RT Journal Article
SR Electronic
T1 Dysfunctional breathing patterns: A literature review and proposal for classification
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2157
VO 44
IS Suppl 58
A1 Richard Boulding
A1 Robert Niven
A1 Stephen Fowler
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P2157.abstract
AB Introduction: Dysfunctional breathing (DB) is a term describing breathing disorders where changes in breathing pattern result in dyspnoea and sometimes associated non-respiratory symptoms without organic respiratory disease. Descriptions in the literature aren't standardised and there is no agreed classification facilitating clinical description or research into causes and treatment. Literature was reviewed in attempt to categorise abnormal breathing patterns.Methods: We searched PUBMED and EMBASE using the terms 'Dysfunctional breathing, hyperventilation, Nijmegen and thoracoabdominal asynchrony' returning 115 papers of which 59 were relevant.Results: Many DB patterns were described; review of symptoms and physiology enabled us to classify each into the following proposed categories;1. Hyperventilation syndrome - symptoms related to respiratory alkalosis and those independent of hypocapnia. Sub-categories include:a. Exercise-induced – symptoms occurring during exercise without bronchospasm.b. Postural - associated with change from supine to standing.2. Periodic Deep Sighing - excessive sighing and erratic breathing pattern.3. Thoracic dominant breathing- - physiologically excessive use of thoracic muscles.4. Forced abdominal expiration - inappropriate and excessive abdominal muscle contraction in aid of expiration.5. Thoracoabdominal asynchrony - delay between rib cage and abdominal contraction resulting in ineffective breathing.Conclusion: Here we attempt to categorize breathing patterns in patients with DB. Our review aims to highlight common abnormalities, diagnostic methods and therapeutic implications and hopefully provides a platform for future research in this difficult diagnostic area.