Understanding Hyperventilation Syndrome | Saint Luke’s Health System

When
you breathe, you get oxygen from the air you breathe in (inhale). You then let out
carbon
dioxide with the air you breathe out (exhale). Hyperventilation syndrome is a pattern
of
breathing where you breathe more quickly and deeply than normal. If it goes on for
some
time, it can cause the carbon dioxide level in the blood to get too low. This can
lead to
concerning symptoms all over the body.

What causes hyperventilation syndrome?

Hyperventilation syndrome may be caused from things such as:

Symptoms of hyperventilation syndrome

You
may have:

• Fast or deep breathing

• Shortness of breath or the feeling that you can’t get enough air

• Anxiety, fear, panic, or strong feeling of dread or doom

• Dizziness

• Chest pain or squeezing in the chest

• Fast, pounding, or skipping heartbeat

• Sweating

• Numbness or tingling around the mouth and in the fingers

• Muscle cramps in the hands or feet

Treatment for hyperventilation syndrome

Treatment is focused on getting your breathing rate and the carbon dioxide level in
your blood back to normal. If you are being treated in a hospital or healthcare
provider’s office, the following or more may be done:

• A healthcare provider may check the level of oxygen in your blood with a pulse
  oximeter.

• A healthcare provider will talk with you and help you to stay calm.

• You may be asked to try different breathing exercises, such as pursed-lip
  breathing. This helps slow down your breathing. You may also be asked to hold your
  breath for short periods.

• You may also be given medicine to help you relax.

How can hyperventilation syndrome be prevented?

To
help prevent episodes in the future, you may be told to try:

Possible complications of hyperventilation syndrome

If
the level of carbon dioxide becomes very low, this is called hypocapnia. It can upset
the acid-base balance in the blood. It can cause problems such as fainting and
seizures.

Other
possible complications of this syndrome will vary based on the cause.

When to call your healthcare provider

Call your healthcare provider right away if you have any of these:

• Fever of 100.4°F (38°C) or higher, or as directed

• Symptoms that don’t get better with treatment, occur more often, or get worse

• New symptoms

Hyperventilation Information | Mount Sinai

Rapid deep breathing; Breathing – rapid and deep; Overbreathing; Fast deep breathing; Respiratory rate – rapid and deep; Hyperventilation syndrome; Panic attack – hyperventilation; Anxiety – hyperventilation

Hyperventilation is rapid and deep breathing. It is also called overbreathing, and it may leave you feeling breathless.

Considerations

You breathe in oxygen and breathe out carbon dioxide. Excessive breathing creates a low level of carbon dioxide in your blood. This causes many of the symptoms of hyperventilation.

You may hyperventilate from an emotional cause such as during a panic attack. Or, it can be due to a medical problem, such as bleeding or infection.

Your health care provider will determine the cause of your hyperventilation. Rapid breathing may be a medical emergency and you need to get treated, unless you have had this before and your provider has told you that you can treat it on your own.

If you frequently overbreathe, you may have a medical problem called hyperventilation syndrome.

When you’re overbreathing, you might not be aware you’re breathing fast and deep. But you’ll likely be aware of the other symptoms, including:

• Feeling lightheaded, dizzy, weak, or not able to think straight
• Feeling as if you can’t catch your breath
• Chest pain or fast and pounding heartbeat
• Belching or bloating
• Dry mouth
• Muscle spasms in the hands and feet
• Numbness and tingling in the arms or around the mouth
• Problems sleeping

Causes

Emotional causes include:

• Anxiety and nervousness
• Panic attack
• Situations where there is a psychological advantage in having a sudden, dramatic illness (for example, somatization disorder)
• Stress

Medical causes include:

• Bleeding
• Heart problem such as heart failure or heart attack
• Drugs (such as an aspirin overdose)
• Infection such as pneumonia or sepsis
• Ketoacidosis and other medical conditions causing excess acid production in the body
• Lung disease such as asthma, COPD, or pulmonary embolism
• Pregnancy
• Severe pain
• Stimulant medicines

Home Care

Your provider will examine you for other causes of your overbreathing.

If your provider has said your hyperventilation is due to anxiety, stress, or panic, there are steps you can take at home. You, your friends, and family can learn techniques to stop it from happening and prevent future attacks.

