Hyperventilation Syndrome

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Hyperventilation Syndrome An information guide for patients Delivering the best in care UHB is a no smoking Trust To see all of our current patient information leaflets please visit www.uhb.nhs.uk/patient-information-leaflets.htm

What is hyperventilation syndrome? Hyperventilation (also called over-breathing or dysfunctional breathing), means taking too many breaths, or breathing too deeply. It is a normal reaction to a stressful situation and usually our breathing returns to normal after this has passed. Sometimes, possibly when the stress has been prolonged, your breathing will not return to normal. When we breathe in, we breathe in oxygen. When we breathe out, we breathe out carbon dioxide, a waste gas. We need a certain level of this carbon dioxide left in the body after the breath out. When you over-breathe, too much of the carbon dioxide is breathed out. This may give you some odd sensations and may be worrying, but they are nothing to be concerned about. How do I know if I have hyperventilation syndrome? Your doctor or health professional may notice you are hyperventilating or over-breathing. You may also find you experience some of the symptoms from the list below: Tingling fingers or around your mouth Dizziness Chest pain Shortness of breath, or feeling you cannot get enough air in Bloated feeling in your stomach You may find your over-breathing is triggered by particular events, such as anxiety about a situation, bereavement, asthma attack or following surgery. 2 PI16_1311_02 Hyperventilation syndrome

What is the treatment? Treatment will be provided by your physiotherapist. It may take several weeks to see some improvement. The treatment will help you to improve your breathing pattern and manage your breathing better. Will I get better? Most people do get better. However, there is a chance that you may have another episode if something triggers it. Hopefully if the symptoms do come back in the future, you will know how to manage your breathing by yourself. If you have any further questions, please ask your physiotherapist: Name of physiotherapist: Contact number: PI16_1311_02 Hyperventilation syndrome 3

Breathing control This is an important exercise to manage your breathing. Sitting comfortably in a chair, or lying on your back on your bed (depending on the advice from your physiotherapist), put your hand on your tummy. Focus on breathing in and out through your nose slowly. Try and feel your tummy moving out when you breathe in. Your shoulders should be relaxed and your upper chest should not move. Breathe out gently and allow your stomach to relax. Take a small pause before the next breath in. Regular practice is required to change your breathing habits. Your practice may include exercises in both sitting and standing. You will be guided in this by your Physiotherapist. 4 PI16_1311_02 Hyperventilation syndrome

Other ways you can help to improve your breathing Try to breathe in and out through your nose. This helps to moisten and filter the air you breathe. You can still breathe through your mouth when you exercise. Try to become more aware of your breathing. It is helpful if you can identify if there are certain times or situations when your breathing changes. If you notice your breathing changing, try and use the breathing control to manage your breathing. Try and make your breathing quieter if it seems loud. When you are speaking, try to slow down, and use the natural punctuation in a sentence (commas, full stops etc) to take a small breath. Try to avoid or postpone sighing, yawning or taking very big breaths of air in. Relaxation can be very effective to help you to gain control of your breathing. Try using the technique shown in this leaflet, please see overleaf. There are many tapes and exercises available from other sources, which you may want to try as well. It is important to have a balanced diet. Try to avoid drinks that contain caffeine (tea, coffee, cola) as these can make your overbreathing worse. Exercising can improve confidence and mood. If this is difficult, discuss it with your physiotherapist. PI16_1311_02 Hyperventilation syndrome 5

Relaxation Ensure you are in a comfortable position and that the room is quiet Close your eyes If there is any noise, notice it and then release it from your mind Imagine you are somewhere you find peaceful and safe Breathe gently, from your tummy, if this is comfortable Focus on your body, on your joints, feel them on the bed or chair Feel your head, tense your face/jaw muscles, then relax them and let your head go heavy on the bed or chair Think again about your breathing and feel yourself gently breathing in and then out Repeat with your arms, working from your shoulder to the tips of your fingers Repeat with your legs, working from your hips to your toes Allow yourself to rest in this position as long as you are comfortable Gradually notice the sounds around you again, open your eyes Get up slowly when you are ready 6 PI16_1311_02 Hyperventilation syndrome

Helpful contacts Physiotherapy for Hyperventilation www.physiohypervent.org NHS direct Telephone: 111 British Lung Foundation Telephone: 03000 030 555 PI16_1311_02 Hyperventilation syndrome 7

The Trust provides free monthly health talks on a variety of medical conditions and treatments. For more information visit www.uhb.nhs.uk/health-talks.htm Physiotherapy Therapy Services North Suite Queen Elizabeth Hospital Birmingham Mindelsohn Way, Edgbaston Birmingham B15 2GW Telephone: 0121 371 3466 PI16/1311/02 UHB/PI/1311 (Edition 2) Author: Kathryn Swindells Date: June 2016 Review date: June 2018