Hyperventilation: Signs, Causes and When to Get Help
Hyperventilation means breathing too fast or deep, causing dizziness, tingling and panic. Learn the signs, causes, how to stop it and when it is an emergency.
Hyperventilation is breathing faster or deeper than your body needs, which lowers carbon dioxide in the blood. It causes dizziness, lightheadedness, tingling in the hands and lips, chest tightness, a racing heart and a feeling of not getting enough air. It is most often triggered by anxiety or panic and can be stopped by slowing your breathing, especially lengthening the exhale.
Key takeaways
- Hyperventilation is overbreathing, not a lack of oxygen.
- Low carbon dioxide causes tingling, dizziness, muscle cramps and chest tightness.
- Anxiety and panic are the most common causes, but medical problems can also cause it.
- Slow breathing (in for 4, out for 6 to 8) usually brings relief within minutes.
- Breathing into a paper bag is no longer recommended.
You suddenly cannot catch your breath. You gulp air, but it never feels like enough. Your fingers tingle, your head spins and your chest feels tight. That frightening experience is often hyperventilation, and paradoxically, the problem is breathing too much, not too little.
This guide explains what hyperventilation is, what causes it, how it connects to panic attacks and anxiety, how to stop it, and when it is a medical emergency.
What is hyperventilation?
Normally your breathing balances oxygen in and carbon dioxide (CO2) out. When you breathe too fast or deeply, you blow off too much CO2. Low CO2 (hypocapnia) changes blood pH and narrows blood vessels to the brain, which explains the dizziness and tingling. Hyperventilation syndrome describes repeated episodes, usually linked to anxiety.
Signs and symptoms
- Feeling short of breath or “air hunger”
- Rapid or deep breathing, frequent sighing or yawning
- Dizziness, lightheadedness or feeling faint
- Tingling or numbness in fingers, toes or around the mouth
- Chest tightness or pain
- Racing or pounding heart
- Muscle cramps or stiff hands
- Dry mouth, bloating, belching
- Feeling detached, anxious or panicky
What causes hyperventilation?
| Type | Common causes |
|---|---|
| Emotional | Anxiety, panic attacks, stress, anger, fear |
| Medical | Asthma, COPD, lung infections, blood clots in the lungs, heart problems, diabetic ketoacidosis |
| Other | Pain, fever, high altitude, pregnancy, some medications or stimulants |
Because hyperventilation can signal a medical emergency, new or unexplained episodes should be checked by a doctor.
How to stop hyperventilating
Recognize it
Tell yourself: “I am overbreathing. I have enough oxygen. This will pass.”
Slow breathing with a long exhale brings carbon dioxide back into balance. Breathe through your nose
Close your mouth and breathe gently through your nose.
Lengthen your exhale
In for 4 seconds, out for 6 to 8 through pursed lips. Repeat for several minutes.
Belly breathing
Place a hand on your belly; let it rise as you inhale, keeping your chest still.
Ground yourself
Focus on what you can see, hear and feel around you.
Avoid the paper bag
Rebreathing into a bag is no longer recommended because it can lower oxygen dangerously, especially if the cause is medical.
Hyperventilation, anxiety and panic
Anxiety and hyperventilation feed each other: anxiety speeds breathing, overbreathing causes frightening sensations, and those sensations increase anxiety. Many people with anxiety or panic disorder chronically overbreathe without noticing. Breathing retraining and CBT break this loop.
Who gets hyperventilation?
It is common in people with anxiety and panic disorders, and more frequent in women and young adults. People with asthma may experience both asthma and anxiety-related overbreathing, so it is important to know which is which.
When hyperventilation is an emergency
Call 911 if you have chest pain or pressure, blue lips, fainting, confusion, high fever, coughing up blood, breathing trouble that does not improve with slow breathing, or if it is your first episode and you are unsure of the cause.
Treatment for recurring hyperventilation
- Breathing retraining: practicing slow, nasal, diaphragmatic breathing daily
- CBT: for anxiety and panic that trigger episodes
- Medication: SSRIs and other options for underlying anxiety or panic disorder
- Treating medical causes such as asthma
How GraceBridge Psychiatry can help
GraceBridge Psychiatry provides secure online psychiatric care for adults in Texas, Arizona and Washington. Care starts with a comprehensive psychiatric evaluation, followed by a personalized treatment plan that may include therapy referrals, lifestyle strategies and medication management when appropriate. Learn more about how we treat panic disorder. Most new patients are seen within days. See insurance we accept and self-pay pricing.
- Free consultation call: tell us what is going on.
- Book your evaluation: meet a board-certified provider by secure video.
- Get your plan: clear next steps and follow-up until you feel better.
Frequently asked questions
What is hyperventilation?
Breathing faster or deeper than your body needs, which lowers carbon dioxide and causes dizziness, tingling and breathlessness.
What does hyperventilation feel like?
Air hunger, dizziness, tingling in hands or around the mouth, chest tightness, a racing heart and anxiety.
How do you stop hyperventilating?
Breathe through your nose, slow your breathing and lengthen your exhale (in 4, out 6 to 8), and focus on belly breathing.
Is hyperventilation dangerous?
Anxiety-related hyperventilation is uncomfortable but usually not dangerous. It can, however, signal serious medical problems, so new or severe episodes need evaluation.
Should I breathe into a paper bag?
No. This is no longer recommended because it can lower oxygen, especially if a medical problem is the cause.
Can anxiety cause hyperventilation?
Yes. Anxiety and panic are the most common causes.
Why do my hands tingle when I hyperventilate?
Low carbon dioxide changes blood chemistry and nerve excitability, causing tingling and sometimes cramping.
How long does hyperventilation last?
Episodes usually last a few minutes to half an hour and ease as breathing slows.
What is hyperventilation syndrome?
Repeated episodes of overbreathing, usually related to anxiety, that cause recurring physical symptoms.
Can you faint from hyperventilating?
Some people feel faint or occasionally faint due to reduced blood flow to the brain. Sit or lie down.
Is it hyperventilation or asthma?
Asthma often involves wheezing and improves with inhalers; anxiety-related overbreathing often includes tingling and improves with slow breathing. A doctor can help tell them apart.
Can hyperventilation happen at night?
Yes, especially with nocturnal panic attacks, nightmares or sleep apnea.
How can I prevent hyperventilation?
Practice slow breathing daily, manage anxiety, avoid excess caffeine and get treatment for underlying conditions.
When should I go to the ER for hyperventilation?
For chest pain, fainting, blue lips, confusion, symptoms that do not improve, or a first unexplained episode.
Can therapy help hyperventilation?
Yes. CBT and breathing retraining are very effective when anxiety or panic is the cause.
Sources
- MedlinePlus. Hyperventilation
- Cleveland Clinic. Hyperventilation
- Meuret AE, et al. Respiratory biofeedback-assisted therapy in panic disorder. Behav Modif. 2001;25(4):584-605.