If you start hyperventilating, the goal is to raise the carbon dioxide level in your blood. This will end most of your symptoms. Ways to do this include:

1. Get reassurance from a friend or family member to help relax your breathing. Words like “you are doing fine,” “you are not having a heart attack,” and “you are not going to die” are very helpful. It’s very important that the person stays calm and uses a soft, relaxed tone.
2. To help get rid of carbon dioxide, learn to do pursed lip breathing. This is done by puckering your lips as if you’re blowing out a candle, then breathing out slowly through your lips.

If you have been diagnosed with anxiety or panic, see a mental health professional to help you understand and treat your condition.

1. Learn breathing exercises that help you relax and breathe from your diaphragm and abdomen, rather than from your chest wall.
2. Practice relaxation techniques, such as progressive muscle relaxation or meditation.
3. Exercise regularly.

If these methods alone don’t prevent overbreathing, your provider may recommend medicine.

When to Contact a Medical Professional

Contact your provider if:

• You are having rapid breathing for the first time. This may be a medical emergency for which you should be taken to the emergency room right away.
• You are in pain, have a fever, or are bleeding.
• Your hyperventilation continues or gets worse, even with home treatment.
• You also have other symptoms.

What to Expect at Your Office Visit

Your provider will perform a physical exam and ask about your symptoms.

Your breathing will also be checked. If you are not breathing quickly at the time, the provider may try to cause hyperventilation by telling you to breathe in a certain way. The provider will then watch how you breathe and check which muscles you’re using to breathe.

Tests that may be ordered include:

• Blood tests for the oxygen and carbon dioxide levels in your blood
• Chest CT scan
• ECG to check your heart
• Ventilation/perfusion scan of your lungs to measure breathing and lung circulation
• X-rays of the chest

Braithwaite SA, Wessel AL. Dyspnea. In: Walls RM, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 21.

Schwartzstein RM, Adams L. Dyspnea. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel’s Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 36.

Last reviewed on: 7/25/2022

Reviewed by: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Hyperventilation syndrome – symptoms, causes and treatment in Moscow

Hyperventilation syndrome (HVS) is a disease that has a neuropsychiatric origin, occurs against the background of disorders in the autonomic nervous system. It is manifested by an abnormal respiratory rhythm, leading to excessive ventilation of the lungs. As a result, a person has painful symptoms from the cardiovascular and respiratory systems, convulsions, panic attacks.

The disease requires long-term complex treatment, which is primarily aimed at restoring the functioning of the autonomic nervous system. Therapists, pulmonologists, cardiologists, psychotherapists and specialists of other profiles are involved in therapy.

General information about the condition

Hyperventilation syndrome is not an independent disease. It was first described in 1871. There are other names for it: respiratory dystonia, respiratory neurosis.

According to statistics, hyperventilation syndrome occurs in 8% of people on the planet. It is more commonly diagnosed in women. The peak incidence occurs at the age of 30-40 years, although this condition also occurs in the elderly.

Despite the fact that HVS is a chronic pathology, with proper treatment and following the doctor’s recommendations, it is possible to significantly reduce the number of attacks of hyperventilation crisis.

Causes of lung hyperventilation

GVS is the result of vegetative, respiratory and mental disorders. The main factor in the development of hyperventilation syndrome is improper breathing. The formation of an abnormal respiratory rhythm is affected by:

• prolonged psycho-emotional overstrain;
• severe stress;
• depression;
• fear associated with the existence of a serious illness, panic attack;
• anxiety disorders, phobias, neurosis, neurasthenia;
• hypertension;
• diabetes mellitus;
• rheumatoid arthritis;
• CNS disorders: hydrocephalus, encephalopathy;
• asthma, chronic obstructive bronchitis or COPD, pulmonary embolism;
• long-term use of hormonal drugs, drugs that excite the central nervous system;
• severe infectious diseases, including past coronavirus infection, especially after undergoing oxygen therapy or being connected to a ventilator;
• inhalations performed in violation of the rules for the use of nebulizers and other inhalation devices.

The main cause of hyperventilation syndrome in adults is an unstable psycho-emotional state, fears and stress. In 35% of cases, psychogenic triggers occur against the background of organic pathologies.

