Sibilance is a hissing sound that can be heard when exhaling. It is often a sign of a narrowing of the bronchi, in most cases caused by a disease such as asthma or chronic obstructive pulmonary disease (COPD).

A rattle is an abnormal sound produced by breathing that a doctor can hear through a stethoscope when auscultating the lungs. There are three types of rattles:

• crackles: occurring at the end of inspiration, they reveal damage to the alveoli and lung tissue;
• snoring or ronchus: occurring mainly on expiration, they are a sign of an accumulation of secretions in the bronchi, as during bronchitis;
• sibilant: the sibilant rattle or sibilance, can be heard during exhalation. It sounds like a high pitched whistle and often corresponds to a narrowing of the bronchi. When breathing, the air passing through the narrowed bronchi causes this hissing sound. The narrowing of the bronchi can be caused by a disease such as asthma or chronic obstructive pulmonary disease (COPD). It can also be the consequence of a transient inflammation, as is the case with bronchitis, for example. A strong emotion can also cause this hissing sound.

Asthma

Asthma is a respiratory disease that causes chronic inflammation of the bronchi. The disease is manifested by attacks in the form of wheezing and difficulty in breathing, which can lead to hospitalization. In an asthma attack, inflammation causes the bronchial muscles to contract, causing the diameter of the bronchi to shrink as well as increased mucus secretion. Both of these factors cause difficulty in breathing. The frequency and severity of seizures vary from person to person. Symptoms may worsen during physical exertion or during the night. The attacks can be a few hours or a few days apart, or even several months or several years. Between two attacks, breathing is usually normal.

It is a disease that affects 4 million people in France. It cannot be cured, but there are treatments that help keep the disease under control and reduce the risk of seizures. It is most often diagnosed during childhood. There are also forms of asthma occurring in adults, such as occupational asthma which represents 5 to 10% of asthma cases in France. It is the consequence of regular exposure to certain products.

COPD

Chronic obstructive pulmonary disease is a chronic inflammatory disease of the bronchi. It is characterized by inflammation of the airways which causes thickening of the walls of the bronchi and hypersecretion of mucus. The narrowing of the airways is gradual and permanent. It causes respiratory discomfort. Inflammation can also lead to the destruction of cells in the pulmonary alveoli.

The disease is manifested by the following symptoms: shortness of breath, chronic cough, phlegm, etc. They often appear gradually and worsen because they are underestimated by the individual. This degradation involves exacerbations, that is to say flare-ups during which the symptoms worsen considerably.

This disease affects 3,5 million people in France. The main risk factor is tobacco: 80% of cases are attributable to smoking, active or passive. There are, of course, other risk factors: air pollution, occupational exposure to chemicals, frequent respiratory infections, etc.

The sibilance in itself is of little consequence, it is the respiratory discomfort that often accompanies it that must be taken seriously. The consequences will be related to the disease causing the wheezing.

Asthma

When not properly managed, the disease can lead to hospitalizations and even death (60 and 000 per year, respectively). In addition, asthma has a significant impact on the quality of life, leading to insomnia, reduced activities or significant absenteeism at school or at work.

COPD

COPD causes many hospitalizations and deaths each year due to exacerbations of the disease (flare-ups during which symptoms worsen).

Asthma

Asthma is not a cure-all disease. However, there are basic treatments to be taken on a daily basis which make it possible to prolong the periods of remission and reduce the frequency of attacks. During attacks, it is also possible to take specific treatments to control the symptoms.

COPD

COPD cannot be cured. Its management can however slow down its evolution and even reverse certain symptoms. This support includes:

• smoking cessation in patients who smoke;
• respiratory rehabilitation;
• physical exercise;
• medication.

Regarding drugs, these are bronchodilators, so the action is to dilate the airways and improve air flow. This treatment can be combined with corticosteroids to reduce local inflammation in case of repeated exacerbations and severe symptoms.

In case of wheezing during breathing, do not hesitate to consult your doctor who will indicate the procedure to follow in case of doubt.