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Relieving Hyperventilation (Over-Breathing)

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anthony

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You have to breathe to live. But if you breathe too much, you could experience a wide range of uncomfortable physical and psychological symptoms. Most people recognize the effects of acute hyperventilation or “over-breathing.” However, chronic hyperventilation at low levels may be missed entirely or misdiagnosed at hypochondria.

In many patients with panic attacks, phobias, or trauma, hyperventilation plays a significant part, yet is seldom diagnosed or treated. Hyperventilation is a normal response to stress. It is the basis of the primitive “fight or flight” mechanism. Rapid shallow breathing cannot increase the amount of oxygen in the blood because the red blood cells normally leave the lungs with their hemoglobin almost entirely saturated with oxygen. But it can increase the amount of carbon dioxide that is blown out, disturbing the body’s acid balance and promoting various psychological changes. It may lead to symptoms such as chest pain, lightheadedness, a feeling of impending disaster, palpitations, tightness in scalp and neck, numbness of the limbs, tingling and burning or itching sensations. These symptoms are frequently accompanied by tension and anxiety, which in some people can lead to panic attacks and agoraphobia. Palpitations, for instance, may be interpreted as the beginning of a heart attack, or tingling sensations as symptomatic of a brain tumor. The problem is the way the symptoms are perceived.

Everyone hyperventilates in response to acute stress, but some people continue to do so even after the cause of stress is removed. Often the symptoms brought about by over-breathing then become a new source of stress, beginning a vicious cycle. Particular personality types seem to be more prone to this problem, such as the ambitious perfectionists who are successful achievers but have mistaken the load they carry.

Hyperventilation can be a habit learned in childhood as a result of psychological stress or physical illness. It could be a more recently acquired habit – the aftermath of two or three years of marital or financial pressures, or the result of severe psychological trauma. It may even be an occupational hazard. Singers, actors, and public speakers are especially at risk. “Stage fright” is often a panic attack which may be caused by hyperventilation. It is common in these situations to see performers breathing into a paper bag which puts carbon dioxide back into the blood. Then there is the “designer jeans syndrome”. Jeans that are too tight can restrict abdominal breathing so that shallow, rapid thoracic breathing becomes a habit. There are also a number of physical problems that can cause hyperventilation so a thorough medical assessment is always recommended. Hyperventilation is also known to be more common among people with allergies.

The low level of carbon dioxide in hyperventilation triggers a wide range of physiological changes, many of which are not fully understood. It affects the activity of many of the cells in the body, especially those in the nervous system.

Even a slight fall in overall levels of carbon dioxide will stimulate nerve cells, which then prime the body for action. Muscle tension is increased, sensitivity and perception heightened, the pain threshold lowered and adrenaline released into the blood – the “fight or flight” mechanism in action.

But as carbon dioxide levels fall even further, cells begin to produce lactic acid to reduce alkalinity, and metabolism begins to suffer. Fatigue, exhaustion or passing out may result. The initial stimulation of nerve cells brought about by hyperventilation can cause tingling sensations or numbness.

The cells making up smooth muscle are also kicked into action by the low levels of carbon dioxide. The effect is to constrict blood vessels, including those serving the heart and brain. The heart may begin to pound, miss a few beats, produce palpitations or angina pains. The brain may receive up to 50% less oxygen than normal, leading to dizziness, faintness, flashing lights or tunnel vision as well as a feeling of unreality.

Low levels of carbon dioxide can also cause chemical changes in the membranes of the mast cells, a type of white blood cell that plays a part in the immune system. This stimulates the cells to release histamine and other chemicals which further restrict the blood vessels.

It is not the lack of oxygen that leads to difficulties, but the low levels of carbon dioxide caused by the over-breathing to compensate for the “starved for oxygen” feeling. Problems arise when your breathing is both shallow and erratic. It is easy to spot the distressed panting seen in cases of acute hyperventilation, but these breathing problems are not readily identified. Over-breathers use only their chest when they breathe, whereas normal breathing is mainly abdominal. The breathing of over-breathers is often dispersed with sighs and yawns.

A simple technique such as breathing slowly and deeply through the nose with the mouth closed tightly, will often end or avert the symptoms. To help understand how the problem is caused by bad breathing habits, an experiment of over-breathing at a rate of 30-40 breaths/minute for 2-3 minutes can produce the symptoms. Breathing retraining can then help many people suffering from panic attacks and phobias. The process takes a bit more time for people who are particularly anxious or depressed.

