Dysfunctional breathing disorders

In this episode, Dr Stephen Child discusses dysfunctional breathing disorders - including assessment, investigation and management.

Dysfunctional breathing is a term describing a group of breathing disorders in patients where chronic changes in breathing pattern result in dyspnoea and often non- respiratory symptoms in the absence of, or in excess of, organic respiratory disease.

Topics

Starting with a definition
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How common are these disorders?
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What’s the pathophysiology behind these groups?
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What about anxious patients?
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Clinical features – how do these patients present?
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What are we looking for on physical examination?
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Is there a guide or questionnaire for diagnosis?
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Diagnosis of exclusion
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Red Flags
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Management of this condition – Breath retraining
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Good results from breath training
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Do other breathing techniques have benefits
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Should we refer to a trained physiotherapist?
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Take home messages
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Take home messages

Consider a disordered breathing pattern when a patient presents with any breathing signs that occur at rest, not an exercise and that will wax and wane.
Remember that it’s a relatively evidence-free area. So it’s a diagnosis of exclusion be very wary of being dogmatic about it as the primary diagnosis. Until you’ve considered the other diagnoses. And always keep an open mind when we’re dealing in evidence
Simple breathing retraining supportive care and control of the breathing may make dramatic improvements to your patients.

Resources

Breathing pattern disorders and physiotherapy: inspiration for our profession Physical Therapy Reviews (2011)
Breathing Dysfunction/ Breathing Pattern Disorders New Zealand Respiratory Conference (2016)
Breathing Pattern Disorders Physiopedia
Breathing pattern disorders - Information for patients NHS (2019)
Dysfunctional breathing: a review of the literature and proposal for classification European Respiratory Review (2016)

Presenter

Stephen Child

General Physician

Contact here

Dr Stephen Child is a Canadian-trained General Physician with a respiratory medicine interest who moved to his current role as General Physician at Auckland District Health Board (ADHB) in 1994. Clinically, he has an interest in asthma and general internal medicine with a strong passion for medical education.

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