How to know if you have a breathing pattern disorder

Breathing is supposed to be the most natural thing in the world, but a surprising number of us are getting it wrong. 

I spent six months last year convinced that I was on the brink of suffocating. It all started one night when, attempting to fall asleep, I realised that I was struggling to breathe.

It was as if no matter how deeply I sucked the air in, I couldn’t take a satisfying breath. I worried that I wasn’t getting enough oxygen—a state that I now know is called “air hunger”.

I became dizzy, disoriented, and my pulse oximeter showed a reading of 146 BPM. Yet, when I got to A&E, they couldn’t find anything wrong. My oxygen levels were at 99, well above the danger zone of 90 or below. With nothing visibly the matter, all they could do was send me home.

It took months of blood samples, chest scans, spirometry tests, and more breathless episodes to find out that my problem wasn’t that I couldn’t breathe, but that I was actually breathing too much. 

In a consultation with breathing physiotherapist Kelly Mitchell, she called it “overbreathing”, or a “breathing pattern disorder”.

Over time, prolonged anxiety can cause rapid, shallow, upper chest breathing to become chronic

In a nutshell, a breathing pattern disorder is where you breathe more than the body needs to, or you develop dysfunctional breathing habits—like rapid shallow breathing, or breathing through your mouth. 

Disordered breathing can emerge after a respiratory illness. You might resort to mouth breathing when your nose is congested, or breathe more shallowly if a bug affects your lungs, but both should go away when you feel better. Some people, though, get stuck.

That’s why some doctors are beginning to look at overbreathing as one reason why COVID long-haulers still feel breathless for months after infection. 

Anxiety, too, can cause a dysfunctional breathing pattern. 

“When we are stressed we tend to overbreathe and resort to breathing through the mouth,” writes breathing expert Patrick McKeown in The Oxygen Advantage. “Many people habitually breathe in this manner every minute of every hour of every day.”

According to the NHS, between six and 12 per cent of the population now live with a breathing pattern disorder. 

The most obvious sign of a breathing pattern disorder is, as you would expect, breathing too much.

The average adult takes between 12 and 16 breaths per minute, but when Mitchell counted mine, I was breathing 25 times without realising. 

I had chronic hyperventilation, which meant that I was almost constantly poised for a “fight or flight” response. A mere cup of coffee could tip me over into a panic attack. 

Other symptoms of a breathing pattern disorder include:

Frustratingly, breathing difficulties can also be a sign of respiratory illnesses like asthma or COPD. 

You should get tested by your GP to check that there is nothing more sinister going on. But if all signs point to you being fit and healthy, speak to them about whether you might be overbreathing. 

Over time, breathing pattern disorders upset the balance between oxygen and carbon dioxide in your body. 

Most of us understand that we need oxygen for our bodies to function properly, but we also need a certain amount of carbon dioxide in our blood too. 

Overbreathers tend to think that we are not getting enough oxygen, so we breathe even more in an attempt to feel better.

But there is only so much oxygen that your blood can carry. If your oxygen level is already at 99 per cent, then taking more breaths will not increase it. The trouble is, you will also be breathing out more carbon dioxide than you should. 

This carbon dioxide deficiency causes your blood vessels to constrict, which makes it harder for your blood cells to move around essential nutrients. Paradoxically, even though you are taking in more oxygen, less of it reaches your brain.

Your blood’s chemical makeup also changes. 

“When we breathe too much, we expel too much carbon dioxide, and our blood pH rises to become more alkaline,” writes journalist James Nestor in Breath: The New Science of a Lost Art. “Almost all cellular functions in the body take place at a blood pH of 7.4, our sweet spot between alkaline and acid.”

To compensate, your body sheds more of its alkaline buffer—which usually moderates the blood’s acidity—while retaining acid in the kidneys. Balance is restored to your blood’s pH, but you now feel the need to keep hyperventilating to maintain this shaky equilibrium. 

This is why chronic hyperventilators find it difficult to correct their breathing. 

Learning to breathe slowly from your diaphragm is one effective way to treat overbreathing

Unless your breathing pattern disorder is a symptom of a physical illness, it is most likely habit-driven. This means that although it is difficult to shift, it is treatable. 

The main goal is to slow down your breathing with regular exercises and lifestyle changes to allow your carbon dioxide levels to build back up.

You’ll need to manage any triggers that increase your heart rate, as these make it more difficult to control your breathing. These include:

A respiratory specialist can advise you on breathing exercises and help you to find a pattern that works for you, but the basics of good breathing are:

This can feel unpleasant at first, as your body is not accustomed to having a healthy amount of carbon dioxide in its body, and may mistakenly feel that it is suffocating. 

Remember not to panic, and repeat your slow, deep breathing exercises at least once a day. Your body will gradually acclimatise to the carbon dioxide. Good breathing patterns should become more automatic with practice. 

Read more: Everything you need to know about sleep apnoea

Read more: What anxiety does to your body and how to heal

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