Hyperventilation

Topic Overview

Hyperventilation is breathing that is deeper and more rapid than normal. It causes a decrease in the amount of a gas in the blood (called carbon dioxide, or CO2). This decrease may make you feel lightheaded, have a rapid heartbeat, and be short of breath. It also can lead to numbness or tingling in your hands or feet, anxiety , fainting, and sore chest muscles.

Some causes of sudden hyperventilation include anxiety, fever, some medicines, intense exercise, or emotional stress . Hyperventilation also can occur because of problems caused by asthma, emphysema, or after a head injury. But it occurs most often in people who are nervous or tense, breathe shallowly, and have other medical conditions, such as lung diseases or panic disorder . Women experience hyperventilation more often than men. Most people who have problems with hyperventilation are between the ages of 15 and 55. Hyperventilation may occur when people travel to elevations over 6000 ft (2000 m). Symptoms can be similar to symptoms that are caused by another, more serious medical problem, such as a lung problem.

Acute (sudden) hyperventilation is usually triggered by acute stress, anxiety, or emotional upset. Chronic (recurring) hyperventilation may be an ongoing problem for people with other diseases, such as asthma, emphysema, or lung cancer.

Many women have problems with hyperventilation during pregnancy, but it usually goes away on its own after delivery.

In many cases, hyperventilation can be controlled by learning proper breathing techniques.

Symptoms of hyperventilation

Symptoms of hyperventilation usually last 20 to 30 minutes and may include:

• Feeling anxious, nervous, or tense.
• Frequent sighing or yawning.
• Feeling that you can't get enough air (air hunger) or need to sit up to breathe.
• A pounding and racing heartbeat.
• Problems with balance, lightheadedness , or vertigo .
• Numbness or tingling in the hands, feet, or around the mouth.
• Chest tightness, fullness, pressure, tenderness, or pain.

Other symptoms may occur less frequently, and you may not realize they are directly related to hyperventilation. These symptoms can include:

• Headache.
• Gas, bloating, or burping.
• Twitching.
• Sweating.
• Vision changes, such as blurred vision or tunnel vision.
• Problems with concentration or memory.
• Loss of consciousness (fainting).

Hyperventilation is not a disease, but you may need to be checked by your doctor if you have repeated episodes of hyperventilation symptoms. If you have recurring symptoms, you might be diagnosed with a condition called hyperventilation syndrome (HVS).

Treatment for hyperventilation depends on the cause. Home treatment is usually all that is needed for mild hyperventilation symptoms. Medical treatment may be needed for hyperventilation symptoms that are moderate to severe, that last for long periods of time, that come back, or that interfere with your daily activities. Medical treatment usually includes reassurance, stress reduction measures, breathing lessons, or medicine.

Use the Check Your Symptoms section to decide if and when you should see a doctor.

Check Your Symptoms

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Home Treatment

Home treatment may help you control your breathing and stop hyperventilation . First, sit down and concentrate on your breathing.

Breathing techniques

• Breathe through pursed lips, as if you are whistling, or pinch one nostril and breathe through your nose. It is harder to hyperventilate when you breath through your nose or pursed lips because you cannot move as much air.
• Slow your breathing to 1 breath every 5 seconds, or slow enough that symptoms gradually go away.
• Try belly-breathing, which fills your lungs fully, slows your breathing rate, and helps you relax.
  • Place one hand on your belly just below the ribs. Place the other hand on your chest. You can do this while standing, but it may be more comfortable while you are lying on the floor with your knees bent.
  • Take a deep breath through your nose. As you inhale, let your belly push your hand out. Keep your chest still.
  • As you exhale through pursed lips, feel your hand go down. Use the hand on your belly to help you push all the air out. Take your time exhaling.
  • Repeat these steps 3 to 10 times. Take your time with each breath.

Always try measures to control your breathing or belly-breathe first. If these techniques don't work and you don't have other health problems, you might try breathing in and out of a paper bag that covers your nose and mouth.

