Tips for presenting with a mask on when you have respiratory issues

April 5, 2023 7:55 PM

I have respiratory issues I am seeing a doctor for which make me short of breath. I wear a mask when in public and usually this is not a problem, but periodically I need to present to a large group and it becomes really difficult for me to breathe. I end up gasping for air and out of breath, which is very awkward. Is there a way to manage this?

I did some googling and every website I found stated that masks do not restrict breathing, even for people with respiratory issues. They definitely restrict my breathing. I use KN95 masks when in public to reduce Covid risk and other respiratory infections.

When presenting, I use a microphone, so I'm not shouting. I think the issue is that I'm talking for periods of time uninterrupted, which is different from a conversation where you'd get regular breaks and pauses. There isn't really room for me to pause or stop or take breaks when presenting due to the specifics of the presentation.

I'm open to trying to find solutions, but also if there aren't good options I could look into seeking accommodation to present unmasked from home over zoom. (I mention that in case someone was going to suggest it). Any suggestions from others who have dealt with this?

posted by Toddles to Health & Fitness (14 answers total)

Oh my, I’m so sorry you have to deal with this. This is a little out of left field, but could you record the audio of your presentation at home and play that? If you face the screen during the presentation, people probably won’t notice. Or, you can preface it by telling the audience that the mask can muffle your voice, so you recorded it for their benefit.

I think that you are correct that the rate of talking is the issue. The only options I can see for that is to lengthen your presentation to allow more time to regain breath, or speak less.
posted by Silvery Fish at 8:14 PM on April 5, 2023 [1 favorite]

How do you react to caffeine? Maybe take a shot of black coffee or cola (if it helps your breathing) just prior to presenting. (I was going to say take a sip while presenting but you said there's no time for breaks.)

Of course, skip this suggestion if you're one of those people who find caffeine causes shortness of breath.
posted by sardonyx at 8:31 PM on April 5, 2023

1. Must it be an N95 or would a KN95/94 work- this would open up some different mask shapes for you

2. Is there any chance you could require the audience to mask while you present and be unmasked yourself?

3. Can you build in questions, animations or something else to your presentation that would make you pause more often?

4. Are you far enough from others during the presentation that running an air purifier by you could be an alternative to wearing a mask?
posted by raccoon409 at 8:31 PM on April 5, 2023

I am still masking, and while I don't do presentations, I do very vigorous functional fitness workouts. I find that wearing a mask cage underneath the mask is an enormous help because it means the mask is always away from your nose/mouth so you have maximum access to oxygen.
posted by BlahLaLa at 8:55 PM on April 5, 2023 [2 favorites]

Best answer: Wearing a mask definitely impinges on my ability to breathe, because the nose bridge impinges on my nostrils, closing them down just a little. They are barely sufficient to do the job at the best of times, and just that little bit of pressure on them makes it pretty much impossible to get enough air through them with the mask on.

Of course you can revert to fully mouth breathing while wearing a mask (which is exactly what I tend to do) but that leads to a variety of other problems.

If you happen to have a similar problem, the steroid nasal sprays help quite a bit, but also, you could experiment with a nasal strip under the mask, something like Breathe Right. This study seems to indicate the strips can help, at least a little (and people definitely liked them). There is a good chance they help most people not at all and a few people quite a bit - so on average not all that helpful, but for particular individuals, possibly very helpful. They might be worth a try, at least as an experiment.

Finally, people tend to feel time pressured while public speaking, and this can lead to shortness of breath even without the complication of masking. You end up taking short and shallow breaths. You kind of "hold your breath" all the time - which seems impossible to do while speaking, but I'm here to testify, it can be done.

Interestingly, if you can figure out how to change these breathing patterns, it can (of course) improve your breathlessness - but perhaps even more important, it can really improve the audience comprehension and the authority of your public speaking. It's the time you take to really breathe between sentences that gives the audience time to fully comprehend what you are saying.

You can find a bunch of examples and tutorials by googling "breathing public speaking," "hold breath public speaking," and such terms.

Here are 3 examples discussing this - just the ones I found from a quick google, so no particular recommendation, but just some illustrations of the idea: 1 2 3 Bonus: Youtube search.
posted by flug at 9:43 PM on April 5, 2023 [9 favorites]

Best answer: I haven't tried them so I can't vouch for their efficacy, but the Moldex Airwave mask (and I suspect there are other designs) are designed to increase airflow with greater surface area (at a higher price) . Check industrial supply companies.

Secondly, in the one situation I faced like this (I'm an immunocompromised transplant patient) at a conference, I decided that the lower-than-usual risk (the podium was 25 feet from the closest person) and the reward was higher than usual (my ability to make a clear high quality presentation including facial expressions) so I took my mask off for the duration of the presentation. That's how I faced the situation, although your calculus may well be different.

