Breathing is essential of course. But not all breathing is good – sometimes it’s downright dysfunctional!  Specifically, dysfunctional breathing is when people breathe more than their body requires. They may use the upper part of the chest rather than the diaphragm or take intermittent gulping breathes. Dysfunctional breathing can even arise from an over reliance on the mouth for respiration.

Most people will suffer a bout of over breathing at some time or other, sometimes breathing twice as much as is required. Periods of stress or anxiety commonly cause a brief attack of over breathing. However, for some people this type of breathing can become persistent and occurs most of the time. Often they’re not even aware they´re doing it and the condition is then known as Chronic Hyperventilation Syndrome.

Sufferers may say they feel very breathless or that the chest feels tight or wheezy (symptoms that can easily be mistaken for or exaggerated in asthma).  They can feel quite dizzy and as though their heart is racing. Often people tell us that “they are worried they aren’t getting enough oxygen.” But it isn´t the oxygen that causes the problems – over breathing lowers the carbon dioxide (CO₂) in our blood and that´s what leads to these scary symptoms.  

Far from being a waste product of breathing CO₂ plays a number of important physiological roles in our bodies. The gas influences many enzyme reactions and controls the constriction or relaxation of blood vessels and airways. It acts to help speed up the release of oxygen from red blood cells into muscle and even plays a part in muscle contraction itself. Pretty important stuff!

CO₂ levels are controlled by breathing. Breathe more than needed, by taking deeper or faster breaths and CO₂ levels in the blood fall. Hold your breath and CO₂ levels rise again. Sometimes a person´s breathing can be quite regular but then a yawn, sigh, or coughing bout brings on symptoms, as CO₂ is reduced. Talking too quickly without pausing for breath lowers the blood CO₂ and that´s why people sometimes tell us they feel worse when chatting on the phone.

Chronic Hyperventilation Syndrome is a condition that mimics many others so investigations are needed to rule out other possible causes. But once a diagnosis is made specialised physiotherapy can help.

How can physiotherapy help ?

Respiratory physiotherapy helps you correct dysfunctional breathing by first assessing your breathing pattern and then teaching breathing techniques to re-educate your breathing muscles and encouraging slower, reduced volume breathing.

Breathing is controlled by the Autonomic Nervous System, this has two branches: the Parasympathetic Nervous System which slows the breathing, reduces cortisol levels and lowers heart rate, and the Sypathetic Nervous System which increases breathing rate, heart rate, blood pressure and cortisol. Often, particularly after a viral illness or if you have an underlying respiratory disease, the Sympathetic Nervous System becomes dominant.

With physiotherapy breathing and stretching exercises we can help calm the body, improve your breathing pattern and ultimately cure this uncomfortable sensation of “air hunger”. Just like changing and improving your posture, with time and practice you can re-educate your breathing so that you breathe slowly, efficiently and effectively and no long feel like you have to “gulp the air in:”