Hyperventilation

What is hyperventilation?

Hyperventilation is abnormal breathing that involves rapid and deep breaths — you exhale more than you inhale. It’s also called overbreathing.

We breathe in (inhale) oxygen and breathe out (exhale) carbon dioxide to maintain a healthy balance of these two gasses. Hyperventilation creates a low level of carbon dioxide in your blood (arterial carbon dioxide, or PaCO₂). This leads to the narrowing of your blood vessels, including the ones that bring blood to your brain. When these blood vessels constrict, it causes certain symptoms (respiratory alkalosis), such as dizziness, a fast heartbeat and feeling breathless.

For most people, hyperventilation is rare and may happen as an occasional response to fear or stress. For others, hyperventilation occurs regularly as a response to strong emotions, like fear, anxiety or anger. This is known as hyperventilation syndrome. Underlying physical conditions can also cause hyperventilation.

What are the symptoms of hyperventilation?

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

If you’re experiencing rapid breathing for the first time, you should seek medical help right away. It might be a sign of a medical emergency.

What causes hyperventilation?

It can be difficult to know the exact cause of hyperventilation in some cases. This is because the symptoms that result from hyperventilation can make it worse. Researchers think of hyperventilation as having initial and sustaining causes. They think that an initial event causes a sudden drop in arterial carbon dioxide, which triggers symptoms such as chest pain and breathlessness. This can be alarming, and you may try to take deep breaths to help the symptoms, which then continues (sustains) the cycle of hyperventilation and the symptoms that follow.

Researchers have identified both psychological and physical contributors to hyperventilation.

Psychological causes include:

• Fear, such as from a phobia.
• Anxiety.
• Panic attack.
• Stress.

These are the most common causes of occasional hyperventilation.

Physical causes include:

• Bleeding.
• Interstitial lung disease (ILD).
• Obstructive lung diseases, such as asthma or COPD.
• Heart problems, such as heart failure or heart attack.
• Traumatic brain injury (TBI) or head injury.
• Infections, such as pneumonia or sepsis.
• Diabetes-related ketoacidosis (DKA) and metabolic acidosis (these specifically cause Kussmaul breathing).
• Pregnancy.
• Severe pain.
• High altitude.

What are the complications of hyperventilation?

In most cases, hyperventilation due to stress or anxiety isn’t dangerous. In rare cases, severe hyperventilation can cause you to pass out (faint), which can lead to injury.

When hyperventilation is the result of a physical condition, it could be a medical emergency due to the underlying condition, not the hyperventilation itself. For example, if you hyperventilate after hitting your head with significant force, it could mean you have a traumatic brain injury.

How is hyperventilation diagnosed?

Healthcare providers don’t typically diagnose hyperventilation as it’s happening. It’s usually temporary and occurs occasionally due to stress or anxiety.

If you’re experiencing sustained hyperventilation or frequent episodes, it’s important to see a provider. They can order tests (like imaging and blood tests) to see if there’s an underlying physical cause, like lung or heart issues. If there’s no physical cause, they may refer you to a psychologist to see if a mental health condition contributes to the episodes.

How is hyperventilation treated?

Treating hyperventilation mainly involves treating the underlying cause. If you have a physical condition, such as COPD or an infection, you’ll need specific treatment for the condition.

If you have a mental health condition that contributes to these episodes, medication and psychotherapy (talk therapy) can help.

How to stop hyperventilating

If you experience hyperventilation due to anxiety, stress or panic, there are steps you can take during the episode. Learning the following techniques can help to stop hyperventilating and prevent future attacks:

• Do pursed lip breathing. To do this, pucker your lips as if you’re blowing out a candle and breathe out slowly through your lips. This will help raise the carbon dioxide level in your blood.
• Try to take slow, deep breaths through your belly instead of your chest.
• Tell your loved ones about the hyperventilation episodes and get reassurance from them during an attack. They can help you relax with simple and calm reassurances like “you’re safe” and “this is temporary.” They can also slowly count to five for each inhale and exhale you take.

How can I prevent hyperventilation?

Not all cases of hyperventilation are preventable. If stress and anxiety contribute to hyperventilation episodes, the following stress management and relaxation techniques may help prevent them:

• Regular physical activity.
• Progressive muscle relaxation.
• Meditation.
• Yoga.
• Practicing mindfulness.

When should I see my healthcare provider about hyperventilation?

Occasional episodes of hyperventilation are usually harmless. But you should see your healthcare provider in any of the following situations:

• You’re experiencing hyperventilation for the first time. This might be a sign of a medical emergency, so you should go to the ER.
• 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. The good news is that, in most cases, it’s not harmful. But if you experience rapid deep breathing for the first time, you should seek medical care to make sure there’s not an underlying health problem. If you hyperventilate frequently, talk to your provider. You may have hyperventilation syndrome. They can recommend treatments to help lessen the attacks.