Hyperventilation | How Common Is Hyperventilation
What is hyperventilation?
Hyperventilation
(or alveolar hyperventilation), since it has the prefix "hyper-", is breathing more air per minute than the medical
norm. The values for normal minute ventilation (or respiratory minute volume) at
rest for a 70-kg man range from 4-6 L/min for older physiological textbooks and
up to 6-9 L/min for some modern textbooks. Obviously, anything that is more 9-10
L/min is defined as "hyperventilation".
Hyperventilation causes hypocapnia (CO2 deficiency) in the alveoli of the lungs and, if there is no ventilation-perfusion mismatch, in the arterial blood and other body cells. In any case (too high or too low arterial CO2 - arterial hypercapnia or hypocapnia), hyperventilation always leads to tissue hypoxia (low oxygen levels in cells).
Official story about hyperventilation
Hyperventilation, as nearly all medical sources imply (e.g., Wikipedia, Emedicine.com, and many others), happens rarely, in such cases as anxiety panic, or other more exotic situations. For example, click here. These medical sources cannot even provide the correct definition of hyperventilation or "hyper" + "ventilation". What do we know about exact numbers for ventilation at rest in people with chronic diseases? Do healthy people have normal minute ventilation rates? How common is hyperventilation? What is the real story related to hyperventilation?
Minute ventilation rates (chronic diseases)
| Condition | Minute ventilation |
Number of people |
All
references or click below for abstracts |
| Normal breathing | 6 L/min | - | Medical textbooks |
| Healthy Subjects | 6-7 L/min | >400 | Results of 14 studies |
| Heart disease | 15 (±4) L/min | 22 | Dimopoulou et al, 2001 |
| Heart disease | 16 (±2) L/min | 11 | Johnson et al, 2000 |
| Heart disease | 12 (±3) L/min | 132 | Fanfulla et al, 1998 |
| Heart disease | 15 (±4) L/min | 55 | Clark et al, 1997 |
| Heart disease | 13 (±4) L/min | 15 | Banning et al, 1995 |
| Heart disease | 15 (±4) L/min | 88 | Clark et al, 1995 |
| Heart disease | 14 (±2) L/min | 30 | Buller et al, 1990 |
| Heart disease | 16 (±6) L/min | 20 | Elborn et al, 1990 |
| Pulm hypertension | 12 (±2) L/min | 11 | D'Alonzo et al, 1987 |
| Cancer | 12 (±2) L/min | 40 | Travers et al, 2008 |
| Diabetes | 12-17 L/min | 26 | Bottini et al, 2003 |
| Diabetes | 15 (±2) L/min | 45 | Tantucci et al, 2001 |
| Diabetes | 12 (±2) L/min | 8 | Mancini et al, 1999 |
| Diabetes | 10-20 L/min | 28 | Tantucci et al, 1997 |
| Diabetes | 13 (±2) L/min | 20 | Tantucci et al, 1996 |
| Asthma | 13 (±2) L/min | 16 | Chalupa et al, 2004 |
| Asthma | 15 L/min | 8 | Johnson et al, 1995 |
| Asthma | 14 (±6) L/min | 39 | Bowler et al, 1998 |
| Asthma | 13 (±4) L/min | 17 | Kassabian et al, 1982 |
| Asthma | 12 L/min | 101 | McFadden & Lyons, 1968 |
| COPD | 14 (±2) L/min | 12 | Palange et al, 2001 |
| COPD | 12 (±2) L/min | 10 | Sinderby et al, 2001 |
| COPD | 14 L/min | 3 | Stulbarg et al, 2001 |
| Sleep apnea | 15 (±3) L/min | 20 | Radwan et al, 2001 |
| Liver cirrhosis | 11-18 L/min | 24 | Epstein et al, 1998 |
| Hyperthyroidism | 15 (±1) L/min | 42 | Kahaly, 1998 |
| Cystic fibrosis | 15 L/min | 15 | Fauroux et al, 2006 |
| Cystic fibrosis | 10 L/min | 11 | Browning et al, 1990 |
| Cystic fibrosis* | 10 L/min | 10 | Ward et al, 1999 |
| CF and diabetes* | 10 L/min | 7 | Ward et al, 1999 |
| Cystic fibrosis | 16 L/min | 7 | Dodd et al, 2006 |
| Cystic fibrosis | 18 L/min | 9 | McKone et al, 2005 |
| Cystic fibrosis* | 13 (±2) L/min | 10 | Bell et al, 1996 |
| Cystic fibrosis | 11-14 L/min | 6 | Tepper et al, 1983 |
| Epilepsy | 13 L/min | 12 | Esquivel et al, 1991 |
| CHV | 13 (±2) L/min | 134 | Han et al, 1997 |
| Panic disorder | 12 (±5) L/min | 12 | Pain et al, 1991 |
| Bipolar disorder | 11 (±2) L/min | 16 | MacKinnon et al, 2007 |
| Dystrophia myotonica | 16 (±4) L/min | 12 | Clague et al, 1994 |
This
data explains the pathological changes and high prevalence of chronic disorders
(or diseases of civilization), due to hyperventilation, in modern population.
Since modern people breathe about 2 times more than the medical norm, they
usually suffer from low CO2 values in the arterial blood (ventilation-perfusion
mismatch is not a very common condition). Therefore, they need to get
managed hosting of their
hyperventilation.
Carbon dioxide is a potent dilator of blood vessels (vasodilator) and is crucial for the Bohr effect (O2 transport from red blood cells to tissues). As a result of hyperventilation, modern people experience reduced oxygen levels in the brain, heart, kidneys and all other vital organs. Cell hypoxia causes or favors inflammatory conditions, production of free radicals and suppression of the immune system. Apart from these effects, there are devastating effects of the hyperventilation syndrome on the brain due to hypocapnia or a lack of CO2, which has calming or sedative properties on nerve cells. These and other hyperventilation-related physiological effects promote pathological changes and the advance of chronic health problems, such as cancer, heart disease and diabetes.
Is hyperventilation common in ordinary people?
Chronic hyperventilation is very common for ordinary people (or "normal subjects") these days. Their average minute ventilation values are much greater than the normal value, which used to be the norm about 80-100 years ago.
Minute ventilation (or respiratory minute volume, or flow of air) is the volume of air which can be inhaled (inhaled minute volume) or exhaled during 1 minute. It is used to measure one's degree of hyperventilation.
Prevalence of hyperventilation in the modern population
|
Based on standard deviations for the above studies related to normal subjects, we can state that over 90% of modern normal subjects breathe more than the medical norms. Therefore, more than 90% of modern normal subjects suffer from chronic hyperventilation. (One can also note that authors of modern yoga books claim that we need to breathe more and expel more CO2.) This YouTube video (on the right side) provides the definition and info about prevalence of hyperventilation: Hyperventilation. |
Technical note. If we consider Wikipedia or some other sources saying 5-8 or 6-8 L/min as a normal range for minute ventilation, then hyper means more than 8 L/min. With numerous studies that found about 12 L/min as an average and bell-shape or Gaussian distribution with standard deviation 2-3 L/min (also common), we know that about 90% will be in the range from 10 to 14 or 9 to 15 L/min. The remaining part will have less than the lower range 9 or 10, or higher than the upper range that 14 or 15 L/min. Therefore, less than 10% of subjects (even less than 5%) are within or less than the norm. We can get the same result even if you assume 6-9 or 5-9 as normal values. These are basics of the theory of probability.
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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