Hyperventilation syndrome

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Overview
In psychiatry, hyperventilation syndrome (HVS) is an episodic disorder that often presents with chest pain and a tingling sensation of the fingertips (paresthesia) and around the mouth, as well as deep and labored breathing (causing hyperventilation), although chronic but subtle hyperventilation can cause these symptoms too.

HVS can be part of a panic attack but, despite all the stigma, most patients are not putting on a show but are in true distress.

People with HVS feel like they can't get enough air, but the opposite is actually true: they have too much oxygen and too little carbon dioxide in their blood. The hyperventilation is self-promulgating as rapid breathing causes carbon dioxide levels to fall, and respiratory alkalosis (high blood pH) develops. This makes the symptoms worse, which causes the patient to try breathing even faster, which further exacerbates the problem.

The respiratory alkalosis leads to changes in the way the nervous system fires and leads to the paresthesia, dizziness, and perceptual changes that often accompany this condition.

A rapid traditional intervention is to have the patient breathe into a paper bag, causing rebreathing and restoration of CO2 levels. Some physicians do not advise the paper bag rebreathing method due to the possibility of inhaling too much carbon dioxide.

The same benefits can be obtained from deliberately slowing down the breathing rate by counting or looking at a the second hand on a watch. This is often referred to as "7-11 breathing", because a gentle inhalation is stretched out to take 7 seconds (or counts), and the exhalation is slowed to take 11 seconds.