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Keywords: breathing, hyperventilation, carbon dioxide, guidelines for patients
Certain aspects of the chemistry underlying respiration should be considered when recommending breathing changes to clients. The interplay of breathing rate, breathing depth, and carbon dioxide (CO2) processing is sometimes dysregulated when psychological factors dominate over physiological ones. Recommending "deep breathing" as a relaxation method can backfire if it initiates hyperventilation symptoms and discourages breath regulation. This article explains some details of breathing/CO2/physiology interactions and offers suggestions regarding giving advice about breathing.
Introduction
In the biofeedback field we often give advice about breathing, so it helps to know about the underlying biochemistry in order to understand what can go wrong and something about how to fix it. Behaviorally, breathing is generally taken for granted; it goes on without our supervision, we breathe more during exertion, and we have a strong reflex to prevent suffocation. Because of our easy access to the breathing mechanism, however, and because we can think beyond the immediate present, we are at unique risk for disrupting the biochemical balance that normally allows for smooth physiological functioning.
Hyperventilation
Hyperventilation is defined as breathing in excess of current metabolic needs. It does not need to be florid and dramatic, or even fast; it can be unnoticeable to the casual observer but still cause trouble. For the majority of people, just 1 minute of determined overbreathing reduces cutaneous and peripheral blood circulation (colder hands, paler skin); interferes with peripheral nerve conduction (tingling in fingers and lips); lowers muscle contraction thresholds (more susceptible to twitching); and stimulates cerebral vasoconstriction (interference with vision, hearing, sensory perception, balance, orientation, judgment, and cognition). Episodes of acute hyperventilation are usually brief and during emotional shock or a panic attack. However, symptoms such as the above can also develop to a lesser degree from chronic hyperventilation, which is more common.
How could this be, that breathing too much can cause such problems? Carbon dioxide (CO2) is a waste gas destined for excretion, but it also has a crucial role in regulation of the body's pH and vascular tone: during its brief ride in the bloodstream, CO2 is converted to carbonic acid and has a large responsibility for maintaining the body's pH. Normally there is a close match, breath by breath,...