At risk are patients with psychoneurological disorders, who are characterized by unreasonable outbursts of emotions, people involved in running, swimming, playing wind instruments, who have experienced difficult life situations.

Pathogenesis of the disease

The functioning of the respiratory system is inextricably linked with the psycho-emotional state of a person. Stressful situations cause the patient to breathe faster, which causes an excess of oxygen and a deficiency of carbon dioxide. The acid-base composition of the blood changes, which affects the functioning of the whole organism.

All changes lead to a reflex increase in breathing. Fear and a feeling of lack of air intensify, consciousness changes, vegetative functions are disturbed. As a result, even after the termination of the trigger factor, hyperventilation syndrome is maintained.

Symptoms of a hyperventilation crisis

Hyperventilation syndrome occurs in crises, that is, attacks. The clinical picture is pronounced. The attack occurs suddenly. The patient’s condition resembles a panic attack. It seems to a person that he will suffocate, that he will not be able to receive medical assistance.

Symptoms of hyperventilation syndrome:

• excessive breathing;
• feeling short of breath;
• a lump in the throat that prevents you from taking a full breath;
• shortness of breath;
• desire to take a deep breath, cough, yawn;
• dizziness;
• blurred consciousness;
• heart palpitations, heartbeat radiates to the head;
• increased blood pressure;
• pain in the region of the heart;
• fear of suffocation, death;
• chills, flushes of heat.

Panic and too rapid breathing can even lead to unconsciousness.

An attack of hyperventilation syndrome lasts from several minutes to 1-2 hours. It starts with fear and ends with it, develops into panic.

In the intervals between crises, a person has no health problems (if the cause of HVS is not an organic pathology), leads a normal life.

Hyperventilation syndrome is manifested by a whole symptom complex. In addition to cardiovascular and respiratory disorders, there are:

• urination disorders: frequent urge, increase in the amount of urine, change in its color;
• gastrointestinal disorders: borborygmi, bloating, vomiting, diarrhoea, constipation;
• musculo-tonic disorders: increased muscle tone, trembling in the body, tingling or numbness of the limbs, convulsions, body pain;
• change of consciousness: loss of reality, feeling of deja vu, fainting, blurred vision.

First aid for hyperventilation syndrome

First of all, you need to calm down. For this purpose, you can take a sedative. Then a decrease in the frequency of breathing helps to normalize the condition. It is necessary to inhale for 7 seconds, exhale for 11 seconds. You can breathe into a plastic bag.

Since hyperventilation syndrome resembles myocardial infarction in clinical manifestations, an ambulance should be called, especially for elderly patients.

Diagnostics

When patients come to the Miracle Doctor clinic with complaints that they are suffocating, they cannot breathe deeply, they have tingling in the heart area, specialists first of all assume the presence of diseases of the lungs or the cardiovascular system.

Mandatory diagnostic procedures for the patient:

• ECG;
• ultrasound of the heart;
• CT scan of the lungs;
• clinical and biochemical blood test.

In hyperventilation syndrome, there are no serious physiological disorders that could cause respiratory disorders. Neurologists and psychotherapists are involved in the examination. Specialists examine the psycho-emotional state of a person, conduct a neurological examination, prescribe electromyography, hyperventilation tests.

In hyperventilation syndrome, deep breaths lead to vegetative changes. However, the diagnosis cannot be made on the basis of a single diagnostic criterion. An important role is assigned to the results of psychogenic analysis.

An individual approach to the patient, combined with modern examination methods, makes it possible to make the correct diagnosis and select an effective therapy.

Treatment of hyperventilation syndrome

At the Miracle Doctor clinic, hyperventilation syndrome is treated by professional neuropathologists and psychotherapists who specialize in disorders of the autonomic nervous system, use the latest techniques and use proven drugs. We guarantee a full recovery, since comprehensive treatment programs are aimed at eliminating not only the symptoms, but also the very cause of the disease.

Psychotherapy sessions are the first step in the treatment of hyperventilation syndrome. Psychotherapists work with the patient, who correct the patient’s attitude to their health, psycho-emotional state, relieve fears and phobias on a subconscious level. Behavioral therapy is very effective.

