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Dysfunctional breathing: a review of the literature and proposal for classification

Richard Boulding, Rebecca Stacey, Rob Niven, Stephen J. Fowler
European Respiratory Review 2016 25: 287-294; DOI: 10.1183/16000617.0088-2015
Richard Boulding
1Respiratory Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
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Rebecca Stacey
1Respiratory Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
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Rob Niven
2Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, The University of Manchester and University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
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Stephen J. Fowler
1Respiratory Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
2Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, The University of Manchester and University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
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  • For correspondence: stephen.fowler@manchester.ac.uk
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    FIGURE 1

    Recordings of quiet tidal breathing at rest, followed by maximal expiration then inspiration. Breathing patterns are shown for: a) a healthy volunteer; b) hyperventilation syndrome, note the rapid respiratory rate, and tidal breathing closer to inspiratory capacity than in panel a; c) erratic breathing pattern, note that the patient was unable to coordinate a maximal expiratory and inspiratory manoeuvre at the end of the recording; d) thoracic dominant breathing, note the large volume breaths with minimal inspiratory reserve capacity; e) forced expiratory pattern before (grey) and after (black) exercise, note tidal breathing occurs at low lung volumes, with minimal expiratory reserve volume; and f) thoraco-abdominal asynchrony, this panel shows recordings from sensors detecting thoracic and abdominal movement, demonstrating asynchrony during quiet tidal breathing.

Tables

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  • TABLE 1

    Proposed classification of dysfunctional breathing patterns, with associated lung diseases and key references

    Breathing patternNumber of papersKey referencesLinked conditions
    Hyperventilation syndrome43[1, 2, 5, 15]Asthma
    Panic disorder
    Periodic deep sighing12[8, 9, 45–47]Asthma
    Panic disorder
    Thoracic dominant breathing4[11, 47–49]Asthma
    COPD
    Heart failure
    Panic disorder
    Forced abdominal expiration2[50, 51]COPD
    Thoraco-abdominal asynchrony6[52–54]Obstruction
    Neuromuscular disease
    Respiratory failure
    • COPD: chronic obstructive pulmonary disease.

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European Respiratory Review: 25 (141)
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Dysfunctional breathing: a review of the literature and proposal for classification
Richard Boulding, Rebecca Stacey, Rob Niven, Stephen J. Fowler
European Respiratory Review Sep 2016, 25 (141) 287-294; DOI: 10.1183/16000617.0088-2015

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Dysfunctional breathing: a review of the literature and proposal for classification
Richard Boulding, Rebecca Stacey, Rob Niven, Stephen J. Fowler
European Respiratory Review Sep 2016, 25 (141) 287-294; DOI: 10.1183/16000617.0088-2015
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  • Article
    • Abstract
    • Abstract
    • Introduction
    • Literature review
    • Epidemiology and comorbid conditions
    • Dysfunctional breathing patterns and associated conditions
    • Methods of assessment
    • Treatment
    • Types of dysfunctional breathing: a proposal for classification
    • Discussion
    • Footnotes
    • References
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