Paradoxical Breathing: Causes and Treatment

Paradoxical breathing (seesaw breathing) means a reverse breathing pattern.

Paradoxical breathing (seesaw breathing) means a reverse breathing pattern when the chest rises during inspiration while the abdomen falls. In normal breathing, both chest, and abdomen rise. When you experience paradoxical breathing, take it seriously as it might be caused by lung ailments or chest injuries.

How Normal Breathing Works?

In normal breathing, the diaphragm controls the breathing and pulls down to make room for the lungs and chest to expand during inhalation. During expiration (exhaling air) – the diaphragm expands upwards, pushes air out and causes the chest to contract. On the other hand, in paradoxical breathing, this process is reversed – the chest expands during expiration and contracts during inspiration. Paradoxical breathing is normal babies but for adults and children, it means an underlying medical problem. When you experience seesaw breathing with breathing difficulties, call an emergency.

What is the Role of the Diaphragm in Breathing?

The diaphragm is indispensable for breathing. It consists of a domed muscle in the chest cavity base and separates the chest from the abdominal cavity. It contracts and expands the chest cavity to make exhalation and inhalation. In paradoxical breathing, the diaphragm is too weak to support the moving chest cavity base. In other words, it does not sync with the expansion of the chest.

Paradoxical Breathing: Causes and Symptoms

The following conditions may cause paradoxical breathing

  • Mineral deficiency: Deficiencies in magnesium, potassium, and calcium can affect breathing.
  • Chronic obstructive pulmonary disease (COPD): It involves symptoms such as chronic bronchitis, long-term mucus, and cough. COPD is caused by too much smoking, exposure to heavy amounts of pollution and second-hand smoke. 
  • Hormonal changes: Hormones constitute your body’s chemical messengers and they play an important role in everybody parts that includes the respiratory system. Changes in hormone balance can lead to changes in breathing patterns and paradoxical breathing. 
  • Flail chest or chest injury: If you had chest trauma, the section that separates your chest wall from ribs will not expand when you inhale. Likewise, it also occurs, when there’s a minimum of four rib fractures and a larger injury to the flail segment. 
  • Obstructive sleep apnea: Sleep apnea disrupts the exhalation of carbon dioxide and inhalation of oxygen.
  • Nerve disruption: Nerve damage can impact the normal function of phrenic nerves that control muscles in the torso and diaphragm movement. Further, nerve disruption is caused by neurodegenerative diseases like Guillain-Barre syndrome, chest injuries,  lung cancer, multiple sclerosis, and muscular dystrophy 
  • Respiratory muscle weakness: Weak muscles can impact the support of respiratory pathways. It occurs when there are conditions such as ALS and multiple sclerosis.
  • Diaphragm paralysis: Caused by illness to the muscle where it connects diaphragm to the brain and damage to the spinal cord.
  • Respiratory failure: Shortness of breath and fatigue the intercostal muscles can lead to seesaw breathing or paradoxical breathing. 
  • Pyopneumothorax: It’s an ailment where pus collects in the pleural cavity.   or pleural empyema impacts efficient breathing and thus lead to paradoxical breathing.
  • Electrolyte imbalances: Metabolic disorders, vomiting, malnutrition, and diarrhea can cause body electrolyte imbalances and respiratory problems. 
  • Airway blockages: Blockages in the nose, throat, upper windpipe, the upper airway can lead to paradoxical breathing. 

Symptoms Of Paradoxical Breathing

  • When you got paradoxical breathing, you have a poor oxygen inhalation.
  • Hypersomnia or oversleeping
  • Nighttime sleep disruption
  • Exhaustion and fatigue not relieved by sleep
  • Tachypnea or abnormal fast breathing
  • Seesaw like the pattern of breathing – Chest rises and abdomen lowers.
  • Weakness, pain, and tension in the stomach and chest.

How it’s Diagnosed?

Your doctor may diagnose you with the following: 

  1. Chest X-rays and other imaging tests.
  2. Chest ultrasounds
  3. Test for vital capacity that measures how much air your lungs can release
  4. Blood test for electrolyte and hormonal imbalances.

The Bottom Line 

Paradoxical breathing as it might be caused by a larger underlying respiratory condition should be taken seriously. 

How It’s Treated?

Treatments may depend upon the severity of the underlying causes. The following are the possible treatments:

  1. Tracheotomy – the use of a breathing tube inserted in the windpipe.
  2. Oxygen mask
  3. Repair of injured diaphragm and chest.
  4. Removing and treating airway blockages.
  5. Treating sleep apnea by using a breath support machine during the night and weight loss.
  6. Taking intravenous fluids to replenish lost electrolytes.

The Bottom Line: How can I Avoid Paradoxical Breathing?

You can’t avoid paradoxical breathing if you have an underlying medical condition but you can avoid it by following a safe and healthy lifestyle that includes the following:

Keep hydrated

Your lungs like the rest of your body contain body fluids. The water keeps the mucous lining thin that helps the lung function better.

Avoid smoking

When you smoke, you’re sending toxic chemicals down to your lungs and thus risking respiratory ailments. When you’re already smoking, quitting gradually can help you regain a healthy lung.

Breathe deeply

Take deep breath exercise that includes counting 1 to 4 while inhaling and counting again 1 to 8 while exhaling. According to the American Lung Association, deep breathing can increase the lung capacity, increase oxygen intake and benefit lung function.

Avoid polluted place

Stay away from areas where there are second-hand smoke and smog from factories. If you can’t avoid such an area, you may stay indoors or wear a mask with a filter. Likewise, avoid pollutants such as artificial candles and air fresheners that contain benzene and formaldehyde. Clean your room to remove pet dander, dust, and mold.

Install an exhaust fan and outlets 

They increase ventilation and help reduce indoor pollutants. 

Observe safety measures

Wear chest protection when you’re in contact sports, riding a bicycle or motorcycle.

Eat foods for lung health

Foods that benefit lungs include apricots, fatty fish, water, berries, beans, ginger, nuts, beans, seeds, grapefruit, onions, carrots, pumpkins, curry, and chili.

Eat foods rich in anthocyanins ( a kind of flavonoid)

It reduces symptoms of chronic obstructive pulmonary disease that might cause paradoxical breathing. Foods rich in flavonoids include oranges, garlic, dark cherries, bilberries, grapefruits, garbanzo beans, sweet potatoes, onions, quinoa, tomatoes, parsley, broccoli, basil, cilantro, and red cabbage. 

Take exercise

Benefits your lungs by taking more oxygen.

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