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Very often, people experience trouble breathing after exercising or when they feel anxious. In some cases, breathing difficulties can signal a medical condition, so it is essential to work out the cause.

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Shortness of breath (SOB), also known as dyspnea (BrE: dyspnoea) is a feeling of not being able to breathe well enough.

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Shortness of breath ( SOB), also known as dyspnea (BrE: dyspnoea) is a feeling of not being able to breathe well enough. The American Thoracic Society defines it as "a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity", and recommends evaluating dyspnea by assessing the intensity of the distinct sensations, the degree of distress involved, and its burden or impact on activities of daily living. Distinct sensations include effort/work, chest tightness, and air hunger (the feeling of not enough oxygen).

Dyspnea is a normal symptom of heavy exertion but becomes pathological if it occurs in unexpected situations or light exertion. In 85% of cases it is due to asthma, pneumonia, cardiac ischemia, interstitial lung disease, congestive heart failure, chronic obstructive pulmonary disease, or psychogenic causes, such as panic disorder and anxiety. Treatment typically depends on the underlying cause.

The American Thoracic Society defines dyspnea as: "A subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity." Other definitions describe it as "difficulty in breathing", "disordered or inadequate breathing", "uncomfortable awareness of breathing", and as the experience of "breathlessness" (which may be either acute or chronic).

While shortness of breath is generally caused by disorders of the cardiac or respiratory system, other systems such as neurological, musculoskeletal, endocrine, hematologic, and psychiatric may be the cause. DiagnosisPro, an online medical expert system, listed 497 distinct causes in October 2010. The most common cardiovascular causes are acute myocardial infarction and congestive heart failure while common pulmonary causes include chronic obstructive pulmonary disease, asthma, pneumothorax, pulmonary edema and pneumonia. On a pathophysiological basis the causes can be divided into: (1) an increased awareness of normal breathing such as during an anxiety attack, (2) an increase in the work of breathing and (3) an abnormality in the ventilatory system.

The tempo of onset and the duration of dyspnea are useful in knowing the etiology of dyspnea. Acute shortness of breath is usually connected with sudden physiological changes, such as laryngeal edema, bronchospasm, myocardial infarction, pulmonary embolism, or pneumothorax. Patients with COPD and idiopathic pulmonary fibrosis (IPF) have a gradual progression of dyspnea on exertion, punctuated by acute exacerbations of shortness of breath. In contrast, most asthmatics do not have daily symptoms, but have intermittent episodes of dyspnea, cough, and chest tightness that are usually associated with specific triggers, such as an upper respiratory tract infection or exposure to allergens.

Acute coronary syndrome frequently presents with retrosternal chest discomfort and difficulty catching the breath. It however may atypically present with shortness of breath alone. Risk factors include old age, smoking, hypertension, hyperlipidemia, and diabetes. An electrocardiogram and cardiac enzymes are important both for diagnosis and directing treatment. Treatment involves measures to decrease the oxygen requirement of the heart and efforts to increase blood flow.

People that have been infected by COVID-19 may have symptoms such as a fever, dry cough, loss of smell and taste, or shortness of breath.

Congestive heart failure frequently presents with shortness of breath with exertion, orthopnea, and paroxysmal nocturnal dyspnea. It affects between 1-2% of the general United States population and occurs in 10% of those over 65 years old. Risk factors for acute decompensation include high dietary salt intake, medication noncompliance, cardiac ischemia, abnormal heart rhythms, kidney failure, pulmonary emboli, hypertension, and infections. Treatment efforts are directed towards decreasing lung congestion.

People with chronic obstructive pulmonary disease (COPD), most commonly emphysema or chronic bronchitis, frequently have chronic shortness of breath and a chronic productive cough. An acute exacerbation presents with increased shortness of breath and sputum production. COPD is a risk factor for pneumonia; thus this condition should be ruled out. In an acute exacerbation treatment is with a combination of anticholinergics, beta₂-adrenoceptor agonists, steroids and possibly positive pressure ventilation.

Asthma is the most common reason for presenting to the emergency room with shortness of breath. It is the most common lung disease in both developing and developed countries affecting about 5% of the population. Other symptoms include wheezing, tightness in the chest, and a non productive cough. Inhaled corticosteroids are the preferred treatment for children, however these drugs can reduce the growth rate. Acute symptoms are treated with short-acting bronchodilators.

Pneumothorax presents typically with pleuritic chest pain of acute onset and shortness of breath not improved with oxygen. Physical findings may include absent breath sounds on one side of the chest, jugular venous distension, and tracheal deviation.

The symptoms of pneumonia are fever, productive cough, shortness of breath, and pleuritic chest pain. Inspiratory crackles may be heard on exam. A chest x-ray can be useful to differentiate pneumonia from congestive heart failure. As the cause is usually a bacterial infection, antibiotics are typically used for treatment.

Pulmonary embolism classically presents with an acute onset of shortness of breath. Other presenting symptoms include pleuritic chest pain, cough, hemoptysis, and fever. Risk factors include deep vein thrombosis, recent surgery, cancer, and previous thromboembolism. It must always be considered in those with acute onset of shortness of breath owing to its high risk of mortality. Diagnosis, however, may be difficult and Wells Score is often used to assess the clinical probability. Treatment, depending on severity of symptoms, typically starts with anticoagulants; the presence of ominous signs (low blood pressure) may warrant the use of thrombolytic drugs.

Anemia that develops gradually usually presents with exertional dyspnea, fatigue, weakness, and tachycardia. It may lead to heart failure. Anaemia is often a cause of dyspnea. Menstruation, particularly if excessive, can contribute to anaemia and to consequential dyspnea in women. Headaches are also a symptom of dyspnea in patients suffering from anaemia. Some patients report a numb sensation in their head, and others have reported blurred vision caused by hypotension behind the eye due to a lack of oxygen and pressure; these patients have also reported severe head pains, many of which lead to permanent brain damage. Symptoms can include loss of concentration, focus, fatigue, language faculty impairment and memory loss.[citation needed ]

Other important or common causes of shortness of breath include cardiac tamponade, anaphylaxis, interstitial lung disease, panic attacks, and pulmonary hypertension. Also, around 2/3 of women experience shortness of breath as a part of a normal pregnancy.

Cardiac tamponade presents with dyspnea, tachycardia, elevated jugular venous pressure, and pulsus paradoxus. The gold standard for diagnosis is ultrasound.

Anaphylaxis typically begins over a few minutes in a person with a previous history of the same. Other symptoms include urticaria, throat swelling, and gastrointestinal upset. The primary treatment is epinephrine.

Interstitial lung disease presents with gradual onset of shortness of breath typically with a history of a predisposing environmental exposure. Shortness of breath is often the only symptom in those with tachydysrhythmias.

Panic attacks typically present with hyperventilation, sweating, and numbness. They are however a diagnosis of exclusion.

Neurological conditions such as spinal cord injury, phrenic nerve injuries, Guillain-Barré syndrome, amyotrophic lateral sclerosis, multiple sclerosis and muscular dystrophy can all cause an individual to experience shortness of breath. Shortness of breath can also occur as a result of vocal cord dysfunction (VCD).

Different physiological pathways may lead to shortness of breath including via ASIC chemoreceptors, mechanoreceptors, and lung receptors.

It is thought that three main components contribute to dyspnea: afferent signals, efferent signals, and central information processing. It is believed the central processing in the brain compares the afferent and efferent signals; and dyspnea results when a "mismatch" occurs between the two: such as when the need for ventilation (afferent signaling) is not being met by physical breathing (efferent signaling).

Afferent signals are sensory neuronal signals that ascend to the brain. Afferent neurons significant in dyspnea arise from a large number of sources including the carotid bodies, medulla, lungs, and chest wall. Chemoreceptors in the carotid bodies and medulla supply information regarding the blood gas levels of O ₂, CO ₂ and H⁺. In the lungs, juxtacapillary (J) receptors are sensitive to pulmonary interstitial edema, while stretch receptors signal bronchoconstriction. Muscle spindles in the chest wall signal the stretch and tension of the respiratory muscles. Thus, poor ventilation leading to hypercapnia, left heart failure leading to interstitial edema (impairing gas exchange), asthma causing bronchoconstriction (limiting airflow) and muscle fatigue leading to ineffective respiratory muscle action could all contribute to a feeling of dyspnea.

Efferent signals are the motor neuronal signals descending to the respiratory muscles. The most important respiratory muscle is the diaphragm. Other respiratory muscles include the external and internal intercostal muscles, the abdominal muscles and the accessory breathing muscles.

As the brain receives its plentiful supply of afferent information relating to ventilation, it is able to compare it to the current level of respiration as determined by the efferent signals. If the level of respiration is inappropriate for the body's status then dyspnea might occur. There is also a psychological component to dyspnea, as some people may become aware of their breathing in such circumstances but not experience the typical distress of dyspnea.

Grade

Degree of dyspnea

0

no dyspnea except with strenuous exercise

1

dyspnea when walking up an incline or hurrying on the level

2

walks slower than most on the level, or stops after 15 minutes of walking on the level

3

stops after a few minutes of walking on the level

4

with minimal activity such as getting dressed, too dyspneic to leave the house

The initial approach to evaluation begins by assessment of the airway, breathing, and circulation followed by a medical history and physical examination. Signs that represent significant severity include hypotension, hypoxemia, tracheal deviation, altered mental status, unstable dysrhythmia, stridor, intercostal indrawing, cyanosis, tripod positioning, pronounced use of accessory muscles ( sternocleidomastoid, scalenes) and absent breath sounds.

A number of scales may be used to quantify the degree of shortness of breath. It may be subjectively rated on a scale from 1 to 10 with descriptors associated with the number (The Modified Borg Scale). Alternatively a scale such as the MRC breathlessness scale might be used - it suggests five grades of dyspnea based on the circumstances in which it arises.

