Stress and Symptoms

Poor Breathing and symptoms


30 years of physiological research  points to many symptoms triggered, caused or exacerbated by dysfunctional breathing.  Several papers outlining the implications of hypocapnia, the condition caused by over-breathing, are listed and linked in the white paper section below.  The specific symptoms that show up in an individual will be a function of genetics, physiological health (respiratory fitness being a key marker of that health), the extent of over-breathing and other contributing factors (i.e. nutrition, inflammation toxins, hydration, mineral deficiencies, etc).  To move away from symptoms and toward optimal health a good place to start is with assessment and education (for a deeper dive into habits that will dramatically give health a boost, see   The second step is ensuring that behaviors or triggers that create the conditions and health risks are removed…. especially those that cause inflammation.  For example cigarette smoke, pet dander, toxins, foods or drinks all can cause an allergenic or inflammatory response that should be avoided or removed as soon as detected.  The third is building more robust physiology and mental balance to shield against dips in these other variables and keep your vehicle (you) running smoothly for many many years.


Responses to the questionnaire below (downloadable by clicking on this link) will provide a better idea of whether life can be improved through breathing modification.  Place a 0,  1 or 2 next to each item below with regard to severity or frequency (1 being occasionally; 2 is often).   Double the score for those answers in italics and add up your score.

  • Intentional breathing, purposeful regulation
  • Wheezing and/or constricted airways
  • Snoring
  • Anxiousness/Over-arousal and/or anxiety
  • Dry or pasty mouth upon waking in the morning
  • Dizziness, light-headedness, fainting
  • Rapid breathing, panicky breathing,
  • Fatigue easily, winded when going up a flight of stairs
  • Worried about breathing
  • Shortness of breath, difficulty breathing
  • Tingling or numbness, e.g., fingers, lips
  • Congestion
  • Unable to breathe deeply
  • Chest breathing, effortful breathing
  • Breath holding, irregular breathing
  • Chest tightness or pressure
  • Daytime mouth breathing
  • Cold hands or feet when the environmental temp is above 70°F
  • Can’t seem to get enough oxygen when doing light chores or walking
  • Deep or irregular breathing, like during talking
  • Altitude Sickness
  • Muscle pain, stiffness, e.g., hands, jaw, back
  • Disconnected, aloof, things seem distant
  • Fast or irregular heartbeat
  • Poor concentration, focus, memory
  • Blurred or hazy vision
  • Disoriented, confused
  • GI issues such as nausea
  • Unexpected mood changes (e.g. anger or irritability)
  • Hypertension/High blood pressure


18 or more:  Your current breathing patterns appear to be stressing out your physiology. Health, performance and well-being (H, P & WB) have been compromised. Confirm by running a quick RF test.  Can you comfortably hold your breath for at least 10 to 15 seconds after a normal ½ exhale?   Do not take a larger than normal inhale prior to this exercise. Stop timing at the first urge to breathe.  If RF is under 15 seconds, habit change (RF training and additional Better Being practices) should be a priority to improve health and performance.  If diagnosed with a formal condition, consult with your doctor prior to undertaking RF training.   If RF is 15 seconds or more and this level of symptoms are present, consider an in-person or web-based consultation with to improve RF.

11 – 17: There is a high probability that your current breathing is deteriorating H, P & WB. This can be confirmed by a capnometry assessment or the RF test.  RF training and Better Being practices are highly recommended.

2 – 10:  Depending on symptoms, your breathing may be compromising  H, P & WB. A capnometry assessment or the RF test will confirm your level of respiratory fitness and whether sub-par breathing and poor CO2 adaptation are stressing internal chemistry and physiology. If your respiratory fitness level is above 30, consider advanced RF training and Better Being practices to move from healthy to bulletproof.

Note: Capnotraining, RF training and Better Being practices are not treatments.  They are guidance and training toward behaviours that will move health and performance in the right direction.

Bronchial Constriction

 From a physiological standpoint, unbalanced pH and low CO2 brought on by over-breathing or environmental triggers (e.g. allergies) result in vasoconstriction of the smooth muscles in the airways.  In susceptible individuals, this leads to bronchial constriction/asthma making it more difficult to breathe. To compound matters, shortage of air can create a psychological component (i.e. anxiety) resulting in further over-breathing and an increased heart-rate –in spite of airway restriction.  Capnometry has been researched as one means of reducing asthma-related symptoms.     Beyond Capnometry training, RF training renormalizes breathing and builds a more robust buffer system so that pH imbalances and vasoconstriction do not occur as readily when environmental or  mental triggers are present.   As an asthmatic myself back in the day (author of website speaking now), it took a number of lifestyle and habit changes to eradicate all asthmatic and sinus congestion/inflammatory symptoms.  Changing my breathing habit was a big part of the solution … especially for exercise induced asthma.  I am happy to share more details and ideas in a consultation session.


