Have you ever taken a deep breath, only to feel that it still wasn’t quite enough?

You take another breath. Then another. Perhaps you find yourself sighing or yawning repeatedly, trying to achieve that one satisfying breath that seems to be missing.

This sensation is often described as air hunger.

It can be unsettling, particularly if you don’t understand why it is happening. You may worry that your lungs aren’t getting enough air, or that something serious is wrong with your breathing.

One possible explanation is breathing pattern disorder; an alteration in the way you breathe that can produce surprisingly physical symptoms.

But air hunger has many possible causes, so understanding the difference is important.

What does air hunger feel like?

Air hunger is essentially the feeling that you cannot get enough air, or that you cannot take a satisfying breath.

People may describe it as:

• feeling unable to fill their lungs
• repeatedly taking deep breaths
• frequent sighing or yawning
• needing to “top up” a breath
• feeling short of breath despite apparently normal breathing
• becoming unusually conscious of breathing
• feeling that breathing takes more effort than it should

For some people, these sensations are occasional. For others, they can become persistent and frustrating.

Air hunger may occur alongside other symptoms, including dizziness, light-headedness, tingling, chest discomfort, palpitations, fatigue or a feeling of tightness around the chest or throat.

The sensation itself can then become a source of worry, potentially making you even more aware of your breathing.

What is breathing pattern disorder?

Breathing pattern disorder refers to an alteration in normal breathing that can cause a variety of symptoms.

Breathing is normally automatic. It adjusts continuously according to what you are doing, whether you are asleep, sitting quietly, walking or exercising.

With a breathing pattern disorder, that pattern can become altered. Someone might breathe more quickly, take unnecessarily large breaths, breathe predominantly into the upper chest, use more of the muscles around the neck and shoulders, or develop an irregular breathing pattern.

It is therefore not simply a matter of “breathing too fast”.

Different people can experience different patterns and symptoms. Some may notice frequent sighing or yawning, while others may experience breathlessness, chest discomfort or a persistent feeling that they cannot get a satisfying breath.

Why can breathing pattern disorder cause air hunger?

This can seem confusing.

If you feel that you cannot get enough air, it is natural to assume that your body must be running out of oxygen. But the sensation of air hunger does not necessarily mean that your blood oxygen level is low.

Changes in breathing can affect the balance of gases in the body, particularly carbon dioxide. Breathing more than the body requires can contribute to symptoms such as light-headedness, tingling, palpitations and changes in how breathing feels.

This can create a frustrating cycle.

You feel that you cannot get a satisfying breath, so you take a larger breath. It may feel better momentarily, but the sensation returns. You take another large breath, perhaps followed by a sigh or yawn.

Over time, you may become increasingly focused on trying to control your breathing.

Understanding this cycle can be reassuring. It doesn’t mean that the symptoms aren’t real. The sensations can be very physical, even when the underlying problem is related to the pattern and control of breathing rather than a lack of oxygen.

What can cause or contribute to an altered breathing pattern?

There isn’t necessarily one single cause.

A breathing pattern can change following an illness or an episode of significant breathlessness. Respiratory conditions such as asthma can also influence the way someone breathes.

Stress and anxiety can contribute too. When we feel threatened or anxious, breathing naturally changes. For some people, that altered pattern can continue after the original stress has passed.

Pain, reduced physical activity, physical deconditioning and increased awareness of bodily sensations may also play a part.

This doesn’t mean that breathing pattern disorder is “all in your head”.

The symptoms can be real and physical. The important question is whether an altered breathing pattern is contributing to those symptoms and, if so, what can be done about it.

Is air hunger always caused by breathing pattern disorder?

No.

This is perhaps the most important point to understand.

Air hunger and breathlessness can occur for many different reasons. Respiratory conditions, cardiovascular problems, infections and other medical conditions can all cause breathlessness or an uncomfortable awareness of breathing.

Consequently, it is not appropriate to assume that persistent breathlessness is a breathing pattern disorder without considering other possible causes.

If your symptoms are new, persistent, unexplained or getting worse, speak to an appropriate healthcare professional.

Sudden or severe breathlessness, particularly when associated with chest pain, fainting, confusion, blue or grey lips, or a significant deterioration in your condition, requires urgent medical attention.

The purpose of recognising breathing pattern disorder is not to explain away unexplained breathlessness. It is to recognise that an altered breathing pattern can sometimes be an important and treatable part of the problem.

How is breathing pattern disorder assessed?

Assessment is usually based on a combination of your symptoms, medical history and observation of your breathing pattern.

A suitably trained healthcare professional may look at your breathing rate and rhythm, whether you breathe predominantly through your chest or abdomen, the muscles you use when breathing and what happens to your breathing during movement or exercise.

They may also consider whether other conditions could be contributing to your symptoms.

For some people, assessment by a respiratory physiotherapist can be particularly helpful. It can provide an opportunity to understand what is happening with your breathing rather than simply being told to “take a deep breath” whenever symptoms occur.

Can breathing pattern disorder be treated?

In many cases, breathing retraining can form an important part of treatment.

The aim isn’t simply to tell someone to breathe more slowly. Instead, treatment can involve learning to recognise an altered breathing pattern and gradually developing a more efficient and comfortable way of breathing.

Depending on the individual, this might include breathing awareness, reducing unnecessary large breaths, developing more appropriate breathing control, relaxation, posture and muscle relaxation, and learning how to maintain a more efficient breathing pattern during physical activity.

A respiratory physiotherapist can help tailor this approach to the individual.

Interestingly, changing an established breathing pattern can initially feel uncomfortable. Someone who has become accustomed to taking large breaths may experience an urge to “top up” their breathing when they begin to breathe more gently.

With appropriate guidance and practice, however, this can become easier.

When should you seek medical advice?

If you regularly experience air hunger or unexplained breathlessness, don’t simply assume that you have a breathing pattern disorder.

It is particularly important to seek medical advice if your symptoms are new, changing or interfering with everyday activities.

Once other potential causes have been appropriately considered, breathing pattern disorder may be something worth discussing with a healthcare professional, particularly if symptoms such as frequent sighing, yawning, difficulty taking a satisfying breath or an uncomfortable awareness of breathing persist.

Understanding air hunger can be the first step

The sensation of not being able to get a satisfying breath can be frightening. It can also be frustrating when medical tests don’t seem to provide an obvious explanation for what you are experiencing.

For some people, air hunger can be associated with an altered breathing pattern. Recognising this possibility doesn’t mean dismissing the symptoms or assuming that anxiety is responsible. It means considering whether the way you breathe could be contributing to how you feel.

If you would like to understand more about the symptoms, causes, assessment and treatment of breathing pattern disorder, you can explore this detailed guide to air hunger.

The important message is that persistent breathing symptoms deserve appropriate assessment. And, when breathing pattern disorder is contributing, there may be practical ways to improve how breathing feels and functions.

Adam Mulligan, a psychology graduate from the University of Hertfordshire, has a keen interest in the fields of mental health, wellness, and lifestyle.