Hyperventilation - taking in more air than needed - is habitual for some people. Dinah Bradley outlines remedies that incorporate breathing exercises, posture adjustments, and stress reduction. This new edition includes a workbook for readers to chart their progress.
|Publisher:||Turner Publishing Company|
|Edition description:||Second Edition|
|Product dimensions:||5.50(w) x 8.50(h) x (d)|
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SELF-HELP FOR Hyperventilation SyndromeRecognizing and Correcting Your Breathing-Pattern Disorder
By DINAH BRADLEY
Hunter House Inc., PublishersCopyright © 2001 Dinah Bradley
All right reserved.
Chapter OneWhat Is Hyperventilation?
You have to breathe to live. But if you breathe too much, life becomes dominated by fear of symptoms, and fear of living life to its fullest. - Mike, 33
The term hyperventilation means moving more air through the chest than the body can deal with. Most people have experienced hyperventilation-also called overbreathing-to some degree, usually in the form of an acute attack. It's a normal reaction to sudden danger or excitement, and the signs are easy to identify:
* Breathing and heart rate speed up
* Adrenaline pours into the bloodstream
* The nervous system is on "red alert"
* Muscles tense up
Sometimes people faint or collapse-or find superhuman reservoirs of strength. When the stressful event is over, the body returns to its normal relaxed state.
Less easy to spot is chronic hyperventilation, a breathing-pattern disorder in which overbreathing becomes a habit-usually in response to prolonged stress or tension. More widespread symptoms are felt, and at times these appear out of the blue. The symptoms may mimic serious disease or remind the sufferer of the perhaps frightening events surrounding a past acute attack. When this happens, more widespread symptoms mysteriously occur, such as the following:
* Breathlessness at rest for no apparent reason
* Frequent deep sighs or yawning
* Chest-wall pains
* Light-headedness and feeling "spaced out"
* Tingling or numb lips or extremities
* Upset stomach or irritable bowel syndrome
* Achy muscles or joints, or tremors
* Tiredness, weakness, broken sleep, and nightmares
* Sexual problems
* Clammy hands and high anxiety or phobias
When overbreathing becomes chronic, the balance between the oxygen-rich air we breathe in and the carbon dioxide-rich air we breathe out is upset: carbon dioxide levels start to drop.
Far from being just a waste gas at the end of the respiratory cycle, carbon dioxide is a powerful governor of many of the body's systems-including blood flow to the brain. With chronic overbreathing the normal acid/alkaline balance (pH) of the tissues is altered. The body becomes more alkaline, and the nerve cells are the first to respond to this respiratory alkalosis. Dizziness and tingling or numbness are often the first signs.
The autonomic nervous system, which looks after the body's involuntary functions (for example, heart rate, blood pressure, and digestion), is affected, too. This system is divided into two: the sympathetic, which governs action and "get up and go"; and the parasympathetic, which is responsible for rest, recuperation, and calmness. Low carbon dioxide levels stimulate the sympathetic nervous system more than the parasympathetic, putting the body on continuous red alert.
If carbon dioxide levels in the blood fall further with continued overbreathing, body cells begin to produce lactic acid in an effort to balance their pH. Muscles ache. Metabolism is less efficient. Exhaustion and chronic tiredness soon follow, with feelings of physical and mental depression-all typical signs of long-term chronic hyperventilation.
Not only nerve cells are affected. Muscle cells become more twitchy, and the smooth muscles of our blood vessels, airways, and gut tighten and constrict in response to lowered carbon dioxide. There is an increased release of histamines, which aggravates allergic responses. The heart starts pounding, and the hyperventilator may feel panic-stricken, with palpitations and feelings of "air hunger."
When carbon dioxide levels are too low, oxygen clings to its carriers-the red blood cells-and tissues, especially the brain, become starved of oxygen. The brain may have its oxygen supply cut by as much as 50 percent, making it difficult to concentrate, let alone feel like a part of this planet. The drop in oxygen supply to the brain stimulates the breathing-control center to increase breathing rates, and the chronic nature of the hyperventilation is reinforced.
Since the oxygen and carbon dioxide exchanges fuel every cell in our body, every system is ultimately going to be affected-leading to a distressing as well as puzzling range of symptoms.
Why Does Chronic Hyperventilation Happen?
Overbreathing is a normal reaction to stress or strain; it only becomes abnormal when stresses and strains reach levels that lead to chronic hyperventilation and outbreaks of symptoms. These stresses and strains may have started from:
* organic causes, for example, asthma, physical pain, pneumonia, anemia, chronic chest or heart disease;
* physiological causes, for example, fever, high progesterone levels, prolonged talking, high altitude, diabetes, liver or kidney disease;
* psychological and social causes, for example, fear, anxiety, depression, perfectionist personality, separation/divorce; unemployment or loneliness; drugs, for example, nicotine, caffeine, aspirin, amphetamines.
While these original causes may be dealt with, stabilized, or cured, in certain people the respiratory center in the brain is reset and the overbreathing becomes habitual. Even though the bad times are over, the increased breathing rate stays.