Breathing Exercises and/or Retraining Techniques in the Treatment of Asthma: Comparative Effectiveness

Breathing retraining for dysfunctional breathing in asthma: a randomised controlled trial

Controlling Asthma by Training of Capnometry-Assisted Hypoventilation (CATCH) vs Slow Breathing

Breathing training for dysfunctional breathing in asthma: taking a multidimensional approach

** Dysfunctional Breathing in Children and Adults with Asthma

**  Treatment suggested toward the end of this research paper:

“The intervention most commonly used for breathing pattern disorders is breathing retraining exercises. Pediatric studies
are limited to reports of case series (51), but a large adult clinical trial in which asthmatics were taught by a trained
physiotherapist or used a self-help online programme reported significant improvements in quality of life scores compared to
placebo (52). A smaller randomized controlled trial also reported positive results (53). A number of adult studies evaluating yoga
and including yoga breathing techniques have shown small improvements in quality of life in unselected populations of asthmatics (54)”

Yoga therapy is risky as many yoga practices advocate deep breathing which can exacerbate asthmatic symptoms.  Those referred to in this article are likely very specific practices that may offer partial results of Respiratory Fitness Training.

Symptom  Correlations

There appears to be a common thread between asthma, anxiety, and panic (see Katon Research Article 2004). Unbalanced physiology could certainly contribute to the correlation.  Lack of CO2 adaptation/respiratory fitness moves the bicarbonate buffer system toward the edge of the buffer zone (see FAQ’s).  Small changes in the external or internal environment –including one’s CO2 level itself in the case of panic attacks according to research— now send physiology beyond limits where symptom flares arise. These symptoms can be in the form of anxiety, panic, asthma or combination thereof.  Unfortunately, this can, in turn, can create more stress and dysfunctional breathing — potentially creating a vicious cycle where both the mind and the nervous system are triggered toward suffering.   Episodic events – whether it be anxiety or an asthma attack –are challenging to escape without proper coping skills or medications. One solution is to avoid all triggers.  This option presents its challenges unless one is living in a bubble and has a settled mind.  A second is to always have rescue medications on hand or take preventative medication to keep symptoms under control.  This strategy has its own long-term health implications and associated costs.  A third is to train underlying physiology and mental balance into a more robust state.   See Technologies and Services for more information on Better Being Training when ready for this more holistic approach.


Sleep Issues

Association of Low PaCO2 with Central Sleep Apnea and Ventricular Arrhythmias in Ambulatory Patients with Stable Heart Failure


Part of the problem is that there is no one thing called sleep and there is no one thing called a sleep disorder.  The kind of disorders treated at a sleep clinic, namely the assessment and management of sleep apnea probably don’t respond well to behavioral interventions of any sort including neurofeedback.  That is typically about 5% of the cases.  Most of the other 95% involve sleep onset which is commonly but poorly treated by medications because virtually every medication that helps us get sleepy also disrupts 1 or more phases of sleep (that is the 4 stages of non-REM sleep plus REM sleep).  Neurofeedback, especially Alpha up training or Alpha and Theta Up training have a long history of jury-journal research establishing that these protocols foster relaxation to include reduced muscle tension, reduced sympathetic arousal and cortical disengagement from processing sensory stimulation and emotional stimulation (essentially because a normal brain in and eyes-closed rest condition spontaneously generates large posterior alpha waves initially until moving into stage 1 sleep, wherein Posterior Theta becomes conspicuous).  What many physicians don’t know is that since the mid-1960’s. neurofeedback has established that it can train brain wave patterns towards normalcy in the case of insufficient Alpha or Theta.  Hence this kind of intervention could be great for reducing sleep onset time.  Another significant class of sleep disorders involves sleep fragmentation, wherein a person may have no difficulty getting to sleep, but wakes frequently due to sleep fragmentation rather than apnea.    When sleep fragmentation is an issue, in many cases due to dysregulated breathing or trips to the bathroom,  modifying behavior through breathing retraining and development of respiratory fitness  … as well as sleep positioning can be most helpful to wakefulness in the night.  Your breathing coach can assist with all of this and can in some cases assist with apnea as well.



Jerry R. DeVore, PhD, ABPP, BCB, BCN

Clinical Psychologist

Additional Studies & White Papers

CapnoLearning: Respiratory Fitness and Acid-Base Regulation by Peter M. Litchfield PhD.

Better Chemistry Through Breathing: The Story of Carbon Dioxide and How It Can Go Wrong  


 The following papers provide insight into the many complications associated with over-breathing/Hypocapnia

Hypocapnia Overview – Medical Progress in the New England Journal of Medicine

Discussion Paper:   Breathing pattern disorders and physiotherapy: inspiration for our profession

Hypocapnia and mental stress can trigger vicious circles in critically ill patients due to energy imbalance: a hypothesis presented through cardiogenic pulmonary oedema

Hypocapnia and the injured brain: more harm than benefit

Mouth Breathing

The effect of mouth breathing versus nasal breathing on dentofacial and craniofacial development in orthodontic patients.

 Care of nasal airway to prevent orthodontic problems in children. 



Breathing Pattern disorders and Functional Movement

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