Sighing and Meaning of Sighs: Dysregulation of Breathing
Definition of sighs (how to define sighs)
Sighing is defined as an involuntary inhalation (inspiration) that is 1.5-2 times greater than the usual tidal volume. Some studies suggest that a sigh should be defined as 1.5 times increase in the personal typical tidal volume (Leiner & Abramowitz, 1958). Some other authors suggested another definition of a sigh: it should be at least as twice as deep as the person's average inhalation (Wilhelm et al, 2001; Caughey et al, 1943).
Respiratory mechanics of sighs
Sighing is usually done using primarily the upper chest, dorsal muscles, or upper sternum (Lum, 1975; Gallavardin, 1925; Leiner & Abramowitz, 1958) and is a sign of chest or thoracic breathing (Katagiri et al, 1998; Lum, 1975; Lum, 1981; Gallavardin, 1925; Leiner & Abramowitz, 1958).
Sighing during sleep
Sighing can be present during sleep in normal adults (Perez-Padilla et al, 1983) and infants (Gerard et al, 2002). This study on sighs during sleep in adults (Perez-Padilla et al, 1983) discovered that all 12 normal adults had sighs during their night sleep, from 1 to 25 sighs per night.
Sighing means inhaling a lot and reduced brain O2
After analyzing hundreds of sighs in more than 80 people with mostly respiratory problems* (see the note below), Leiner & Abramowitz (1958) found that in more than 80% of people the volume of air for one sigh was more than 1,300 ml and in some people up to 2.5-3 liters, with an average of about 1,700 ml per sigh for this group. These authors also discovered that, for the majority of subjects (more than 82%), the amount of air for one sigh was ranging from 40% to 60% of their vital capacity (the difference between the maximum inhalation and maximum exhalation).
This produces a similar effect on brain O2 content as light hyperventilation.
The normal vital capacity in healthy people is 4,500 ml which indicates that this group of subjects had reduced vital capacity (due to presence of respiratory problems). Hence, this study suggests that the average sighing volume in normal adults (with no lung pathologies) is over 2,000 ml. The normal tidal volume is 500 ml. This suggests that a typical adult's sigh is 4 times larger, a lot more, than the normal tidal volume.
Meaning of sighing: health problems
Sighing is generally regarded as a symptom of abnormal or dysregulated breathing since normal breathing in healthy subjects is regular or periodic (i.e., without sighing). Excessive or frequent sighing is considered a sign of panic disorder (Abelson et al, 2001; Schwartz et al, 1996; Wilhelm et al, 2001a; Wilhelm et al, 2001b), anxiety states (Lum, 1981), low back pain (Chaitow, 2004), nervous disturbance (Rechnitzer et al, 1929), dyspnea (Magarian et al, 1983), neurocirculatory asthenia (cardiovascular disease) and nervous instability in young women (White & Hahn, 1929), and respiratory neurosis (Christie, 1935). Some studies point that people with depression often suffer from excessive sighing. In comparison with normal and healthy subjects, sighing is more common in patients with rheumatoid arthritis who have depression (Robbins et al, 2011). Hence, in most cases, frequent or excessive sighing means being under stress.
However, sometimes excessive sighing and/or yawning can take place due to resetting of the respiratory center (e.g., after the meal is digested, after or even during physical exercise, and so forth). In such cases, one should hold the breath after their usual exhalation (perform the body-oxygen test) and do Buteyko reduced breathing exercise with air hunger for 1-2 minutes to stop sighing and increase brain oxygenation.
Respiratory causes of frequent sighing
While many causes of sighing have been suggested, the most impressive evidence relates to the link between sighing and typical symptoms of hyperventilation (Aljadeff et al, 1993; Brashear, 1983; Okel BB & Hurst, 1961; Saltzman et al, 1963). Many other researchers consider sighing as a hallmark and classical symptom - or form - of hyperventilation (Bass & Gardner, 1985; Berczeller, 1993; Brashear, 1983; Fraser & Pare, 1979; Gliebe PA & Auerback, 1944; Howell, 1990; Ker, 1937; Lum, 1975; Lum, 1981; Magarian et al, 1983; Rice et al, 1950).
Blashear (1983) in his article in Lung titled "Hyperventilation Syndrome" suggested that physicians should regard occasional sighing as a subtle clue to presence of hyperventilation syndrome. Hence, decades of clinical research suggest that hyperventilation is the cause of sighing.
Some researchers revealed that the sigh rate was higher during conditions of relief compared to conditions of stress (Vlemincx et al, 2009), while later, in another study, they found that sighing could be triggered by both mental load and recovery from the attention task (Vlemincx et al, 2011). Sighs can be an expression of an activity, intention or desire that has to be discarded (Teigen, et al, 2008).
When infants are not swaddled, they have increased frequency of sighs during sleep (Gerard et al, 2002). This is probably due to the fact that swaddling restricts ventilation, prevents chest breathing, increases arterial CO2 and cellular O2 concentrations, and makes breathing more regular.
Sighing is sometimes thought to be caused by a spasm of the diaphragm (Gallavardin, 1925; Katagiri et al, 1998; Leiner & Abramowitz, 1958). Indeed, chest breathing means poor diaphragm function with insufficient stimulation of lung tissue and stretch receptors located in the lower parts of the lungs. Therefore, sighing can provide some relief or solution to these problems. However, these problems are natural effects of hyperventilation.
Hyperventilation leads to alveolar hypocapnia and reduced oxygenation of the diaphragm. Furthermore, arterial hypocapnia (CO2 deficiency in the arterial blood) leads to spasms in all muscles of the human body, including the diaphragm (see CO2 links below).