Worldwide, the last decade has been one of change and uncertainty. Our minds evolved in an ancestral environment that lacked the pressure, noise, and speed of the present electronic age. We're constantly bombarded with information and our brains often can't cope with it all. We need to consciously take time out to counter this megastimulation, but few of us do.
The increase in stress disorders and diseases is alarming. Computerization has pinned many workers in front of screens for extended periods of time, but the human body is not designed for prolonged sitting. We experience maximum stimulation from minimum effort, and breathing is affected.
Adapting to rapid change is especially difficult if the change is unwanted or out of our personal control. Stress levels soar, and with them adrenaline levels and heart rate, and nervous exhaustion follows-all fueled by overactive lungs.
Is Hyperventilation a Modern Disorder?
For centuries philosophers and scientists have understood the importance of good breathing. Hippocrates, the father of Western medicine, noted in the fifth century B.C., "The brain exercises the greatest power in mankind-but the air supplies sense to it."
Adherents of both Buddhism, which originated in India also in the fifth century B.C., and Taoism, from ancient China, combined breathing with relaxation and exercise to harmonize heart rate, breathing, digestion, and circulation. Yoga and t'ai chi are modern versions of these ancient wisdoms.
Despite well-observed accounts in Western literature of "breathless" heroines, or of heroes with their "breath taken away," little was understood about the link between overbreathing and ill health. The first detailed medical description of hyperventilation was not published until 1871, in a study of 300 American Civil War soldiers. A doctor noticed "disabling shortness of breath, irritable heart and oppression of breathing" and thought the cause of these problems lay in the heart.
Around the turn of the century, other medical researchers experimented with normal subjects, asking them to hyperventilate voluntarily; their results noted neurological effects (tingling and muscles spasms) as well.
The term hyperventilation syndrome (HVS) was coined in the 1930s. One British physician called it "one of the commonest chronic afflictions of sedentary town dwellers." Breathing into a paper bag (re-inhaling carbon dioxide-rich air) became a popular treatment for acute attacks of HVS.
No theater would be without a paper bag in the wings ready for stage-fright victims, frozen in respiratory alkalosis (terror) while awaiting their cue. However, while the paper-bag method may be useful in helping with acute panic attacks, it is of no use to chronic overbreathers. It may temporarily restore normal blood gases, but it does nothing to correct the underlying cause: breathing-pattern disorders.
It is extremely dangerous during an acute asthma attack to try to control rapid, wheezy breathing using a paper bag. Increased drives to breathe are normal during an attack. It is on record that at least one person has breathed his last breath into a brown paper bag.
Recent medical research has revealed more about the physiological system derangements, metabolic imbalances, and anxiety-related symptoms caused by habitual overbreathing, but it is still an underrecognized and undertreated disorder.
Whether it is primarily a mental or a physical health problem has been hotly debated. Fortunately, the move towards holistic medicine, in which body and soul are treated together, has been of benefit to the vast number of people suffering from chronic hyperventilation and to their doctors, who can add this distressing disorder to their diagnostic repertoire.
I had a medical file as thick as a phone book, and I always seemed to be at the doctor's having tests for this and that. Nothing was ever found to be really wrong. But a doctor substituting for my GP nailed it straight away. My breathing was grossly askew, and my symptoms were a result of this. At last I had something to work on. - Joan, 54
Chapter TwoWho Develops Breathing-Pattern Disorders?
When I went to the physical therapist for breathing retraining, my daughter went along and took her nine-year-old son-my grandson-who was off from school. It was really funny seeing how we all breathed alike and had little habits the same. We all had disordered patterns-all three generations. - Ann, 63
All sorts of people develop breathing-pattern disorders, and at all ages. Note the following facts:
* Children are not exempt. Chronic blocked noses and habitual mouth-breathing often establish chaotic breathing patterns from quite early ages.
* People with asthma-about 14.9 million in the United States-are particularly prone to chronic hyperventilation. With recent advances in user-friendly inhalers to manage symptoms, few benefit from breathing retraining and physical therapies to improve respiratory function and the mechanical changes to the neck and chest muscles common in overbreathers.
* Following major surgery, some people find that the breathing techniques encouraged at the time of their operation-very big in-breaths to reexpand the lungs after anesthesia-trigger hyperventilation during recovery. With the rapid turnaround in hospitals, or by having to travel to other centers for treatment, some do not receive postoperative care to correct this problem. (It's best to concentrate on restoring low, slow nose/abdominal breathing and relaxation between bouts of "big breathing" and coughing.)
* Those with more permanent lung damage-chronic obstructive airway diseases or emphysema, for instance-often develop inefficient breathing patterns, with HVS adding to their stress levels.
* People with heart disease and hypertension may also find that anxiety about health adds to their HVS symptoms. While medication to manage the disease is prescribed, often little attention is paid to the coexisting breathing disorder.
* Some women are extrasensitive to hormonal changes, either in the week before their period or in the second half of pregnancy. Higher progesterone levels increase respiratory drives. Carbon dioxide levels may be reduced by up to 25 percent, inducing HVS symptoms.
