Trouble Completing Deep Breath or Yawning

[MindPieces]

I'm a 30 year old male, 6'0", 180 pounds, have never smoked, and exercise every single day. I do have a past history of binge drinking, as well as anorexia and overeating, but haven't indulged in any of these bad habits for years.

For the past couple weeks I've found it difficult to complete a deep breath or a yawn. Sometimes I can, but sometimes I feel compelled to get a deep intake of breath and simply can't complete it. This mainly happens when I'm sitting or standing, and though it also happens during my exercise routine, the lack of breath hasn't affected my workouts, nor has it affected my sleep. It should be noted that this symptom appeared out of nowhere after about a week of very high anxiety. I was awaiting some test results that I was extremely nervous about, and though everything came back clear, this symptom appeared a couple days later.

My first thought was a heart issue, though I haven't had any pain or other symptoms. I've had two EKGs, all sorts of blood work, a chest X-ray, the "breathe into a tube" test, and everything has been fine. No red flags to be found. I'm scheduled for an echocardiogram, but I'm sure that'll be fine as well. The doctor I saw yesterday thought it might be acid reflux and advised trying an antacid. I've never had noticeable heartburn, and the antacid I took this morning hasn't done much. I felt a slight clearing up, but still had that need to take a deep breath and couldn't.

The only thing that appears to be wrong with me is elevated blood pressure. It's ranged between 133/80 to 144/88 over my past few doctor's visits.

What could be causing this? High BP? Anxiety? GERD? GERD brought on by anxiety? I'm finally starting to believe it's not a heart issue, so that brings me some relief.

[National Jewish Health]

What you describe is, as you say, “not a heart issue.”  And, with a normal Chest X-ray and a normal pulmonary function test (the “breathe into a tube test”) and your age and otherwise good health, the cause is very unlikely to be some type of lung disease.  You might want to confirm with your doctor that both tests were unequivocally normal and not “borderline” or “low normal.”  If either test were borderline abnormal, then further testing, such as a CT Scan of the lungs, might be appropriate.  GERD is very unlikely to be the cause

Given your description, however, the most likely diagnosis would be Anxiety, possibly associated with what is called Panic Disorder.  Another possibility, however, would be a condition called Vocal Cord Dysfunction (either with or without asthma), referred to as, VCD.  VCD can be diagnosed either by direct examination of the larynx, via a fiberoptic laryngoscope, or strongly suggested by an abnormal (flattened) Inspiratory Flow Volume Loop.  This breathing test is one that is often, not routinely performed or, when performed, not reported.  Note the word Inspiratory.  Often, only an Expiratory loop is performed and reported.

You and your doctor may want to consider a trial of an Anxiolytic Drug.  You might also try to determine if you are still, for whatever reason, feeling anxious and, if so, why.

Good luck

[MindPieces]

Thank you for your help! I've been taking a multivitamin for the past couple days and have noticed that my constant need to take a deep breath has disappeared. Could this sort of thing be caused by a vitamin deficiency of some sort?

It seems the issue is gone, but if it returns I'll definitely look into VCD.

[winthrop1]

This is an overlooked, underappreciated problem.  The history is classic for neuogenic dyspnea.  The sensation of dyspnea described is often mistreated as asthma.  It is a mild form of hyperventilation that is associated with underlying anxiety/stress that may be unknown to the patient.  In a way it is the mildest from of panic attack.  Classic findings are the sensation that one can not get a full breath, yawning, chest pain, dizziness, paresthesias.  This often is worse at rest and improves with a distracting activity.  Once cardiac and pulmonary disease are excluded, and thus does not necessarilly mean anything more than cxr, pft, and a decent H&P.  LISTENing to, and asking the right questions is key.  Patients often reject the dx, thus the Dr must be very careful how he discusses this issue.
I have seen many many patients with this dx who have been treated for asthma with multiple meds including steroids for years.  They often frequent EDs where they are txd as asthma with big doses of steroids.  Even though none of this helps the patient often develops a belief system that renders them dependent on the wrong dx and tx.  I have seen patients with severe diabetes, muscle wasting, osteoporosis, etc etc as a result of chronic high dose corticosteroids.  It breaks my heart.
Treatment is generally with an SSRI with known anti-anxiety effects.  Benzos should be avoided.  Cognitive therapy may also help.
Doug Kane MD
Highland Rim Respiratory Specialists
145 w 4th st
Cookeville TN  38501
931-783-2799
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[Mindpowerjunkie]

I am 22 years old.70kg with perfect health and i also have these symptoms sometimes. My yawn and deep breathing switches are malfunctioning. I believe that this is a matter of the mind. I found that the more i concentrate on my breathing the more this happens. As if my body tells me that breathing should be automatic and not focused on. I tried to think less about how i breathe and over time these symptoms started to dissapear. I only yawn when i am tired (naturally), also breathing with my chest instead of my diaphragma causes chest pain.. One more sign that this disorder might be mentally driven. My doctor said that the mind controls everything in one's body. From blood pressure to the diaphragma. And it is possible to shift the control of breathing from the diaphragma to the lungs which isn't normal.hence the chest pain.. I found that if i try taking deep breaths using my diaphragma i succeed in getting satisfied all the time and stop feeling compelled to yawn. I also think that it isn't anxiety that causes this . But this that causes anxiety which worsens the symptoms.. Another thought . . During sleep the subconcious takes over breathing maybe that is why the only time we can feel comfortable is during sleep. After waking up thinking and worrying about breathing comes to mind first and these symptoms persist. I Hope all you peeps can overcome this uncomfortable problem with the power of your mind.