And thirdly, if your area is anything like mine, nobody else is masking. They do make masks with exhalation valves, where your breath in is through the mask but your breath flows out freely through a valve. That should substantially help breathing, since your inhalation won't contain the CO2 of your recent exhalations. Obviously, this wouldn't be ethical in a medical setting, or one where you suspected you had an illness, or if masking compliance is high.

But the way I look at it, I voted for masks and society and taking care of each other, and the majority voted that they were bored and wanted to go to the bar. If nobody else is interested in preventing respiratory illnesses for themselves, I feel no ethical obligation to help them.
posted by Superilla at 10:23 PM on April 5, 2023 [4 favorites]

Best answer: I did some googling and every website I found stated that masks do not restrict breathing, even for people with respiratory issues.

That's not entirely accurate, and I suspect anything you find online is an answer to the uniformed question that people were asking in 2020: "will I pass out and die in a mask".

All masks respirators have a testing standard for "how hard is it to breathe through", and if the tested respirator exceeds the limit, it is no longer certified as protective equipment. The N95 standard is < 35mm/H2O (measurement of pressure), however any half-decent N95 should be at most the mid-teens and some are below ten. (3M's stuff is really good in this regard)

The KN95 standard is very similar to the N95 standard; but some manufacturers, as a way of cutting costs, achieve the filtration requirement of 95% by simply having using really thick and hard to breathe filtration layers. I've seen estimates of some KN95s tested in the 20s for breathing resistance. The cheapest masks that you can find may be stamped KN95, but may not meet the actual KN95 filtration standard and/or be really hard to breathe through, there is no guarantee of quality.

There is also the problem of "dead space" in masks. The air that you exhale that stays in the mask is going to be re-inhaled at your next breath, and will have less oxygen. This is exacerbated by higher breathing resistance (also, exhalation valves work here). This problem can be reduced by taking in larger breaths instead of shorter ones that take in less air from outside the mask. This can be really hard under stress like public speaking.
posted by meowzilla at 12:31 AM on April 6, 2023 [5 favorites]

I was also going to suggest a well-fitting valved n95, if this is a situation where most are not even bothering to mask. The leakage out the valve membrane (a thin flap that doesn’t open all the way) is less than what most people are putting out with a surgical mask or imperfectly fitting KN95. You could restrict its use to when you’re up at the podium/dais etc and presumably distanced from other attendees, if you’re still feeling conflicted about wearing something valved.
posted by blue suede stockings at 2:59 AM on April 6, 2023

There are some inexpensive PAPR devices available now that look more medical aid than Darth Vader.
posted by Mitheral at 5:28 AM on April 6, 2023

I’ve been lecturing for the past two years wearing an N 95. I notice this feeling of suffocation on rare occasions, and I think it is a combination of anxiety, along with me talking too much, and taking only shallow breaths in between words.

Masks have a small “dead air” space, which means that if you take only a shallow breath in, you are mostly breathing in your own exhalation. This will be higher in carbon dioxide and slightly lower in oxygen. To avoid this make sure you are taking very deep breaths both in and out on occasion. This will ensure that, in addition to the small amount of exhalation air in the dead space, you were getting plenty of clean, fresh air as well.

[On preview I see meowzilla has the same idea]
posted by soylent00FF00 at 7:11 AM on April 6, 2023 [1 favorite]

Airgami masks are designed to be worn while speaking or singing, might be worth a try? They’re expensive but cleanable.
posted by momus_window at 7:29 AM on April 6, 2023 [1 favorite]

The Moldex airwave masks mentioned above are awesome. I particularly like the ones with the adjustable strap, as I have a larger-than-average head, apparently.
posted by mcgsa at 7:40 AM on April 6, 2023

We wear N95 equivalent masks for our dance group, lots of us have washable masks from Enro. Yes, I get a little more out of breath, when dancing hard.

Things that help some - slow your speech, take pauses, consciously relax your shoulders. I spoke at a public meeting, tension made it harder to breathe well, these things helped. And talking slower was much more effective than the people who read from prepared remarks, tried to say everything, and fast-talked. It's okay tp pause to get your breath; you can say at the start I may need to pause to catch my breath, thanks for being patient.
posted by theora55 at 9:08 AM on April 6, 2023 [1 favorite]

Best answer: Have you done a full run through of your presentation at home while wearing a mask? I would try that, and see how it feels to do the whole thing in a mask even when you're not in front of others. I have done some presentations and talks in masks, and I don't love it, in part because the mask gets a bit damp when I talk more. It's also very different than casual conversations I might have while masked.
posted by bluedaisy at 12:54 PM on April 6, 2023