What is the difference between acute and chronic hyperventilation? In an acute attack the sufferer is usually breathing very rapidly and is in an obvious anxious or panicked state - the sympathetic nervous system is operating under 'fight or flight ' conditions. Conversely, with chronic hyperventilation the sufferer does not look like they are breathing hard or fast, at least to an untrained eye. Commonly they will yawn or heavy sigh a lot and it is these deep breaths, with only a slightly elevated breathing rate, that can maintain someone in a state of chronic hyperventilation.
What does it mean to hyperventilate, or overbreathe, all the time? When we breathe more than the body needs (to meet its metabolic requirements at any particular time), we blow off too much carbon dioxide. This alters the body's pH or acid-alkaline balance. Carbon dioxide is acid so by reducing the levels in the body, it becomes more alkaline. When this occurs because of an increased breathing rate or depth, it is called respiratory alkalosis. This sets up a biochemical imbalance that produces some disturbing symptoms.
NB: Many of the symptoms of acute and chronic hyperventilation are the same, it is the lack of obvious overbreathing or distress with chronic hyperventilation that often has doctors searching erroneously for other diagnoses.
- Dizziness, confusion, unexplained fatigue, weakness ( these are common presentations because low CO2 reduces blood flow to the brain).
- Tingling or numbness, especially around the mouth or in the hands, due to nerve hypersensitivity from the biochemical imbalance.
- Chest pain - your chest may feel sore. The chest pain may feel like angina but in this case it is usually relieved by exercise and not relieved by nitroglycerin.
- Frequent yawning and sighing as mentioned above.
- Air 'hunger' and feeling like you cannot take a deep breath or 'get your breath'.
- Poor exercise tolerance. You may get breathless much more easily and your legs ache and feel weak upon exercise - this is because your body is retaining lactic acid in order to counter the prevailing alkaline environment.
- You may have an upset or sore stomach probably due to swallowing air.
- Phobic reactions to certain places or events that have brought on symptoms in the past are common. This can lead to frequent panic episodes with more acute hyperventilatory type symptoms.
All of these hyperventilation symptoms are typical in people who routinely overbreathe. So, why is chronic Hyperventilation Syndrome so seldom diagnosed and talked about? Especially since medical studies have estimated that up to 10% of the otherwise healthy population suffer from chronic hyperventilation to some degree. People with asthma and COPD are also prone to overbreathing. That's a lot of people wandering around out there, breathing more than they need to be. Many of them are also wondering why they feel so bad as their doctors have found nothing wrong or told them they are suffering 'anxiety'.
Certainly the symptoms of Hyerperventilation Syndrome alone are enough to make one anxious, but in most cases the overbreathing precedes the panic and worry. Dr Claude Lum, a British chest physician who wrote extensively about chronic hyperventilation said that one of the diagnostic clues to this disorder was 'fat folder syndrome' - anyone with a fat case file and no obvious organic disease but symptoms that include some of those listed above, should be considered a prime candidate for a diagnosis of chronic Hyperventilation Syndrome.
If this is you, I suggest you contact your doctor to talk about this. You can also visit www.breathingwise.com for more information. Chronic hyperventilation is not usually life threatening, but it is unpleasant and you can be helped. Treatment is relatively straightforward and involves learning to breathe in a different way and manage your stress levels so that your breathing doesn't take over when life starts to get a little rugged...or someone cuts you off in traffic....or your colleague sends you a nasty email.... but more about that next time! There is a lot more to learn about hyperventilation syndrome and I'll cover it in my next few blog posts.
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