to eat and drink and this can result in malnourishment and dehydration. Unless contraindicated, patients