Dysfunctional breathing and its impact on asthma control in children and adolescents

Abstract

Background: Dysfunctional breathing (DB) has been shown to negatively affect asthma control in adults, but for children and adolescents, the knowledge is scarce.DB is among others characterized by dyspnea and hyperventilation. The Nijmegen Questionnaire (NQ) is often used as a marker for DB. We conducted a cross-sectional survey to estimate the prevalence of DB in patients with asthma in a pediatric outpatient clinic and to determine the impact of DB on asthma control.Methods: Patients between 10 and 17 years were invited to complete the NQ and the Asthma Control Questionnaire (ACQ) and report the use of beta2 agonist (β2).Spirometry data and prescribed asthma medications were noted from the patient record.Results: Three hundred and sixty-three patients (180 boys) completed the survey.Sixty-seven patients (18%) scored ≥23 points in the NQ predicting DB. The DB group was older (median (range)) 15.

Dysfunctional Breathing in Children: A Literature Review

“…Additionally, the Forced Expiratory Volume in one second percentage (FEV 1 %) was higher in the DB group (mean (SD): 89.4 (9.0) vs. 85.7 (11.8), p < 0.02). The Asthma Control Questionnaire (ACQ) score (median (range): 2.0 (0-4) vs. 0.6 (0-3.4), p < 0.01) and the use of beta2 agonist (median (range): 2 (0-56) vs. 0 (0-20) puffs/week, p < 0.01) were also higher in the DB group [12].…”

Progress in diagnosis and treatment of difficult-to-treat asthma in children

“…The most typical symptoms include dyspnea (both at rest and during exercise), chest tightness, chest pain, yawns, heavy sighs, and hyperventilation. 133 It includes respiratory pattern disturbance, hyperventilation syndrome, and malfunction of the vocal cords. 134 DB is one of the risk factors for poor symptom control and quality of life in patients with asthma.…”

“… 137 A recent study discovered that roughly 18% of children with asthma had DB. 133 Given that the participants in the earlier trial were younger, the gap can likely be attributed to age differences.…”

Puzzled by dysfunctional breathing disorder(s)? Consider the Bayesian brain hypothesis!

“…There is currently growing interest and awareness concerning dysfunctional breathing disorder(s) (DBD), an umbrella term (used throughout this article) for a set of poorly distinguishable clinical conditions including the most emblematic and anciently known hyperventilation syndrome. Either in isolation or in combination with other diseases, notably asthma ( Thomas et al, 2001 , 2005 ), DBD affects in a variable proportion (between 5 and 35%) both adults ( Thomas et al, 2001 ; Agache et al, 2012 ; Connett and Thomas, 2018 ) and children ( D'Alba et al, 2015 ; Connett and Thomas, 2018 ; Vahlkvist et al, 2023 ) in a variable proportion (between 5 and 35%), with a highly negative impact on health-related quality of life ( Chenivesse et al, 2014 ). DBD is consensually considered as a condition encompassing one or several forms of altered breathing pattern (dysfunctional breathing) associated with an array of intermittent or chronic symptoms that may be respiratory, notably dyspnea, and/or non-respiratory in the absence or in excess of, organic disease ( reviewed in : Barker and Everard, 2015 ; Boulding et al, 2016 ; Vidotto et al, 2019 ; Barker et al, 2020 ; Denton et al, 2022 ).…”