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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, and emotional stress. Hyperventilation also can occur because of problems caused by asthma or 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 15 to 55 years old. 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:
- Gas, bloating, or burping.
- 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.
Check your symptoms to decide if and when you should see a doctor.
Check Your Symptoms
The medical assessment of symptoms is based on the body parts you have.
- If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
- If your symptoms aren’t related to those organs, you can choose the gender you identify with.
- If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
- Your age. Babies and older adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
- Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
- Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
- Try home treatment to relieve the symptoms.
- Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
Symptoms of difficulty breathing can range from mild to severe. For example:
- You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
- It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you're at rest (severe difficulty breathing).
Severe trouble breathing means:
- You cannot talk at all.
- You have to work very hard to breathe.
- You feel like you can't get enough air.
- You do not feel alert or cannot think clearly.
Moderate trouble breathing means:
- It's hard to talk in full sentences.
- It's hard to breathe with activity.
Mild trouble breathing means:
- You feel a little out of breath but can still talk.
- It's becoming hard to breathe with activity.
Symptoms of a heart attack may include:
- Chest pain or pressure, or a strange feeling in the chest.
- Shortness of breath.
- Nausea or vomiting.
- Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
- Lightheadedness or sudden weakness.
- A fast or irregular heartbeat.
The more of these symptoms you have, the more likely it is that you're having a heart attack. Chest pain or pressure is the most common symptom, but some people, especially women, may not notice it as much as other symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, or a strange feeling in your chest or other areas.
Make an Appointment
Based on your answers, the problem may not improve without medical care.
- Make an appointment to see your doctor in the next 1 to 2 weeks.
- If appropriate, try home treatment while you are waiting for the appointment.
- If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.
Call 911 Now
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
Seek Care Today
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
- Call your doctor today to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care today.
- If it is evening, watch the symptoms and seek care in the morning.
- If the symptoms get worse, seek care sooner.
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
- Call your doctor now to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care in the next hour.
- You do not need to call an ambulance unless:
- You cannot travel safely either by driving yourself or by having someone else drive you.
- You are in an area where heavy traffic or other problems may slow you down.
Call 911 Now
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
After you call 911 , the operator may tell you to chew 1 adult-strength (325 mg) or 2 to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.
Home treatment may help you control your breathing and stop hyperventilation. First, sit down and concentrate on your breathing.
- 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 breathe through your nose or pursed lips, because you can't 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
- Use a paper bag to control your breathing. 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.
- 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
Call your doctor if any of the following occur during home treatment:
- Symptoms do not improve with home treatment measures.
- Symptoms become more severe or frequent.
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.
- Practice healthy thinking and stop negative thoughts.
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?
Current as of
Author: Healthwise Staff
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine