Breathing pattern disorders - an overview

This leaflet is intended to provide information on breathing pattern disorders (BPD) which is most commonly known as dysfunctional breathing (DB) to people who have BPD, their families and carers.

What is a BPD?

BPD most commonly known as DB refers to a group of breathing disorders where there is an alteration in the normal patterns of breathing that can result in intermittent or chronic (long-term) respiratory and non-respiratory symptoms. Breathing should change, based on what we challenge ourselves with: for example, exercising.

Breathing should then return to normal once the challenge has passed. Sometimes, due to persistence of the challenge, breathing does not return to normal; at this point the breathing can then alter and become dysfunctional. Sometimes it may coexist with other conditions such as asthma.

What happens with BPD?

Your breathing should have equal effort from your upper chest and your diaphragm/abdominal region. If this is not the case dysfunction breathing can occur and become long standing (chronic) where your symptoms of breathlessness persist. Often this is not a sudden change and will happen over a long period of time. You can sometimes have a pattern of over breathing even when the body does not demand it. This then leads to your body adapting to this, often in a counterproductive way. You may experience symptoms such as a racing heart, tingling fingers, chest and throat tightness, chest pain and light headedness

What are the causes of BPD?

What are the possible signs and symptoms of BPD?

• Inability to take deep breath
• Sensation of not enough air in the chest
• Tightness around chest or throat
• Chest pain
• Yawning
• Sighing
• Dizziness of light headedness
• Blurred vision
• Sensation of fast or irregular heart beats
• Bloating feeling in the stomach
• Tingling fingers
• Cold hands or feet

How might I know if my breathing pattern is affected or wrong?

• If I am breathing through my mouth
• If my breathing is noisy
• If I am breathing too fast or shallow
• If my upper chest moves outwards more than my tummy during my in-breath
• If I am frequently yawning and sighing
• If I am finding difficulty co-ordinating my breathing during talking and or eating
• If I am having muscular tension, aches/pains mainly around shoulder, neck and jaw
• If I am feeling exhausted all the time and finding difficult to concentrate.

How is BPD assessed?

BPD can be assessed by a respiratory physiotherapist or doctor in a clinical setting, sometimes requiring an exercise test called a cardiopulmonary exercise test (CPET). This will give a more detailed report into how you respond to exercise and possibly give explanations for your symptoms.

How can I manage BPD?

Being aware and recognising the pattern, symptoms and triggers is the first step in managing this. Once aware of these things and seeing a specialist respiratory physiotherapist, this will then help educate you and advice on strategies that may help. In some cases seeing a clinical or health psychologist may also be helpful and this is something you can discuss in clinic.