Also known as hyperventilation syndrome (HVS)

Key points about hyperventilation

  • Hyperventilation syndrome is a common breathing disorder.
  • It affects between 10–30% of otherwise healthy people.
  • Symptoms include shortness of breath, rapid breathing and heart rate.
  • Symptoms such as chest pain or dizziness should be checked by a doctor.
  • Hyperventilation may be a response to emotional or environmental factors.
  • The condition can cause changes to bodily systems, tension and headaches.
  • Treatment involves breathing retraining and medication in some cases.
Woman clutching chest with breathing problem or pain

Hyperventilation syndrome (HVS) is defined simply as moving more air through your chest than your body can deal with. It may be caused by breathing faster than normal (more than 15 breaths a minute), mouth breathing, sighing or yawning frequently. Most people have experienced short episodes of acute over-breathing during stressful or frightening events, and that is very easy to spot. But chronic hyperventilation, characterised by a wide array of symptoms, mimics serious disease and is baffling to both sufferer and doctor alike.

The balance between the oxygen-rich air you breathe in and the carbon-dioxide rich air breathed out is controlled by your lungs. In chronic ‘over breathers’, too much carbon dioxide is flushed out of your system, producing unpleasant changes. Even slight falls in carbon dioxide levels directly affect nerve cells, as well as blood flow to your heart and brain, producing a wide variety of symptoms in any organ or system in your body.

Natural anxiety over symptoms leads to further over-breathing, creating a vicious circle. This new breathing pattern becomes a major stress all by itself. The normal pattern of breathing often changes from abdominal breathing to upper chest breathing, often through your mouth, leading to changes in upper chest and neck muscles, which in turn causes pain, tension and headaches.

Hyperventilation syndrome is your body’s way of signalling distress. There are many triggers, involving physical, emotional and environmental factors.

  • Especially at risk are people who push themselves too hard at work, study or sport. or simply burn the candle at both ends.
  • For some, hyperventilation syndrome is an occupational hazard if their jobs involve a lot of speaking (eg, actors, lawyers, telephonists).
  • Dusty or noisy workplaces.
  • Chronic mouth-breathers are particularly prone, as are people with asthma.
  • Anaemia (not enough red oxygen carrying cells in your blood) stimulates breathing rates.
  • Hormonal triggers. CO2 levels drop by up to 25% post-ovulation, during pregnancy and menopause.
  • Poor posture or ergonomics at work and resulting occupational overuse syndrome are common triggers.
  • After surgery, illness or prolonged social or physical stress

Acute attack – agitation, rapid upper chest breathing and heart-rate, chest pain, shortness of breath, nausea, tingling, dizziness, clammy hands, dilated pupils, perhaps fainting and general weakness.

Chronic or long-standing – general tiredness, lack of concentration and sleep disturbances, tingling, dizziness, chest pain and palpitations, irritable cough and breathing discomfort with frequent sighs and yawns, erratic blood pressure, upset gut, bloated feelings, nausea, sexual problems, achy muscles, twitching and cramps, tension and panicky feelings, depression and anxiety.

Chronic hyperventilation is increasingly recognised as a significant cause of ill-health, although it remains widely under-diagnosed. If undiagnosed and untreated, the chronic hyperventilator lives in fear of symptoms and self-confidence can take a nose-dive. Life can become a misery for the over-breather.

Caution: Known as the great mimic, some hyperventilation syndrome symptoms such as chest pain, dizziness and shortness of breath need checking by your doctor to rule out serious events.

Image credit: 123rf

You need an accurate diagnosis so do go and see your doctor. They may refer you to a specialist physiotherapist for further assessment and to help identify possible triggers.

Half of the cure is knowledge of the disorder and its triggers. Half is hard work – undertaking and committing to breathing pattern retraining and learning effective specific relaxation methods.

A structured treatment plan often includes:

  • breathing retraining
  • upper respiratory health assessment
  • postural and upper chest musculoskeletal balancing
  • stress recognition
  • physical coping strategies
  • sleep hygiene
  • a graduated fitness regimen/lifestyle appraisal
  • counselling for anxiety and depression if required
  • medicine such as anti-anxiolytics/muscle relaxants if indicated.

It takes up to 6–8 weeks to change an established pattern from dysfunctional breathing back to normal. For some, it may take longer. Regular and effective practice is essential with regular checks with your specialist physiotherapist and liaison with your GP and/or counsellor.

Am I going mad? Have I got a serious disease? Why me? Will I ever get over it? These are all common expressions of disbelief at being diagnosed with HVS. The good news is HVS/breathing pattern disorders are just that – a disorder not a disease. The bad news is that it takes time, patience and practice, practice, practice. There is no instant cure.

As you learn to normalise your breathing and so restore balanced carbon dioxide and oxygen levels, the unpleasant symptoms associated with over-breathing will subside. You can enjoy life again!

Breathing Works(external link) Breathing pattern disorders clinic and resource centre, Auckland

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Credits: Dinah Bradley, Respiratory Physiotherapist. From Family Doctor NZ. Used with permission

Reviewed by: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.

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