A number of labs may be helpful in determining the cause of shortness of breath. D-dimer, while useful to rule out a pulmonary embolism in those who are at low risk, is not of much value if it is positive, as it may be positive in a number of conditions that lead to shortness of breath. A low level of brain natriuretic peptide is useful in ruling out congestive heart failure; however, a high level, while supportive of the diagnosis, could also be due to advanced age, kidney failure, acute coronary syndrome, or a large pulmonary embolism.

A chest x-ray is useful to confirm or rule out a pneumothorax, pulmonary edema, or pneumonia. Spiral computed tomography with intravenous radiocontrast is the imaging study of choice to evaluate for pulmonary embolism.

The primary treatment of shortness of breath is directed at its underlying cause. Extra oxygen is effective in those with hypoxia; however, this has no effect in those with normal blood oxygen saturations.

Individuals can benefit from a variety of physical therapy interventions. Persons with neurological/neuromuscular abnormalities may have breathing difficulties due to weak or paralyzed intercostal, abdominal and/or other muscles needed for ventilation. Some physical therapy interventions for this population include active assisted cough techniques, volume augmentation such as breath stacking, education about body position and ventilation patterns and movement strategies to facilitate breathing. Pulmonary rehabilitation may alleviate symptoms in some people, such as those with COPD, but will not cure the underlying disease. Fan therapy to the face has been shown to relieve shortness of breath in patients with a variety of advanced illnesses including cancer. The mechanism of action is thought to be stimulation of the trigeminal nerve.

Systemic immediate release opioids are beneficial in emergently reducing the symptom of shortness of breath due to both cancer and non cancer causes; long-acting/sustained-release opioids are also used to prevent/continue treatment of dyspnea in palliative setting. There is a lack of evidence to recommend midazolam, nebulised opioids, the use of gas mixtures, or cognitive-behavioral therapy.

Shortness of breath is the primary reason 3.5% of people present to the emergency department in the United States. Of these individuals, approximately 51% are admitted to the hospital and 13% are dead within a year. Some studies have suggested that up to 27% of people suffer from dyspnea, while in dying patients 75% will experience it. Acute shortness of breath is the most common reason people requiring palliative care visit an emergency department.

English dyspnea comes from Latin dyspnoea, from Greek dyspnoia, from dyspnoos, which literally means "disordered breathing". Its combining forms ( + ) are familiar from other medical words, such as dysfunction ( + ) and apnea ( + ). The most common pronunciation in medical English is disp-NEE-ə, with the p expressed and the stress on the /niː/ syllable. But pronunciations with a silent p in pn (as also in ) are common ( or ), as are those with the stress on the first syllable ( or ).

In English, the various -pnea- suffixed words commonly used in medicine do not follow one clear pattern as to whether the first syllable or the /niː/ syllable is stressed; the p is usually expressed but is sometimes silent. The following collation shows the preponderance of how major dictionaries transcribe them (less-used variants are omitted):

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Shortness of breath ( SOB), also known as dyspnea (BrE: dyspnoea) is a feeling of not being able to breathe well enough. The American Thoracic Society defines it as "a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity", and recommends evaluating dyspnea by assessing the intensity of the distinct sensations, the degree of distress involved, and its burden or impact on activities of daily living.

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Humid weather could pose problems for people who have trouble breathing

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Dry cough, fever, fatigue—by now, most have heard about the commonest symptoms of COVID-19, the disease caused by the novel coronavirus (SARS-CoV-2). For the most part, those symptoms are pretty self-explanatory. But another common symptom—shortness of breath—has been raising a lot of questions, including what the sensation feels like, and when it might warrant a call to your doctor (or a trip to the emergency room).

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Yes, it can be a sign of COVID-19...but it's also a symptom of anxiety.

Dry cough, fever, fatigue-by now, most have heard about the commonest symptoms of COVID-19, the disease caused by the novel coronavirus (SARS-CoV-2). For the most part, those symptoms are pretty self-explanatory. But another common symptom-shortness of breath-has been raising a lot of questions, including what the sensation feels like, and when it might warrant a call to your doctor (or a trip to the emergency room).

Essentially, shortness of breath-aka, dyspnea or breathlessness-is "a group of subjective sensations that suggest our respiratory system is not functioning well," Subinoy Das, MD, chief medical officer of Tivic Health Inc tells Health. Those sensations usually feel like an increased work or effort to breathe, chest tightness, and air hunger or "the feeling of not getting enough oxygen." he says.

Shortness of breath can be caused by a number of things, according to the American Lung Association (ALA)-the least severe of which include strenuous exercise, extreme temperatures, or high altitude. Even anxiety- which many of us are feeling right now -can sometimes lead to a sensation of breathlessness. Sometimes, however, shortness of breath can signal more serious illnesses like asthma, heart disease, or chronic obstructive pulmonary disease (COPD). And in some cases, when shortness of breath comes on quickly, it can signal emergency situations like carbon monoxide poisoning, pneumonia, or a heart attack, per the ALA.

When it comes to COVID-19, shortness of breath is thought to be due to the development of pneumonia, an inflammation of the lungs linked to a coronavirus infection, says Dr. Das. In that case, the shortness of breath occurs when oxygen in the lungs doesn't make its way to the blood as a result of the viral attack, he adds. The American College of Chest Physicians echoes this, saying that when blood carbon dioxide levels rise, a person's breathing rate can increase, which can lead to the sensation of difficulty breathing. Too much acid in the blood from an infection can also lead to the feeling of breathlessness, per the ACCP.

For some diagnosed with COVID-19, shortness of breath is a more severe symptom, and can be treated in a hospital setting with supplemental oxygen, says Dr. Das. The extra oxygen helps increase the amount of oxygen in a patient's blood. "In rare cases, pressurized oxygen through a mechanical ventilator is needed to force the oxygen through severely inflamed lungs into the blood stream," adds Dr. Das.

Overall, if you're worried you're experiencing shortness of breath possibly related to COVID-19, the first thing to do is try to calm down (easier said than done)-that's because, again, shortness of breath is a common symptom of anxiety. In that moment, take stock of how your body is feeling and looking overall: anxiety can also make your heart race, palms sweat, and pupils dilate.

If you're still concerned about a possible coronavirus infection after that-and you have other symptoms common with coronavirus, like dry cough, fever, and fatigue-give your doctor a call; they can then help you determine whether you qualify for a COVID-19 test. However, if your shortness of breath is severe, and accompanied by other symptoms like chest pain, lightheadedness, and lips turning blue, it's best to seek medical attention ASAP.
The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources. To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter

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Shortness of Breath is a Common Coronavirus Symptom-Here's What it Feels Like

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Yes, it can be a sign of COVID-19...but it's also a symptom of anxiety. Dry cough, fever, fatigue-by now, most have heard about the commonest symptoms of COVID-19, the disease caused by the novel coronavirus (SARS-CoV-2). For the most part, those symptoms are pretty self-explanatory.

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When you're short of breath, it's hard or uncomfortable for you to take in the oxygen your body needs. You may feel as if you're not getting enough air. Sometimes you can have mild breathing problems because of a stuffy nose or intense exercise. But shortness of breath can also be a sign of a serious disease.

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Many conditions can make you feel short of breath.

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Many conditions can make you feel short of breath.

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What Are These?

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MedlinePlus links to health information from the National Institutes of Health and other federal government agencies. MedlinePlus also links to health information from non-government Web sites. See our disclaimer about external links and our quality guidelines.

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Breathing Problems | Shortness of Breath | MedlinePlus

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MedlinePlus links to health information from the National Institutes of Health and other federal government agencies. MedlinePlus also links to health information from non-government Web sites. See our disclaimer about external links and our quality guidelines.

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Experiencing shortness of breath (dyspnea) or other breathing difficulties can feel scary. But it’s common symptom of anxiety.

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Difficulty Breathing – Anxiety and Panic Symptoms Explained!

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Asthma is a clinical syndrome of chronic airway inflammation characterized by recurrent, reversible, airway obstruction. Airway inflammation also leads to airway hyperreactivity, which causes airways to narrow in response to various stimuli.

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What facts should I know about asthma?

Picture of a girl with asthma using an inhaler by iStock

What is asthma?
Asthma is a clinical syndrome of chronic airway inflammation characterized by recurrent, reversible, airway obstruction. Airway inflammation also leads to airway hyperreactivity, which causes airways to narrow in response to various stimuli.
Who is at risk to develop asthma?
Asthma is a common chronic condition, affecting 68 per thousand individuals in most recent asthma surveys. Asthma remains a leading cause of missed workdays. It is responsible for 1.5 million emergency department visits annually and up to 500,000 hospitalizations. Over 3,300 Americans die annually from asthma. Furthermore, as is the case with other allergic conditions, such as eczema ( atopic dermatitis), hay fever ( allergic rhinitis), and food allergies, the prevalence of asthma appears to be on the rise.

Asthma Related Symptoms and Signs

Wheezing

Shortness Of Breath

Cough

Asthma vs. COPD: What are the differences?

Asthma is characterized by reversible airway narrowing, whereas COPD (chronic obstructive pulmonary disease) typically has fixed airway narrowing.

Some symptoms of COPD are similar to asthma, including wheezing, shortness of breath, and cough.

The cough in COPD can be more productive of mucus than asthma, and patients with severe COPD may need oxygen supplementation.

COPD is very often a result of cigarette smoke exposure, either direct or secondhand, although severe asthma can evolve to COPD over time in the absence of smoke exposure.

Medications used to treat COPD include inhaled corticosteroids, bronchodilators, inhaled corticosteroid/bronchodilator combinations, long-acting muscarinic antagonists, and oral steroids.

There is a newly described syndrome called asthma/COPD overlap syndrome that displays characteristics of both asthma and COPD. This is an area of medicine that needs further study.

