Hyperventilation
Hyperventilation is characterized by rapid, deep, or quick shallow breathing that can significantly lower carbon dioxide levels in the blood, leading to an increase in blood pH. This condition often results in symptoms such as breathlessness, dizziness, and, in severe cases, fainting, as low carbon dioxide levels can constrict blood vessels in the brain. Common triggers include anxiety, panic attacks, depression, and certain lifestyle factors like excessive caffeine consumption. Hyperventilation can also be associated with underlying health issues, including heart and lung disorders.
Many individuals may not recognize when they are hyperventilating, and chronic hyperventilation syndrome (HVS) can lead to various physical problems, including gastrointestinal symptoms and changes in heart function. Contrary to popular belief, breathing into a paper bag is not a recommended treatment due to the risk of exacerbating serious medical conditions. Instead, effective management focuses on reassurance, education, and techniques such as diaphragmatic breathing. Preventive measures, including physical exercise, meditation, and yoga, may help reduce the frequency of hyperventilation episodes.
On this Page
Subject Terms
Hyperventilation
Anatomy or system affected:Lungs, respiratory system
Definition:Breathing at a faster rate than what is needed for metabolism, results in the exhalation of carbon dioxide faster than it is produced.
Causes and Symptoms
Hyperventilation is rapid deep or quick shallow breathing, both of which can result in a dramatic decrease in carbon dioxide levels and an increase in the pH of the blood. While its purpose is to get more oxygen, hyperventilation can result in feeling breathless or dizzy and, in extreme cases, fainting.
As a person hyperventilates, their low carbon dioxide levels can narrow the blood vessels supplying the brain. This further results in a diminished blood supply to the brain, leading to lightheadedness and other symptoms. Many people who are hyperventilating do not realize this is occurring. As this condition persists and becomes more severe, it can result in loss of consciousness.
There are several possible causes or reasons for hyperventilation, including anxiety, panic attacks, agoraphobia (fear of open spaces), depression, anger, and overconsumption of caffeine. Hyperventilation can also be a symptom of an underlying disease process such as an infection, bleeding, or heart and lung disorder, as well as a response to altitude exposure. Hyperventilation syndrome (HVS) can be manifested either acutely or chronically. Although the causes of hyperventilation syndrome are not completely known, there appear to be linkages with panic disorders. Approximately 50% of those afflicted with panic disorder also suffer from hyperventilation syndrome.
Chronic HVS can cause a variety of physical problems involving respiratory, cardiac, neurologic, or gastrointestinal (GI) systems. Aerophobia, a fear of fresh air, brings on the GI problems such as flatulence, bloating, and belching. Besides rapid breathing, hyperventilation can cause a fast pulse, shortness of breath, chest pain or tightening, dry mouth (from mouth breathing), numbness around the lips and hands, and, in more severe cases, blurred vision, seizures, and loss of consciousness. The chest pain resembles typical angina but does not usually respond to nitroglycerine. Changes in the patient’s electrocardiogram (ECG) are common, including ST segment elevation or depression, T-wave inversion, or a prolonged QT interval. Patients with mitral valve prolapse are particularly susceptible to HVS. On occasion, hyperventilation can also be manifested with extreme agitation, tingling in the extremities, or painful hand and finger spasms. The chief characteristic of chronic HVS is multiple complaints without supporting physical evidence. Hence, classic hyperventilation is not readily apparent, but frequent sighing may be evidenced, along with chest wall tenderness, numbness, and tingling sensations. To rule out more serious conditions, arterial blood gases, toxicology screens, and chest x-rays are suggested.
Hyperventilation is a technique purposely used by swimmers and deep-sea divers to enable prolonged breath-holding. Many drownings have been related to this practice, however, because it can cause delayed unconsciousness underwater and subsequent death.
Treatment and Therapy
Contrary to popular belief, breathing into a paper bag to slow down respiration and retain carbon dioxide is not recommended as a treatment for hyperventilation. This is because of the potential life-threatening aggravation of a more serious medical problem such as hypoxia, a myocardial infarction (heart attack), pneumothorax, or pulmonary embolism.
After life-threatening causes of hyperventilation are eliminated, the most successful treatment for hyperventilation is reassurance, discussion of how hyperventilation is causing the patient’s symptoms, and removal of the cause of the anxiety, if possible. Instructions from a respiratory therapist on proper abdominal diaphragmatic breathing are also helpful. A patient who faints should be placed flat on the floor with legs elevated. For more severe recurrent cases, antidepressants, beta-blockers, stress management classes, or breathing retraining have all been proven effective in reducing hyperventilation episodes.
Prevention may also be an effective way to curtail hyperventilation syndrome. Activities such as breathing, physical exercise, meditation, and yoga may have positive results in forestalling future instances of hyperventilation.
Bibliography
Bradley, Dinah.Hyperventilation Syndrome: Breathing Pattern Disorders and How to Overcome Them. Auckland: Random, 2012. Print.
Callaham, M. “Hypoxic Hazards of Traditional Paper Bag Rebreathing in Hyperventilating Patients.” Annals of Emergency Medicine 18.6 (1989): 622–28. Print.
Cowley, D. S., and P. P. Roy-Byrne. “Hyperventilation and Panic Disorder.” American Journal of Medicine 83.5 (1987): 929–37. Print.
Decuyper, Mieke. "The Relevance of Personality Assessment in Patients with Hyperventilation Symptoms." Health Psychology 31.3 (2012): 316–22. Print.
Fried, Robert Z. Hyperventilation Syndrome Research and Clinical Treatment. Baltimore: Johns Hopkins UP, 1986. Print.
Gardner, W. N. “The Pathophysiology of Hyperventilation Disorders.” Chest 109.2 (1996): 516–34. Print.
Hearne, C. R. "Acupuncture in the Treatment of Anxiety in Hyperventilation Syndrome." Journal of the Acupuncture Association of Chartered Physiotherpaists (2011): 83–89. Print.
"Hyperventilation." Johns Hopkins Medicine, 2023, www.hopkinsmedicine.org/health/conditions-and-diseases/hyperventilation#. Accessed 16 Aug. 2023.
"Hyperventilation Syndrome." Cleveland Clinic 2023, my.clevelandclinic.org/health/diseases/24860-hyperventilation-syndrome. Accessed 16 Aug. 2023.
McArdle, William, Frank I. Katch, and Victor L. Katch. Exercise Physiology: Energy, Nutrition, and Human Performance. 8th ed. Boston: Lippincott, 2015. Print.
"What to Know About Hyperventilation: Causes and Treatments" Healthline, 14 Apr. 2023, /www.healthline.com/health/hyperventilation. Accessed 16 Aug. 2023.