Wheezing

What is wheezing?

Wheezing is the shrill, coarse whistling or rattling sound your breath makes when your airway is partially blocked or narrowed. It’s usually most apparent when you breathe out (exhale). Sometimes, it can be a sign that you’re having breathing problems due to an underlying condition. But, other times, wheezing can be a reaction to dust in the air or because you have a cold.

Many treatments are available for wheezing, depending on what’s causing it. Your healthcare provider may recommend seeing a pulmonologist or allergist if your symptoms persist or if wheezing is due to a chronic health condition like asthma.

What does wheezing sound like?

Some wheezes can only be heard with a stethoscope, but often, you can hear them with your own ears. Wheezing is more obvious when you breathe out but can also be heard when you breathe in. The tone of the wheeze can vary depending on which part of your respiratory system is blocked or narrowed. Narrowing in the upper respiratory system may make for a hoarser wheeze. Lower obstructions may have a more musical tone, like how a wind instrument like a clarinet might sound.

How common is this condition?

Anyone — from infants to older adults — can develop wheezing. In adults, people who smoke and people with emphysema or heart failure are most prone to wheezing.

Wheezing is also quite common in infants. Up to 25% to 30% of infants develop wheezing in their first year. This may happen because babies have smaller airways. Children under 2 are also more susceptible to wheezing because they tend to get viral upper respiratory infections.

Adults and children with asthma and allergies may also be more likely to experience wheezing.

What are common causes of wheezing?

An obstruction (blockage) or narrowing of the small bronchial tubes in your chest usually causes wheezing. An obstruction in your larger airways or vocal cords can also cause it. The causes range from chronic but manageable conditions like asthma to serious conditions like heart failure.

Many different things can cause wheezing, such as medical conditions, infections or viruses, and lifestyle factors.

Lung issues

• Asthma: A chronic condition that causes spasms and swelling in your bronchial tubes. Exposure to airborne allergens such as pollen, mold or dust can trigger wheezing in asthma. Viral illnesses can also make asthma symptoms worse. Asthma is one of the most common causes of wheezing.
• Aspirating: Breathing a foreign object or substance into your lungs.
• Bronchitis: Inflammation of the lining inside your bronchial tubes.
• Bronchiolitis: A virus most common in young children that causes inflammation and irritation in their airways.
• Bronchiectasis: Damage to the large airways in your lungs.
• Chronic obstructive pulmonary disease (COPD):  Inflammation and damage of the lining of your bronchial tube, most commonly from smoking cigarettes.
• Cystic fibrosis (CF): A condition that causes thick mucus to clog your airways and make breathing difficult.
• Emphysema: A lung condition that makes you short of breath.
• Pneumonia: Lung inflammation caused by a virus or bacteria. Other viral infections can cause wheezing, especially in infants and toddlers.
• Respiratory syncytial virus (RSV): A seasonal lung infection that’s common in children.

Vocal cord issues

• Vocal cord dysfunction: VCD causes your vocal cords to close instead of open when you breathe in and out, making it harder to get air into or out of your lungs.

Issues with your digestive tract

• GERD: Chronic acid reflux can relax the lower esophageal valve, causing wheezing.

Allergies

• Allergies: Allergen triggers like dust mites, pollens, pets, mold spores and foods can cause wheezing.
• Anaphylaxis: A severe allergic reaction typically caused by food allergies or insect stings can make you wheeze.

Heart conditions:

• Heart failure: Fluid in your lungs due to heart failure can make you wheeze.

Lifestyle factors

• Smoking: Smoking tobacco increases your risk of developing COPD and emphysema and makes it harder to manage conditions like asthma.
• Medications: Certain medications (like aspirin) may contribute to wheezing.
• Sleep apnea: Sleep disorders can cause wheezing.

How do you get rid of wheezing?

Your treatment for wheezing depends on its underlying cause. If you go to the ER or see a healthcare provider, they may begin with oxygen therapy to help you breathe. If wheezing is severe or doesn’t improve with supplemental oxygen, you may need to be hospitalized until your breathing improves.

What medicines can you take for wheezing?

Most of the time, taking medication to treat the cause of the wheezing improves your symptoms. For example, using an inhaler for asthma or taking antibiotics for an infection usually helps.

Asthma medications

If asthma is causing you to wheeze, your healthcare provider will likely prescribe an inhaler to reduce inflammation and open your airways (a bronchodilator). Inhaled corticosteroids and pills such as montelukast (Singulair®) are anti-inflammatory medicines to treat asthma.

Bronchitis medications

If your provider determines bronchitis is causing your wheezing, they may prescribe a bronchodilator such as albuterol (Proair® HFA, Proventil® HFA, Ventolin® HFA) or an antibiotic to heal a bacterial infection. This should help you breathe better as you recover.

Other causes of wheezing may require specific treatments like oxygen therapy. Your provider will prescribe a plan to treat the underlying cause of your condition and soothe symptoms to help you feel better faster.

What are OTC (over-the-counter) treatments for wheezing?

There are many ways you can improve wheezing at home without a prescription. Some of those treatments include:

• Breathing exercises. Taking slow, deep breaths helps expand your lung capacity and relaxes your airways (diaphragmatic breathing). Deep breathing in a moist, humid environment (like a steam room) can also help.
• Drink hot herbal tea. The warmth and moisture of tea will help relax your bronchial tubes. Some studies show green tea has antibacterial properties, as well.
• Don’t smoke. Smoking irritates your lungs and inflames your airways. Take precautions to avoid secondhand smoke.
• Use an air purifier with a HEPA filter. High-quality filters help remove allergens in your home.
• Vaporize your air: Humidifiers or vaporizers moisten the air to help you breathe better.
• Stay away from known allergy triggers. Avoid things that trigger your allergies.

When should I be worried about wheezing?

See your healthcare provider if your wheezing is new, if it keeps coming back or if any of the following symptoms accompany it:

• Shortness of breath or rapid breathing.
• Confusion or altered mental state.
• Chest tightness or chest pain.
• Swelling of your lips or tongue.
• A bluish tinge around your skin, mouth or nails.

Finding the cause of wheezing

Your healthcare provider will perform a physical exam, listen to your lungs and breath and ask about your symptoms. Questions could include things like:

• When did the wheezing start?
• Is the wheezing getting worse or staying the same?
• Is the wheezing constant or all day, or does it come and go?
• Do certain factors make the wheezing worse, like exercise, lying down or being outside?

Your provider may also order tests like:

• Pulse oximetry (pulse ox, a finger sensor to measure oxygen levels).
• Chest X-rays.
• Pulmonary function tests.
• Blood tests.

Whatever the cause, there are things you can do to get relief. Follow your healthcare provider’s instructions on taking medication, choosing not to smoke (or quitting) and running a vaporizer or humidifier to moisten the air. Doing all these things will help you breathe easier.

When should I go to the ER?

If your skin, mouth or nails are turning blue or you’re gasping for air, it’s a sign that your lungs don’t have enough air. This is a medical emergency and you should have a family member or friend take you to the nearest emergency room. If you’re alone, call 911 (or your emergency services number) and describe your breathing.

If you suddenly start wheezing after a bee sting, after you take a new medication or eat a new food, that could indicate an allergic reaction, and you should seek medical attention right away.

A note from Cleveland Clinic

Hearing a wheezing sound from yourself or a loved one can be alarming. While it’s not always a reason to panic, an underlying medical condition could be the cause. Wheezing happens when your airways are blocked, and many things can cause it. It may be OK to wheeze when you have a cold or another temporary illness. But if it happens frequently and you become short of breath or blue, seek care from a healthcare provider immediately.