Hyperventilation refers to rapid, full breathing that exceeds metabolic needs. This symptom can have many causes including stress, anxiety and hypoxia (lack of oxygen supply).

Hyperventilation is characterized by:

• increased respiratory rate, which manifests itself in rapid breathing with an increase in the number of respiratory cycles (inspiration and expiration) per minute;
• increased range of breathing movements, which results in full breathing with a increased volume of inhaled and exhaled air (tidal volume).

During hyperventilation, the increase in the volume of inhaled and exhaled air disrupts pulmonary gas exchange:

• a large supply of oxygen, which is found to be greater than metabolic requirements;
• excessive release of carbon dioxide, which results in a decrease in the partial pressure of carbon dioxide in the blood (hypocapnia).

Special case: what is voluntary hyperventilation?

Voluntary hyperventilation is a technique practiced by divers before an apnea. It consists of reducing the concentration of carbon dioxide in the blood to increase the duration of apnea. However, voluntary hyperventilation is a dangerous technique because it disrupts the body’s respiratory reflex and can lead to syncope (loss of consciousness).

Special case: what is hyperventilation syndrome?

Hyperventilation syndrome is often associated with what is commonly referred to as spasmophilia. This term is generally used to designate seizures that combine muscle tetany and breathing difficulties, including hyperventilation.

Hyperventilation syndrome, or spasmophilia, manifests itself by a set of symptoms such as:

• feeling weak and tired;
• dizziness and vertigo;
• discomfort;
• headaches;
• difficulty concentrating;
• irritability;
• anxiety;
• a depressive state;
• sleep disturbances, such as insomnia.

Hyperventilation can have different explanations. It can be voluntary but can also be the sign or the consequence:

• a state of stress oranxiety, which can lead to anxiety or panic attacks with the onset of hyperventilation;
• an hypoxia, a lack of oxygen supply which can occur in particular during stays at altitude;
• lung disease, such as asthma (inflammatory disease of the airways), pneumonia (a lung infection of bacterial or viral origin), pulmonary embolism (obstruction of one or more arteries supplying the lungs), pneumothorax (abnormal infiltration of air in the pleural cavity), pulmonary fibrosis (lung injury) or cardiogenic pulmonary edema (lung disease due to heart failure);
• metabolic acidosis, a disorder of the acid-base balance of metabolic origin (acute poisoning, renal failure, lactic acidosis by excess lactic acid, acido-ketosis by excess ketone bodies) that the body may want to compensate by hyperventilation;
• central nervous system damage, especially in the event of head trauma, meningitis or intracranial hemorrhage;
• of sepsis, a generalized inflammatory response throughout the body that often results from sepsis, a serious and widespread infection of bacterial origin.

The consequences and the course of hyperventilation depend on various parameters including the origin of the respiratory disorder and the patient’s condition. While this breathing disorder can be mild (harmless), it can sometimes be the cause of serious complications. In the most serious cases, hyperventilation can lead to acute respiratory distress, the consequences of which can be life-threatening.

The medical management consists in treating the origin of the hyperventilation. Depending on the case, the diagnosis can be made by a general practitioner or a pulmonologist. In the most serious cases, treatment by emergency medical services is essential to limit the risk of complications.

Depending on the diagnosis, several treatments can be considered:

• sessions of physiotherapy ;
• drug treatment ;
• mechanical assisted ventilation.