Recovery · Lungs

Incentive Spirometry, Explained Simply

After surgery you'll often be handed a clear plastic device with a piston or balls inside and asked to breathe into it every hour. It's called an incentive spirometer, and it's one of the easiest things you can do to keep your own lungs healthy and avoid a chest infection.

Medically reviewed by Dr. Saurabh Shukla, MBBS, DNB Anesthesiology · Last updated June 2026

Why your lungs need help after surgery

Anesthesia, lying down, and the natural urge to take shallow breaths when an incision hurts all make you breathe less deeply than usual. When you don't take full breaths, the tiny air sacs at the bottom of your lungs can collapse — this is called atelectasis. Collapsed areas trap mucus and can turn into a chest infection or pneumonia, one of the more common setbacks after chest and abdominal operations.

Slow, deep breaths re-open those air sacs. The incentive spirometer simply gives you a visual target so you can see how deep your breath is and keep improving — turning "breathe deeply" into something you can actually measure.

The one-line version

Take slow, deep breaths often — the device just shows you how well you're doing. Aim for around 10 breaths every hour you're awake, then cough to clear your chest.

How to use it, step by step

  1. Sit up as upright as you can — in bed or a chair.
  2. If you have a tummy or chest incision, hug a pillow against it to support it (this makes deep breaths and coughing much less sore).
  3. Breathe out normally, then seal your lips tightly around the mouthpiece.
  4. Breathe in slowly and deeply through the device — slow is the secret. Raise the piston (or balls) up to your target mark and keep it steady.
  5. Hold that deep breath for 3–5 seconds (let the marker show you), then take the mouthpiece out and breathe out gently.
  6. Rest for a few normal breaths, then repeat — about 10 breaths.
  7. Finish with a cough (pillow still hugged to the incision) to bring up any mucus.
  8. Repeat the whole set every hour you're awake, or as your team advises.

Make it easier

Take your pain medicine in good time so deep breaths don't hurt, set an hourly reminder on your phone, and note your best mark each time as a target to beat. Slow and steady beats fast and forced.

Practising before surgery (prehab)

If your team gives you a spirometer before the operation, practise with it for a few days. Learning the technique while you're comfortable means you'll do it well when you're sore afterward — and it sets your personal target breath. Practising matters most if you smoke or vape, have asthma or COPD, or are having chest or abdominal surgery. Even stopping smoking for a short time before surgery measurably lowers your chance of a chest problem — and practising your breathing exercises and walking early both help too.

Tell your team if…

You develop a fever, a cough bringing up green/brown or bloody phlegm, new breathlessness, or chest pain after surgery. These can be early signs of a chest infection that needs treatment.

Frequently asked questions

What is an incentive spirometer for?

It's a simple breathing device that encourages you to take slow, deep breaths after surgery. Deep breaths keep the small air sacs in your lungs open, which lowers the chance of part of the lung collapsing (atelectasis) and of a chest infection or pneumonia. The moving piston or balls give you a visual target to aim for.

How often should I use my incentive spirometer?

A common plan is about 10 slow deep breaths every hour you're awake, for the first days after surgery. Each breath: sit up, breathe out normally, then breathe in slowly and deeply through the mouthpiece to raise the piston to your target, hold for 3–5 seconds, and relax. Follow the exact target and routine your team gives you.

Does incentive spirometry actually help?

It's most useful as part of a bundle: deep breathing, sitting up and walking early, good pain control, and coughing to clear your chest. On its own the evidence is mixed, but it's simple, safe, and gives you an active way to help your recovery — which is why it's so widely used, especially after chest and abdominal surgery.

Should I practise before my operation?

Yes, if you're given one beforehand. Practising while you're comfortable means you'll know the technique and your target breath, so it's much easier to do well when you're sore after surgery. It's especially worth it if you smoke, have asthma or COPD, or are having chest or tummy surgery.

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