QUESTION
See Answer

What are risk factors and causes of asthma?

Asthma results from complex interactions between an individual's inherited genetic makeup and interactions with the environment. The factors that cause a genetically predisposed individual to become asthmatic are poorly understood. The following are risk factors for asthma:

Family history of allergic conditions

Personal history of hay fever (allergic rhinitis)

Viral respiratory illness, such as respiratory syncytial virus (RSV), during childhood

Exposure to cigarette smoke

Obesity

Lower socioeconomic status

Exposure to air pollution or burning biomass

What are the different types of asthma?

Asthma may not be the same in different affected individuals. Asthma specialists currently use a variety of clinical data to categorize a patient's asthma. This data includes the age of asthma onset, the presence or absence of environmental allergies, the presence or absence of elevated blood or sputum levels of eosinophils (a type of white blood cell), lung function testing ( spirometry and fractional excretion of nitric oxide), obesity, and cigarette smoke exposure.

Types: T2 high or non T2 (T2 low)

Your doctor may refer to asthma as being "allergic" or "eosinophilic." One or both of these characteristics make up a "T2 high" phenotype of asthma, which is the term for the type of immune inflammation associated with asthma. The allergic type typically develops in childhood and is associated with environmental allergies, which approximately 70%-80% of children with asthma have. Typically, there is a family history of allergies. Additionally, other allergic conditions, such as food allergies or eczema, are often also present. Allergic asthma often goes into remission in early adulthood. However, in many cases, the asthma reappears later. Sometimes allergic asthma can appear with elevated blood or sputum eosinophils. Asthma that develops in adulthood may be associated with sputum or blood eosinophils but without environmental allergies. Sometimes patients in this category also have nasal polyps, which are eosinophil-rich growths in the nasal lining.

Non T2 asthma, or T2 low asthma, comprises a smaller yet difficult to treat proportion of asthma that is not associated with allergies or eosinophils. This type of asthma is sometimes called "neutrophilic asthma" and may be associated with obesity.

What are asthma symptoms and signs?

The classic signs and symptoms of asthma are shortness of breath, cough (often worse at night), and wheezing (high-pitched whistling sound produced by turbulent airflow through narrow airways, typically with exhalation). Many patients also report chest tightness. It is important to note that these symptoms are episodic, and individuals with asthma can go long periods without any symptoms.

Common triggers for asthmatic symptoms include exposure to allergens (pets, dust mites, cockroach, molds, and pollens), exercise, and viral infections. Other triggers include strong emotion, odor exposure, and temperature extremes. Tobacco use or exposure to secondhand smoke complicates asthma management.

Many of the symptoms and signs of asthma are nonspecific and can be seen in other conditions as well. Symptoms that might suggest conditions other than asthma include new symptom onset in older age, the presence of associated symptoms (such as chest discomfort, lightheadedness, palpitations, and fatigue), and lack of response to appropriate medications for asthma.

The physical exam in asthma is often completely normal. Occasionally, wheezing is present. In an asthma exacerbation, the respiratory rate increases, the heart rate increases, and the work of respiration increases. Individuals often require accessory muscles to breathe, and breath sounds can be diminished. It is important to note that the blood oxygen level typically remains fairly normal even in the midst of a significant asthma exacerbation. Low blood oxygen level is therefore concerning for impending respiratory failure.

IMAGES
See a medical illustration of the bronchioles plus our entire medical gallery of human anatomy and physiology See Images

How do doctors diagnose asthma?

The diagnosis of asthma begins with a detailed history and physical examination. Primary-care providers are familiar with the diagnosis of asthma, but specialists such as allergists or pulmonologists may be involved. A typical history is an individual with a family history of allergic conditions or a personal history of allergic rhinitis who experiences coughing, wheezing, and difficulty breathing, especially with exercise, viral infections, or during the night. In addition to a typical history, improvement with a trial of appropriate medications is very suggestive of asthma.

In addition to the history and exam, the following are diagnostic procedures that can be used to help with the diagnosis of asthma:

Lung function testing with spirometry: This test measures lung function as the patient breathes into a tube. If lung function improves significantly following the administration of a bronchodilator, such as albuterol, this essentially confirms the diagnosis of asthma. It is important to note, however, that normal lung function testing does not rule out the possibility of asthma.

Measurement of exhaled nitric oxide (FeNO): This can be performed by a quick and relatively simple breathing maneuver, similar to spirometry. Elevated levels of exhaled nitric oxide are suggestive of T2 inflammation seen in some types of asthma.

Skin testing for common aeroallergens: The presence of sensitivities to environmental allergies increases the likelihood of asthma. Of note, skin testing is more accurate than blood work (in vitro testing) for environmental allergies. Testing for food allergies is not indicated in the diagnosis of asthma.

Doctors often perform blood tests for the allergic antibody (IgE) and eosinophils to establish the present of T2 high asthma.

Other potential but less commonly used tests include provocation testing such as a methacholine challenge, which tests for airway hyperresponsiveness. Hyperresponsiveness is the tendency of the breathing tubes to constrict or narrow in response to irritants. A negative methacholine challenge makes asthma unlikely. Specialists sometimes also measure sputum eosinophils, another marker for "allergic" inflammation seen in asthma. Chest X-rays or CT-scans may show hyperinflation, but are often normal in asthma. Tests to rule out other conditions, such as cardiac testing, may also be indicated in certain cases.

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What are asthma treatment options? Are there home remedies for asthma?

The treatment goals for asthma are to:

adequately control symptoms,

minimize the risk of future exacerbations,

maintain normal lung function,

maintain normal activity levels, and

take the least amount of medication possible with the least amount of potential side effects.

Inhaled corticosteroids (ICS) are the most effective anti-inflammatory agents available for the chronic treatment of asthma and are first-line therapy per most asthma guidelines. It is well recognized that ICS are effective in decreasing the risk of asthma exacerbations. Furthermore, the combination of a long-acting bronchodilator (LABA) and an ICS has a significant additional beneficial effect on improving asthma control. Short-acting rescue inhalers are the standard of care for break through symptoms.

The most commonly used asthma medications include the following:

Short-acting bronchodilators (albuterol [Proventil, Ventolin, ProAir, ProAir RespiClick, Maxair, Xopenex]) provide quick relief for symptoms occurring despite controller medications. These may also be used alone in patients with occasional symptoms or patients experiencing symptoms with exercise only. Inhaled steroids (budesonide [Pulmicort Turbuhaler, Pulmicort Respules], fluticasone [Flovent, Arnuity Ellipta, Armon Air RespiClick], beclomethasone [Qvar], mometasone [Asmanex], ciclesonide [Alvesco], flunisolide [Aerobid, Aerospan]) are first-line anti-inflammatory therapies.

Long-acting bronchodilators (salmeterol [Serevent], formoterol [Foradil], vilanterol) can be added to ICS as additive therapy. LABAs should never be used alone for the treatment of asthma.

ICS/LABA combination agents combine corticosteroids and long-acting bronchodilators. Fluticasone/salmeterol (Advair, AirDuo, Wixela), budesonide/formoterol (Symbicort), fluticasone/vilanterol (Breo), mometasone/formoterol (Dulera).

Leukotriene modifiers (montelukast [Singulair], zafirlukast [Accolate], zileuton [Zyflo]) can also serve as anti-inflammatory agents.

Anticholinergic agents or antimuscarinic agents (ipratropium [Atrovent, Atrovent HFA], tiotropium [Spiriva], umeclidinium [Incruse Ellipta]) can help decrease sputum production.

There is one triple combination agent of an inhaled corticosteroid, long-acting bronchodilator, and anti-muscarinic agent: fluticasone/vilanterol/umeclidium (Trelegy) that is most often used for asthma/COPD overlap.

Anti-IgE treatment (omalizumab [Xolair]) can be used in allergic asthma.

Anti-IL5 treatment (mepolizumab [Nucala], reslizumab [Cinqair], and benralizumab [Fasenra]) can be used in eosinophilic asthma.

Anti IL-4 receptor antagonist (dupilumab, Dupixent) is approved for moderate to severe eosinophilic asthma. It is also approved for atopic dermatitis and nasal polyposis.

Chromones (cromolyn [Intal, Opticrom, Gastrocrom], nedocromil [Alocril]) stabilize mast cells (allergic cells) but are rarely used in clinical practice.

Theophylline (Respbid, Slo-Bid, Theo-24) also helps with bronchodilation (opening the airways) but is rarely used in clinical practice due to an unfavorable side-effect profile.

Systemic steroids (prednisone [Deltasone, Liquid Pred], prednisolone [Flo-Pred, Pediapred, Orapred, Orapred ODT], methylprednisolone [Medrol, Depo-Medrol, Solu-Medrol], dexamethasone [DexPak]) are potent anti-inflammatory agents that are routinely used to treat asthma exacerbations but pose numerous unwanted side effects if used repeatedly or chronically.

Numerous additional monoclonal antibodies are also currently being studied and will likely be available within the next couple of years.

Immunotherapy or allergy shots have been shown to decrease medication reliance in allergic asthma.

There are no home remedies that have proven benefit for asthma.

There is often concern about potential long-term side effects of inhaled corticosteroids. Numerous studies have repeatedly shown that even long-term use of inhaled corticosteroids has very few if any sustained, clinically significant side effects, including changes in bone health, growth, or weight. However, the goal always remains to treat all individuals with the least amount of medication that is effective. Patients with asthma should be routinely reassessed for any appropriate changes to their medical regimen.

Asthma medications can be administered via inhalers either with or without a spacer or nebulized solution. It is important to note that if an individual has proper technique with an inhaler, the amount of medication deposited in the lungs is no different than that when using a nebulized solution. When prescribing asthma medications, it is essential to provide the appropriate teaching on proper delivery technique.

