Although drug therapies and pulmonary rehabilitation have greatly improved COPD symptoms, as many as 50% of patients with severe COPD have inadequately controlled dyspnea. Device-guided breathing is a behavioral intervention that guides respiratory rates into a therapeutic range; prolongation of the expiratory phase improves hyperinflation, the most significant driver of dyspnea in this population. Device-guided breathing, has no known side-effects, and may represent a cost effective adjunctive treatment for dyspnea in severe COPD.

Inclusion Criteria:

• Current or former cigarette smokers of at least 10 pack-years
• Clinically significant dyspnea, as determined by a score of at least 2 on the Medical Research Council Dyspnea Score questionnaire (0-4), or through pulmonary function test results of a residual volume (RV) of > 150% predicted or an FEV1 of <65% predicted
• Clinical diagnosis of chronic obstructive pulmonary disease

Exclusion Criteria:

• Unable to use the slow-breathing device due to hearing impairment
• Poor motivation or lack of interest in using the device
• Pulmonary Rehabilitation ordered as a new therapy at the time of enrollment