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Hyperventilation
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Hyperventilation

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Rapid deep breathing; Breathing - rapid and deep; Overbreathing; Fast deep breathing; Respiratory rate - rapid and deep

Hyperventilation is rapid or deep breathing that can occur with anxiety or panic. It is also called overbreathing, and it may leave you feeling breathless.

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  • Considerations

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

    Feeling very anxious or having a panic attack are the usual reasons that you may hyperventilate. But rapid breathing can be a symptom of a disease, such as:

    • Bleeding
    • Heart or lung disorder
    • Infection

    Your health care provider will determine the cause of your hyperventilation. Rapid breathing may be a medical emergency 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.

    Often, panic and hyperventilation become a vicious cycle. Panic leads to rapid breathing, and breathing rapidly can make you feel panicked.

    If you frequently overbreathe, you may have hyperventilation syndrome that is triggered by emotions of stress, anxiety, depression, or anger. Hyperventilation from panic may be related to a specific fear or phobia, such as a fear of heights, dying, or closed-in spaces (claustrophobia).

    If you have hyperventilation syndrome, you might not be aware you are breathing fast. But you will be aware of having many of the other symptoms, including:

    • Belching
    • Bloating
    • Chest pain
    • Confusion
    • Dizziness
    • Dry mouth
    • Light-headedness
    • Muscle spasms in the hands and feet
    • Numbness and tingling in the arms or around the mouth
    • Palpitations
    • Shortness of breath
    • Sleep disturbances
    • Weakness
  • Causes

    • Anxiety and nervousness
    • Bleeding
    • Cardiac disease, such as congestive heart failure or heart attack
    • Drugs (such as an aspirin overdose)
    • Infection such as pneumonia or sepsis
    • Ketoacidosis and similar medical conditions
    • Lung disease such as asthma, chronic obstructive pulmonary disease (COPD), or pulmonary embolism
    • Panic attack
    • Pregnancy
    • Severe pain
    • Situations where there is a psychological advantage in having a sudden, dramatic illness (for example, somatization disorder)
    • Stimulant use
    • Stress
  • Home Care

    Your doctor will examine you and see if there are other causes of your overbreathing.  

    If your doctor 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 is extremely important that the person helping you remain calm and deliver these messages with a soft, relaxed tone.
    2. To increase your carbon dioxide, you need to take in less oxygen. To accomplish this, you can breathe through pursed lips (as if you are blowing out a candle), or you can cover your mouth and one nostril, and breathe through the other nostril.

    Over the long term, measures to help you stop overbreathing include:

    1. If you have been diagnosed with anxiety or panic, see a psychologist or psychiatrist to help you understand and treat your condition.
    2. Learn breathing exercises that help you relax and breathe from your diaphragm and abdomen, rather than from your chest wall.
    3. Practice relaxation techniques regularly, such as progressive muscle relaxation or meditation.
    4. Exercise regularly.

    If these methods alone do not prevent your overbreathing, your doctor may recommend a beta-blocker medication.

  • When to Contact a Medical Professional

    Call your health care provider if:

    • You are experiencing rapid breathing for the first time. (This is a medical emergency and you should be taken to the emergency room right away.)
    • You are in pain, have a fever, or notice any bleeding.
    • Your hyperventilation continues or gets worse, even with home treatment.
    • You also have other symptoms.
  • What to Expect at Your Office Visit

    Your doctor will perform a careful physical examination. The doctor will also ask detailed questions about your symptoms.

    Your breathing will also be checked. If you are not breathing quickly, the doctor may try to cause hyperventilation by telling you to breathe in a certain way.

    While you hyperventilate, the doctor will ask how you feel and watch how you breathe. The doctor will see which muscles you are using in your chest wall and surrounding areas.

    Tests that may be performed include:

    • Blood tests for the oxygen and carbon dioxide levels in your blood
    • Chest CT scan
    • ECG
    • Ventilation/perfusion scan of your lungs
    • X-rays of the chest

Related Information

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References

Buttaravoli P, Leffler SM. Minor Emergencies. 3rd ed. Philadelphia, PA: Saunders Elsevier; 2012:chap 3.

Duffin J, Phillipson EA. Hypoventilation and hyperventilation syndromes. In: Mason RJ, Broaddus CV, Martin TR, et al. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, PA: Saunders Elsevier; 2010:chap 78.

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Review Date: 8/17/2014  

Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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