Poor breathing


Regular, healthy breathing is essential to our physical and mental wellbeing.

When we’re born, we instinctively breathe in the most healthy way, through our abdomens. But as we get older, life can take its toll in the form of stress, weight issues, unhealthy lifestyles, or the effects of urban living.

As a result, we may develop bad breathing habits, which can be difficult to break. Some of these can contribute to mental health issues.

The two main kinds of unhealthy breathing are hypoventilation (under-breathing) and hyperventilation (over-breathing).


Hypoventilation, or under-breathing, is when we don’t take in enough air, or do it too slowly.

It can lead to low levels of oxygen and high levels of carbon dioxide in our blood, which can be detrimental to our health.

However, certain breathing techniques such as Buteyko breathing and other types of breath retraining, can deliberately try to induce hypoventilation to strengthen our resilience to hypercapnia (high CO2) and ultimately increase the levels of oxygen that enter our cells. However these must be practiced consciously and under close supervision of a qualified practitioner, and do not always have a strong body of evidence behind them.

Hypoventilation is usually noticeable as a shortness of breath, caused by slow and/or shallow breathing.

Other symptoms of hypoventilation can include:Higuera, V., Marcin, J. (2017). ‘Respiratory depression (hypoventilation). [online] Healthline. Available at: https://www.healthline.com/health/respiratory-depression [accessed 16 Nov. 2017].

  • Tiredness
  • Lethargy
  • Confusion or disorientation
  • A blue colour to our skin, especially at the lips, fingers, or toes
  • Headaches
  • Seizures
  • Depression

When we’re healthy, our bodies instinctively fight against hypoventilation. This is what makes it impossible to stop breathing through willpower alone.Parkes, M.J. (2006). ‘Breath-holding and its breakpoint’. Experimental Physiology [online], 1, pp. 1–15. Available at: http://onlinelibrary.wiley.com/doi/10.1113/expphysiol.2005.031625/full [accessed 16 Nov. 2017].

But if we have an underlying issue, we may continue to breathe too little or too slowly. Some possible contributors to hypoventilation include:

The most common mental health effects of hypoventilation are:American Sleep Association. (2007). ‘Hypoventilation’. [online] Available at: https://www.sleepassociation.org/patients-general-public/hypoventilation/ [accessed 16 Nov. 2017].

It can also contribute to physical issues such as headaches, heart problems, and gut problems.


Hyperventilation, or over-breathing, is when we take in too much air, or do it too quickly.

It’s natural to think this can’t be harmful, because we’re getting more oxygen and lowering the levels of carbon dioxide in our blood. But hyperventilation can actually reduce the amount of oxygen that enters our cells.

This is because our blood needs to maintain a certain level of carbon dioxide, so that our red blood cells will release the oxygen we need. When we don’t have enough carbon dioxide in our blood, these cells hold onto the oxygen, instead of releasing it.

We can easily measure whether we’re unconsciously breathing too much. If we relax, breathe in and out, then pinch our noses, we can measure how long we’re able to wait before breathing again. This is called the ‘control pause’.

A healthy person should be able to hold a control pause for forty seconds or more. If we can’t manage this, and have no other underlying issue with our breathing, it may be a symptom of hyperventilation.

Other symptoms of hyperventilation can include:Tilles, I.H. and Sing, K.A. (2016). ‘Hyperventilation’. [online] Emedicine. Available at: https://www.emedicinehealth.com/hyperventilation/article_em.htm#hyperventilation_symptoms [accessed 26 Oct. 2017].

  • Excessive sighing
  • Burping, passing excess gas, or feeling pressure in the abdomen
  • Increased chest wall movement
  • Weakness or dizziness, to the point of fainting
  • Confusion or agitation
  • Numbness and tingling (often in the arms and around the mouth)
  • Muscle spasms or cramps (often in the hands and feet)
  • Chest pains
  • Hallucinations

There is some overlap between the symptoms of panic disorders and those of hyperventilation, because anxiety and panic can often lead to hyperventilation, and vice versa.

There are a range of possible contributors to our hyperventilation. They can include:Nixon, P. (1993). The grey area of effort syndrome and hyperventilation: From Thomas Lewis to today. Journal of the Royal College of Physicians of London, 27(4), pp. 377-383.News Medical Life Sciences. (2013). ‘Sleep deprivation affects vascular function and impairs breathing control’. [online] Available at: https://www.news-medical.net/news/20130423/Sleep-deprivation-affects-vascular-function-and-impairs-breathing-control.aspx [accessed 26 Oct. 2017].

  • Stress and anxiety, (which can then lead to respiratory alkalosis and make the issue worse)
  • Rapid changes of breathing pattern, such as when doing exercise or waking up suddenly
  • Urban pollution, which can cause inflammation of the lungs
  • Sleep deprivation
  • Lack of fitness, reducing our breathing efficiency
  • Lack of muscle tone in the abdomen or diaphragm
  • High altitude
  • Overeating, causing the stomach to put pressure on the diaphragm
  • Respiratory alkalosis (when blood levels of carbon dioxide drop too low, raising the PH of our blood to become too alkaline. This itself can be caused by stress, fever, high altitude, pulmonary disorder, and yes, hyperventilation, among other things)

The most common symptoms of hyperventilation are anxiety and panic.

Others can include:Lum, L. (1975). ‘Hyperventilation: the tip and the iceberg’. Journal of Psychosomatic Research, 19(5–6), pp. 375–383.Gajadharsingh, G. (2017). ‘Breathing re-education’. [online] The Health Equation. Available at: https://www.thehealthequation.co.uk/breathing-re-education/ [accessed 16 Aug. 2017].

Respiratory alkalosis

Not having enough carbon dioxide in our blood, due to hyperventilation, can also make it dangerously alkaline. This is known as ‘respiratory alkalosis’.Nixon, P. (1993). ‘The grey area of effort syndrome and hyperventilation: from Thomas Lewis to today’. Journal of the Royal College of Physicians of London, 27(4), pp. 377–383.

Symptoms of respiratory alkalosis can include:

  • Dizziness
  • Confusion
  • Numbness
  • Lethargy or weakness

We may mistake these symptoms for a heart attack or a stroke, and feel anxious or panicked. If our hyperventilation has been caused by those feelings, respiratory alkalosis can make them worse.