Smoking cessation and/or minimizing exposure to secondhand smoke are critical when treating asthma. Treating concurrent conditions such as allergic rhinitis and gastroesophageal reflux disease ( GERD) may also improve asthma control. Vaccinations such as the annual influenza vaccination and pneumonia vaccination are also indicated.

Although the vast majority of individuals with asthma are treated as outpatients, treatment of severe exacerbations can require management in the emergency department or hospital. These individuals typically require use of supplemental oxygen, early administration of systemic steroids, and frequent or even continuous administration of bronchodilators via a nebulized solution. Individuals at high risk for poor asthma outcomes are referred to a specialist ( pulmonologist or allergist). The following factors should prompt consideration or referral:

History of ICU admission or multiple hospitalizations for asthma

History of multiple visits to the emergency department for asthma

History of frequent or daily use of systemic steroids for asthma

Ongoing symptoms despite the use of appropriate medications

Significant allergies contributing to poorly controlled asthma

From

What should someone do when experiencing an asthma attack?

Patients experiencing acute asthma symptoms should first use their rescue inhaler (albuterol). If asthma symptoms are worsening and use of albuterol is increasing, then asthma patients should have a medical evaluation. A course of oral steroids may be indicated and an adjustment in asthma maintenance therapy may be needed. If symptoms are rapidly progressive, asthma patients should seek emergency medical care.

What is an asthma action plan?

Patient education is a critical component in the successful management of asthma. An asthma action plan provides an individual with specific directions for daily asthma management and for adjusting medications in response to increasing symptoms or decreasing lung function.

What is the prognosis for asthma?

The prognosis for asthma is generally favorable. Children experience complete remission more often than adults. Although adults with asthma experience a greater rate of loss in their lung function as compared to age-controlled counterparts, this decline is usually not as severe as seen in other conditions, such as chronic obstructive pulmonary disease (COPD) or emphysema. Asthma in the absence of other comorbidities does not appear to shorten life expectancy. Risk factors for poor prognosis from asthma include

a history of hospitalizations, especially ICU admissions or intubation,

frequent reliance on systemic steroids,

significant medical comorbidities.

The airway narrowing in asthma may become fixed over time and can resemble COPD or emphysema. The other main complication of asthma is due to side effects from oral steroid use, which can include bone loss ( osteoporosis), weight gain, and glucose intolerance.

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Is it possible to prevent asthma?

With the increasing prevalence of asthma, numerous studies have looked for risk factors and ways to potentially prevent asthma. It has been shown that individuals living on farms are protected against wheezing, asthma, and even environmental allergies. The role of air pollution has been questioned in both the increased incidence of asthma and in regards to asthma exacerbations.

Climate change is also being studied as a factor in the increased incidence of asthma. Maternal smoking during pregnancy is a risk factor for asthma and poor outcomes. Tobacco smoke is also a significant risk factor for the development and progression of asthma. Treatment of environmental allergies with allergen immunotherapy, or allergy shots, has been shown to decrease a child's risk of developing asthma. The development of asthma is ultimately a complex process influenced by many environmental and genetic factors, and currently there is no proven way to decrease an individual's risk of developing asthma.

Medically Reviewed on 7/30/2019

Centers for Disease Control and Prevention (CDC). "Vital signs: asthma prevalence, disease characteristics, and self-management education: United States, 2001--2009." Morbidity and Mortality Weekly Report 60.17 (2011): 547-552.

Kaur, R., and G. Chupp. "Phenotypes and endotypes of adult asthma: Moving toward precision medicine." J Allergy Clin Immunol 144.1 July 2019: 1-12. doi: 10.1016/j.jaci.2019.05.031.

National Asthma Education and Prevention Program. "Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma." 2007.

Complete List

Esophageal pH Monitoring

Esophageal pH monitoring is a procedure for measuring the reflux (regurgitation or backwash) of acid from the stomach into the esophagus. The Esophageal pH test is used to diagnose gastroesophageal reflux disease (GERD) and to determine if the acid is responsible for symptoms such as:

cough,

hoarseness,

and sore throat.

Side effects of the procedure are few but may include mild discomfort in the back of the throat while the catheter is placed, and swallowing.

GERD (Acid Reflux, Heartburn)

GERD (gastroesophageal reflux disease) is a condition in which the acidified liquid contents of the stomach backs up into the esophagus. The symptoms of uncomplicated GERD are:

heartburn,

regurgitation, and

nausea.

Effective treatment is available for most patients with GERD.

Neutropenia

Neutropenia is a marked decrease in the number of neutrophils, neutrophils being a type of white blood cell (specifically a form of granulocyte) filled with neutrally-staining granules, tiny sacs of enzymes that help the cell to kill and digest microorganisms it has engulfed by phagocytosis.

Signs and symptoms of neutropenia include gum pain and swelling, skin abscesses, recurrent ear and sinus infections, sore mouth, low-grad fever, pneumonia-like symptoms, and pain and irritation around the rectal area.

Neutropenia has numerous causes, for example, infections (HIV, TB, mono); medications (chemotherapy); vitamin deficiencies (anemia); bone marrow diseases (leukemias), radiation therapy, autoimmune destruction of neutrophils, and hypersplenism.

Treatment of neutropenia depends upon the cause and the health of the patient.

Otoplasty

Otoplasty, or cosmetic and reconstructive surgery of the external ear, is often performed to correct prominent ears or repair defects resulting from injuries. Complications may include

narrowing of the external ear canal,

suture extrusion,

scarring,

permanent numbness of the skin of the ear,

temporary numbness of the skin of the ear,

bleeding, and

infection.

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Asthma Causes, Prevention, Treatment, Definition, Symptoms

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What facts should I know about asthma? Picture of a girl with asthma using an inhaler by iStock What is asthma? Asthma is a clinical syndrome of chronic airway inflammation characterized by recurrent, reversible, airway obstruction. Airway inflammation also leads to airway hyperreactivity, which causes airways to narrow in response to various stimuli.

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Pneumonia is a lung disease characterized by inflammation of the airspaces in the lungs, most commonly due to an infection.

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Bronchitis: Symptoms, Causes, Treatments - Dr. My-Huyen Tran

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Anemia is a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body's tissues. Having anemia can make you feel tired and weak.

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Overview

Anemia is a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body's tissues. Having anemia, also referred to as low hemoglobin, can make you feel tired and weak.

There are many forms of anemia, each with its own cause. Anemia can be temporary or long term and can range from mild to severe. In most cases, anemia has more than one cause. See your doctor if you suspect that you have anemia. It can be a warning sign of serious illness.

Treatments for anemia, which depend on the cause, range from taking supplements to having medical procedures. You might be able to prevent some types of anemia by eating a healthy, varied diet.

Types

Symptoms

Anemia signs and symptoms vary depending on the cause and severity of anemia. Depending on the causes of your anemia, you might have no symptoms.

Signs and symptoms, if they do occur, might include:

Fatigue

Weakness

Pale or yellowish skin

Irregular heartbeats

Shortness of breath

Dizziness or lightheadedness

Chest pain

Cold hands and feet

Headaches

At first, anemia can be so mild that you don't notice it. But symptoms worsen as anemia worsens.

When to see a doctor

Make an appointment with your doctor if you feel fatigued and you don't know why.

Fatigue has many causes besides anemia, so don't assume that if you're tired you must be anemic. Some people learn that their hemoglobin is low, which indicates anemia, when they donate blood. If you're told that you can't donate because of low hemoglobin, make an appointment with your doctor.

Causes

Anemia can be due to a condition present at birth (congenital) or to a condition you develop (acquired). Anemia occurs when your blood doesn't have enough red blood cells.

This can happen if:

Your body doesn't make enough red blood cells

Bleeding causes you to lose red blood cells more quickly than they can be replaced

Your body destroys red blood cells

What red blood cells do

Your body makes three types of blood cells - white blood cells to fight infection, platelets to help your blood clot, and red blood cells to carry oxygen from your lungs to the rest of your body and carbon dioxide from the body back to the lungs.

Red blood cells contain hemoglobin - an iron-rich protein that gives blood its red color. Hemoglobin enables red blood cells to carry oxygen from your lungs to all parts of your body and to carry carbon dioxide from other parts of the body to your lungs to be exhaled.

Most blood cells, including red blood cells, are produced regularly in your bone marrow - a spongy material found within the cavities of many of your large bones. To produce hemoglobin and red blood cells, your body needs iron, vitamin B-12, folate and other nutrients from the foods you eat.

Causes of anemia

Different types of anemia have different causes. They include:

Iron deficiency anemia. This most common type of anemia is caused by a shortage of iron in your body. Your bone marrow needs iron to make hemoglobin. Without adequate iron, your body can't produce enough hemoglobin for red blood cells.

Without iron supplementation, this type of anemia occurs in many pregnant women. It's also caused by blood loss, such as from heavy menstrual bleeding; an ulcer in the stomach or small bowel; cancer of the large bowel; and regular use of some pain relievers that are available without a prescription, especially aspirin, which can cause inflammation of the stomach lining resulting in blood loss. It's important to determine the source of iron deficiency to prevent recurrence of the anemia.

Vitamin deficiency anemia. Besides iron, your body needs folate and vitamin B-12 to produce enough healthy red blood cells. A diet lacking in these and other key nutrients can cause decreased red blood cell production. Some people who consume enough B-12 aren't able to absorb the vitamin. This can lead to vitamin deficiency anemia, also known as pernicious anemia.

Anemia of inflammation. Certain diseases - such as cancer, HIV/AIDS, rheumatoid arthritis, kidney disease, Crohn's disease and other acute or chronic inflammatory diseases - can interfere with the production of red blood cells.

Aplastic anemia. This rare, life-threatening anemia occurs when your body doesn't produce enough red blood cells. Causes of aplastic anemia include infections, certain medicines, autoimmune diseases and exposure to toxic chemicals.

