Hyperventilation

Topic Overview

Hyperventilation is breathing that is deeper and more rapid than normal. It causes a decrease in the amount of a gas in the blood (called carbon dioxide, or CO2). This decrease may make you feel light-headed, have a rapid heartbeat, and be short of breath. It also can lead to numbness or tingling in your hands or feet, anxiety, fainting, and sore chest muscles.

Some causes of sudden hyperventilation include anxiety, fever, some medicines, intense exercise, and emotional stress. Hyperventilation also can occur because of problems caused by asthma or emphysema or after a head injury. But it occurs most often in people who are nervous or tense, breathe shallowly, and have other medical conditions, such as lung diseases or panic disorder. Women experience hyperventilation more often than men. Most people who have problems with hyperventilation are 15 to 55 years old. Hyperventilation may occur when people travel to elevations over 2000 m (6000 ft). Symptoms can be similar to symptoms that are caused by another, more serious medical problem, such as a lung problem.

Acute (sudden) hyperventilation is usually triggered by acute stress, anxiety, or emotional upset. Chronic (recurring) hyperventilation may be an ongoing problem for people with other diseases, such as asthma, emphysema, or lung cancer.

Many women have problems with hyperventilation during pregnancy, but it usually goes away on its own after delivery.

In many cases, hyperventilation can be controlled by learning proper breathing techniques.

Symptoms of hyperventilation

Symptoms of hyperventilation usually last 20 to 30 minutes and may include:

Feeling anxious, nervous, or tense.
Frequent sighing or yawning.
Feeling that you can't get enough air (air hunger) or need to sit up to breathe.
A pounding and racing heartbeat.
Problems with balance, light-headedness, or vertigo.
Numbness or tingling in the hands, feet, or around the mouth.
Chest tightness, fullness, pressure, tenderness, or pain.

Other symptoms may occur less frequently, and you may not realize they are directly related to hyperventilation. These symptoms can include:

Headache.
Gas, bloating, or burping.
Twitching.
Sweating.
Vision changes, such as blurred vision or tunnel vision.
Problems with concentration or memory.
Loss of consciousness (fainting).

Hyperventilation is not a disease, but you may need to be checked by your doctor if you have repeated episodes of hyperventilation symptoms. If you have recurring symptoms, you might be diagnosed with a condition called hyperventilation syndrome (HVS).

Treatment for hyperventilation depends on the cause. Home treatment is usually all that is needed for mild hyperventilation symptoms. Medical treatment may be needed for hyperventilation symptoms that are moderate to severe, that last for long periods of time, that come back, or that interfere with your daily activities. Medical treatment usually includes reassurance, stress reduction measures, breathing lessons, or medicine.

Check your symptoms to decide if and when you should see a doctor.

Check Your Symptoms

Do you have problems with hyperventilation?

Hyperventilation is breathing that is faster than normal.

Yes

Hyperventilation

How old are you?

Less than 12 years

12 years or older

Are you male or female?

Male

Female

The medical assessment of symptoms is based on the body parts you have.

If you are transgender or non-binary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
If your symptoms aren’t related to those organs, you can choose the gender you identify with.
If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.

Have you noticed irregular heartbeats or heart rate changes even when you are not hyperventilating?

Yes

Arrhythmia or heart rate changes when not hyperventilating

Do you think there could be a breathing problem other than hyperventilation?

Yes

Respiratory problem other than hyperventilation

Do you think you have a breathing problem other than hyperventilation?

Yes

Respiratory problem other than hyperventilation

Did you pass out completely (lose consciousness)?

Yes

Lost consciousness

If you are answering for someone else: Is the person unconscious now?

(If you are answering this question for yourself, say no.)

Yes

Unconscious now

Are you back to your normal level of alertness?

After passing out, it's normal to feel a little confused, weak, or light-headed when you first wake up or come to. But unless something else is wrong, these symptoms should pass pretty quickly and you should soon feel about as awake and alert as you normally do.

Yes

Has returned to normal after loss of consciousness

Did the loss of consciousness occur during the past 24 hours?

