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Pathological Reflexes: Hyperventilation & Main Primitive Reflexes

Man with overbreathing (primitive pathological reflex)A reflex is an involuntary and almost instantaneous (muscular) reaction in response to a stimulus. Among all primitive and pathological reflexes, hyperventilation is the main primitive reflex of the nervous system. This autonomic pathological reflex is highly prevalent these days in a chronic form: chronic hyperventilation is present in over 99% of subjects with diseases.

Minute ventilation rates (chronic diseases)

Condition Minute
Number of
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

Note that advanced stages of asthma can lead to lung destruction, ventilation-perfusion mismatch,
and arterial hypercapnia causing further reduction in body oxygen levels.

Note that breathing more air at rest reduces oxygen levels in cells of the body.

During evolution of life on Earth, most of the time our lungs were developing and evolving in conditions when the CO2 content in outer air was very high: up to 7-12% during the first stages of lung development in primitive creatures living 2-3 billion years ago. Oxygen content in primitive air was very low (about 1% or less during the first stages of evolution before and after appearance of green cells with chlorophyll). During these stages of evolution the process of control of breathing by the autonomic nervous system was also developed. Since this primitive air had very little O2 and high CO2, our evolutionary predecessors could get more oxygen in tissues only by breathing more. Therefore, breathing more air in the past was beneficial for survival.

Composition of air in atmosphere (past and now) and cells of the human body

 CO2 and oxygen: Evolution of air composition on Earth

Any stressful situation, fight, flight, search for food, digestion, mating, playing, and any other activity required more oxygen. How? By breathing more. Hence, hyperventilation became the most fundamental primitive reflex of the autonomic nervous system, as soon as first lungs (or prototypes of human lungs) appeared on Earth. Only totally peaceful, stress-free rest had low metabolic rates when heavy breathing could not provide any advantages for survival.

Effects of air changes on pathological reflexes

However, the modern air composition is very different: modern air is hyperoxic (too much oxygen as leading respirologist agree) and almost no CO2. Therefore, from being advantageous, hyperventilation became the main pathological reflex since it reduces O2 levels in body cells. It is unlikely that there are any other equally destructive pathological reflexes.

This pathological reflex to hyperventilate is now more fundamental for humans than all other pathological reflexes, instincts and drives: to drink, eat, mate, and other primitive reflexes. Why is it so? This is because when the human baby is born, the first things it starts to do is to breathe deeply as if expecting that air has very little O2 and a lot of CO2. (All developing or survived human cultures and tribes have used swaddling of infants to ensure their survival and good health, as we discussed before.)

Most sick people (over 90%) die due to the same pathological reflex of the autonomic nervous system: hyperventilation. This primitive reflex again gains control over the human brain and autonomous nervous system during last days/weeks of life. As a result, the dying sufferers frantically gasp for more air, as if expecting to get more oxygen (see Heavy Breathing Pattern - Highest Mortality Rates). Hence, hyperventilation is the main among in-built primitive pathological reflexes of the autonomous nervous system.

For the list of the quoted references click here.

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