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The Doctors Book of Home Remedies: Hyperventilation

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Hyperventilation

8 Tactics to Overcome It

The first time it happened, Gary Varner thought he was having a heart attack. "My heart was racing and it just felt like everything inside my body—my chest—was vibrating. And I felt some tingling."

Understandably, he was scared. But at a hospital, emergency room doctors said his heart was fine. Their diagnosis: hyperventilation.

Simply put, hyperventilation is "breathing fast," or overbreathing, says Stephen J. Harrison, M.D., senior emergency medical resident at the Medical Center of Delaware in Wilmington.

"Anxiety is a common cause," says Gabe Mirkin, M.D., a sports medicine expert from Silver Spring, Maryland, and an associate clinical professor at Georgetown University School of Medicine. "When some people are frightened, they breathe rapidly and deeply, even though they don't need the extra oxygen. This causes them to breathe out a large amount of carbon dioxide, and excessive loss of carbon dioxide causes the blood to become alkaline. This in turn causes the symptoms of a panic attack."

Episodes of hyperventilation can last for hours but typically just 20 to 30 minutes. But to the heavy-breathing sufferer it can seem like hours.

Of course Varner was relieved to learn he had not suffered a heart attack. But his experience with hyperventilation was just beginning—repeat attacks are not uncommon. But Varner learned there are things you can do to stop attacks and to prevent them.

MEDICAL ALERT

Let Your Doctor Diagnose

One moment you're breathing normally—then suddenly you are breathing fast—out of control—your heart is pounding, your fingers are tingling, and your palms are sweating. You feel as if you're going to die, but in all probability you'll live to pay next year's taxes.

Hyperventilation, in most cases, is caused by anxiety. But if you've never experienced hyperventilation before, "you probably should be seen by a doctor," says Stephen J. Harrison, M.D.

Though it is uncommon, hyperventilation could be connected to a lung disease, a blood infection, pneumonia—even poisoning. Also, it's possible that what feels like a heart attack is a heart attack.

Of course, it's probably nothing that serious—but leave the official diagnosis to a doctor.

Breathe into a paper bag. This has long been the primary treatment for hyperventilation. The theory is that rebreathing into a paper bag will allow the person to replace the carbon dioxide "blown off" while hyperventilating.

"Blowing into a paper bag is fine," Dr. Harrison says, "if you've hyperventilated before, been evaluated by a doctor, and are sure there is nothing seriously wrong." Most people who hyperventilate meet that criteria, but a few may have more severe problems. (See "Let Your Doctor Diagnose" on the opposite page.)

Varner says using a paper bag not only helped him halt attacks, but it may have prevented some, too. "When I was battling this problem daily, I would carry a paper bag with me all the time," he says. "And just knowing I had that sack with me was a big help."

Sit down, be calm, and relax. You need to slow your breathing, says Dr. Mirkin. The more tense you are, the faster you'll breathe.

Practice breathing naturally. Don't take exaggerated breaths and don't take very shallow breaths—take normal breaths. That's one breath every 6 seconds or ten breaths a minute. Do this twice a day, 10 minutes per session, Dr. Mirkin advises.

Think beyond yourself. "Once I had that first hyperventilation experience, I became consumed with thoughts of having another one. And I did have several more," Varner says. So while you want to focus on your breathing in the practice sessions, Dr. Mirkin suggests you don't want to spend all your time thinking about your breathing and the possibility of hyperventilating.

"After all," says Dr. Harrison, "breathing is a natural thing."

Exercise. "It decreases anxiety and helps people cope better," Dr. Harrison says. "Especially if you get your heart rate up." And when exercising, breathing a little faster is fine.

Avoid uncomfortable situations. For Varner, that means not trapping himself in a crowd where he has to sit or stand still for long periods of time. Identify situations in your life that trigger hyperventilation and eliminate or reduce them. "If your fear of black cats, for example, makes you hyperventilate, then steer clear of black cats," says Dr. Mirkin.

Cut caffeine. It's a stimulant, and therefore, a potential trigger for hyperventilation, says Dr. Harrison. Watch out for coffee, tea, colas, and chocolate.

Don't smoke. Nicotine is also a stimulant.

PANEL OF ADVISERS

Stephen J. Harrison, M.D., is senior emergency medical resident at the Medical Center of Delaware in Wilmington.

Gabe Mirkin, M.D., is in private practice at the Sportsmedicine Institute in Silver Spring, Maryland. He is also associate clinical professor of pediatrics at Georgetown University School of Medicine in Washington, D.C. He is the author of several sports medicine books, including Dr. Gabe Mirkin's Fitness Clinic, and is a syndicated newspaper columnist and radio broadcaster.

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