Yes

Loss of consciousness in past 24 hours

Could you be having symptoms of a heart attack?

If you're having a heart attack, there are several areas where you may feel pain or other symptoms.

Yes

Symptoms of heart attack

Are you having trouble breathing (more than a stuffy nose)?

Yes

Difficulty breathing more than a stuffy nose

Would you describe the problem as severe, moderate, or mild?

Severe

Severe difficulty breathing

Moderate

Moderate difficulty breathing

Mild

Mild difficulty breathing

Can you control your breathing?

Some people can control their hyperventilation by breathing into a paper bag or using different breathing techniques.

Yes

Able to control hyperventilation

Not able to control hyperventilation

Do you feel light-headed or dizzy, like you are going to faint?

It's normal for some people to feel a little light-headed when they first stand up. But anything more than that may be serious.

Yes

Feels faint

Are you still hyperventilating after 30 minutes of home treatment?

Yes

Has tried more than 30 minutes of home treatment without improvement

Do you hyperventilate often?

Yes

Hyperventilates often

Does the problem interfere with your daily activities?

Yes

Hyperventilation interferes with daily activities

Are you having more frequent or severe problems with hyperventilation?

Yes

Symptoms are becoming more frequent or severe

Have you had problems with hyperventilation for more than a week?

Yes

Hyperventilation problems for more than a week

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

Your age. Babies and older adults tend to get sicker quicker.
Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, or natural health products can cause symptoms or make them worse.
Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

Try home treatment to relieve the symptoms.
Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

HomeTreatment

RelatedInformation

Symptoms of difficulty breathing can range from mild to severe. For example:

You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you're at rest (severe difficulty breathing).

Severe trouble breathing means:

You cannot talk at all.
You have to work very hard to breathe.
You feel like you can't get enough air.
You do not feel alert or cannot think clearly.

Moderate trouble breathing means:

It's hard to talk in full sentences.
It's hard to breathe with activity.

Mild trouble breathing means:

You feel a little out of breath but can still talk.
It's becoming hard to breathe with activity.

Symptoms of a heart attack may include:

Chest pain or pressure, or a strange feeling in the chest.
Sweating.
Shortness of breath.
Nausea or vomiting.
Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
Light-headedness or sudden weakness.
A fast or irregular heartbeat.

For men and women, the most common symptom is chest pain or pressure. But women are somewhat more likely than men to have other symptoms, like shortness of breath, nausea, and back or jaw pain.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

Make an appointment to see your doctor in the next 1 to 2 weeks.
If appropriate, try home treatment while you are waiting for the appointment.
If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

HomeTreatment

RelatedInformation

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

Call your doctor today to discuss the symptoms and arrange for care.
If you cannot reach your doctor or you don't have one, seek care today.
If it is evening, watch the symptoms and seek care in the morning.
If the symptoms get worse, seek care sooner.

HomeTreatment

RelatedInformation

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

Call your doctor now to discuss the symptoms and arrange for care.
If you cannot reach your doctor or you don't have one, seek care in the next hour.
You do not need to call an ambulance unless:
- You cannot travel safely either by driving yourself or by having someone else drive you.
- You are in an area where heavy traffic or other problems may slow you down.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

After you call 911, the operator may tell you to chew 1 adult-strength (325 mg) or 2 to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.

Respiratory Problems, Age 12 and Older

Respiratory Problems, Age 11 and Younger

Change in Heartbeat

Home Treatment

Home treatment may help you control your breathing and stop hyperventilation. First, sit down and concentrate on your breathing.

Breathing techniques

Breathe through pursed lips, as if you are whistling, or pinch one nostril and breathe through your nose. It is harder to hyperventilate when you breathe through your nose or pursed lips, because you can't move as much air.
Slow your breathing to 1 breath every 5 seconds, or slow enough that symptoms gradually go away.
Try belly-breathing, which fills your lungs fully, slows your breathing rate, and helps you relax.
- Place one hand on your belly just below the ribs. Place the other hand on your chest. You can do this while standing, but it may be more comfortable while you are lying on the floor with your knees bent.
- Take a deep breath through your nose. As you inhale, let your belly push your hand out. Keep your chest still.
- As you exhale through pursed lips, feel your hand go down. Use the hand on your belly to help you push all the air out. Take your time exhaling.
- Repeat these steps 3 to 10 times. Take your time with each breath.

