Section 4
Dysfunctional Breathing
Normal Breathing Pattern
Breathing is the process that moves air in and out of the lungs. This allows the body to
maintain the correct levels of oxygen and carbon dioxide for normal bodily function. The
diaphragm is the half moon shaped muscle at the bottom of your rib cage and is the main
muscle used during breathing. During inhalation the diaphragm moves down to draw
oxygen into your lungs working in conjunction with the intercostals muscles which are
attached to your rib cage they contract to increase the volume of the thorax. When the
diaphragm and intercostals muscles relax they compress the lung which increases
pressure for carbon dioxide to be expelled through your nose and mouth.
Dysfunctional Breathing Pattern
Dysfunctional breathing is also known as hyperventilation syndrome or abnormal breathing
pattern. Dysfunctional breathing can be defined by the presence of unexplained breathing
symptoms. Dysfunctional breathing can occur from physical or emotional stress
responses causing the body to over breathe when it is not indicated and becomes difficult
to return to a normal breathing pattern. This can become a chronic condition or come in
“attacks” and can present itself with numerous symptoms.
Symptoms of Dysfunctional Breathing
Chest Tightness
Wheezing
Shortness of breath
Yawning/Sighing
Bloating
Burping
Palpitations
Dizziness/light headiness
Fainting
Weakness
Anxiety
Confusion
Memory Problems
Agitation
Numbness & Tingling
Dry Mouth
Unsteadiness
Muscle Spasms
Dysfunctional breathing is usually brought on by triggers for example
bereavement, anxieties related to work or your personal life, underlying chest
disease or even post surgery. Recognising these triggers and warning signs are
an important mechanism in controlling your breathing pattern.
Physiotherapy Treatment of dysfunctional breathing
Physiotherapy treatment of dysfunctional breathing generally works on re-training
your respiratory system to breath correctly. This can take some time and needs
to be broken down into small simple steps to retrain your brain how to breathe
correctly. Your physiotherapist will assess your breathing pattern and break this
down into the inspiratory phase and expiratory phase and work on exercises to
correct these phases. They will give you a self awareness of how you breathe
and when to recognise symptoms of dysfunctional breathing. Once this has been
progressed to a more normal pattern of breathing your physiotherapist will teach
you how to breathe using your diaphragm (see Below).
It has recently been recognised that breathing retraining alone is not the only way
to improve your symptoms. As dysfunctional breathing can alter your
mechanisms of breathing it is important to look at the muscles and bone
structures surrounding your rib cage known as your musculoskeletal system.
You may need an assessment of your musculoskeletal system and exercises to
get this system functioning in the right way again. Your physiotherapist will
provide you with an individual based exercise programme based upon their
assessment.
Diaphragmatic breathing technique
1- Lying comfortably on your back with your knees bent and pillows to make you
comfortable. Place one hand on your chest and the other just below your rib
cage so that you can feel the movement of your diaphragm.
2-Slowly inhale through your nose or through pursed lips (to slow down the intake
of breath).
3-As you inhale, push your belly/ stomach out and feel your stomach expand with
your hand, the hand on your chest wall should remain as still as possible.
4-Slowly exhale through pursed lips to regulate the release of air while squeezing
your stomach, repeat for 1-2 minutes.
Once you feel confident with this technique in lying you can progress to trying the
exercises in sitting you will probably find this more difficult and a little tiring.
Physiotherapy Department
Physiotherapy Department
Burnley General Hospital
Royal Blackburn Hospital
Telephone: 01282 804110
Telephone: 01254 735091
Physiotherapy Department
Physiotherapy Department
Accrington Victoria Hospital
Rossendale Primary Health
Care Centre
01254 359061
Telephone: 01706 253607
Physiotherapy Department
Physiotherapy Department
Pendle Community Hospital
Clitheroe Physiotherapy Centre
01282 804983
01200 423805
Physiotherapy Department
Physiotherapy Department
Accrington PALS
St Peters Centre
Telephone: 01254 282390
Telephone: 01282 644086
Author:
Date of issue:
Revision date:
Version:
Document ID No:
Physiotherapy
March 2014
February 2016
3
PHYSIO – 003 – dysfunctionalbreathing –2014