Hyperventilation

Definition

Hyperventilation is rapid and deep breathing. It is also called overbreathing, and it may leave you feeling breathless.

Alternative Names

Rapid deep breathing; Breathing - rapid and deep; Overbreathing; Fast deep breathing; Respiratory rate - rapid and deep; Hyperventilation syndrome; Panic attack - hyperventilation; Anxiety - hyperventilation

Considerations

You breathe in oxygen and breathe out carbon dioxide. Excessive breathing creates a low level of carbon dioxide in your blood. This causes many of the symptoms of hyperventilation.

You may hyperventilate from an emotional cause such as during a panic attack. Or, it can be due to a medical problem, such as bleeding or infection.

Your health care provider will determine the cause of your hyperventilation. Rapid breathing may be a medical emergency and you need to get treated, unless you have had this before and your provider has told you that you can treat it on your own.

If you frequently overbreathe, you may have a medical problem called hyperventilation syndrome.

When you're overbreathing, you might not be aware you're breathing fast and deep. But you'll likely be aware of the other symptoms, including:

• Feeling lightheaded, dizzy, weak, or not able to think straight
• Feeling as if you can't catch your breath
• Chest pain or fast and pounding heartbeat
• Belching or bloating
• Dry mouth
• Muscle spasms in the hands and feet
• Numbness and tingling in the arms or around the mouth
• Problems sleeping

Causes

Emotional causes include:

• Anxiety and nervousness
• Panic attack
• Situations where there is a psychological advantage in having a sudden, dramatic illness (for example, somatization disorder)
• Stress

Medical causes include:

• Bleeding
• Heart problem such as heart failure or heart attack
• Drugs (such as an aspirin overdose)
• Infection such as pneumonia or sepsis
• Ketoacidosis and other medical conditions causing excess acid production in the body
• Lung disease such as asthma, COPD, or pulmonary embolism
• Pregnancy
• Severe pain
• Stimulant medicines

Home Care

Your provider will examine you for other causes of your overbreathing.

If your provider has said your hyperventilation is due to anxiety, stress, or panic, there are steps you can take at home. You, your friends, and family can learn techniques to stop it from happening and prevent future attacks.

If you start hyperventilating, the goal is to raise the carbon dioxide level in your blood. This will end most of your symptoms. Ways to do this include:

1. Get reassurance from a friend or family member to help relax your breathing. Words like "you are doing fine," "you are not having a heart attack," and "you are not going to die" are very helpful. It's very important that the person stays calm and uses a soft, relaxed tone.
2. To help get rid of carbon dioxide, learn to do pursed lip breathing. This is done by puckering your lips as if you're blowing out a candle, then breathing out slowly through your lips.

If you have been diagnosed with anxiety or panic, see a mental health professional to help you understand and treat your condition.

1. Learn breathing exercises that help you relax and breathe from your diaphragm and abdomen, rather than from your chest wall.
2. Practice relaxation techniques, such as progressive muscle relaxation or meditation.
3. Exercise regularly.

If these methods alone don't prevent overbreathing, your provider may recommend medicine.

When to Contact a Medical Professional

Contact your provider if:

• You are having rapid breathing for the first time. This may be a medical emergency for which you should be taken to the emergency room right away.
• You are in pain, have a fever, or are bleeding.
• Your hyperventilation continues or gets worse, even with home treatment.
• You also have other symptoms.

What to Expect at Your Office Visit

Your provider will perform a physical exam and ask about your symptoms.

Your breathing will also be checked. If you are not breathing quickly at the time, the provider may try to cause hyperventilation by telling you to breathe in a certain way. The provider will then watch how you breathe and check which muscles you're using to breathe.

Tests that may be ordered include:

• Blood tests for the oxygen and carbon dioxide levels in your blood
• Chest CT scan
• ECG to check your heart
• Ventilation/perfusion scan of your lungs to measure breathing and lung circulation
• X-rays of the chest

References

Braithwaite SA, Wessel AL. Dyspnea. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 21.

Schwartzstein RM, Adams L. Dyspnea. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 36.