Breathlessness

Breathlessness is the feeling that breathing is more difficult or that you are not getting enough air. Some people feel they cannot breathe in deeply enough, while others become out of breath more quickly than normal or describe a feeling of pressure or tightness in the chest.

The medical term for breathlessness or shortness of breath is dyspnoea. Everyone is short of breath at times, for example after intensive sport, climbing stairs or heavy physical exertion. This is not immediately something to worry about and disappears on its own after a short period of rest. 

What does breathlessness feel like?

Not everyone experiences breathlessness in the same way. Possible symptoms are:

• Feeling you are not getting enough air.

• Difficulty breathing in or out.

• Breathing faster or more shallowly.

• Gasping for air.

• Being unable to take a deep enough breath.

• A feeling of pressure or tightness in the chest.

• Becoming out of breath more quickly than normal.

Some people are only short of breath during exertion. Others also experience it at rest, when lying flat or during the night.

Breathlessness sometimes occurs together with other symptoms, such as coughing, a wheeze, coughing up mucus, chest pain, palpitations, dizziness or tiredness.

Possible causes of breathlessness

There are many different causes of breathlessness. The cause is not always in the lungs. Conditions of the heart, problems with circulation, reduced fitness or tension can also cause shortness of breath.

Possible causes are:

• Asthma: the airways are inflamed and extra sensitive. As a result they narrow temporarily. During an asthma attack breathlessness increases suddenly. Coughing or a wheeze are often also present.

• COPD: a chronic lung disease in which the airways are permanently narrowed. Shortness of breath usually first occurs during exertion. Coughing, mucus and a wheeze also occur.

• Respiratory infection: a cold, flu, bronchitis or pneumonia can also be accompanied by breathlessness. In many cases there are also symptoms such as coughing, fever, mucus or feeling unwell.

• Heart problems: when the heart pumps blood around less effectively, breathlessness can occur that sometimes worsens during exertion or when lying flat.

• Pulmonary embolism: a blood clot blocks a blood vessel in the lungs. This brings sudden shortness of breath and chest pain.

• Anaemia: the blood can carry less oxygen. This regularly leads to tiredness, palpitations and shortness of breath during exertion.

• Allergic reaction: some severe allergic reactions cause swelling of the airways and lead to sudden breathlessness.

• Anxiety, stress or hyperventilation: tension causes someone to breathe faster or deeper with an incorrect breathing technique. The muscles around the chest and the airways are also more tense. This gives a strong feeling of a lack of air, dizziness and tingling as a result of hyperventilation.

• Reduced fitness or overweight: the body has to work harder while moving, causing someone to become short of breath more quickly. In addition, with overweight more weight presses on the chest, especially when lying down.

Several causes can sometimes play a role at the same time.

Breathlessness and coughing

Breathlessness and coughing often occur together. Coughing is a natural reaction by which the body tries to remove mucus, dust and other irritants from the airways.

The combination of breathlessness and coughing occurs, among other things, in asthma , COPD, a cold, bronchitis , pneumonia or an allergic reaction.

Contact the GP if the symptoms persist for a long time, get worse or occur together with fever, chest pain, coughing up blood or unexplained weight loss.

Wheezing (wheeze)

A wheeze is also called wheezing. During breathing, a high, whistling or wheezing sound can be heard. The sound usually arises because air flows through narrowed airways. The wheeze is usually most audible during exhalation.

A wheeze occurs regularly in asthma and COPD, but can also result from a respiratory infection, an allergic reaction or another narrowing of the airways. Sometimes the wheeze occurs together with coughing, chest tightness or breathlessness.

A wheeze does not always mean there is a serious condition. Do contact the GP if the wheeze is new, keeps coming back, does not disappear or occurs together with breathlessness.

Does the wheeze start suddenly and is someone severely short of breath? Then seek medical help immediately.

Breathlessness during exertion

It is normal to breathe faster and deeper during sport or heavy physical exertion. The muscles then need more oxygen. Breathing naturally becomes calmer when you stop moving.

Is the shortness of breath worse than normal? Or does the breathlessness already occur during light activities, such as a gentle walk, getting dressed or climbing stairs? Then it is wise to contact the GP.

What can you do yourself?

With mild breathlessness it helps to stop the activity and sit upright calmly. Some people find it helpful to lean slightly forwards and rest the arms on the thighs or on a table.

Try to breathe calmly. If needed, breathe in gently through the nose and out slowly through slightly pursed lips. Ensure fresh air and avoid smoke, dust and strong smells.

Do you have medicines for asthma or COPD? Then use them as prescribed.

Do symptoms persist, keep coming back or get worse? Then have them assessed by a doctor (GP).

When to seek emergency help?

Call the emergency number if someone:

• Is severely short of breath.

• Is hardly able to speak because of the breathlessness.

• Is bluish, purple or strikingly pale in colour.

• Is drowsy, confused or difficult to wake.

• Becomes suddenly short of breath and has chest pain or pressure on the chest.

• Faints.

• May have a severe allergic reaction.

• Is deteriorating rapidly.

Do not wait to see if severe symptoms will go away by themselves.