Asthma and COPD Inhalers: How to Use Them Right for Better Breathing

Dec, 18 2025

More than 70% of people with asthma or COPD are using their inhalers wrong. Not because they don’t want to, but because no one ever showed them how. And that’s not just a small mistake-it’s the difference between breathing easy and struggling for air. If your inhaler isn’t working like it should, it’s not the medicine. It’s the technique.

Why Your Inhaler Might Not Be Working

You take your inhaler every day. You follow the prescription. But your symptoms don’t improve. You’re not alone. Studies show that between 70% and 90% of people use their inhalers incorrectly. That means only 8% to 30% of the medicine actually reaches your lungs. The rest? It sticks in your mouth, throat, or gets spit out. That’s why you still feel wheezy, even after puffing.

The problem isn’t the device. It’s the method. Many people press the inhaler and breathe in too fast. Or they don’t hold their breath long enough. Some shake the inhaler once and forget to shake it again. Others use a dry powder inhaler like it’s a metered-dose inhaler-and vice versa. These aren’t minor slips. They’re critical errors that cut your medication’s effectiveness in half.

And here’s the scary part: you probably don’t even know you’re doing it wrong. Most people think they’re using their inhaler correctly because they’ve been doing it the same way for years. A 2023 survey found that 37% of users said their biggest worry was, “I don’t know if I’m using it right.” That’s not confidence. That’s guesswork.

The Three Main Types of Inhalers

Not all inhalers work the same way. There are three main types, and each needs a different technique. Mixing them up can make your treatment useless-or even harmful.

• Metered-Dose Inhalers (MDIs): These are the classic canisters with a mouthpiece. You press down while breathing in. They use a propellant to spray medicine out. Common brands include ProAir HFA and Ventolin HFA. They’re great for quick relief, but they require perfect timing. Press and inhale at the same moment. Miss that window, and most of the dose is wasted.
• Dry Powder Inhalers (DPIs): These include Diskus, Turbuhaler, and Ellipta. No propellant. No button to press. You breathe in hard and fast to pull the powder into your lungs. But if you’re too weak, too slow, or too tired-like during a flare-up-you won’t get enough medicine. These are not for everyone, especially older adults or those with severe COPD.
• Soft Mist Inhalers: The Respimat is the only one in this category. It releases a slow, fine mist over 1.5 seconds. You don’t need to time your breath perfectly. It’s easier for people who struggle with coordination. But you still need to inhale slowly and deeply.

There are over 20 different inhaler devices on the market. Each has its own quirks. Just because you switched from one brand to another doesn’t mean you can use it the same way. Always check the instructions that come with your new inhaler-even if it looks familiar.

The Right Way to Use a Metered-Dose Inhaler (MDI)

If you’re using an MDI, here’s the exact sequence you need to follow. Do this every time, no exceptions.

1. Remove the cap and shake the inhaler well for 5 seconds.
2. Stand or sit up straight. Tilt your head back slightly.
3. Breathe out fully-empty your lungs as much as you can.
4. Place the mouthpiece in your mouth. Seal your lips tightly around it.
5. Start breathing in slowly through your mouth. As you begin to inhale, press down on the inhaler to release the dose.
6. Keep breathing in slowly for 3 to 5 seconds until your lungs are full.
7. Hold your breath for 10 seconds. This lets the medicine settle into your airways.
8. Breathe out slowly through your nose.

If you need a second puff, wait at least 60 seconds. Don’t rush. And if you’re using an inhaled steroid like fluticasone or budesonide, rinse your mouth with water afterward. Spit it out. Don’t swallow. This cuts your risk of oral thrush by 75%.

Shaking the inhaler isn’t optional. One study found 45% of users skip this step. That means the medicine settles at the bottom of the canister. You get a weak dose-or nothing at all.

How to Use a Dry Powder Inhaler (DPI)

DPIs are simpler in some ways, but harder in others. No button to press. No timing needed. But you need strong, fast breaths.

1. Load the dose according to the device instructions. For Diskus, slide the lever. For Turbuhaler, twist the base. Don’t open capsules or shake the device.
2. Stand or sit upright. Breathe out fully-away from the inhaler.
3. Place the mouthpiece in your mouth. Seal your lips tightly.
4. Breathe in quickly and deeply, like you’re trying to suck through a straw.
5. Hold your breath for 10 seconds.
6. Breathe out slowly.

