How to stop hyperventilating

How to stop hyperventilating, step by step

Make each breath smaller and the out-breath longer. Start with a pace you can match, then slow it down. The players on this page do that; Breathform does it anywhere, even offline.

What does hyperventilation feel like?

Your breathing is fast or deep, or both. You feel as if you can’t get enough air. Then come the body signs: tingling or numb fingers and lips, a light or swimming head, a tight chest, a racing heart. Sometimes your hands cramp.

Here’s why, in brief. When you breathe more than your body needs, you blow off too much carbon dioxide, and that shift causes many of the strange sensations (Boulding et al. 2016). Your oxygen is usually fine. That’s why breathing more makes it worse and breathing less settles it.

Why do my hands tingle when I hyperventilate?

Low carbon dioxide makes your nerves more twitchy, especially in your hands, feet and around your mouth. That’s the pins and needles, and sometimes the cramp that curls your fingers. It’s uncomfortable, but it isn’t harmful, and it fades as your breathing slows.

Why does breathing into a paper bag help?

The idea is that you breathe back in some of the carbon dioxide you’ve just breathed out. The trouble is that you also breathe in less oxygen.

In a study of 20 volunteers who over-breathed into a paper bag, their oxygen dropped a lot within the first few minutes. The same doctor described three deaths where the bag was given to people whose fast breathing was really caused by low oxygen or a heart problem (Callaham 1989). That’s why many doctors now advise against it, though a few leaflets still suggest it.

A slow out-breath does the useful part of the job without the risk: breathing less lets your carbon dioxide build back up by itself. Pursed lips help too. In people with COPD, breathing out through pursed lips during exercise slowed their breathing rate (Mayer et al. 2018). There’s more on the technique in pursed-lip breathing.

Can anxiety cause hyperventilation?

Yes. Anxiety and panic are well-known triggers, and the low carbon dioxide from over-breathing seems to play a part in panic itself (Meuret and Ritz 2010). If panic is part of it, breathing exercises for panic attacks is written for that moment. For anxiety that hums along most days, start with breathing exercises for anxiety.

Fast breathing can also come from pain, fever, asthma and other illnesses. If it’s your first episode, or it comes with chest pain, blue or grey lips or no clear trigger, get medical help rather than breathing through it, whether it’s you or someone you’re with.

Some people over-breathe a little most of the time, not just in a crisis: lots of sighing, yawning and the feeling that a breath is never quite full. That pattern has a name, dysfunctional breathing (hyperventilation syndrome is one form of it), and respiratory physiotherapists teach breathing retraining for it. Air hunger anxiety and when breathing feels hard go into it gently.

How do I help someone who is hyperventilating?

Every study on this page (4)

• Boulding et al., 2016: Review: dysfunctional breathing includes hyperventilation syndrome, with symptoms related to respiratory alkalosis (low carbon dioxide), and periodic deep sighing.
• Callaham, 1989: Paper bag rebreathing lowered oxygen substantially within minutes in 20 volunteers who had hyperventilated; the author reports three deaths in which the treatment was wrongly applied to patients who were actually short of oxygen or had heart ischaemia.
• Mayer et al., 2018: In eight trials of people with the lung disease COPD, pursed-lips breathing during exercise slowed breathing but didn't help them walk further.
• Meuret and Ritz, 2010: Review: hyperventilation is linked to a range of physical symptoms; low carbon dioxide plays an important role in panic disorder, and reversing over-breathing is linked to reductions in panic symptoms.

Questions people ask

Is paper bag breathing safe?

Not always, which is why many doctors now advise against it. Rebreathing from a bag raises carbon dioxide, but it also lowers the oxygen you breathe in. That matters most when fast breathing is caused by something other than anxiety, such as asthma or a heart problem, and from the inside you can’t always tell. A slow out-breath raises carbon dioxide gently, without the risk.

How long does hyperventilating last?

Often only a few minutes once your breathing slows down. The tingling and the light head usually fade first, and you may feel tired or shaky for a while afterwards. Breathing smaller and slower is what shortens it: the more gently you breathe, the sooner it settles.

Should I breathe through my nose or my mouth?

In through your nose, if you can. It slows the in-breath and keeps it small, which is exactly what you want. Then out through softly pursed lips, which stretches the out-breath without any effort. If your nose is blocked, breathe in through your mouth, small and slow. The pace matters more than the route.

Is hyperventilating the same as a panic attack?

Not quite. Hyperventilating is the fast breathing itself. A panic attack is a sudden surge of fear, which often brings fast breathing with it. They feed each other: the tingling and dizziness from over-breathing feel frightening, and fear speeds the breath up. For the fear side, see breathing exercises for panic attacks.