Psychotherapy is supplemented with breathing exercises, biofeedback therapy and medicines.

It is also important to change the way of life, to normalize the mode of rest and work, to do what you love, to avoid stressful situations.

Prevention

To reduce the likelihood of developing pathology, the patient should adhere to the following recommendations:

• think positively, form a positive outlook on life;
• avoid stress, change attitude towards stressful situations;
• seek psychological help;
• give up bad habits;
• treat neuropsychiatric disorders, cardiovascular and pulmonary diseases in time, without waiting for the development of complications;
• refrain from using drugs or eating foods or drinks that stimulate the nervous system.

Prognosis

Hyperventilation syndrome does not pose a threat to life, but significantly affects its quality. Without treatment, a person’s psycho-emotional state and performance deteriorate, fears and phobias appear, and social isolation increases.

You can prevent these consequences if you seek qualified help at the Miracle Doctor clinic in time. Experienced specialists will help to get out of a serious condition and prevent recurrence of the disease in the future.

Questions and answers

How long is the treatment for hyperventilation syndrome?

Duration of therapy 4-6 months. To prevent relapse, the patient should be under medical supervision.

What are the possible complications?

Hyperventilation syndrome causes psychological and physical discomfort. A person experiences a strong fear that he can suffocate, but it is impossible to die during an attack.

Causes, symptoms and effective treatments for hyperventilation syndrome

Hyperventilation syndrome (HVS) refers to neuropsychiatric diseases. It manifests itself in the form of a pathological disturbance of the respiratory rhythm, an increase in lung ventilation and pH of the blood and other tissues. The patient has vegetative, muscular-tonic, respiratory, mental disorders. In the treatment, drug and non-drug methods are used.

What is hyperventilation syndrome

Hyperventilation syndrome occurs when the carbon dioxide content in the blood decreases. Sometimes this condition is a compensatory reaction of the body to stress, intense physical activity, and a long stay in highlands. Another name for pathology in medicine is respiratory neurosis, dysfunctional breathing.

Hyperventilation of the lungs is one of the types of respiratory disorders. The level of lung ventilation is higher than the physiological needs of the body. This is the main difference from the hypoventilation syndrome, when breathing is insufficient, depressed.

A distinction should be made between hyperventilation and problems with central hypoventilation. These are sleep-related breathing disorders, apnea. Pathologies can be congenital or acquired.

The normal content of carbon dioxide in the blood is 6%. With such indicators, cells and tissues receive a sufficient amount of oxygen, vascular tone is not disturbed.

Normal breathing in physiology is supported by several mechanisms. A person can arbitrarily control the depth and frequency of respiratory movements, make a delay on inhalation or exhalation. On the internal endothelium of the vessels there are special receptors that respond to any changes in the biochemical and gas composition of the blood. Quote: During hypoxia or oxygen starvation, breathing becomes deeper and faster, this is called hyperpnea. With a decrease in carbon dioxide levels, the opposite effect develops, which is called hypocapnia.

With hyperventilation of the lungs, there is a failure in the respiratory regulation system, dissatisfaction with the breath. There are negative respiratory and somatic symptoms. Due to the deterioration of well-being, anxiety and a feeling of restlessness arise, breathing becomes even more frequent, hypocapnia progresses. To break this vicious circle, medication and psychotherapy are required.

Pay attention! The average age of patients with hyperventilation is 30-40 years. The disease predominantly proceeds in a chronic form, acute cases occur in only 2% of cases.

Why hyperventilation develops

Various reasons can provoke the development of respiratory neurosis. Hyperventilation can be an independent disease or a symptom, a complication of other pathologies.

Main reasons:

• prolonged stress, severe emotional or mental shock, depression, anxiety and phobic disorders, neurasthenia, hysterical neurosis;
• acute or chronic diseases of the respiratory system;
• pathology of the heart, blood vessels;
• intoxication, drug overdose, use of alcohol, narcotic and psychotropic substances;
• lack of sleep;
• disorders in the work of the gastrointestinal tract;
• VSD;
• brain damage – hydrocephalus, dyscirculatory encephalopathy, arachnoiditis;
• obese people develop alveolar hyperventilation.