Never exhale into a DPI. That’s the most common mistake. It clogs the powder with moisture and ruins the dose. Also, never try to open the capsule. People do this thinking they’ll “see if it’s working.” That’s dangerous. The powder is designed to be inhaled as-is. If you open it, you lose the dose and risk inhaling too much at once.

DPIs are not for everyone. If you have severe COPD, your lungs might not generate enough airflow to activate the powder. In that case, stick with an MDI-or ask your doctor about a soft mist inhaler.

Why Spacers Are a Game-Changer

If you’re using an MDI, get a spacer. It’s not a luxury. It’s a necessity.

A spacer is a tube that attaches to your inhaler. It holds the medicine in a chamber while you breathe in. This removes the need for perfect timing. You press the inhaler, then breathe in slowly over several seconds. It’s easier, more reliable, and delivers 70% to 100% more medicine to your lungs.

Studies show that using a spacer with an MDI can make your treatment just as effective as a DPI-without requiring strong breaths. It’s especially helpful for children, older adults, and anyone with shaky hands or poor coordination.

But here’s the catch: spacers only work with MDIs. Never use a spacer with a DPI. That blocks the airflow and cuts the medicine delivery by 50% to 70%. It’s like putting a sock over a fan. The powder can’t move. The medicine doesn’t reach your lungs.

Spacers are cheap. Most cost under $20. Many pharmacies give them out for free. Ask your doctor or pharmacist for one. If you’re using an MDI without a spacer, you’re not getting the full benefit of your medication.

Common Mistakes (And How to Fix Them)

Here are the five most common mistakes-and how to stop them.

• Not shaking the inhaler: 45% of users skip this. Always shake for 5 seconds before each puff.
• Exhaling into the inhaler: Especially with DPIs. Always breathe out away from the device.
• Not holding your breath: 63% of people exhale right after inhaling. Hold for 10 seconds. It’s hard, but it doubles the medicine in your lungs.
• Using multiple inhalers without training: If you have two different types, get specific instruction for each. Technique confusion cuts effectiveness by 35% to 50%.
• Storing inhalers wrong: Heat kills medicine. Don’t leave your inhaler in a hot car or by the sink. Keep it at room temperature (20-25°C). If it’s been exposed to extreme heat, replace it.

And don’t forget: never use an expired inhaler. Medication loses potency after the expiration date. In a flare-up, that could mean the difference between control and an emergency room visit.

What Your Doctor Should Be Checking

Your doctor should check your inhaler technique at every visit. Not once a year. Every time. The American Lung Association and the Global Initiative for Asthma (GINA) both say this is non-negotiable.

Studies show that when healthcare providers regularly assess technique, patients have 22% fewer emergency visits. That’s huge. It means fewer hospital stays, fewer missed workdays, and better quality of life.

Ask your doctor: “Can you watch me use my inhaler right now?” Don’t be shy. Most providers are happy to do it. If they say no, ask why. You’re not being difficult-you’re being smart.

Some clinics now use video tools or apps to record your technique. You can even send a clip to your doctor between visits. It’s easier than you think.

Smart Inhalers and What’s Coming Next

Technology is catching up. Smart inhalers with built-in sensors are now FDA-approved. They track when you use your inhaler-and whether you used it correctly. One device, Propeller Health, has been shown to monitor technique with 92% accuracy.

These devices connect to your phone and send reminders. They show you trends: “You used your rescue inhaler 8 times last week-that’s more than usual.” They can even alert your doctor if your usage spikes.

By 2025, 40% of inhalers are expected to have digital tracking. That doesn’t mean you need one now. But if you’re struggling, it’s worth asking your doctor about them. Some insurance plans cover them.

Future inhalers will adjust the dose based on your breathing patterns. Others will sense when you’re about to have an attack and deliver medicine before symptoms start. These aren’t science fiction. They’re coming by 2026 or 2027.

Final Takeaway: Technique Is Everything

The best medicine in the world won’t help if you don’t use it right. Inhalers are simple tools. But they demand precision. The device you use matters less than how you use it.

Take 10 minutes today to review your technique. Watch a video from the American Lung Association or the National Asthma Council Australia. Practice in front of a mirror. Ask someone to watch you. Don’t guess. Don’t assume. Do it right.

One person can’t fix the 70% misuse rate. But you can fix yours. And when you do, you’re not just taking medicine-you’re taking back your breathing.