Anemias associated with bone marrow disease. A variety of diseases, such as leukemia and myelofibrosis, can cause anemia by affecting blood production in your bone marrow. The effects of these types of cancer and cancer-like disorders vary from mild to life-threatening.

Hemolytic anemias. This group of anemias develops when red blood cells are destroyed faster than bone marrow can replace them. Certain blood diseases increase red blood cell destruction. You can inherit a hemolytic anemia, or you can develop it later in life.

Sickle cell anemia. This inherited and sometimes serious condition is a hemolytic anemia. It's caused by a defective form of hemoglobin that forces red blood cells to assume an abnormal crescent (sickle) shape. These irregular blood cells die prematurely, resulting in a chronic shortage of red blood cells.

Risk factors

These factors place you at increased risk of anemia:

A diet lacking in certain vitamins and minerals. A diet consistently low in iron, vitamin B-12, folate and copper increases your risk of anemia.

Intestinal disorders. Having an intestinal disorder that affects the absorption of nutrients in your small intestine - such as Crohn's disease and celiac disease - puts you at risk of anemia.

Menstruation. In general, women who haven't had menopause have a greater risk of iron deficiency anemia than do men and postmenopausal women. Menstruation causes the loss of red blood cells.

Pregnancy. Being pregnant and not taking a multivitamin with folic acid and iron, increases your risk of anemia.

Chronic conditions. If you have cancer, kidney failure or another chronic condition, you could be at risk of anemia of chronic disease. These conditions can lead to a shortage of red blood cells.

Slow, chronic blood loss from an ulcer or other source within your body can deplete your body's store of iron, leading to iron deficiency anemia.

Family history. If your family has a history of an inherited anemia, such as sickle cell anemia, you also might be at increased risk of the condition.

Other factors. A history of certain infections, blood diseases and autoimmune disorders increases your risk of anemia. Alcoholism, exposure to toxic chemicals and the use of some medications can affect red blood cell production and lead to anemia.

Age. People over age 65 are at increased risk of anemia.

Complications

Left untreated, anemia can cause many health problems, such as:

Extreme fatigue. Severe anemia can make you so tired that you can't complete everyday tasks.

Pregnancy complications. Pregnant women with folate deficiency anemia can be more likely to have complications, such as premature birth.

Heart problems. Anemia can lead to a rapid or irregular heartbeat (arrhythmia). When you're anemic your heart pumps more blood to make up for the lack of oxygen in the blood. This can lead to an enlarged heart or heart failure.

Death. Some inherited anemias, such as sickle cell anemia, can lead to life-threatening complications. Losing a lot of blood quickly results in acute, severe anemia and can be fatal. Among older people, anemia is associated with an increased risk of death.

Prevention

Many types of anemia can't be prevented. But you can avoid iron deficiency anemia and vitamin deficiency anemias by eating a diet that includes a variety of vitamins and minerals, including:

Iron. Iron-rich foods include beef and other meats, beans, lentils, iron-fortified cereals, dark green leafy vegetables and dried fruit.

Folate. This nutrient, and its synthetic form folic acid, can be found in fruits and fruit juices, dark green leafy vegetables, green peas, kidney beans, peanuts, and enriched grain products, such as bread, cereal, pasta and rice.

Vitamin B-12. Foods rich in vitamin B-12 include meat, dairy products, and fortified cereal and soy products.

Vitamin C. Foods rich in vitamin C include citrus fruits and juices, peppers, broccoli, tomatoes, melons and strawberries. These also help increase iron absorption.

If you're concerned about getting enough vitamins and minerals from food, ask your doctor whether a multivitamin might help.

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Anemia is a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body's tissues. Having anemia, also referred to as low hemoglobin, can make you feel tired and weak. There are many forms of anemia, each with its own cause.

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Lung Cancer: Symptoms, Causes and Treatment

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Breathing (or ventilation) is the process of moving air into and out of the lungs to facilitate gas exchange with the internal environment, mostly by bringing in oxygen and flushing out carbon dioxide.

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Real-time magnetic resonance imaging of the human thorax during breathing

X-ray video of a female American alligator while breathing.

Breathing ( spiration or ventilation) is the rhythmical process of moving air into and out of the lungs to facilitate gas exchange with the internal environment, mostly to flush out carbon dioxide and bring in oxygen.

All aerobic creatures need oxygen for cellular respiration, which extracts energy from the reaction of oxygen with molecules derived from food and produces carbon dioxide as a waste product. Breathing, or external respiration, brings air into the lungs where gas exchange takes place in the alveoli through diffusion. The body's circulatory system transports these gases to and from the cells, where cellular respiration takes place.

The breathing of all vertebrates with lungs consists of repetitive cycles of inhalation and exhalation through a highly branched system of tubes or airways which lead from the nose to the alveoli. The number of respiratory cycles per minute is the breathing or respiratory rate, and is one of the four primary vital signs of life. Under normal conditions the breathing depth and rate is automatically, and unconsciously, controlled by several homeostatic mechanisms which keep the partial pressures of carbon dioxide and oxygen in the arterial blood constant. Keeping the partial pressure of carbon dioxide in the arterial blood unchanged under a wide variety of physiological circumstances, contributes significantly to tight control of the pH of the extracellular fluids (ECF). Over-breathing ( hyperventilation) and under-breathing ( hypoventilation), which decrease and increase the arterial partial pressure of carbon dioxide respectively, cause a rise in the pH of ECF in the first case, and a lowering of the pH in the second. Both cause distressing symptoms.

Breathing has other important functions. It provides a mechanism for speech, laughter and similar expressions of the emotions. It is also used for reflexes such as yawning, coughing and sneezing. Animals that cannot thermoregulate by perspiration, because they lack sufficient sweat glands, may lose heat by evaporation through panting.

The lungs are not capable of inflating themselves, and will expand only when there is an increase in the volume of the thoracic cavity. In humans, as in the other mammals, this is achieved primarily through the contraction of the diaphragm, but also by the contraction of the intercostal muscles which pull the rib cage upwards and outwards as shown in the diagrams on the right. During forceful inhalation (Figure on the right) the accessory muscles of inhalation, which connect the ribs and sternum to the cervical vertebrae and base of the skull, in many cases through an intermediary attachment to the clavicles, exaggerate the pump handle and bucket handle movements (see illustrations on the left), bringing about a greater change in the volume of the chest cavity. During exhalation (breathing out), at rest, all the muscles of inhalation relax, returning the chest and abdomen to a position called the "resting position", which is determined by their anatomical elasticity. At this point the lungs contain the functional residual capacity of air, which, in the adult human, has a volume of about 2.5-3.0 liters.

During heavy breathing ( hyperpnea) as, for instance, during exercise, exhalation is brought about by relaxation of all the muscles of inhalation, (in the same way as at rest), but, in addition, the abdominal muscles, instead of being passive, now contract strongly causing the rib cage to be pulled downwards (front and sides). This not only decreases the size of the rib cage but also pushes the abdominal organs upwards against the diaphragm which consequently bulges deeply into the thorax. The end-exhalatory lung volume is now less air than the resting "functional residual capacity". However, in a normal mammal, the lungs cannot be emptied completely. In an adult human, there is always still at least one liter of residual air left in the lungs after maximum exhalation.

Diaphragmatic breathing causes the abdomen to rhythmically bulge out and fall back. It is, therefore, often referred to as "abdominal breathing". These terms are often used interchangeably because they describe the same action.

When the accessory muscles of inhalation are activated, especially during labored breathing, the clavicles are pulled upwards, as explained above. This external manifestation of the use of the accessory muscles of inhalation is sometimes referred to as clavicular breathing, seen especially during asthma attacks and in people with chronic obstructive pulmonary disease.

The lower airways.

Ideally, air is breathed first out and secondly in through the nose. The nasal cavities (between the nostrils and the pharynx) are quite narrow, firstly by being divided in two by the nasal septum, and secondly by lateral walls that have several longitudinal folds, or shelves, called nasal conchae, thus exposing a large area of nasal mucous membrane to the air as it is inhaled (and exhaled). This causes the inhaled air to take up moisture from the wet mucus, and warmth from the underlying blood vessels, so that the air is very nearly saturated with water vapor and is at almost body temperature by the time it reaches the larynx. Part of this moisture and heat is recaptured as the exhaled air moves out over the partially dried-out, cooled mucus in the nasal passages, during exhalation. The sticky mucus also traps much of the particulate matter that is breathed in, preventing it from reaching the lungs.

The anatomy of a typical mammalian respiratory system, below the structures normally listed among the "upper airways" (the nasal cavities, the pharynx, and larynx), is often described as a respiratory tree or tracheobronchial tree (figure on the left). Larger airways give rise to branches that are slightly narrower, but more numerous than the "trunk" airway that gives rise to the branches. The human respiratory tree may consist of, on average, 23 such branchings into progressively smaller airways, while the respiratory tree of the mouse has up to 13 such branchings. Proximal divisions (those closest to the top of the tree, such as the trachea and bronchi) function mainly to transmit air to the lower airways. Later divisions such as the respiratory bronchioles, alveolar ducts and alveoli are specialized for gas exchange.

The trachea and the first portions of the main bronchi are outside the lungs. The rest of the "tree" branches within the lungs, and ultimately extends to every part of the lungs.

The alveoli are the blind-ended terminals of the "tree", meaning that any air that enters them has to exit the same way it came. A system such as this creates dead space, a term for the volume of air that fills the airways at the end of inhalation, and is breathed out, unchanged, during the next exhalation, never having reached the alveoli. Similarly, the dead space is filled with alveolar air at the end of exhalation, which is the first air to breathed back into the alveoli during inhalation, before any fresh air which follows after it. The dead space volume of a typical adult human is about 150 ml.