Respiratory neurosis may be the result of childhood psychological trauma. Pathology develops if the child saw asphyxia, suffocation in a drowning person, a severe attack of bronchial asthma.

In newborns, physiological transient hyperventilation is observed. This is short-term pulmonary ventilation, which occurs in the first 30 minutes of life after the completion of the phase of acute adaptation to new environmental conditions.

Pay attention! With coronavirus, the bronchopulmonary system suffers the most. Therefore, many adult patients complain of hyperventilation syndrome after covid, especially if the disease was severe.

Clinical manifestations

The main symptom of hyperventilation syndrome is shortness of breath, which increases not during, but after physical exertion. It is difficult for a person to be in stuffy, unventilated rooms, he does not tolerate pungent odors.

Hyperventilation syndrome proceeds in crises. Signs of pathology appear suddenly and strongly, accompanied by panic, then gradually disappear. The duration of the attack is 1-2 hours.

The hyperventilation crisis begins with an unreasonable feeling of anxiety, after a while respiratory disorders occur. Symptoms progress, fear of death appears.

Characteristic manifestations:

Toward the end of the crisis, frequent urination is observed, a large amount of light urine is released.

Pay attention! Sports activities during hyperventilation contribute to the restoration of a normal respiratory rhythm.

First Aid Rules for Breathing Problems

With an attack of hyperventilation syndrome, it is necessary to reduce the concentration of oxygen in the blood.

Attacks of hyperventilation – what can be done:

1. Breathe into a paper or cellophane bag. It is necessary to inhale the exhaled air, which contains a lot of carbon dioxide. This quickly reduces the intensity of the manifestations of the attack.
2. Breathe through one nostril or through your mouth, covering it with your hand or through tightly compressed lips.
3. Joint breathing. The caregiver should take no more than one breath every 10 seconds, the patient should strive to breathe the same way.

If the breathing process cannot be restored or negative symptoms do not disappear after an attack, you need to call an ambulance.

Diagnostics

Diagnosis begins with an examination, history taking and analysis of complaints. During the examination, the doctor pays attention to uneven breathing due to an extended inhalation and a shortened exhalation.

Diagnostic methods:

1. Collection of psychogenic anamnesis. The doctor collects information about childhood traumas, recent emotional upheavals, neurosis, depression, and neurasthenia.
2. Neurological examination. The characteristic symptoms are pronounced hyperhidrosis, positive tests for latent tetany.
3. Electromyography. The method of studying the bioelectric activity of muscles is used to detect increased neuromuscular excitability.
4. hyperventilation test. The patient breathes deeply and forcefully, the respiratory rate is approximately 20 per minute for 3 minutes. In patients with hyperventilation, typical psycho-emotional, vegetative disorders are observed.
5. Blood test for electrolyte levels. There is a decrease in magnesium, calcium.
6. Additional methods – electrocardiogram, x-ray of the lungs, examination of the organs of the gastrointestinal tract.

The most informative method for diagnosing the syndrome of unsatisfied inspiration is capnography. With the help of a special device, the concentration of carbon dioxide in the exhaled air is measured. If the indicators are significantly different from the norm, hyperventilation is diagnosed.

Additionally, doctors use special questionnaires to identify symptoms of dysfunctional breathing.

Be sure to conduct a differential diagnosis. With COPD, there are problems with exhalation, with hyperventilation – with inhalation. With a decrease in the functional activity of the parathyroid glands, pathological thickening of the bones, calcium deposition in the internal organs, and a decrease in the parameters of parathyroid hormone are observed.

The diagnosis of hyperventilation syndrome is difficult. If you have signs of pathology, you can contact our specialists at any time. At a remote consultation, doctors will talk about the features of diagnostics and necessary examinations, and select a suitable clinic.

Principles of therapy

In the treatment of hyperventilation, an integrated approach is used. To restore the functioning of the organs of the respiratory system, respiratory gymnastics and exercise therapy are prescribed to strengthen the muscles. Useful long walks in the fresh air, Nordic walking, jogging, cardio.

Methods of therapy depend on the stage of dysfunctional breathing and the general condition of the patient. At the initial stage, sessions of psychotherapy help well. The doctor finds out the causes of the development of the disease, teaches methods of relaxation and sedation. Successfully apply cognitive-behavioral therapy, psychoanalysis.

