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quote:hyperventilation syndrome (HVS) is an episodic disorder that often presents with chest pain and a tingling sensation of the fingertips (paresthesia) and around the mouth, as well as deep and labored breathing (causing hyperventilation), although chronic but subtle hyperventilation can cause these symptoms too.HVS can be part of a panic attack but, despite all the stigma, most patients are not putting on a show but are in true distress. The hyperventilation is self-promulgating as carbon dioxide (CO2) levels fall and respiratory alkalosis (high blood pH) develop. The respiratory alkalosis leads to changes in the way the nervous system fires and leads to the paresthesiae, dizziness and perceptual changes that often accompany this condition.A rapid traditional intervention is to make the patient breathe into a paper bag, causing rebreathing and restoration of CO2 levels. The same benefits can be obtained from deliberately slowing down the breathing rate by counting or looking at a watch - often referred to as "7-11 breathing", where the inhalation is counted to 7 and the exhalaltion to 11. Some doctors do not advise the paper bag rebreathing method due to the chance of inhaling too much cabon dioxide.
quote:HYPERVENTILATION SYNDROME - a patient's guide Ms Dinah Bradley -Respiratory physiotherapist Overview Hyperventilation syndrome is a breathing disorder It affects about 10 percent of people Symptoms include shortness of breath, rapid breathing and heart rate Symptoms such as chest pain should be checked by a doctor Hyperventilation may be a response to emotional or environmental factors The condition can cause changes to bodily organs, tension and headaches Treatment involves breathing retraining and medication is some cases What is it? Hyperventilation syndrome is a breathing pattern disorder which affects about one in ten people in the normal population.A largely unrecognised side effect of prolonged stress, hyperventilation syndrome (HVS) often holds the key to a wide range of health problems.Most people have experienced short episodes of acute hyperventilation during stressful events and its very easy to spot. But more subtle is CHRONIC hyperventilation which is characterised by a wide array of symptoms, mimicking serious disease, baffling to both sufferer and doctor alike.The balance between the oxygen-rich air we breathe in and the carbon-dioxide rich air breathed out is balanced by the lungs. In chronic hyperventilators, too much carbon dioxide is breathed out, altering normal body chemistry and disturbing the body's pH (acid/alkaline balance), producing unpleasant body changes. Even slight falls or fluctuations in carbon dioxide levels will directly effect nerve cells, as well as blood flow to the heart and brain, producing a wide variety of symptoms in any organ or system in the body.Natural anxiety over symptoms leads to further over-breathing, creating a vicious circle. Hyperventilation becomes a major stress in itself.The normal pattern of breathing often changes from abdominal breathing to upper chest breathing, often through the mouth, leading to musculo-skeletal changes of upper chest and neck muscles which in turn causes pain, tension and headaches.Described as a diagnosis begging for recognition, HVS is increasingly recognised as a significant cause of ill-health, although remains widely under-diagnosed.Why does this happen? HVS is the body's way of signaling distress, and there are many triggers, involving physical, emotional and environmental factors:Especially at risk are people who push themselves too hard at work, study, or sport. Or simply burn the candle at both ends. For some HVS is an occupational hazard if their jobs involve a lot of speaking. (Actors, lawyers, telephonists). Dusty or noisy workplaces. Chronic mouth-breathers are particularly prone, as are people with asthma. Anaemia (not enough red oxygen carrying cells in the blood) stimulates breathing rates. Hormonal triggers. CO2 levels drop by up to 25% post ovulation, during pregnancy, and menopause. Poor posture or ergonomics at work and resulting Occupational Overuse Syndrome are common triggers. After surgery, or illness, or prolonged social or physical stress What are the symptoms? ACUTE ATTACK - agitation, rapid upper chest breathing and heart-rate, chest pains, shortness of breath, nausea, tingling dizziness, perhaps fainting and general weakness.CHRONICITY - general tiredness, lack of concentration, and sleep disturbances, tingling, dizziness, chest pains and palpitations, irritable cough and breathing discomfort with frequent sighs and yawns, erratic blood pressure, upset gut, bloated feelings, nausea, sexual problems, achy muscles, twitching and cramps, tension and panicky feelings, depression and anxiety.If undiagnosed and untreated, the chronic hyperventilator lives in fear and loathing of symptoms, self confidence takes a nose-dive. Life becomes a misery for the over-breather as well as family and friends.Caution: known as the great mimic, some HVS symptoms such as chest pain, dizziness and shortness of breath need checking by your doctor to rule out serious events.What can be done to help? An accurate diagnosis, recognition of causes or triggers, and an expert assessment by a specialist respiratory physiotherapist is the first step.This will provide a structured plan of attack - in breathing retraining, upper respiratory health assessment , postural and upper chest musculo-skeletal balancing , stress recognition, physical coping strategies, sleep hygiene and a graduated fitness regimen/lifestyle appraisal.Counselling for anxiety and depression if required. Medication such as anti-anxiolytics/muscle relaxants if indicated.Fifty percent of the cure is knowledge of the disorder. Fifty percent is hard graft, undergoing breathing pattern retraining.It takes 6 to 8 weeks to change an established pattern from dysfunctional breathing, back to normal. Some take longer.Regular and effective practise is essential with regular checks with yourspecialist physiotherapist and liaison with your GP, and/or counsellor.Common concerns Am I going mad? Have I got a serious disease? Why me? Will I ever get over it? These are all common expressions of disbelief at being diagnosed with HVS.The good news HVS is a disorder not a disease. The bad news is that it takes time, patience, and practice, practice, practice. There is no instant cure.As you learn to normalise your breathing and so restore balanced carbon dioxide and oxygen levels, the unpleasant symptoms associated with over-breathing will subside. You can enjoy life again!