How do you measure your breathlessness?

Dyspnoea scale - NICE guidelines

When we become breathless, most of the time we know why we felt the way we did. However, at times, we may feel breathlessness, which cannot be associated with the degree of exertion we have just performed. In such instances, it is likely that the breathlessness is associated with some kind of bodily disorder. If that is the case, breathlessness itself can be used as a measure of worsening or improvement of the said condition in most instances.

However, there need to be a way we can measure the breathlessness before we can compare it with how it was at an earlier stage. The National Institute for Health and Care Excellence (NICE) UK has published many different guidelines on various health and care related practices. One such guideline is aimed at measuring the level of dyspnoea or breathlessness, for clinicians. The dyspnoea scale is thus a tool for medical professionals and caregivers although anyone who knows the items in the scale would be able to assess the degree of breathlessness by his or her own.

The dyspnoea scale recommended by NICE range from 1 to 5 and it is associated with the physical activities of the person.

Grade 1 - Not troubled by breathlessness except on strenuous exercise

Grade 2 - Short of breath when hurrying or walking up a slight hill

Grade 3 - Walks slower than contemporaries on level ground because of breathlessness, or has to stop for breath when walking at own pace

Grade 4 - Stops for breath after walking about 100m or after a few minutes on level ground

Grade 5 - Too breathless to leave the house, or breathless when dressing or undressing

Although the scale is somewhat relative and may not be useful in all patients with breathlessness, it can be used in practice to assess the level of breathlessness in ambulatory patients and perhaps by caregivers to assess how their loved ones are coping. 

A sudden change from one grade to another should not be a cause for alarm as it is possible for a patient to move from one grade to another due to various reasons apart from a worsening of his or her condition. Thus, the grade of breathlessness should be assess based on the context of assessment and should be carefully interpreted in clinical practice. However, it is one of the most widely used scales for assessing breathlessness and is usable by anyone with a understanding of the patient’s condition.