Drug treatment of HVS is prescribed for severe forms of pathology. The following groups of drugs are used:

• B vitamins, magnesium and calcium preparations, vitamin D;
• sedatives;
• neuroleptics;
• tranquilizers;
• antidepressants;
• beta blockers.

Biofeedback is used in the treatment of hyperventilation. The essence of the method is the control of respiratory functions. With the help of special devices, the patient receives information about the state of breathing, learns to control the respiratory process.

Important! Duration of treatment – 4-6 months. Regular visits to the doctor are essential to prevent relapse.

Breathing exercises for hyperventilation syndrome

Breathing exercises are one of the essential elements in the treatment of hyperventilation syndrome. Classes are necessary for the formation of normal, physiological breathing patterns.

Technique:

1. Lie on your back, close your eyes, relax as much as possible for 5-7 minutes. You can use meditative or autogenic practices.
2. Take a full slow breath, while inflating the stomach, and not retracting. This is necessary to fill the lower part of the lungs. As you exhale, slowly lower your stomach, relax your chest.
3. During breathing, you can make a slight guttural sound to control the duration and rhythm of breathing movements.
4. At the initial stage, the duration of inhalation is 4 seconds, exhalation – 8 seconds. You can select a different comfort mode, but the proportions must always be 1:2. Run 10-15 cycles. Breathe with the selected parameters for a month.
5. Gradually increase the duration of inhalation and exhalation, every 3-5 days add one respiratory cycle. The longest duration of inhalation is 30 seconds, exhalation – 1 minute.
6. If you breathe correctly, there is a feeling of inner comfort, peace, begins to fall asleep.

During the development of breathing exercises, you can not smoke, drink alcohol, caffeinated drinks and drugs that stimulate mental activity.

You need to do it in complete silence, pre-ventilate the room. Choose free clothes. You need to perform the exercises every day in the morning or before going to bed, preferably at the same time. Before classes, it is necessary to empty the intestines and bladder. The last meal – for 2-3 hours, then you can drink only water.

Contraindications for breathing exercises are severe cardiovascular pathologies, diseases of the lungs, abdominal organs, and blood. It is impossible to engage in glaucoma, mental disorders, elevated body temperature, during pregnancy and menstruation.

Important! If the exercise is performed correctly, there should be no shortness of breath, tension, restlessness, dizziness, weakness and fatigue. At the initial stage, a person feels heart beats, which is the norm.

FAQ

Why is hyperventilation syndrome dangerous?

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The condition of hyperventilation responds well to treatment with timely access to a doctor. But without proper treatment, psychological and neurological negative consequences develop. Even with short-term hyperventilation, performance decreases, cognitive functions and the functioning of the central nervous system deteriorate. But with proper complex therapy, you can get rid of hyperventilation syndrome.

Who is most likely to develop hyperventilation syndrome?

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Doctors identify several factors that increase the risk of hyperventilation. This is advanced age, smoking, overweight, sedentary lifestyle. Hyperventilation syndrome is often detected in people with atherosclerosis, bronchial asthma, pulmonary cystic fibrosis, chronic obstructive bronchitis. The cause may be heart disease, diabetes. Women get sick 4-5 times more often than men.

Which doctor treats hyperventilation syndrome?

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First you need to visit a therapist. Then you will need an examination by a pulmonologist, a cardiologist. With the emotional coloring of complaints, increased anxiety, a consultation with a neurologist, a psychotherapist is needed.

How to avoid the development of respiratory neurosis?

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To avoid the development of hyperventilation syndrome, it is necessary to treat life with optimism, learn how to adequately respond to stress, and correct psychological problems in a timely manner. Useful regular moderate exercise, outdoor recreation. It is necessary to observe the daily routine, try to avoid working at night, give up bad habits, do not drink drinks, foods and medicines that excite the nervous system. Be sure to carefully read the instructions for the drugs, breathing problems are a common side effect.

Expert opinion

Hyperventilation syndrome is a complex disease that should only be treated by a specialist. Self-medication, improperly selected methods of therapy lead to a deterioration in the quality of life, the development of serious mental disorders.