Using a paper bag

• Take 6 to 12 easy, natural breaths, with a small paper bag held over your mouth and nose. Then remove the bag from your nose and mouth and take easy, natural breaths. See a picture of how to use a paper bag to control hyperventilation .
• Next, try belly-breathing (diaphragmatic breathing).
• Alternate these techniques until your hyperventilation stops.

If hyperventilation continues for longer than 30 minutes, call your doctor immediately.

Do not use a paper bag if:

• You have any heart or lung problems, such as coronary artery disease, asthma , chronic obstructive pulmonary disease (COPD, emphysema), or a history of deep vein thrombosis , stroke , or pulmonary embolism .
• Rapid breathing occurs at a high altitude [above 6000 ft (2000 m)]. Breathing faster than normal is a natural response to an increased altitude.

Follow these precautions when using the bag method:

• Do not use a plastic bag.
• Do not breathe continuously into a paper bag. Take 6 to 12 natural breaths, with a paper bag held over your mouth and nose, then remove the bag from your nose and mouth.
• Do not hold the bag for the person who is hyperventilating. Allow the person to hold the bag over his or her own mouth and nose.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment:

• Symptoms do not improve with home treatment measures.
• Symptoms become more severe or frequent.

Prevention

You may be able to avoid hyperventilation:

• Breathe through your nose. It is harder to hyperventilate when your mouth is closed because you can't move as much air through your nose.
• Loosen your clothing. Tight belts and waistbands, girdles, bras, and skintight jeans can all restrict breathing and cause shallow, upper-chest breathing.
• Learn belly-breathing (diaphragmatic breathing) techniques and practice them when you are not hyperventilating so that you can use the techniques when you need them. People who hyperventilate usually take shallow breaths, filling only their upper chest when they inhale.
• Try different relaxation techniques and see what works best for you. For more information, see the topic Stress Management.
• Talk to friends, family members, or a counselor to help you relieve anxiety. Keep a journal to help you focus on your problems and find workable solutions.
• Eat a healthy mix of foods. Watch out for caffeine: drink less coffee, tea, and soda and do not eat as much chocolate. For more information, see the topic Healthy Eating.
• Exercise. Regular aerobic exercise forces you to take full breaths and helps you to reduce anxiety that contributes to hyperventilation. For more information, see the topic Fitness.
• Make sure you get a good night's sleep. Being rested may help reduce daytime anxiety. For more information, see the topic Sleep Problems, Age 12 and Older.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

• What are your main symptoms? How long have you had your symptoms? What was happening in your life when your symptoms began?
• Have you had this problem before? If so, do you know what caused the problem at that time? How was it treated?
• What activities make your symptoms better or worse?
• Do you think that sports activities or activities related to your job or hobbies caused your symptoms? Have you recently changed jobs, been laid off, or been fired?
• Do you have a lot of stress in your life? Have you recently had a change in your family, such as a divorce or death of a loved one?
• Has anyone else in your family ever had problems with hyperventilation or been diagnosed with an anxiety disorder or depression ?
• What home treatment measures have you tried? Did they help?
• What nonprescription medicines have you tried? Did they help?
• What prescription and nonprescription medicines do you take?
• Do you smoke or use other tobacco products?
• Are you using alcohol or illegal drugs, such as marijuana or cocaine, to help manage your symptoms?
• Do you have any health risks?

While waiting for your appointment, it may be helpful to keep a diary of your symptoms (What is a PDF document?) .

Related Information

• Anxiety
• Dizziness: Lightheadedness and Vertigo

Credits

Author	Jan Nissl, RN, BS
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Tracy Landauer
Primary Medical Reviewer	William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Primary Medical Reviewer	Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer	Martin Gabica, MD - Family Medicine
Specialist Medical Reviewer	Lisa S. Weinstock, MD - Psychiatry
Last Updated	September 12, 2008