The primary purpose of breathing is to refresh air in the alveoli so that gas exchange can take place in the blood. The equilibration of the partial pressures of the gases in the alveolar blood and the alveolar air occurs by diffusion. After exhaling, adult human lungs still contain 2.5-3 L of air, their functional residual capacity or FRC. On inhalation, only about 350 mL of new, warm, moistened atmospheric air is brought in and is well mixed with the FRC. Consequently, the gas composition of the FRC changes very little during the breathing cycle. This means that the pulmonary capillary blood always equilibrates with a relatively constant air composition in the lungs and the diffusion rate with arterial blood gases remains equally constant with each breath. Body tissues are therefore not exposed to large swings in oxygen and carbon dioxide tensions in the blood caused by the breathing cycle, and the peripheral and central chemoreceptors measure only gradual changes in dissolved gases. Thus the homeostatic control of the breathing rate depends only on the partial pressures of oxygen and carbon dioxide in the arterial blood, which then also maintains a constant pH of the blood.

The rate and depth of breathing is automatically controlled by the respiratory centers that receive information from the peripheral and central chemoreceptors. These chemoreceptors continuously monitor the partial pressures of carbon dioxide and oxygen in the arterial blood. The first of these sensors are the central chemoreceptors on the surface of the medulla oblongata of the brain stem which are particularly sensitive to pH as well as the partial pressure of carbon dioxide in the blood and cerebrospinal fluid. The second group of sensors measure the partial pressure of oxygen in the arterial blood. Together the latter are known as the peripheral chemoreceptors, and are situated in the aortic and carotid bodies. Information from all of these chemoreceptors is conveyed to the respiratory centers in the pons and medulla oblongata, which responds to fluctuations in the partial pressures of carbon dioxide and oxygen in the arterial blood by adjusting the rate and depth of breathing, in such a way as to restore the partial pressure of carbon dioxide to 5.3 kPa (40 mm Hg), the pH to 7.4 and, to a lesser extent, the partial pressure of oxygen to 13 kPa (100 mm Hg). For example, exercise increases the production of carbon dioxide by the active muscles. This carbon dioxide diffuses into the venous blood and ultimately raises the partial pressure of carbon dioxide in the arterial blood. This is immediately sensed by the carbon dioxide chemoreceptors on the brain stem. The respiratory centers respond to this information by causing the rate and depth of breathing to increase to such an extent that the partial pressures of carbon dioxide and oxygen in the arterial blood return almost immediately to the same levels as at rest. The respiratory centers communicate with the muscles of breathing via motor nerves, of which the phrenic nerves, which innervate the diaphragm, are probably the most important.

Automatic breathing can be overridden to a limited extent by simple choice, or to facilitate swimming, speech, singing or other vocal training. It is impossible to suppress the urge to breathe to the point of hypoxia but training can increase the ability to hold one's breath. Conscious breathing practices have been shown to promote relaxation and stress relief but have not been proven to have any other health benefits.

Other automatic breathing control reflexes also exist. Submersion, particularly of the face, in cold water, triggers a response called the diving reflex. This has the initial result of shutting down the airways against the influx of water. The metabolic rate slows down. This is coupled with intense vasoconstriction of the arteries to the limbs and abdominal viscera, reserving the oxygen that is in blood and lungs at the beginning of the dive almost exclusively for the heart and the brain. The diving reflex is an often-used response in animals that routinely need to dive, such as penguins, seals and whales. It is also more effective in very young infants and children than in adults.

Following on from the above diagram, if the exhaled air is breathed out through the mouth on a cold and humid conditions, the water vapor will condense into a visible cloud or mist.

Inhaled air is by volume 78% nitrogen, 20.95% oxygen and small amounts of other gases including argon, carbon dioxide, neon, helium, and hydrogen.

The gas exhaled is 4% to 5% by volume of carbon dioxide, about a 100 fold increase over the inhaled amount. The volume of oxygen is reduced by about a quarter, 4% to 5%, of total air volume. The typical composition is:

In addition to air, underwater divers practicing technical diving may breathe oxygen-rich, oxygen-depleted or helium-rich breathing gas mixtures. Oxygen and analgesic gases are sometimes given to patients under medical care. The atmosphere in space suits is pure oxygen. However, this is kept at around 20% of Earthbound atmospheric pressure to regulate the rate of inspiration.[citation needed ]

Atmospheric pressure decreases with the height above sea level (altitude) and since the alveoli are open to the outside air through the open airways, the pressure in the lungs also decreases at the same rate with altitude. At altitude, a pressure differential is still required to drive air into and out of the lungs as it is at sea level. The mechanism for breathing at altitude is essentially identical to breathing at sea level but with the following differences:

The atmospheric pressure decreases exponentially with altitude, roughly halving with every 5,500 metres (18,000 ft) rise in altitude. The composition of atmospheric air is, however, almost constant below 80 km, as a result of the continuous mixing effect of the weather. The concentration of oxygen in the air (mmols O ₂ per liter of air) therefore decreases at the same rate as the atmospheric pressure. At sea level, where the ambient pressure is about 100 kPa, oxygen constitutes 21% of the atmosphere and the partial pressure of oxygen () is 21 kPa (i.e. 21% of 100 kPa). At the summit of Mount Everest, 8,848 metres (29,029 ft), where the total atmospheric pressure is 33.7 kPa, oxygen still constitutes 21% of the atmosphere but its partial pressure is only 7.1 kPa (i.e. 21% of 33.7 kPa = 7.1 kPa). Therefore, a greater volume of air must be inhaled at altitude than at sea level in order to breathe in the same amount of oxygen in a given period.

During inhalation, air is warmed and saturated with water vapor as it passes through the nose and pharynx before it enters the alveoli. The saturated vapor pressure of water is dependent only on temperature; at a body core temperature of 37 °C it is 6.3 kPa (47.0 mmHg), regardless of any other influences, including altitude. Consequently, at sea level, the tracheal air (immediately before the inhaled air enters the alveoli) consists of: water vapor ( = 6.3 kPa), nitrogen ( = 74.0 kPa), oxygen ( = 19.7 kPa) and trace amounts of carbon dioxide and other gases, a total of 100 kPa. In dry air, the at sea level is 21.0 kPa, compared to a of 19.7 kPa in the tracheal air (21% of [100 - 6.3] = 19.7 kPa). At the summit of Mount Everest tracheal air has a total pressure of 33.7 kPa, of which 6.3 kPa is water vapor, reducing the in the tracheal air to 5.8 kPa (21% of [33.7 - 6.3] = 5.8 kPa), beyond what is accounted for by a reduction of atmospheric pressure alone (7.1 kPa).

The pressure gradient forcing air into the lungs during inhalation is also reduced by altitude. Doubling the volume of the lungs halves the pressure in the lungs at any altitude. Having the sea level air pressure (100 kPa) results in a pressure gradient of 50 kPa but doing the same at 5500 m, where the atmospheric pressure is 50 kPa, a doubling of the volume of the lungs results in a pressure gradient of the only 25 kPa. In practice, because we breathe in a gentle, cyclical manner that generates pressure gradients of only 2-3 kPa, this has little effect on the actual rate of inflow into the lungs and is easily compensated for by breathing slightly deeper. The lower viscosity of air at altitude allows air to flow more easily and this also helps compensate for any loss of pressure gradient.

All of the above effects of low atmospheric pressure on breathing are normally accommodated by increasing the respiratory minute volume (the volume of air breathed in - or out - per minute), and the mechanism for doing this is automatic. The exact increase required is determined by the respiratory gases homeostatic mechanism, which regulates the arterial and . This homeostatic mechanism prioritizes the regulation of the arterial over that of oxygen at sea level. That is to say, at sea level the arterial is maintained at very close to 5.3 kPa (or 40 mmHg) under a wide range of circumstances, at the expense of the arterial , which is allowed to vary within a very wide range of values, before eliciting a corrective ventilatory response. However, when the atmospheric pressure (and therefore the atmospheric ) falls to below 75% of its value at sea level, oxygen homeostasis is given priority over carbon dioxide homeostasis. This switch-over occurs at an elevation of about 2,500 metres (8,200 ft). If this switch occurs relatively abruptly, the hyperventilation at high altitude will cause a severe fall in the arterial with a consequent rise in the pH of the arterial plasma leading to respiratory alkalosis. This is one contributor to high altitude sickness. On the other hand, if the switch to oxygen homeostasis is incomplete, then hypoxia may complicate the clinical picture with potentially fatal results.

Pressure increases with the depth of water at the rate of about one atmosphere - slightly more than 100 kPa, or one bar, for every 10 meters. Air breathed underwater by divers is at the ambient pressure of the surrounding water and this has a complex range of physiological and biochemical implications. If not properly managed, breathing compressed gasses underwater may lead to several diving disorders which include pulmonary barotrauma, decompression sickness, nitrogen narcosis, and oxygen toxicity. The effects of breathing gasses under pressure are further complicated by the use of one or more special gas mixtures.

Air is provided by a diving regulator, which reduces the high pressure in a diving cylinder to the ambient pressure. The breathing performance of regulators is a factor when choosing a suitable regulator for the type of diving to be undertaken. It is desirable that breathing from a regulator requires low effort even when supplying large amounts of air. It is also recommended that it supplies air smoothly without any sudden changes in resistance while inhaling or exhaling. In the graph, right, note the initial spike in pressure on exhaling to open the exhaust valve and that the initial drop in pressure on inhaling is soon overcome as the Venturi effect designed into the regulator to allow an easy draw of air. Many regulators have an adjustment to change the ease of inhaling so that breathing is effortless.

Breathing patterns

Graph showing normal as well as different kinds of pathological breathing patterns.

Abnormal breathing patterns include Kussmaul breathing, Biot's respiration and Cheyne-Stokes respiration.

