Shortness of breath occurs when air has difficulty reaching the lungs, which can happen with excess exercise, anxiety, nervousness, bronchitis or asthma, in addition to other more serious situations that require medical assessment.
When experiencing shortness of breath, you should sit down and try to keep calm. If the shortness of breath does not resolve within half an hour or, you should proceed to the emergency room.
During you assessment, it is important that you tell your doctor how often shortness of breath occurs and how severe it gets to help reach a diagnosis. Testing may be ordered, like bloodwork, chest x-ray, ECG or spirometry, to identify the cause, which will help guide the appropriate treatment.
Some of the most common conditions or reasons for shortness of breath are:
1. Stress and anxiety
Emotions are one of the most common causes for shortness of breath in otherwise healthy people, especially in adolescents and young adults. Many people experience difficulty breathing with anxiety, excess stress or during a panic attack.
What to do: It is important to seek psychological assistance to help you cope with problems that can impact your health. You should also engage in regular physical activity and maintain a healthy diet. Relaxing teas may also be helpful, as well as soothing herbs like chamomile and valerian.
2. Excess physical activity
People who are out-of-shape may feel shortness of breath when starting any activity, especially when walking or running, due to decreased conditioning. People who are overweight may also be affected, but shortness of breath can also happen to people with a healthy body weight.
What to do: In this case, you should continue to engage in regular physical activity so that your heart, lungs and other body muscles can keep up with the higher oxygen demand.
3. Pregnancy
Shortness of breath is common after 26 weeks due to the growth of the fetus, which displaces the diaphragm and results in less space for the lungs to expand.
What to do: You should sit in a comfortable chair with your back supported, close your eyes and concentrate on your breathing. Try to inhale and exhale deeply and slowly. Ensure you are well-supported by pillows when you are sleeping.
4. Cardiac problems
Cardiac problems, like heart failure, can cause shortness of breath on exertion, like getting up from bed or going up stairs. Normally, people with a cardiac condition will experience worsening shortness of breath over time. They may also feel chest pain, like angina.
What to do: You should follow treatment as indicated by your doctor, which generally involves the use of medications. You should also be aware of what symptoms may indicate a heart.
5. COVID-19
A COVID-19 is an infection caused by a coronavirus, specifically SARS-CoV-2. Symptoms can vary from person to person, ranging from a mild flu to a more serious pneumonia, which can include shortness of breath in some people.
In addition to shortness of breath, people with COVID-19 may also present with headache, high fever, general malaise, muscle pain, loss of taste or smell, and dry cough. More severe symptoms will occur more frequently in people with a history of nervous system illnesses or who are older in age. Healthy people are still prone to developing more serious symptoms, however, therefore it is important to adopt behaviours that prevent infection.
What to do: If you suspect you have been exposed to COVID-19 or if you have symptoms, you should inform your public health authorities so that you can complete a test and confirm diagnosis.
If you test positive, you should remain in isolation from others and communicate your result to anyone you may have come in contact with.
6. Respiratory illnesses
A cold or flu, especially in people who have high quantities of phlegm, may result in shortness of breath and coughing. However, certain conditions, like asthma, bronchitis, pneumonia, pulmonary edema or a pneumothorax can also make breathing difficulty. The following is a list of respiratory conditions and how each one presents with shortness of breath:
- Asthma: Difficulty breathing starts suddenly, and can feel like suffocation or cause chest pain. Symptoms like coughing and prolonged expiration may also occur.
- Bronchitis: Difficulty breathing is directly related with phlegm in the airways or lungs.
- COPD: Shortness of breath begins slowly and worsens over days. It normally affects people with a history of bronchitis or emphysema. It occurs with a strong, productive cough and prolonged expiration.
- Pneumonia: Shortness of breath comes on gradually and worsens overtime. You may also experience back or lung pain when breathing, fever and a cough.
- Pneumothorax: Shortness of breath starts suddenly and is associated with back or lung pain with breathing.
- Embolus: Shortness of breath starts suddenly. This condition mostly affects people who recently underwent surgery, people who are on bedrest, and women who take birth control. It can also occur with coughing, chest pain and fainting.
What to do: With a cold or flu, you can take cough syrup to improve the cough. Learn about the different medicines available for different types of cough. You can also perform nasal irrigations to improve your breathing. More serious conditions require monitoring by a doctor, with appropriate treatment that involves medication and respiratory therapy.
7. Objects in the airway
With objects in the airway, shortness of breath emerges suddenly. It can feel like something is in the nose or throat, and can occur with eating. Generally, you may hear a slight breathing sound, or it may be impossible to talk to cough. Babies and children are most affected, although this can also happen to people who are bed-bound.
What to do: When an object if found in the nose or can be easily removed from the mouth, you can try to retrieve it very carefully using tweezers. It is safest to lay the person on their side to remove objects obstructing the airway. If you are unable to retrieve the object, you should call for medical assistance immediately.
8. Allergic reaction
In this case, shortness of breath starts suddenly. It can be triggered by a medication, a food or insect bite.
What to do: People with serious allergies will carry an Epi Pen with them to use in case of emergency. It can be used immediately at the first sign of allergy. Once used, you should call for medical assistance. If an Epi Pen is not available, or if the allergy was not previously known, you should call an ambulance or proceed immediately to the emergency
9. Obesity
Excess weight and obesity can also cause shortness of breath when lying or sleeping. Extra weight can diminish the lungs’ capacity to expand with inspiration.
What to do: In order to breathe better with less effort, you can use extra pillows to sleep in a more upright position. The priority here would be to lose weight, with guidance from a registered dietitian.
10. Neuromuscular disease
Myasthenia gravis and amyotrophic lateral sclerosis can cause shortness of breath due to decreased weakness in the muscles that help with breathing.
What to do: You should follow the treatment plan indicated by your doctor. It usually involves the use of medication and frequent follow-up to monitor, so that medication can be adjusted as needed.
11. Paroxysmal nocturnal dyspnea
Paroxysmal nocturnal dyspnea this is one of the common causes of shortness of breath at night that happens while sleeping. It can make sleeping difficult, and is usually associated with cardiac problems or respiratory illnesses like chronic bronchitis or asthma.
What to do: In these cases, you should consult a doctor to order appropriate testing for diagnosis. Treatment will be based on the results.
What to do immediately
If you feel shortness of breath, the first step is to maintain calm and to sit in a comfortable place. Close your eyes so that you can concentrate on your breathing. Then, you should focus your attention on the air entering and exiting your lungs so that you can regulate your breathing.
If your shortness of breath is due to a temporary illness, like a cold or flu, you can do at-home inhalations with eucalyptus tea vapor to unblock your airways, which will help to restore airflow and decrease discomfort.
If your shortness of breath is due to a more chronic condition, like asthma or bronchitis, you may need to use medications specifically prescribed to restore airway flow, like bronchodilators or steroids.
