Dysfunctional breathing: what do we know?

Laís Silva Vidotto, Celso Ricardo Fernandes de Carvalho, Alex Harvey, Mandy Jones, Laís Silva Vidotto, Celso Ricardo Fernandes de Carvalho, Alex Harvey, Mandy Jones

Abstract

Dysfunctional breathing (DB) is a respiratory condition characterized by irregular breathing patterns that occur either in the absence of concurrent diseases or secondary to cardiopulmonary diseases. Although the primary symptom is often dyspnea or "air hunger", DB is also associated with nonrespiratory symptoms such as dizziness and palpitations. DB has been identified across all ages. Its prevalence among adults in primary care in the United Kingdom is approximately 9.5%. In addition, among individuals with asthma, a positive diagnosis of DB is found in a third of women and a fifth of men. Although DB has been investigated for decades, it remains poorly understood because of a paucity of high-quality clinical trials and validated outcome measures specific to this population. Accordingly, DB is often underdiagnosed or misdiagnosed, given the similarity of its associated symptoms (dyspnea, tachycardia, and dizziness) to those of other common cardiopulmonary diseases such as COPD and asthma. The high rates of misdiagnosis of DB suggest that health care professionals do not fully understand this condition and may therefore fail to provide patients with an appropriate treatment. Given the multifarious, psychophysiological nature of DB, a holistic, multidimensional assessment would seem the most appropriate way to enhance understanding and diagnostic accuracy. The present narrative review was developed as a means of summarizing the available evidence about DB, as well as improving understanding of the condition by researchers and practitioners.

Figures

Figure 1. Representative figure showing the “normal”…
Figure 1. Representative figure showing the “normal” breathing patterns and the “abnormal” breathing patterns presented by individuals with dysfunctional breathing. Normal breathing is the standard tidal volume and respiratory rate of an individual; breath holding is when a breath is held for a period of time; a deep sigh is a deep inspiration that happens at any time during breathing; and hyperventilation is an increase in the respiratory rate, tidal volume, or both. Note: The order in which abnormal breathing patterns appear may vary.
Figure 2. Representative diagram of the proposed…
Figure 2. Representative diagram of the proposed aspects involved in the multidimensional diagnosis of dysfunctional breathing.

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