Breathing Pattern Disorders (BPDs), also known as dysfunctional breathing, refer to abnormal respiratory patterns characterized by chronic changes in breathing that result in dyspnea and other symptoms. These disorders can occur in the absence of or in excess of underlying physiological respiratory or cardiac disease.

Types of Breathing Pattern Disorders

• Hyperventilation syndrome
  • Associated with symptoms related to respiratory alkalosis
  • Can occur with or without hypocapnia
• Periodic deep sighing
  • Characterized by frequent sighing and irregular breathing patterns
  • May overlap with hyperventilation
• Thoracic dominant breathing
  • Higher levels of dyspnea
  • Can manifest in somatic diseases or occur without an underlying condition
• Forced abdominal expiration
  • Inappropriate and excessive abdominal muscle contraction during expiration
• Thoracoabdominal asynchrony
  • Delay between rib cage and abdominal contraction
  • Can occur as a normal physiological response in upper airway obstruction

Symptoms

• Dyspnea (shortness of breath)
• Chest tightness
• Sighing
• Irregular breathing patterns
• Dizziness
• Fatigue
• Anxiety

Diagnosis

Diagnosis of BPDs can be challenging due to the lack of a gold standard method. Common diagnostic approaches include:

• Clinical history and physical examination
• Nijmegen Questionnaire
• Manual Assessment of Respiratory Motion (MARM)
• Respiratory induction plethysmography

Treatment

The primary treatment for BPDs is breathing retraining, which may include:

• Diaphragmatic breathing exercises
• Pursed lip breathing
• Relaxation techniques
• Posture correction
• Education on normal breathing mechanics

Physiotherapy and manual therapy techniques may also be beneficial in addressing co-existing musculoskeletal issues.