Hyperventilation is a condition when you breathe deeper and more rapid than normal. It is more common in women than men and in people between 15 to 55 years of age. It is also most commonly associated with panic attacks.
We breathe in oxygen and breathe out carbon dioxide. During hyperventilation, we tend to breathe excessively, that is, we over-breathe and this leaves us breathless. This increases the removal of carbon dioxide from the blood, so the carbon dioxide pressure inside the blood decreases causing a condition called respiratory alkalosis where the blood becomes more alkaline. Alkalosis further causes the blood vessels supplying blood to the brain to constrict.
Scientists believe hyperventilation is more of a consequence rather than a cause of certain diseases or conditions. In most cases, hyperventilation is caused by –
- Stress, anxiety, depression, anger
- Severe pain
- Drug overdose, for example, aspirin overdose
There are few clinical conditions that increase your risk of suffering from hyperventilation. These include -
Anxiety or panic disorder: Anxiety and panic disorder which is a severe form of anxiety, is probably the most common cause of hyperventilation. This type of hyperventilation is called acute or sudden hyperventilation. The two almost form a vicious cycle, in the sense, anxiety can lead to hyperventilation, and this rapid breathing can make you panic. Anxiety is also accompanied by faster heart rate, sweating, trembling and dizziness.
Heart failure and heart attack: Heart failure, a chronic condition in which your heart is no longer able to pump out oxygen-rich blood, can cause you to hyperventilate. But this type of hyperventilation is called chronic hyperventilation. You can have heart failure if your high blood pressure is not well controlled or if you have coronary artery disease wherein the blood vessels supplying blood to the heart become narrow.
Lung disease: Lung disease such as asthma, chronic obstructive pulmonary disease (COPD), pulmonary embolism are some of the common lung diseases that cause chronic hyperventilation.
- Asthma – This disease is caused by inflammation in the airways in which the airways of the lungs swell and narrow. Symptoms include cough, wheezing, hyperventilation, shortness of breath, tightness in the chest, difficulty breathing, anxiety, and sweating.
- Chronic obstructive pulmonary disease (COPD) – This is a disease where you have long-term cough with mucus (chronic bronchitis) mostly in combination with emphysema which gradually destroys your lungs. Smoking, second hand smoke and pollution are the leading cause of COPD.
- Pulmonary embolus – Any embolus is a blockage of artery because of blood clot, tumor cells or fat. When the blockage is in the artery leading to the lungs it is called pulmonary embolus.
Pneumonia: Pneumonia is an infection of the lung by the Streptococcus pneumoniae bacteria. COPD, smoking, brain disorders, immune system problems, or sometimes even a surgery can increase the chances of being infected by pneumonia.
Ketoacidosis: Ketoacidosis is a condition in which your body cannot use sugar as fuel (energy source) because of insufficient or no insulin. During such cases, the body fat break down to supply the required fuel. This results in build-up of waste products called ketones. Ketoacidosis normally occurs in diabetics and is considered to be a life threatening condition.
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The symptoms are usually caused due to reduced blood supply to the brain. These include -
- Lightheadedness and dizziness
- Numbness and tingling in the fingertips, arms and around the mouth
- Chest pain
- Confusion, palpitation and shortness of breath
- Shortness of breath
- Bloating and belching
However, severe hyperventilation can even cause loss of consciousness.
The treatment options depend on what’s causing your hyperventilation. Let’s take a look at some of them.
Anxiety or panic disorder:
- Cognitive-behavioural therapy where you are guided to identify and challenge the negative thinking patterns causing anxiousness and panic.
- Exposure therapy where you confront your fears in a controlled environment.
- Medication such as benzodiazepines and anti-depressants combined with self help therapies and behavioural therapies.
Heart failure and heart attack:
- Medicines that treat the symptoms and prevent the heart failure from getting worse, for example, drugs to reduce cholesterol, keep your blood from clotting, reduce arrhythmias, open up clogged blood vessels, and other symptoms. Caution – Ibuprofen and naproxen may worsen heart failure.
- Devices such as pacemaker and defibrillator.
- Coronary bypass surgery or angioplasty with or without stenting. Heart valve surgery may also be suggested by surgeons.
- Intra-aortic balloon pump (IABP) and left ventricular assist device (LVAD) are two treatments in case of end stage heart failure when no other treatment work and you are waiting for a heart transplant.
- Inhalers with steroids or long acting beta-agonists as maintenance or controller medicines.
- Quick relief medicines such as short-acting inhaled bronchodilators or oral corticosteroids.
- Hospital stay in case of severe asthma where you will be given breathing assistance and intravenous medications.
Chronic obstructive pulmonary disease (COPD):
- Bronchodilators to open the airways.
- Steroids administered orally, intravenously, or through inhalers.
- Antibiotics in case of respiratory infections.
Pulmonary embolus: Pulmonary embolus is an emergency situation that needs hospitalization. You will be given clot dissolving medication and then blood thinners to prevent formation of new clots.
- Oxygen therapy
Ketoacidosis: The treatment requires hospitalization where the doctor will correct the high blood sugar level and/ or treat the infection causing ketoacidosis.
If you are over-breathing due to stress, panic, anger or depression, (and this is the most common cause) try the following breathing techniques to control hyperventilation.
- Try breathing once every 5 seconds or slow enough till gradually your over-breathing stops.
- Purse your lips as if you are whistling and breathe.
- Pinch one nostril and breathe through your nose.
- Place one hand on your belly and the other on your chest. Take a deep breath as if you are filling your belly and let your belly push your hand out. Exhale slowly pushing the air out of your belly with your hands. Repeat these steps 5 to 10 times.
The purpose of these breathing techniques is to get more carbon dioxide circulating in your blood. If hyperventilation continues for 30 minutes, get medical help. Also get medical attention if you are hyperventilating for the first time, or if you have fever, bleeding or pain.
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