Other breathing disorders include shortness of breath (dyspnea), stridor, apnea, sleep apnea (most commonly obstructive sleep apnea), mouth breathing, and snoring. Many conditions are associated with obstructed airways. Chronic mouth breathing may be associated with illness. Hypopnea refers to overly shallow breathing; hyperpnea refers to fast and deep breathing brought on by a demand for more oxygen, as for example by exercise. The terms hypoventilation and hyperventilation also refer to shallow breathing and fast and deep breathing respectively, but under inappropriate circumstances or disease. However, this distinction (between, for instance, hyperpnea and hyperventilation) is not always adhered to, so that these terms are frequently used interchangeably.

A range of breath tests can be used to diagnose diseases such as dietary intolerances. A rhinomanometer uses acoustic technology to examine the air flow through the nasal passages.

The word "spirit" comes from the Latin spiritus, meaning breath. Historically, breath has often been considered in terms of the concept of life force. The Hebrew Bible refers to God breathing the breath of life into clay to make Adam a living soul ( nephesh). It also refers to the breath as returning to God when a mortal dies. The terms spirit, prana, the Polynesian mana, the Hebrew ruach and the psyche in psychology are related to the concept of breath.

In tai chi, aerobic exercise is combined with breathing exercises to strengthen the diaphragm muscles, improve posture and make better use of the body's . Different forms of meditation, and yoga advocate various breathing methods. A form of Buddhist meditation called anapanasati meaning mindfulness of breath was first introduced by Buddha. Breathing disciplines are incorporated into meditation, certain forms of yoga such as pranayama, and the Buteyko method as a treatment for asthma and other conditions.

In music, some wind instrument players use a technique called circular breathing. Singers also rely on breath control.

Common cultural expressions related to breathing include: "to catch my breath", "took my breath away", "inspiration", "to expire", "get my breath back".

Certain breathing patterns have a tendency to occur with certain moods. Due to this relationship, practitioners of various disciplines consider that they can encourage the occurrence of a particular mood by adopting the breathing pattern that it most commonly occurs in conjunction with. For instance, and perhaps the most common recommendation is that deeper breathing which utilizes the diaphragm and abdomen more can encourage relaxation. Practitioners of different disciplines often interpret the importance of breathing regulation and its perceived influence on mood in different ways. Buddhists may consider that it helps precipitate a sense of inner-peace, holistic healers that it encourages an overall state of health and business advisers that it provides relief from work-based stress.

During physical exercise, a deeper breathing pattern is adapted to facilitate greater oxygen absorption. An additional reason for the adoption of a deeper breathing pattern is to strengthen the body's core. During the process of deep breathing, the thoracic diaphragm adopts a lower position in the core and this helps to generate intra-abdominal pressure which strengthens the lumbar spine. Typically, this allows for more powerful physical movements to be performed. As such, it is frequently recommended when lifting heavy weights to take a deep breath or adopt a deeper breathing pattern.

1. ^ Tortora, Gerard J.; Anagnostakos, Nicholas P. (1987). Principles of anatomy and physiology (Fifth ed.). New York: Harper & Row, Publishers. pp. 556-582. ISBN 978-0-06-350729-6.

2. ^ Ades TB, ed. (2009). "Breathwork". American Cancer Society Complete Guide to Complementary and Alternative Cancer Therapies (2nd ed.). American Cancer Society. pp. 72-74. ISBN 9780944235713.

3. ^ Michael Panneton, W (2013). "The Mammalian Diving Response: An Enigmatic Reflex to Preserve Life?". Physiology. 28 (5): 284-297. doi:10.1152/physiol.00020.2013. PMC . PMID 23997188.

4. ^ Lindholm, Peter; Lundgren, Claes EG (1 January 2009). "The physiology and pathophysiology of human breath-hold diving". Journal of Applied Physiology. 106 (1): 284-292. doi:10.1152/japplphysiol.90991.2008. PMID 18974367.

5. ^ Thornton SJ, Hochachka PW (2004). "Oxygen and the diving seal". Undersea Hyperb Med. 31 (1): 81-95. PMID 15233163. Archived from the original on 11 December 2008.

6. ^ Zapol WM, Hill RD, Qvist J, Falke K, Schneider RC, Liggins GC, Hochachka PW (September 1989). "Arterial gas tensions and hemoglobin concentrations of the freely diving Weddell seal". Undersea Biomed Res. 16 (5): 363-73. PMID 2800051. Archived from the original on 11 December 2008.

7. ^ Pedroso, F. S.; Riesgo, R. S.; Gatiboni, T; Rotta, N. T. (2012). "The diving reflex in healthy infants in the first year of life". Journal of Child Neurology. 27 (2): 168-71. doi:10.1177/0883073811415269. PMID 21881008. S2CID 29653062.

8. ^ Dhami, P. S.; Chopra, G.; Shrivastava, H. N. (2015). A Textbook of Biology. Jalandhar, Punjab: Pradeep Publications. pp. V/101.

9. ^ Eisenmann, Alexander; Amann, Anton; Said, Michael; Datta, Bettina; Ledochowski, Maximilian (2008). "Implementation and interpretation of hydrogen breath tests". Journal of Breath Research. 2 (4): 046002. Bibcode:2008JBR.....2d6002E. doi:10.1088/1752-7155/2/4/046002. PMID 21386189. S2CID 31706721.

10. ^ Phillips, Michael; Herrera, Jolanta; Krishnan, Sunithi; Zain, Mooena; Greenberg, Joel; Cataneo, Renee N. (1999). "Variation in volatile organic compounds in the breath of normal humans". Journal of Chromatography B: Biomedical Sciences and Applications. 729 (1-2): 75-88. doi:10.1016/S0378-4347(99)00127-9. PMID 10410929.

11. ^ De Lacy Costello, B.; Amann, A.; Al-Kateb, H.; Flynn, C.; Filipiak, W.; Khalid, T.; Osborne, D.; Ratcliffe, N. M. (2014). "A review of the volatiles from the healthy human body". Journal of Breath Research. 8 (1): 014001. Bibcode:2014JBR.....8a4001D. doi:10.1088/1752-7155/8/1/014001. PMID 24421258. S2CID 1998578.

12. ^ "Online high altitude oxygen calculator". altitude.org. Archived from the original on 29 July 2012.

13. ^ Diem, K.; Lenter, C. (1970). Scientific Tables (7th ed.). Basle, Switzerland: Ciba-Geigy. pp. 257-8.

14. ^ Koen, Chrisvan L.; Koeslag, Johan H. (1995). "On the stability of subatmospheric intrapleural and intracranial pressures". News in Physiological Sciences. 10 (4): 176-8. doi:10.1152/physiologyonline.1995.10.4.176.

15. ^ Pacheco, Maria Christina Thomé; Casagrande, Camila Ferreira; Teixeira, Lícia Pacheco; Finck, Nathalia Silveira; de Araújo, Maria Teresa Martins (2015). "Guidelines proposal for clinical recognition of mouth breathing children". Dental Press Journal of Orthodontics. 20 (4): 39-44. doi:10.1590/2176-9451.20.4.039-044.oar. ISSN 2176-9451. PMC . PMID 26352843.

16. ^ Andreoli, Thomas E.; et al., Dorland's Illustrated Medical Dictionary (30th ed.), Philadelphia, PA: Saunders, pp. 887, 891, 897, 900, archived from the original on 11 January 2014

17. ^ Swami Saradananda (2009). The Power of Breath: The Art of Breathing Well for Harmony, Happiness, and Health. Watkins Media. ISBN 978-1-84483-798-4.

18. ^ Zaccaro, Andrea; Piarulli, Andrea; Laurino, Marco; Garbella, Erika; Menicucci, Danilo; Neri, Bruno; Gemignani, Angelo (2018). "How Breath-Control Can Change Your Life: A Systematic Review on Psycho-Physiological Correlates of Slow Breathing". Frontiers in Human Neuroscience. 12: 353. doi:10.3389/fnhum.2018.00353. ISSN 1662-5161. PMC . PMID 30245619.

19. ^ Hobert, Ingfried (1999). "Healthy Breathing - The Right Breathing". Guide to Holistic Healing in the New Millennium. Harald Tietze. pp. 48-49. ISBN 978-1-876173-14-2.

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Breathing ( spiration or ventilation) is the rhythmical process of moving air into and out of the lungs to facilitate gas exchange with the internal environment, mostly to flush out carbon dioxide and bring in oxygen.

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🎶 Take a deep breath

Put you hands on your tummy
Feel your belly rise and fall
In through your nose
Out through your mouth
It’s not hard at all 🎶

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"I can't breathe" is a slogan associated with the Black Lives Matter movement in the United States. The phrase originates from the last words of Eric Garner, an unarmed black man who was killed in 2014 after being put in a chokehold by New York City Police.
#BlackLivesMatter

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" I can't breathe" is a slogan associated with the Black Lives Matter movement in the United States. The phrase originates from the last words of Eric Garner, an unarmed black man who was killed in 2014 after being put in a chokehold by New York City Police. A number of other African-Americans, such as Javier Ambler, Manuel Ellis, Elijah McClain, and George Floyd, have said the same phrase prior to dying during law-enforcement encounters. According to a 2020 report by the New York Times, the phrase has been used by over 70 people who died in police custody.

The phrase is now used in worldwide protest against police brutality in the United States and against the lack of police accountability due to qualified immunity.

The phrase originated in July 2014 during the death of Eric Garner who was put into a chokehold by Daniel Pantaleo, a New York City Police Department officer. A video of Garner restrained by multiple officers which showed him saying "I can't breathe" 11 times before losing consciousness and dying was widely circulated. When it was announced on December 3 that after considering the case for two months the grand jury had decided not to indict Officer Pantaleo, protests erupted with Garner's last words, "I can't breathe" used as a slogan and as a chant. Following the December 2014 acquittal of the officer who put Garner into a chokehold, the slogan experienced a dramatic increase in popularity amid widespread protests.

