Ineffective Breathing Pattern: Causes and Solutions
By Dr. Artour Rakhimov - Last updated on August 9, 2018
pattern is a term that is often used in medical articles for nurses in
order to describe a breathing pattern with reduced respiratory rate and reduced
tidal volume, as if this is the main respiratory problem for people with chronic
health problems. Other people may imply that this term can also relate
to chest breathing or mouth breathing.
Usually such articles about ineffective breathing pattern (intended for nurses)
do not provide any clinical evidence or references. What do we know about
breathing in the sick? Do they indeed breathe too little air and require
A typical respiratory rate in the sick is about 15-20 breaths/min and the
tidal volume is about 700-900 mL. When patients get even sicker, their
respiratory rate is even higher, while the tidal volume may get reduced.
Therefore, we see that the term "ineffective breathing pattern" is
used to confuse nurses with an attempt to promote an idea that sick people
do not get enough oxygen because they breathe too little air. The real story
is the opposite. They do not get enough O2 in their cells due to hyperventilation.
There is no evidence that sick people and even severely sick
people commonly breathe too little air (hypoventilation).
Cases with reduced ventilation or hypoventilation do exist, but they are
rare. Hypoventilation normally leads to alveolar hypercapnia and arterial
hypercapnia which can easily be confirmed by arterial CO2 measurements.
Over 95% of sick people suffer
from too heavy and fast breathing that is
the real ineffective breathing pattern. Let us consider it in more detail.
For sick people, with
their ineffective breathing pattern, the durations of inhalations and
exhalations, breathing rate, amount of air inhaled per breath and other
parameters are individual. Many sick people can have the following
parameters of their breathing cycle (see the Figure below):
- inhalation (about 1.5-2 s)
- exhalation (1.5-2 s)
- no automatic pause (2 s in healthy subjects)
- the depth of
inhalation or tidal volume is about 700-1,000 ml instead of 500-600 ml (the
- the respiratory rate
is 15-20 breaths/min (usually over 25 breaths/min for the severely sick) instead
of the normal 12 breaths/min at rest for a 70-kg person
- the body oxygen level (found with a special DIY breath holding time test)
is less than 20 s. Hence, they breathe too deep and too fast in
comparison with the normal breathing pattern.
There are 2 common aggravating factors of the ineffective breathing pattern, apart from hyperventilation, that drastically reduce O2 transport:
mouth breathing and chest breathing. (For their effects, see links below.)
Fig. Ineffective breathing pattern, typical for the sick: deep and heavy
breathing pattern; deep, forceful, and fast inhalations and exhalations, no
automatic pause. Hypocapnia (CO2 deficiency) reduces blood oxygenation and the
CP (cells oxygen level).
Hence, all medical evidence and clinical experience show that sick people, with chronic health problems, have a heavy and deep ineffective breathing pattern.
This video clip from YouTube (Breathing
Patterns and Buteyko Oxygen Test (Buteyko Technique)
explains the link between the ineffective
breathing pattern (present in most sick people) and body oxygenation test results.