title: Dysfunctional breathing: a review of the literature and proposal for classification.
abstract: Dysfunctional breathing is a term describing breathing disorders where chronic changes in breathing pattern result in dyspnoea and other symptoms in the absence or in excess of the magnitude of physiological respiratory or cardiac disease. We reviewed the literature and propose a classification system for the common dysfunctional breathing patterns described. The literature was searched using the terms: dysfunctional breathing, hyperventilation, Nijmegen questionnaire and thoraco-abdominal asynchrony. We have summarised the presentation, assessment and treatment of dysfunctional breathing, and propose that the following system be used for classification. 1) Hyperventilation syndrome: associated with symptoms both related to respiratory alkalosis and independent of hypocapnia. 2) Periodic deep sighing: frequent sighing with an irregular breathing pattern. 3) Thoracic dominant breathing: can often manifest in somatic disease, if occurring without disease it may be considered dysfunctional and results in dyspnoea. 4) Forced abdominal expiration: these patients utilise inappropriate and excessive abdominal muscle contraction to aid expiration. 5) Thoraco-abdominal asynchrony: where there is delay between rib cage and abdominal contraction resulting in ineffective breathing mechanics.This review highlights the common abnormalities, current diagnostic methods and therapeutic implications in dysfunctional breathing. Future work should aim to further investigate the prevalence, clinical associations and treatment of these presentations.
authors: Respiratory Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK.
authors: Richard
authors: R
authors: Boulding
authors: Respiratory Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK.
authors: Rebecca
authors: R
authors: Stacey
authors: Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, The University of Manchester and University Hospital of South Manchester NHS Foundation Trust, Manchester, UK.
authors: Rob
authors: R
authors: Niven
authors: Respiratory Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, The University of Manchester and University Hospital of South Manchester NHS Foundation Trust, Manchester, UK stephen.fowler@manchester.ac.uk.
authors: Stephen J
authors: SJ
authors: Fowler
mesh_terms: D015897:Comorbidity; D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D011237:Predictive Value of Tests; D012120:Respiration Disorders / Q000145:classification* / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D015656:Respiratory Mechanics; D012307:Risk Factors; D009626:Terminology as Topic