Always try measures to control your breathing or belly-breathe first. If these techniques don't work and you don't have other health problems, you might try breathing in and out of a paper bag that covers your nose and mouth.

Using a paper bag

Use a paper bag to control your breathing. Take 6 to 12 easy, natural breaths, with a small paper bag held over your mouth and nose. Then remove the bag from your nose and mouth and take easy, natural breaths.
Next, try belly-breathing (diaphragmatic breathing).
Alternate these techniques until your hyperventilation stops.

If hyperventilation continues for longer than 30 minutes, call your doctor immediately.

Do not use a paper bag if:

You have any heart or lung problems, such as coronary artery disease, asthma, chronic obstructive pulmonary disease (COPD, emphysema), or a history of deep vein thrombosis, stroke, or pulmonary embolism.
Rapid breathing occurs at a high altitude [above 2000 m (6000 ft)]. Breathing faster than normal is a natural response to an increased altitude.

Follow these precautions when using the bag method:

Do not use a plastic bag.
Do not breathe continuously into a paper bag. Take 6 to 12 natural breaths, with a paper bag held over your mouth and nose, then remove the bag from your nose and mouth.
Do not hold the bag for the person who is hyperventilating. Allow the person to hold the bag over his or her own mouth and nose.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

Symptoms do not improve with home treatment measures.
Symptoms become more severe or frequent.

Prevention

You may be able to avoid hyperventilation:

Breathe through your nose. It is harder to hyperventilate when your mouth is closed, because you can't move as much air through your nose.
Loosen your clothing. Tight belts and waistbands, girdles, bras, and skintight jeans can all restrict breathing and cause shallow, upper-chest breathing.
Learn belly-breathing (diaphragmatic breathing) techniques, and practice them when you are not hyperventilating so that you can use the techniques when you need them. People who hyperventilate usually take shallow breaths, filling only their upper chest when they inhale.
Try different relaxation techniques and see what works best for you. For more information, see the topic Stress Management.
Talk to friends, family members, or a counsellor to help you relieve anxiety. Keep a journal to help you focus on your problems and find workable solutions.
Eat a healthy mix of foods. Watch out for caffeine: drink less coffee, tea, and soda, and do not eat as much chocolate. For more information, see the topic Healthy Eating.
Exercise. Regular aerobic exercise forces you to take full breaths and helps you to reduce anxiety that contributes to hyperventilation. For more information, see the topic Fitness.
Make sure you get a good night's sleep. Being rested may help reduce daytime anxiety. For more information, see the topic Sleep Problems, Age 12 and Older.
Practice healthy thinking and stop negative thoughts.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

What are your main symptoms? How long have you had your symptoms? What was happening in your life when your symptoms began?
Have you had this problem before? If so, do you know what caused the problem at that time? How was it treated?
What activities make your symptoms better or worse?
Do you think that sports activities or activities related to your job or hobbies caused your symptoms? Have you recently changed jobs, been laid off, or been fired?
Do you have a lot of stress in your life? Have you recently had a change in your family, such as a divorce or death of a loved one?
Has anyone else in your family ever had problems with hyperventilation or been diagnosed with an anxiety disorder or depression?
What home treatment measures have you tried? Did they help?
What non-prescription medicines have you tried? Did they help?
What prescription and non-prescription medicines do you take?
Do you smoke or use other tobacco products?
Are you using alcohol or illegal drugs, such as cocaine, to help manage your symptoms?
Do you have any health risks?

While waiting for your appointment, it may be helpful to keep a diary of your symptoms .

Credits

Current as of:
July 1, 2021

Author: Healthwise Staff
Medical Review:
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
David Messenger MD - Emergency Medicine, Critical Care Medicine