In my teen years I developed allergic rhinitis, nasal congestion and asthma. Several years later I became aware of a tightness in my chest, breathlessness and an overexcitability within my body. One time, I had a panic attack. My GP thought I had anxiety and sent me off to a psychologist. These symptoms came and went over the next 10 years or so, usually exacerbated by stress. I cannot recall my breathing being questioned or assessed.
Last year I noticed being breathless while walking with my children, who, with short legs, were walking pretty slowly. Thankfully this observation coincided with my studies in orofacial myology and Integrative Breathing Therapy.
Dr Rosalba Courtney, an osteopath who has specialised in breathing for over 30 years, became my doctor as well as teacher of Integrative Breathing Therapy. Questionnaire, manual and instrumental assessments, revealed that I had “Dysfunctional Breathing”, an umbrella term for a number of disorders of breathing. My specific problem was hypocapnia, which refers to low carbon dioxide levels. It can be diagnosed with a machine called a capnometer. A capnometer measures carbon dioxide and oxygen levels in expired nasal gas. My carbon dioxide levels were severely depleted. I felt sick every day, with unshakeable fatigue, daily headaches and facial pain, body pain, dizziness, running out of air when talking and feeling that I could not get enough air. I had cardiac symptoms over a number of years (palpitations and tight chest) but heart problems had been ruled out. I felt that my attention and memory skills had suffered significantly. And I had lost my zest for life, struggling to accept my life the way it was.
Despite feeling short of breath, I was in fact hyperventilating (overbreathing). Hyperventilating results in low carbon dioxide levels (hypocapnia). Hyperventilation is surprisingly common – approximately 1 in 10 people, including those who appear otherwise healthy. It is more common in people with panic disorder, anxiety disorder, PTSD, depression, asthma, nasal allergy and obstruction, ADHD, Autism, Irritable Bowel Syndrome and several other conditions.
Hypocapnia is known to cause or exacerbate a number of problems. I’ll mention just a few here. There is depletion of bicarbonate, magnesium, sodium, potassium and calcium in the body, related to metabolic acidosis (raised pH in the body). Carbon dioxide level is the single most important influencer of the body’s pH level, much more so than diet. Hypocapnia can also result in lowered oxygen availability to tissues, especially the brain. It is commonly associated with fatigue, which was my experience.
The good news
Breathing is trainable. Breathing retraining also has the benefits of being portable, simple (when properly understood and taught) and cheap. I have responded very well to breathing exercises over a number of months. Others with hypocapnia can recover in weeks, with commitment to daily exercises at home.
Integrative Breathing Therapy is unique in bringing together a range of assessment and therapy tools, and recognising that breathing is a complex interaction of the biochemical, biomechanical and psychophysiological aspects of the breath. I was fortunate to find this approach, because some traditional breathing approaches made me feel worse and may have exacerbated my problem. My case required a gentle approach to therapy, and a range of techniques, to build the responsiveness, adaptability and functionality of my breathing.
I’m happy to say that my carbon dioxide levels are now in the normal range. This has correlated with a renewed sense of health, energy and wellness.
Investigating the cause
I’m a sucker for understanding the causes of things!
I’ll never really know when or why I developed dysfunctional breathing, but I suspect the origin of my hypocapnia was allergic rhinitis and nasal congestion. Nasal congestion leads to mouth breathing and nasal disuse. Nasal breathing results in 10% oxygen uptake compared with mouth breathing and mouth breathing increases upper airway resistance, which can make breathing more difficult. In an effort to get more oxygen people who mouth breathe can develop compensatory breathing patterns, including hyperventilation and upper thoracic breathing.
It is not a stretch to imagine that, for me, nasal congestion led to hypocapnia.
Getting on top of chronic nasal congestion early is so important. Identifying hypocapnia, which is measured reliably through capnometry, is also crucial, when someone is experiencing symptoms of dysfunctional breathing. Integrative Breathing Therapy is a unique and effective treatment for dysfunctional breathing.
