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Dyspnea at rest
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Dyspnea at rest

I am 41 and have been experiencing dyspnea (more of sighing dyspnea) since past 8 weeks. I underwent following tests:

Chest X-ray: Normal, minor hyperventilation
Chest CT-Scan (without contrast): Normal
Blood tests: Normal including blood gases etc, minor anemia seen (not iron related, iron levels were great)
ECG: Normal
Spirometry: Normal functions

I am continuing to experience the symptoms (at rest as well) through out the day. I am not feeling tired at all even after 45 minutes of gym work (including bicycling, treadmill run etc). What could be the reason of my continued sighing dyspnea?




242587_tn?1355427710
While a nuisance and often a source of concern, excessive sighing (with or without the dyspnea) is with the rarest of exceptions, not a sign of disease.  Most often it is a reflection of anxiety, worry, situational nervous tension or a number of other altered emotional states.

What you are experiencing falls within the category of what is called, Dysfunctional Breathing. This term refers chronic or recurrent changes in breathing pattern have also been associated with physical symptoms of breathlessness, chest tightness, chest pain, dizziness, and anxiety that have also, in the past, referred to as the hyperventilation syndrome.

The causes of this syndrome is not always evident but there are numerous reports in the medical literature that attempt to identify these causes.

The following is an example of such reports.  My intent in providing this report is to place your disorder in the proper context.  I realize that this report is somewhat technical, containing much medical jargon and could be confusing to you.  I submit it as an example of this disorder, to be shared with your pulmonary specialist for his/her consideration.  To fully explore this possibility, it may be necessary for you and your doctor to seek consultation with a subspecialist with clinical and research experience with this disorder.  The authors of this report might be able to identify a physician with that experience, in your geographical area.

Given all the negative/normal test results, and your high exercise capacity, it is reasonable to conclude that your symptoms are not reflective of serious physical disease.

Good luck,

Authors Courtney R. van Dixhoorn J. Greenwood KM. Anthonissen EL.

Authors Full Name Courtney, Rosalba. van Dixhoorn, Jan. Greenwood, Kenneth Mark. Anthonissen, Els L M.
Institution School of Health Science, Royal Melbourne Institute of Technology (RMIT) University, Melbourne, Australia. ***@****

Title Medically unexplained dyspnea: partly moderated by dysfunctional (thoracic dominant) breathing pattern.


Source Journal of Asthma. 48(3):259-65, 2011 Apr.
Abstract BACKGROUND: Dysfunctional breathing (DB) may contribute to disproportionate dyspnea and other medically unexplained symptoms. The extent of dysfunctional breathing is often evaluated using the Nijmegen Questionnaire (NQ) or by the presence of abnormal breathing patterns. The NQ was originally devised to evaluate one form of dysfunctional breathing - hyperventilation syndrome. However, the symptoms identified by the NQ are not primarily due to hypocapnia and may be due to other causes including breathing pattern dysfunction.

OBJECTIVES: The relationships between breathing pattern abnormalities and the various categories of NQ symptoms including respiratory or dyspnea symptoms have not been investigated. This study investigates these relationships.

METHOD: 62 patients with medically unexplained complaints, that seemed to be associated with tension and breathing dysfunction, were referred, or self-referred, for breathing and relaxation therapy. Dysfunctional breathing symptoms and breathing patterns were assessed at the beginning and end of treatments using the NQ for assessment of DB symptoms, and the Manual Assessment of Respiratory Motion (MARM) to quantify the extent of thoracic dominant breathing. Subscales for the NQ were created in 4 categories, tension, central neurovascular, peripheral neurovascular and dyspnea. Relationships between the NQ (sum scores and subscales) and the MARM were explored.

RESULTS: Mean NQ scores were elevated and mean MARM values for thoracic breathing were also elevated. There was a small correlation pre-treatment between MARM and NQ (r=0.26, p<0.05), but classification of subjects as normal/abnormal on both measurements agreed in 74% (p < 0.001) of patients. From the sub scores of NQ only the respiratory or 'dyspnea' items correlated with the MARM values. Dyspnea was only elevated for subjects with abnormal MARM. After treatment, both MARM and NQ returned to normal values (p< 0.0001). Changes in NQ were largest for subjects with abnormal MARM pre-treatment. There was a large interaction between the change in the NQ sub score dyspnea and initial MARM values. (p<0.001).
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