Breathing Pattern Disorder (BPD)

Breathing is automatic—but the way we breathe can change in response to stress, illness, injury, asthma, poor breathing habits, or repeated episodes of breathlessness.

Over time, breathing may become unnecessarily fast, shallow, effortful, or dominated by the upper chest. These patterns can become habitual, particularly during exercise or other situations that increase respiratory demand.

This is sometimes referred to as breathing pattern disorder (BPD) or dysfunctional breathing.

BPD does not necessarily mean there is something structurally wrong with your lungs. Instead, the problem may be how your breathing system is functioning and responding to demand.

Breathing pattern disorder and exercise-induced laryngeal obstruction (EILO) are not the same condition.

With EILO, the problem occurs at the level of the larynx, where abnormal narrowing of the upper airway during exercise can make it difficult to get air in.

With BPD, the primary issue is the pattern and coordination of breathing.

However, the two can coexist.

An athlete who experiences repeated episodes of airway restriction or breathlessness may develop compensatory breathing patterns over time. Conversely, an inefficient breathing pattern can contribute to increased respiratory effort and discomfort during exercise.

This is why understanding the whole breathing system is important.

BPD can also be confused with exercise-induced bronchoconstriction (EIB), sometimes referred to as exercise-induced asthma.

EIB involves narrowing of the lower airways during or after exercise.

BPD involves an inefficient or dysfunctional breathing pattern.

Symptoms can overlap, including:

• Shortness of breath
• Chest tightness
• Coughing
• Difficulty exercising
• Feeling unable to get enough air

Some athletes may have asthma or EIB, BPD, EILO, or a combination of conditions.

When symptoms do not fit a typical asthma pattern — or do not adequately respond to an inhaler — it may be important to consider other contributors to exercise-related breathlessness.