* Menopause, with its hormonal fluctuations, is also a common cause of breathing-pattern disorders.
* Older people facing retirement may have problems adjusting to aging, the loss of a loved one, or erratic health. They are prime candidates for breathing-pattern disorders.
* HVS is surprisingly common among teenagers, with raging hormones, peer pressures, parental expectations, and educational and recreational demands adding up to megastress.
* High achievers and workaholics who put huge pressures on themselves are sitting ducks for HVS. High stress levels equate with sympathetic-system overload.
* Victims of abuse or torture often suffer chronic breathing-pattern disorders and sympathetic-system overload, with a frightening array of symptoms adding to their distress.
* Migrant groups, adjusting to a new culture while grieving for the loss of their own, frequently have breathing-related disorders, especially if they are refugees from abuse or torture.
No one is immune, as the following accounts show:
My first attack of acute hyperventilation happened at a street parade. It was hot, crowded, and noisy, and I left my husband and two kids to find some shade.
I couldn't stay still and paced up and down, feeling terrible. Then I lost my hearing and I felt dizzy, as though I might faint. But I didn't, and nothing seemed to change for about 15 minutes or so. I could see a policeman nearby, so I felt fairly safe.
I found my husband and got the keys to go back to the car. He could see I wasn't well so we went home. I went to my doctor the next morning. He took about 20 tubes of blood and did all kinds of tests, but they all came back negative. His diagnosis was that I had a virus-even though all the tests said I was in good health. I spent two weeks in bed, but after three weeks I still felt terrible so I abandoned the virus idea. I then went to another doctor for a second opinion and he diagnosed an anxiety disorder. He said it would go away, and no other help was offered. I didn't really know what to think about that diagnosis. I certainly was anxious about my symptoms, and I dreaded attacks.
I got heaps of self-help books-I had them stacked up by my bed. But I only looked at them; I couldn't actually do anything. I wasn't sleeping much by then, either. I was convinced I had a huge brain tumor that the doctors weren't telling me about. How could I continue to feel so spaced out and ill, yet have all my tests come back okay?
One evening not long after this I insisted on going to an accident and emergency clinic; I was about to die. There were around twenty people waiting, and I looked at all those sick people ahead of me. I couldn't wait for them. After all, they were only sick-I was dying! We raced into the pharmacy next door to ask the pharmacist to help me. He peered over his glasses and pigeonholed me instantly as a flake. He didn't think I was dying.
"I bet your house is tidy," he said. "You can come down and dust this place any time." He thought I was a rather extreme example of the worrywart, with a dash of overachiever's zeal.
I begged for something to take that would at least help me to sleep. He suggested a strong over-the-counter sedative which would make me feel awful (he wasn't going to let me off lightly), but that I would sleep, and he said if that didn't work my husband should give me a good boxing round the ear. It was all very jokey, but no help at all to me or my husband.
I was getting frantic by now. Every scan, test, and X-ray showed I was well, but I still had symptoms-the dizziness, achy muscles (especially my upper chest, neck, and shoulders), terrible stomach upsets. I felt so unwell I had to give up my part-time job-a job I really loved. I didn't even want to go out.
I heard about HVS and went to a physical therapist to have that checked out. I hadn't been aware of my breathing except for the feeling I wasn't getting enough air-which I interpreted on an emotional level ("I'm going to die")-but I sighed all the time and hunched my shoulders up.
The physical therapist's lengthy assessment showed that my breathing rates and patterns were all over the place, and, mechanically, that my upper chest was doing all the work and I was holding myself tight around my waist-through all the anxiety and fear. I was mouth-breathing all the time, too. It felt really uncomfortable when I tried to nose-breathe. I was pushing truckloads more air through my chest than normal.
Going back over my history, it became apparent that the attack I had at the parade was a severe acute attack on top of what was probably long-standing chronic overbreathing. So what seemed normal after that dreadful episode wasn't normal at all. In fact, my resting breathing rate was twenty-four breaths a minute. (Normal is half that.)
Excerpted from SELF-HELP FOR Hyperventilation Syndrome by DINAH BRADLEY Copyright © 2001 by Dinah Bradley. Excerpted by permission.
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Table of Contents
|Part I||All About Hyperventilation Syndrome||3|
|Chapter 1||What Is Hyperventilation?||4|
|Chapter 2||Who Develops Breathing-Pattern Disorders?||12|
|Chapter 3||What Is "Good Breathing"?||23|
|Chapter 4||Why Do People Become Hyperventilators?||35|
|Chapter 5||What Can I Do About HVS?||39|
|Part II||The BETTER Breathing Plan||45|
|Chapter 6||The BETTER Breathing Plan: B--Breathing Retraining||46|
|Chapter 7||The BETTER Breathing Plan: E--Esteem||56|
|Chapter 8||The BETTER Breathing Plan: T--Total Body Relaxation||62|
|Chapter 9||The BETTER Breathing Plan: T--Talk||72|
|Chapter 10||The BETTER Breathing Plan: E--Exercise||77|
|Chapter 11||The BETTER Breathing Plan: R--Rest and Sleep||84|