Breathing exercises for dysfunctional breathing/hyperventilation syndrome in adults

Abstract

Background: Dysfunctional breathing/hyperventilation syndrome (DB/HVS) is a respiratory disorder, psychologically or physiologically based, involving breathing too deeply and/or too rapidly (hyperventilation) or erratic breathing interspersed with breath-holding or sighing (DB). DB/HVS can result in significant patient morbidity and an array of symptoms including breathlessness, chest tightness, dizziness, tremor and paraesthesia.DB/HVS has an estimated prevalence of 9.5%in the general adult population, however, there is little consensus regarding the most effective management of this patient group.

Objectives: 1) To determine whether breathing exercises in patients with DB/HVS have beneficial effects as measured by quality of life indices. 2) To determine whether there are any adverse effects of breathing exercises in patients with DB/HVS

Search methods: We identified trials for consideration using both electronic and manual search strategies. We searched CENTRAL, MEDLINE, EMBASE, and four other databases. The latest search was in February 2013.

Selection criteria: We planned to include randomised, quasi-randomised or cluster randomised controlled trials (RCTs) in which breathing exercises, or a combined intervention including breathing exercises as a key component, were compared with either no treatment or another therapy that did not include breathing exercises in patients with DB/HVS. Observational studies, case studies and studies utilising a cross-over design were not eligible for inclusion. We considered any type of breathing exercise for inclusion in this review, such as breathing control, diaphragmatic breathing, yoga breathing, Buteyko breathing, biofeedback-guided breathingmodification, yawn/sigh suppression. Programs where exercises were either supervised or unsupervised were eligible as were relaxation techniques and acute-episode management, as long as it was clear that breathing exercises were a key component of the intervention. We excluded any intervention without breathing exercises or where breathing exercises were not key to the intervention.