Dysfunctional Breathing and Breathing Pattern Disorders: Clinical Retraining Evidence
What dysfunctional breathing and breathing pattern disorders are, why a clinician must rule out heart and lung causes first, and what research says about breathing retraining.
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Urgent first
Rapid breathing that is new for you can be an emergency. MedlinePlus says rapid breathing for the first time may be a medical emergency for which you should be taken to the emergency room right away. [1] In the US, call 911 if breathing is severe, if you have chest pain or a pounding heartbeat that does not settle, or if you are unsure. For help telling panic, overbreathing and emergencies apart, see hyperventilation, panic attack or medical emergency.What the terms mean
Doctors use several overlapping terms. Dysfunctional breathing describes breathing disorders in which long-lasting changes in breathing pattern cause breathlessness and other symptoms, out of proportion to any measurable heart or lung disease. [2] Breathing pattern disorder is another name, used for altered breathing that cannot be fully explained by organic causes at the current time. [3] Dysfunctional breathing is also described as an umbrella term that includes hyperventilation syndrome and vocal cord dysfunction. [4]One review proposed five patterns: hyperventilation syndrome, periodic deep sighing, thoracic-dominant breathing, forced abdominal expiration, and thoraco-abdominal asynchrony, where the rib cage and belly move out of step. [2] These labels are a proposal, not a final standard. [2]
How common and how it feels
A narrative review reports a UK primary-care prevalence of about 9.5% in adults. [5] It also reports that a third of women and a fifth of men with asthma had a positive diagnosis. [5] A Cochrane review gives a figure of 10% of the general population. [4] Estimates differ and depend on how the condition is defined.MedlinePlus lists symptoms of overbreathing: feeling lightheaded, dizzy, weak or unable to think straight, numbness and tingling, and a feeling that you cannot catch your breath. [1] Dizziness and palpitations also occur. [5]
Why a clinician comes first
Symptoms overlap with serious conditions. MedlinePlus lists heart problems such as heart failure or heart attack, and lung disease such as asthma, COPD or pulmonary embolism, among medical causes of overbreathing. [1] A review notes that dysfunctional breathing is often underdiagnosed or misdiagnosed for this reason. [5]There is no single test. Diagnosis combines questionnaires, direct observation by experienced clinicians and, sometimes, exercise testing. [3] A 2026 review proposed screening with the Nijmegen questionnaire, a physical assessment and excluding or optimising other conditions, and noted that many tools have not been validated for this condition. [6]
What clinical breathing retraining is
Breathing retraining is clinical care. In the Thorax trial below it was a short course led by physiotherapists. [7] The types of exercise considered in a Cochrane review included breathing control, diaphragmatic breathing, yoga breathing, Buteyko breathing, biofeedback-guided breathing and suppressing yawns and sighs. [4] The sources we read do not give one standard session script, and the details vary between clinics.What research shows
| Question | What the sources found | Strength |
|---|---|---|
| Retraining in adults (systematic review, 68 studies) | Breathing retraining was the most studied approach, with low-quality evidence of benefit. [8] Only 19 of the studies were randomized trials, most had high or unclear risk of bias, and the components were highly variable and poorly reported. [8] | Insufficient evidence |
| Retraining in adults with asthma and dysfunctional breathing (33 people) | Short physiotherapy retraining was compared with asthma nurse education. [7] The authors reported a clinically relevant improvement in quality of life, maintained at 6 months in over 25% of patients. [7] | Promising but limited |
| Retraining in asthma generally (UK trial, funded by the National Institute for Health Research) | Quality of life improved with little effect on lung function or airway inflammation. [9] | Promising but limited |
| Children and teens | The Cochrane review found no suitable trials, so it is unknown whether breathing exercises add value. [4] | Proper evidence not found |
For children, Proper evidence not found: the Cochrane review searched CENTRAL, MEDLINE and EMBASE and found no suitable trial. [4] In trials of this kind participants know what they are doing and many outcomes are self-reported, which can make benefits look larger than they are. See how breathing research is done and its limits.
Gentle self-help after a diagnosis
Only after a provider has found the cause. If a provider has said your overbreathing is due to anxiety, stress or panic, MedlinePlus suggests learning breathing exercises that relax you and use the diaphragm and belly rather than the chest wall, practicing relaxation techniques such as progressive muscle relaxation or meditation, and exercising regularly. [1] It also describes pursed-lip breathing, which means puckering the lips as if blowing out a candle and breathing out slowly. [1] Keep it easy: no forcing, no deep or fast breathing, and no breath-holding. Sit or lie down, and stop and breathe normally if you feel dizzy, tingly or faint. See warning signs and when to stop.If these methods alone do not prevent overbreathing, MedlinePlus says your provider may recommend medicines. [1] Never change prescribed medicines because of a breathing practice.
Related pages
Frequently asked questions
Is dysfunctional breathing the same as hyperventilation?
Not exactly. Hyperventilation syndrome is one proposed pattern within the broader group. [2] Hyperventilation itself means rapid, deep breathing, also called overbreathing. [1]
Can breathing retraining cure it?
No cure is promised by the sources we read. A systematic review found breathing retraining frequently studied but supported by low-quality evidence. [8]
How do I know it is not my heart or lungs?
You cannot tell on your own. Many heart and lung conditions cause similar symptoms, so a provider needs to examine you. [1] [5]
Can I do the exercises by myself?
Only after a provider has found the cause. MedlinePlus describes gentle home steps for overbreathing due to anxiety, stress or panic. [1] Stop if you feel worse.
What about children?
Proper evidence not found: a Cochrane review identified no trials of breathing exercises for children with dysfunctional breathing. [4] A pediatric clinician should assess breathing problems.
References
- MedlinePlus Medical Encyclopedia, review date 7/23/2024. Hyperventilation. Read 2026-10-22.
- Boulding R and colleagues, European Respiratory Review 2016. Dysfunctional breathing: a review of the literature and proposal for classification. Read 2026-10-22.
- Breathing pattern disorder: introduction and diagnostics, Immunology and Allergy Clinics of North America 2025. PubMed record. Read 2026-10-22.
- Barker N and colleagues, Cochrane Database of Systematic Reviews 2013. Breathing exercises for dysfunctional breathing/hyperventilation syndrome in children. Read 2026-10-22.
- Vidotto LS and colleagues, Jornal Brasileiro de Pneumologia 2019 (narrative review). Dysfunctional breathing: what do we know?. Read 2026-10-22.
- Breathing pattern disorder assessment and diagnosis, ERJ Open Research 2026. PubMed record. Read 2026-10-22.
- Thomas M and colleagues, Thorax 2003. Breathing retraining for dysfunctional breathing in asthma: a randomised controlled trial. Read 2026-10-22.
- Systematic review of nonpharmacological interventions for dysfunctional breathing in adults, Journal of Allergy and Clinical Immunology: In Practice 2025. PubMed record. Read 2026-10-22.
- Bruton A and colleagues, Lancet Respiratory Medicine 2018. Physiotherapy breathing retraining for asthma: a randomised controlled trial. Read 2026-10-22.