title: Getting to grips with 'dysfunctional breathing'.
abstract: Dysfunctional breathing (DB) is common, frequently unrecognised and responsible for a substantial burden of morbidity. Previously lack of clarity in the use of the term and the use of multiple terms to describe the same condition has hampered our understanding. DB can be defined as an alteration in the normal biomechanical patterns of breathing that result in intermittent or chronic symptoms. It can be subdivided into thoracic and extra thoracic forms. Thoracic DB is characterised by breathing patterns involving relatively inefficient, excessive upper chest wall activity with or without accessory muscle activity. This is frequently associated with increased residual volume, frequent sighing and an irregular pattern of respiratory effort. It may be accompanied by true hyperventilation in the minority of subjects. Extra thoracic forms include paradoxical vocal cord dysfunction and the increasingly recognised supra-glottic 'laryngomalacia' commonly seen in young sportsmen and women. While the two forms would appear to be two discreet entities they often share common factors in aetiology and respond to similar interventions. Hence both forms are considered in this review which aims to generate a more coherent approach to understanding, diagnosing and treating these conditions.
authors.affiliation: Department of Respiratory Medicine, Sheffield Children's Hospital, Western Bank, Sheffield, S10 2TH, UK.
authors.forename: Nicki
authors.initials: N
authors.lastname: Barker
authors.affiliation: School of Paediatrics and Child Health, University of Western Australia, Princess Margaret Hospital for Children, Roberts Road, Subiaco 6008, Western Australia. Electronic address: mark.everard@uwa.edu.au.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Everard
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D012120:Respiration Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D012143:Respiratory Physiological Phenomena; D035441:Thoracic Wall / Q000503:physiopathology