Hence, various causes of hyperventilation, such as supine sleep, mouth breathing, stress, anxiety, overeating, overheating, and poor posture, can intensify sighing. It makes sense then that sighing is often accompanied by other symptoms of hyperventilation, such as dyspnea (or shortness of breath), breathlessness (or heavy and deep breathing), yawning, and coughing. These observations also support the idea about the key role of overbreathing in the pathophysiology of sighing. Therefore, excessive or frequent sighing means that a person is hyperventilating.
Since the overwhelming majority of modern people are hyperventilators and chest breathers (see links below), most modern studies cannot shed more light on the root causes of sighing, unless their subjects retrain and normalize their automatic breathing patterns.
Effects of occasional sighs
Even several very deep and fast breaths cannot improve oxygenation of the arterial blood (which is equal to 98-99% for tiny normal breathing). The main effect of frequent or excessive sighing is hypocapnia (lack of CO2) in the lungs, arterial blood and body cells. Many authors suggest that markedly reduced arterial-CO2 tension could be maintained with very little effort with only an occasional sigh superimposed on the normal breathing pattern (Brashear, 1983; Okel BB & Hurst, 1961; Saltzman et al, 1963). Hence, even occasional sighing means chronic hyperventilation and a reduced oxygen level in cells, while frequent or excessive sighing produces devastating effects on the main gases (CO2 and O2) in the brain, heart and other vital organs.
Many people with dyspnea (breathlessness) testify that sighing brings some relief to their respiratory muscles. This relief may relate to the mechanical effects of sighing on the diaphragm and other respiratory muscles. Several studies have found that artificial sighs, during mechanical ventilation of various lung patients, have positive effects on oxygenation of their arterial blood and diminished viscoelastic impedance.
Treatment of sighing: increase body O2
People with sighing have less than 20 seconds for the body-oxygen test. If they achieve more than 30 s for the body-oxygen test, they will be free from this symptom.
Sighing disappear very quickly with the application of resistive breathing devices (such as the Frolov device, Samozdrav, Amazing DIY breathing device, and many others) since they provide a double positive effect on the causes of sighing. These devices increase CO2 levels in airways and stimulate the lungs and respiratory muscles. In addition, correct physical exercise and other lifestyle changes (in the Section Learn) are necessary for complete remission of sighing.
* The main health problems in this study of sighs (Leiner & Abramowitz, 1958) were tuberculosis, tuberculosis pleurisy, emphysema, bronchogenic carcinoma, sarcoidosis, hemoptysis, asthma, bronchiectasis, arteriosclerotic heart disease, rheumatic heart disease, and cor pulmonale.
Reference pages: Breathing norms and medical facts:
- Breathing norms: Parameters, graph, and description of the normal breathing pattern
- 6 breathing myths: Myths and superstitions about breathing and body oxygenation (prevalence: over 90%)
- Hyperventilation: Definitions of hyperventilation: their advantages and weak points
- Hyperventilation syndrome: Western scientific evidence about prevalence of chronic hyperventilation in patients with chronic conditions (37 medical studies)
- Normal minute ventilation: Small and slow breathing at rest is enjoyed by healthy subjects (14 studies)
- Hyperventilation prevalence: Present in over 90% of normal people (24 medical studies)
- HV and hypoxia: How and why deep breathing reduces oxygenation of cells and tissues of all vital organs
- Body-oxygen test (CP test) : How to measure your own breathing and body oxygenation (two in one) using a simple DIY test
- Body oxygen in healthy: Results for the body-oxygen test for healthy people (27 medical studies)
- Body oxygen in sick : Results for the body-oxygen test for sick people (14 medical studies)
- Buteyko Table of Health Zones: Clinical description and ranges for breathing zones: from the critically ill (severely sick) up to super healthy people with maximum possible body oxygenation
- Morning hyperventilation: Why people feel worse and critically ill people are most likely to die during early morning hours
References: pages about CO2 effect:
- Vasodilation: CO2 expands arteries and arterioles facilitating perfusion (or blood supply) to all vital organs
- The Bohr effect: How and why oxygen is released by red blood cells in tissues
- Cell oxygen levels: How alveolar CO2 influences oxygen transport
- Oxygen transport: O2 transport is controlled by vasoconstriction-vasodilation and the Bohr effects, both of which rely on CO2
- Free radical generation: Reactive oxygen species are produced within cells due to anaerobic cell respiration caused by cell hypoxia
- Inflammatory response: Chronic inflammation in fueled by the hypoxia-inducible factor 1, while normal breathing reduces and eliminates inflammation
- Nerve stabilization: People remain calm due to calmative or sedative effects of carbon dioxide in neurons or nerve cells
- Muscle relaxation: Relaxation of muscle cells is normal at high CO2, while hypocapnia causes muscular tension, poor posture and, sometimes, aggression and violence
- Bronchodilation: Dilation of airways (bronchi and bronchioles) is caused by carbon dioxide, and their constriction by hypocapnia (low CO2)
- Blood pH: Regulation of blood pH due to breathing and regulation of other bodily fluids
- CO2: lung damage: Elevated carbon dioxide prevents lung injury and promotes healing of lung tissues
- CO2: Topical carbon dioxide can heal skin and tissues
- Synthesis of glutamine in the brain, CO2 fixation, and other chemical reactions
- Deep breathing myth: Ignorant and naive people promote the idea that deep breathing and breathing more air at rest is beneficial for health
- Breathing control: How is our breathing regulated? Why hypocapnia makes breathing uneven, irregular and erratic.
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