Definition of Hyperventilation and Its Physiology
Hyperventilation (or overbreathing) is defined as a physiological state of breathing at rest that is faster and/or deeper than normal. This mechanical definition of hyperventilation is based on calculations of normal minute ventilation
(which is 6 L/min at rest for a 70-kg man) and
can be found in many sources (Wikipedia, National Institute of Health,
WebMD, and many medical textbooks). Although this hyperventilation definition
works in most situations, it is not suitable for some cases described below.
In contrast, Dr. Buteyko's definition of hyperventilation
(or what he implied in relation to hyperventilation) is based on the
pathological physiological effects that are caused by reduced CO2
levels in the alveoli of the lungs due to hyperventilation.
above medical hyperventilation definition incorrectly includes
numerous positive situations, for example:
- Breathing gets much deeper and faster during physical exercise,
however, alveolar and arterial CO2 increase for nose breathing (in and
out) during exercise
- Fire breath in hatha yoga is an example of very fast
breathing, but due to a small tidal volume, which is close to dead
volume, arterial and alveolar CO2 may get even higher during this
special breathing practice
- Buteyko reduced breathing exercise (where CO2 accumulation in
the alveoli can be achieved by frequent and small breathing for
students with less than 20 s CP) also leads to CO2 increase
- Breathing exercises with various breathing devices (the
Frolov breathing device, Samozdrav device, Cosmic Breath, Amazing DIY
breathing device, etc.) can be accompanied by increased minute
ventilation (depending on the amount of additional volume) and low
breathing frequency, but with increased CO2 levels in the alveoli of
the lungs due to CO2 getting trapped in the device
- Breathing CO2-rich air (like carbogen and other mixtures)
increases minute ventilation (leading to faster and deeper breathing),
but alveolar and arterial CO2 concentrations usually become higher.
(They could become lower, if a person is in a state of panic after
starting to breathe CO2-rich air).
During all these situations, the levels of CO2 in the
arterial blood and cells get higher than before these situations, while
classical overbreathing (or voluntary hyperventilation with normal air)
reduces cell O2 and CO2 content.
Many medical textbooks suggest defining hyperventilation based on
arterial hypocapnia. Hyperventilation is a physiological
state when the partial pressure of arterial CO2 is
less than 35 mm Hg. However, people with ventilation-perfusion
mismatch normally have elevated minute ventilation (e.g., over 10-12
L/min at rest for bronchitis, COPD, cystic fibrosis, etc.) with obvious
alveolar hypocapnia (reduced CO2 in the alveoli of the lungs), but
their arterial CO2 can be very high (e.g., up to 50 mm Hg and more).
Physiologically, it is obvious that these patients require more CO2 in
order to restore airways and lung tissues due to CO2 bronchodilating
effects (expansion of airways) and the abilities of CO2 to heal
alveoli. Breathing less for all these groups of patients leads to a
reduction of the abnormally high arterial CO2 and an increase in
arterial O2 content due to the reduced ventilation-perfusion
abnormality. This effect can be easily confirmed using finger oximeters
and other types of devices that measure oxygen content of the blood.
How to define hyperventilation
the most logical and physiologically strict way to define
hyperventilation is the following. Hyperventilation is
the physiological state of the human organism
characterized by alveolar hypocapnia (CO2 deficiency in the alveoli of
the lungs). This definition of hyperventilation is based on an abnormally low
concentration of CO2 (carbon dioxide) in the functioning alveoli of the
lungs, causing reduced oxygen transport, tissue hypoxia (low O2 in
cells) and other pathological effects that intensify breathing.
hyperventilation definition satisfies various practical
situations with no exceptions due to its physiological (or biochemical)
basis: abnormally low CO2 tension in the alveoli of the lungs. It has
an important therapeutic value since it is based on known physiological
and biochemical effects of carbon dioxide on airways, lung tissue,
blood vessels, and other organs and tissues of the human body.
However, since alveolar CO2 is very difficult to measure, in most
situations, the "mechanical" definition of hyperventilation works fine
and this is the reason why many tables on this site quote minute
ventilation. Indeed, when minute ventilation is above 10 L/min at rest,
while metabolic rate might be only slightly above normal, it is obvious
that this "mechanical" hyperventilation causes physiological
hyperventilation (alveolar hypocapnia).
On the other hand, ventilation-perfusion abnormalities are confined
to only a small portion of people with emphysema, severe asthma, severe
bronchitis, COPD, cystic fibrosis, and some other conditions. Hence, arterial
hypocapnia, as a definition and criterion of hyperventilation, is also a
sensible idea because, for most people, in most situations, arterial
hypocapnia means deep and/or fast breathing with low CO2 levels in the
This YouTube video (on the right side) provides the definition and info about
prevalence of hyperventilation:
The physiological effects of hyperventilation can be organized in books since nearly any chronic disease is based on low O2 content in cells of the human body. You can see the table on the Homepage of this site for exact ventilation numbers in people with heart disease, diabetes, cancer, asthma, COPD, and many other condition. Therefore, if you want to learn more about hyperventilation physiology, consider separate pages devoted to diseases and symptoms.
words about physical exercise and its relation to CO2 changes
"Next is about physical activity, labor, and sports. Here again the
fact that in our press and everywhere else, there are people who are
illiterate in physiology. They have imposed upon us a thought, and
again contrary to the truth, that physical activity, sport and labor
deepen our breathing. This is quite the opposite! It is wrong to
consider any function bureaucratically, as a fact detached from life.
After all, breathing is done to ensure metabolism. Therefore, breathing
must be considered in parallel with metabolism. It turns out that
physical labor, sports, and workouts increase metabolism, i.e., they
increase production of carbon dioxide and carbon dioxide increases,
during exercise, in the blood, while oxygen is reduced. This is what
physical exercise does." Dr. Buteyko's
Lecture at the Moscow State University
While the normal MV is 6 L/min at rest for a 70-kg man, and normal CO2 value is 40 mm Hg at sea level, Dr. Buteyko and his medical colleagues suggested different norms for minute ventilation at rest and for carbon dioxide levels in airways. After testing breathing retraining of thousands of people, they found that there are amazing health benefits in breathing slower and less. You can find these numbers right below here as your bonus content.
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