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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, 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:

  • 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.

Check your symptoms to decide if and when you should see a doctor.

Check Your Symptoms

Do you have problems with hyperventilation?
Hyperventilation is breathing that is faster than normal.
Yes
Hyperventilation
No
Hyperventilation
How old are you?
Less than 12 years
Less than 12 years
12 years or older
12 years or older
Are you male or female?
Male
Male
Female
Female
Have you noticed irregular heartbeats or heart rate changes even when you are not hyperventilating?
Yes
Arrhythmia or heart rate changes when not hyperventilating
No
Arrhythmia or heart rate changes when not hyperventilating
Do you think there could be a breathing problem other than hyperventilation?
Yes
Respiratory problem other than hyperventilation
No
Respiratory problem other than hyperventilation
Do you think you have a breathing problem other than hyperventilation?
Yes
Respiratory problem other than hyperventilation
No
Respiratory problem other than hyperventilation
Did you pass out completely (lose consciousness)?
Yes
Lost consciousness
No
Lost consciousness
If you are answering for someone else: Is the person unconscious now?
(If you are answering this question for yourself, say no.)
Yes
Unconscious now
No
Unconscious now
Are you back to your normal level of alertness?
After passing out, it's normal to feel a little confused, weak, or lightheaded when you first wake up or come to. But unless something else is wrong, these symptoms should pass pretty quickly and you should soon feel about as awake and alert as you normally do.
Yes
Has returned to normal after loss of consciousness
No
Has returned to normal after loss of consciousness
Did the loss of consciousness occur during the past 24 hours?
Yes
Loss of consciousness in past 24 hours
No
Loss of consciousness in past 24 hours
Could you be having symptoms of a heart attack?
If you're having a heart attack, there are several areas where you may feel pain or other symptoms.
Yes
Symptoms of heart attack
No
Symptoms of heart attack
Are you having trouble breathing (more than a stuffy nose)?
Yes
Difficulty breathing more than a stuffy nose
No
Difficulty breathing more than a stuffy nose
Would you describe the problem as severe, moderate, or mild?
Severe
Severe difficulty breathing
Moderate
Moderate difficulty breathing
Mild
Mild difficulty breathing
Can you control your breathing?
Some people can control their hyperventilation by breathing into a paper bag or using different breathing techniques.
Yes
Able to control hyperventilation
No
Not able to control hyperventilation
Do you feel lightheaded or dizzy, like you are going to faint?
It's normal for some people to feel a little lightheaded when they first stand up. But anything more than that may be serious.
Yes
Feels faint
No
Feels faint
Are you still hyperventilating after 30 minutes of home treatment?
Yes
Has tried more than 30 minutes of home treatment without improvement
No
Has tried more than 30 minutes of home treatment without improvement
Do you hyperventilate often?
Yes
Hyperventilates often
No
Hyperventilates often
Does the problem interfere with your daily activities?
Yes
Hyperventilation interferes with daily activities
No
Hyperventilation interferes with daily activities
Are you having more frequent or severe problems with hyperventilation?
Yes
Symptoms are becoming more frequent or severe
No
Symptoms are becoming more frequent or severe
Have you had problems with hyperventilation for more than a week?
Yes
Hyperventilation problems for more than a week
No
Hyperventilation problems for more than a week

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.
HomeTreatment
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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.
  • Sweating.
  • 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.
HomeTreatment
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WhereToGo

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.
HomeTreatment
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WhereToGo

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.
HomeTreatment
RelatedInformation
WhereToGo

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.

Respiratory Problems, Age 12 and Older
Respiratory Problems, Age 11 and Younger
Change in Heartbeat

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 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:

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.

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.
  • Practice healthy thinking and stop negative thoughts.

Preparing For 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?).

Credits

ByHealthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Adam Husney, MD - Family Medicine
Kathleen Romito, MD - Family Medicine

Current as ofNovember 20, 2017

Current as of: November 20, 2017

Author: Healthwise Staff

Medical Review: William H. Blahd, Jr., MD, FACEP - Emergency Medicine & Adam Husney, MD - Family Medicine & Kathleen Romito, MD - Family Medicine