THE HYPERVENTILATION PROCESS
  • Stress
  • Increase in ventilation – (as more oxygen picked up by hemoglobin and released to body tissues, more carbon dioxide picked up and exhaled from body)
  • Blood gas changes: Lower carbon dioxide, Higher pH or alkalinity – (stimulates the nerve cells which prime the body for action)
  • Physical symptoms – (muscle tension increases, tingling, numbness, feeling of not getting enough air)
  • Affects cell making smooth muscle, which constricts blood vessels – (blood taken away from skin surface – feel colder, numbness, tingling)
  • Release of histamine – (reinforces constriction of the blood vessels – heart pounds or misses beats, angina pains)
  • Brain receives 50% less oxygen – (dizziness, faintness, flashing of lights, tunnel vision, feelings of unreality)
  • Chemical changes in membranes of the mast cells – (a type of white blood cell that plays a part in the immune system)
  • Adrenaline released into the blood – (fight or flight response)
  • Further increase in ventilation – (carbon dioxide falls further, alkalinity remains higher, body is now very sensitive to sudden changes in carbon dioxide from yawning, sighing, breath holding)
  • Metabolism affected – (fatigue, exhaustion)
  • Apprehension – (misinterpret the symptoms as dangerous, afraid of a perceived threat, sensitivity and perception heightened)
  • Panic or anxiety attack
Over-Breathing and Stress

Instead of inhaling and exhaling at a slow, steady pace, habitual over-breathers tend to take quick shallow breaths. As a result, they exhale too much carbon dioxide, setting off an internal reaction that alters the acid balance of the blood and other body fluids. The result of the chemical change, called hypocarbia, can produce physical symptoms or disturbances of functioning in virtually any organ of the body system.

The traditional medical view of hyperventilation has been as a symptom of stress. But it now appears that blaming stress for hyperventilation may be putting the cart before the horse. Many physicians and psychologists now believe that hyperventilation often precedes and in many cases may be the cause of, not the effect of, stress and all of its related physical and psychological symptoms.

Over-Breathers’ Ailments

If your doctor can find no other cause, any of the following symptoms may be due to hyperventilation, or over-breathing:
  • Shortness of breath
  • Dizziness, feeling faint or lightheaded
  • Headache (including migraine)
  • Chronic fatigue, sleeping problems
  • Anxiety or panic attacks
  • Chest pain, tightness in the chest, palpitations
  • Trouble thinking or talking clearly
  • Nervousness, agitation
  • Perspiration
  • Nausea, vomiting or diarrhea
  • Trembling or habitually clenching hands
  • Numb or tingling hands, feet, tongue or face
  • Ringing in ears
  • Blurred vision
  • Lump in throat, dry mouth
  • Cold, pale hands, cold shudders
  • Frequent urination
  • Sighing, frequent yawning
  • Feeling of unreality, feeling far away, crying without reason
  • Blacking out (unconsciousness)
Before attributing any physical or psychological problem to stress or hyperventilation, you should see your doctor to make sure there is no underlying medical cause.

Learning to Breathe

You can test yourself to learn whether you are a habitual over-breather. Here are some clues to help determine if you over-breathe. Since most of us don’t breathe naturally when we’re consciously watching how we breathe, you may need some help:
  • Ask a few people who you see often whether you sigh frequently. Don’t rely on yourself for an answer; you may be unaware of the habit. Frequent sighing is a probable sign that you do hyperventilate.
  • Do you often breathe through your mouth? If so, you may be hyperventilating.
  • Next, observe your breathing. Sit comfortably on a couch or chair with your legs extended. Place a heavy book on your upper abdomen, above the navel. Watch the book as you breathe. If it does not move, you may be hyperventilating.
Correct breathing is a rather complicated process. To fill our lungs with air we have to contract the diaphragm, the muscle that divides the chest cavity from the abdominal cavity. Contracting the diaphragm pushes the abdomen out and gives the lungs room to expand. When the lungs are full, abdominal muscles contract, pushing the diaphragm back into its original position and squeezing the lungs to expel the air.

If you have a severe problem with hyperventilation, you may need to break the habit with some structured breathing exercises. You may begin by trying the following:
  • Sit comfortably in a chair. Make sure that your clothes are loose and comfortable and that you are relaxed.
  • Place your left hand on top of your breastbone and your right hand on top of your navel.
  • Watch your hands as you breathe in and out through your nose. You should see your right hand on your navel move up and down while your left hand on your breastbone remains still.
  • Consciously try to slow down your breathing, inhaling and exhaling at an even pace.
  • Practice three or four times. Repeat this exercise later in the day.
  • After practicing twice a day for 3-4 days, you should be able to do the exercise without watching your hands, by remembering what abdominal breathing feels like from inside your body.
Continue practicing at this pace until you find that you are taking fewer and deeper breaths. We normally breathe at a rate of 12-15 breathes per minute, but during the exercise you should breathe much more slowly (approximately 6-8 breaths per minute).

If you are feeling particularly stressed, there are a few things you may try that may help in handling hyperventilation and heading off the physical or psychological consequences:
  • Jog in place for a minute or two (this should work about 80% of the time).
  • Walk up and down a flight of stairs a few times.
Hyperventilation may not be the cause of everything that ails us, but it can’t hurt to try to breathe our stress away.
 
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