Breathing problems

Can breathing ‘wrongly’ make me feel ill?

Breathing is an unconscious action, as critical to our survival as eating and drinking. However, it is obvious that many of us eat and drink ‘wrongly’ (in speed, quality and quantity). But can we breathe wrongly?

The answer, it appears, is yes. If we breathe more quickly than is required to supply our body’s need for oxygen, particularly if we take short shallow breaths, we may unintentionally alter our blood chemistry, which may make us feel like we must breathe even more intensively. As we breathe too fast we lose more carbon dioxide and this makes the blood more alkaline. The most common trigger for this change is when we feel stressed, anxious, or under pressure. In the short term this is potentially a helpful strategy to prepare us to deal with the stress, threat or challenge, if it were a physical threat. Unfortunately, in our world today the threat is much more likely mental or emotional, and the effects of our response to the threat therefore do not get discharged by physical activity.

A panic attack is an extreme version of such a response. As the blood chemistry changes it may lead to our muscles cramping, particularly in our hands and feet, we feel dizzy or faint and nervous (because there is an increase in adrenaline in our blood), and there may be tingling in the hands or face. The sense of panic is increased by the feeling that even though I am breathing faster and faster I still feel desperately out of breath. A traditional treatment for this is for the sufferer to breathe into a paper bag, so that they breathe the air that they have already breathed out. This increases the carbon dioxide in their blood again, which has risen fallen to a very low level.

Chronic breathing pattern disorders

These are due to the way we are breathing (usually too fast and/or too shallow) and are different from lung or heart diseases which may cause someone to feel breathless (along with other symptoms). In contrast to a panic attack the abnormal breathing pattern is less obvious, and may be more apparent from other associated symptoms that occur, for instance sighing frequently or yawning.

Jane sought help about her low back pain. When asked, she mentioned that she tended to get breathless sometimes when sitting, for no obvious reason, and when she was under pressure or feeling stressed she developed tingling in her fingers and felt numb around her mouth. While she talked it was obvious that from time to time she stopped and sighed deeply. With further examination it became apparent that Jane was hyperventilating – breathing faster than she needed and this was causing many symptoms. The overbreathing also caused her muscles to fatigue more quickly, aggravating her low back problem. Helping her change her breathing pattern allowed many of the symptoms to settle down over a number of weeks.

Research into those who presented to osteopaths with muscle and joint symptoms indicated that at least 20% of patients had a breathing pattern disorder. This is not surprising since the altered blood chemistry associated with a reduction in carbon dioxide causes more rapid fatigue in muscles and altered control of muscles by the nervous system. Thus in those with low back pain, the muscles may be more tight and there is less efficient co-ordination of the spinal joints, predisposing to muscle and joint dysfunction and pain.

Below is a summary of a wide range of symptoms, some or all of which may occur:

Respiratory-Breathlessness at rest for no apparent reason, frequent deep sighs or yawning, chest wall tightness –inability to breathe deeply, fast breathing

Circulation- Palpitations, Cold hands and feet

Neurological-Light-headedness and feeling spaced out/dizziness, Tingling or numbness in lips or extremities/finger-tips, Headaches, Blurred vision, Confusion, lost touch with environment

Gastro-intestinal-Dry throat, heartburn, regurgitation, Tight around mouth, IBS, Bloating from air swallowing

Muscular-Achy muscles /joints or even tremors, Stiffness in fingers and arms (due to build up of lactic acid)

Psychological-Feeling tense, tiredness, weakness, broken sleep, nightmares, Clammy hands and high anxiety level

Notice that a combination of these symptoms, causing problems in a variety of body systems may leave the patient with the impression that they have a serious illness. Sometimes it is hard to convince someone to the contrary. How could breathing wrongly cause all these symptoms? But it does.

Hyperventilation syndrome is more likely if breathlessness is
• Occurring at rest while reading or watching TV.
• Associated with lightheadedness and tingling.
• Poorly related to severity of exertion.
• Associated with fear of dying during attacks.

Other causes of hyperventilation ie breathing too fast and a sense of breathlessness include lung and heart disease and renal failure. Fever, toxins and drugs can all increase the respiratory rate, possibly by a central action on the brain. Notice in these cases there will be other signs and symptoms of the various body systems affected. If in doubt these should be discussed with a doctor, though your osteopath will look out for these and refer you as appropriate.

How can the problem be corrected?

For short term first aid, if you are aware of any symptoms, or that you are breathing fast, try these:
1. Hold your breath. Holding your breath for as long as you comfortably can will prevent the dissipation of carbon dioxide. If you hold your breath for a period of between 10 and 15 seconds and repeat this a few times that will be sufficient to calm hyperventilation quickly.
2. Breathe in and out of a paper bag. This will cause you to re-inhale the carbon dioxide that you exhaled. Naturally there are many times when this would be inappropriate and may appear a little strange. It really helps though.
3. Thirdly you can take vigorous exercise while breathing in and out through your nose. A brisk walk or jog whilst breathing through the nose will counter hyperventilation. Regular exercise will decrease general stress levels decreasing the chance of panic attacks.

Symptoms can be reduced or even eliminated by retraining the breathing pattern. The primary challenge is to reduce the loss of carbon dioxide by breathing more slowly, particularly when breathing out. Some suggest that it is important to breathe using the diaphragm and breathe into the abdomen. However, just slowing the breathing down, by breathing out through pursed lips is a simple technique that will have the desired effect. (See below) This is useful if you are feeling tense or anxious as a first aid measure to help you relax. If you have a persistent breathing pattern disorder you will need to practise your breathing consciously for 5-15 minutes a day (gradually increasing) over a number of weeks. Initially you may feel dizzy as you breathe more slowly. If this occurs just go back to your normal pattern, or even just hold your breath, to allow your carbon dioxide to rise again.

Treatment at Lincoln Osteopaths  can help the process of relaxing and retraining, but it cannot and will not correct the breathing pattern without active breathing exercise. Manual treatment by itself will not cause a lasting change in the breathing pattern but it can help stretch out muscles and joints that have become persistently tight as a result of low grade but persistent hyperventilation.

Breathing for relaxation (‘blowing on a candle’) and hyperventilation

• Hold up one finger about 10 inches (25cm) away from your mouth.blowing
• Gently blow on your finger. Imagine that your finger is a small flame; you want to make it flicker but you do not want to blow it out.
• Gently blow for as long as you feel comfortable to. Do not force or strain.
• Allow your lungs to refill and then gently blow again
(Once you understand the ‘blowing on a candle’ you no longer need to hold up your finger.
• Concentrate on your breathing and if other thoughts, worries or concerns come into your mind, just let them go, and concentrate on breathing.
• Sometimes counting as you breathe in and out helps. Aim to breathe out for 6-8 seconds and then allow your lungs to refill as you feel comfortable. Do not attempt to breathe in for as long as you breathe out – we relax more during the OUT-breath
• If you are in pain, or aware a part of your body is tight, use your imagination to relax that area. As you breathe out, imagine that you are gently blowing warm air on or through the painful or tight part of your body– this may increase your relaxation.

P Searle-Barnes
West Parade Osteopaths
Lincoln 01522 537103