Hyperventilation Syndrome

What is hyperventilation syndrome?

Hyperventilation syndrome involves frequent episodes of hyperventilation that aren’t due to underlying physical conditions. The episodes can last several minutes to an hour and go away on their own.

Hyperventilation is abnormal breathing that involves rapid and deep breathing. It’s also called overbreathing.

Hyperventilation creates a low level of carbon dioxide (respiratory alkalosis) in your bloodstream. This leads to the constriction (narrowing) of blood vessels, including the ones that supply blood to your brain. When these blood vessels constrict, it causes a cascade of symptoms such as dizziness, a pounding heartbeat and feelings of breathlessness.

Most people with hyperventilation syndrome don’t realize they’re breathing abnormally. They just notice the symptoms that hyperventilation causes.

What are the symptoms of hyperventilation syndrome?

Episodes of hyperventilation may happen in response to strong emotions or begin randomly. They can last up to an hour and stop on their own without medical intervention.

Hyperventilation happens when you take fast, deep breaths. You may not be aware that you’re breathing like this. But you’ll likely notice the symptoms hyperventilation causes, including:

• Feeling lightheaded, dizzy or weak.
• Shortness of breath (dyspnea).
• Chest pain.
• Fast and pounding heartbeat.
• Numbness and tingling in your arms or around your mouth.
• Muscle spasms in your hands and feet.
• Difficulty focusing.
• Burping or bloated stomach.
• Dry mouth.
• Headache.

What causes hyperventilation syndrome?

Researchers don’t know the exact cause of hyperventilation syndrome. In some cases, stress, fear and anxiety can trigger episodes. In other cases, the person can’t name any kind of trigger, and the episodes seem to start randomly.

It’s not clear how emotional stress causes hyperventilation, but researchers think it has to do with your body’s “fight-or-flight” response. Your sympathetic nervous system activates body processes that help you in times of need, especially times of stress or danger. During these times, your body needs more oxygen to supply your muscles, which triggers rapid breathing. If there’s no need to exert yourself in these situations, rapid breathing can turn into hyperventilation.

What’s the difference between hyperventilation syndrome and panic attacks?

Hyperventilation syndrome and panic disorder (panic attacks) are distinct conditions, though their symptoms may overlap.

A panic attack causes sudden, temporary feelings of fear and strong physical reactions in response to ordinary, nonthreatening situations. Panic disorder is an anxiety disorder that involves multiple unexpected panic attacks. A main feature of panic disorder is that the attacks usually happen without warning and aren’t due to another mental or physical condition.

Episodes of hyperventilation syndrome can happen in response to strong emotions, such as fear, anxiety or anger. Sometimes the episodes happen randomly. Alternatively, hyperventilation can also be a trigger for anxiety and fear.

About half of people with panic disorder have hyperventilation syndrome, and 25% of people with hyperventilation syndrome have panic disorder.

How is hyperventilation syndrome diagnosed?

There are no specific diagnostic criteria for hyperventilation syndrome. Healthcare providers have to rule out other possible causes of hyperventilation in order to diagnose it.

A provider will ask about your symptoms and medical history and perform a physical exam. They may start with the following tests to rule out common underlying conditions that cause hyperventilation:

• Pulse oximetry (Pulse ox): People with hyperventilation syndrome usually have blood oxygen saturation levels at or close to 100%. A reading less than 95% may indicate an underlying condition.
• Chest X-ray: This imaging test can check for any lung issues.
• Electrocardiogram (EKG): This test can check for heart issues.

There are several possible physical causes of hyperventilation, so they may order additional tests, such as blood tests and other imaging tests.

What is the treatment for hyperventilation syndrome?

The main treatments for hyperventilation syndrome are reassurance and breathing retraining.

If your healthcare provider has ruled out all other possible causes of hyperventilation, they’ll reassure you that your episodes and symptoms aren’t a sign of a harmful underlying condition. They’ll also teach you certain breathing exercises to try to prevent future episodes.

One type of breathing retraining is diaphragmatic (abdominal) breathing. This type of breathing involves the use of your belly rather than your chest. By using this technique, you can slow down your breathing to stop or prevent hyperventilation.

To practice this type of breathing, lie flat on your back. Then, place one hand on your upper chest and the other on your belly (just below your rib cage). Breathe in slowly through your nose. As you breathe, pay attention to how much your hands are rising from your lung movements. The goal is to have the hand on your belly rise more than the hand on your chest.

If you have an underlying mental health condition (like depression or anxiety) that may be contributing to hyperventilation syndrome, your provider may recommend psychotherapy (talk therapy) and/or medication to treat these conditions.

Can hyperventilation syndrome be prevented?

As researchers don’t know the exact cause of hyperventilation syndrome, you generally can’t prevent it. However, there are steps you can take to try to prevent future episodes. If stress and anxiety are contributing to hyperventilation episodes, the following stress management and relaxation techniques may help prevent them:

• Breathing exercises.
• Regular exercise.
• Progressive muscle relaxation.
• Meditation.
• Yoga.
• Practicing mindfulness.

When should I see my healthcare provider about hyperventilation syndrome?

Although hyperventilation syndrome can be alarming, hyperventilation itself isn’t harmful. However, it’s possible to hyperventilate for other, more serious reasons. You should see your healthcare provider in the following situations:

• You’re in pain, hurt your head, have a fever or are bleeding.
• Your hyperventilation gets worse or becomes more frequent, even with home treatment.
• You have other symptoms.

A note from Cleveland Clinic

Experiencing hyperventilation can be scary. While it may take a toll on your mental health, know that hyperventilation syndrome isn’t harmful to your physical health. The good news is that breathing retraining, especially diaphragmatic breathing, can help prevent future episodes. If breathing exercises aren’t helping, reach out to your healthcare provider. They’re available to help you.