Fred Shapiro editor of The Yale Book of Quotations relates that he had already finished his 2014 list of most notable quotes and sent it out to the media on Dec. 3, the same day that the grand jury decided to not indict Pantaleo for the death of Garner. Shapiro states that as he watched the news coverage with protesters turning Garner's final words into a rallying cry, within an hour he revised his list, making "I can't breathe" the top quote of the year. He expressed that it was not a slogan of only that moment, but "a phrase with real and lasting impact" Shapiro said that it was the first time he had ever revised a list.

Aided by expressions of solidarity from amateur and professional athletes and others, the hashtag "#ICantBreathe" was tweeted over 1.3 million times during the month of December.

The first display from athletes was when the Notre Dame Fighting Irish women's basketball team wore T-shirts emblazoned with "I can't breathe" during a December 13 game warm-up. Athletes from both the National Football League and National Basketball Association, notably LeBron James, wore clothing printed with "I can't breathe." Following criticism of James, President Barack Obama came to his defense, stating "I think LeBron did the right thing...We forget the role that Muhammad Ali, Arthur Ashe and Bill Russell played in raising consciousness." In late December, officials from the Fort Bragg Unified School District in Mendocino, California banned athletes from wearing "I can't breathe" T-shirts before a three-day high school basketball tournament, before reversing the ban. The American Civil Liberties Union wrote a letter in support of the students.

Linguist Ben Zimmer compared it to similar slogans such as " Hands up, don't shoot," which originated in the 2014 shooting of Michael Brown, and the older " No justice, no peace." Zimmer called it "a peculiarly powerful rallying cry," and noted, "to intone the words 'I can't breathe,' surrounded by thousands of others doing the same, is an act of intense empathy and solidarity. The empathy comes from momentarily stepping into the persona of Eric Garner at that instant the life was being choked out of him." Zimmer noted that, in the variant "We can't breathe," the phrase becomes directed towards social change and more metaphorical. Phrases seen on protests signs such as "Justice can't breathe" and "Our democracy can't breathe" extend the meaning beyond the physical circumstances of Garner's death.

Joshua D. Rothman of the University of Alabama noted that fashion statements such as the "I can't breathe" T-shirts are "easily and often dismissed by opponents as a cheap gesture or a stunt." However, analyzing the fashion craze in the late 18th and early 19th century for the "Am I Not a Man and a Brother?" cameos made by Josiah Wedgwood for bracelets and hair ornaments, and subsequent incorporation of the kneeling slave image into many different types of products as the most widely used symbol of the American abolitionist movement, Rothman asserted that "we ought not underestimate fashion's value and significance for building momentum and visibility for a political cause."

The cast of the movie wore "I can't breathe" shirts to their December premiere. Actor David Oyelowo recounts that members of the Academy of Motion Picture Arts and Sciences complained to movie producers and stated that in retaliation they would not vote for Selma to receive Oscars. Oyelowo states, "It's part of why that film didn't get everything that people think it should've got and it birthed #OscarsSoWhite."

Professor Grace Ji-Sun Kim and Reverend Jesse Jackson wrote in a December 2014 opinion piece that the phrase "has become a slogan for the people who have taken to social media and the streets to protest the killing of unarmed African Americans, challenging a system that fails to indict and calling for greater equality."

The phrase has been frequently invoked in protest songs and other music. Eric Garner's siblings released the song "I Can't Breathe" in 2016. The first English song by Russian band Pussy Riot was entitled "I Can't Breathe". Songwriter H.E.R. released a song by the same name in 2020.. Kole Black also released a controversial anthem entitled i.Cant.Breathe on July 21st 2020.

Supporters of the New York City Police Department marched on December 19, 2014 in black hoodies emblazoned with "I can breathe, thanks to the NYPD" and shouted "Don't resist arrest!" at counter-protesters. Separately, shirts produced and sold online by Jason Barthel, a police officer in Mishawaka, Indiana, that stated, "Breathe Easy: Don't break the law" drew criticism. Barthel stated, "When you break the law, unfortunately there's going to be consequences, and some of them aren't going to be pretty." Members of the city council of South Bend, Indiana asked then-mayor and future-U.S. presidential candidate Pete Buttigieg for cooperation in banning the city from future contracts with Barthel's uniform business. Buttigieg's political opponent Henry Davis Jr. described the response: "He refused to touch it. And when he touched it, he agreed with both sides."

Anti-mask protesters and conspiracy theorists have misappropriated the phrase to signal their opposition to mask requirements during the COVID-19 pandemic.

Christopher Lowe died while handcuffed in the back of a police cruiser in Fort Worth, Texas on July 26, 2018. When Lowe told officers he was dying and could not breathe, officers told him "Don't pull that shit," berated him, threatened to pepper spray him, and conspired not to tell medical staff about his medical condition, according to disciplinary letters issued against the officers. Five of the officers were fired while two were suspended without pay. Six officers have appealed; one waived his right to appeal and accepted the suspension in lieu of termination.

In March 2019, Javier Ambler II died while being arrested in Austin, Texas. Ambler was arrested and tased after fleeing from deputies who sought to stop him for a traffic violation and leading them on a 22-minute car chase which ended in crash. His final words were "I can't breathe." Ambler's death was ruled a homicide, caused by congestive heart failure and hypertensive cardiovascular disease in combination with forcible restraint.

Derrick Scott died in Oklahoma City in May 2019 after being restrained by officers for about 13 minutes. Police were responding to a call about someone brandishing a gun. Scott fled when confronted by police and a gun was removed by an officer during the arrest. One officer put her knee between Scott's shoulder blades and a second straddled Scott's back. When Scott told officers multiple times that he couldn't breathe, one officer responded, "I don't care," and another said, "You can breathe just fine." Scott died at the hospital an hour later due to a collapsed lung, according to an autopsy that found physical restraint, recent methamphetamine use, asthma, bullous emphysema and atherosclerotic heart disease contributed to Scott's death. Following an investigation that cleared the officers of wrongdoing, Oklahoma County District Attorney David Prater told the press, "I mean, he's just a perfect candidate to die when you've got meth in your system and those kinds of physical ailments and then you fight with police. [The officers] didn't do anything wrong at all."

Byron Williams died in police custody in Las Vegas on September 5, 2019, saying, "I can't breathe." Williams had been flagged down by Las Vegas Metro Police officers after they spotted him riding his bike without a safety light just before sunrise at 5:48 a.m. He fled officers and abandoned his bike and then scaled two walls before being arrested 1 minute and 40 seconds after the start of the encounter. According to police, he resisted by refusing to give up on his arms and that he had drugs on him which he tried to conceal. He was arrested and according to the police video, Williams was held down while on his stomach, he said "I can't breathe" at least 17 times before he eventually lost consciousness. At the end of the pursuit, five officers had arrived at the scene to assist in the arrest. Paramedics arrived 14 minutes after Williams lost consciousness and he was later declared dead at the hospital. Las Vegas police controlled the narrative by releasing only some of the bodycam video to the public.[citation needed ] None of the officers involved has been charged. The incident is one of several police custody deaths that re-emerged following the death of George Floyd.

John Elliott Neville died in Winston-Salem, North Carolina December 2, 2019 after being restrained in the Forsyth County jail. During a medical emergency, he was behaving erratically. He said, "I can't breathe" at least ten times, as well as "Help me", "Let me go" and "Mama". While he was in prone restraint, a technique discouraged in 1995 by the National Law Enforcement Technology Center, jail staff had difficulty removing his handcuffs. Neville had no pulse and CPR was used, but after being hospitalized he died December 4. Five jailers and a nurse were charged. As of July 24, protests had continued for two weeks. Video of the incident was released after news outlets demanded it.

Manuel Ellis died on March 3, 2020 during an arrest by police officers in Tacoma, Washington. Ellis pleaded "I can't breathe" with officers before dying in the minutes after his arrest. A witness contradicted earlier police accounts of his arrest and death. Video showed police punching Ellis during the arrest. The Pierce County medical examiner ruled that Ellis's death was a homicide, resulting from hypoxia due to physical restraint. The medical examiner said other factors contributed to Ellis's death, including methamphetamine intoxication, heart disease and a mask officers had placed over his mouth meant to stop spitting or biting.

On May 25, 2020, Minneapolis Police Department officer Derek Chauvin was accused of killing George Floyd by kneeling on the back of his neck for nearly nine minutes. Police body camera video showed that Floyd said that he couldn't breathe before he was on the ground and under Chauvin's knee. Spectator video of the incident showed Floyd saying "I can't breathe" multiple times while he was under Chauvin's knee. Despite his pleas, as well as a bystander exclaiming that the officer was preventing Floyd from breathing, Chauvin continued the restraint for 2 minutes and 53 seconds after Floyd became unresponsive, while three other officers watched. All four officers were subsequently dismissed from the police force, with Chauvin being charged with second-degree murder, and the three others with aiding and abetting murder.

"I can't breathe" became rallying cry for the subsequent nationwide protests. Protestors have adopted it as a chant. In his first public speech on George Floyd's death and protests on June 2, presidential candidate Joe Biden began with, "I can't breathe. I can't breathe. George Floyd's last words. But they didn't die with him. They're still being heard. They're echoing across this nation." That same day, ViacomCBS-owned networks paused their programming to show a black screen for 8 minutes and 46 seconds with the words "I can't breathe" displayed.

At the location of his death, artists painted a mural memorializing Floyd, but deliberately used the words, "I can breathe now," to promote community healing and reclaim a sense of power.

On June 24, Scottsdale, Arizona City Councilman Guy Phillips said, "I can't breathe," as he took off his mask at a rally protesting the mandatory mask wearing announced by Scottsdale Mayor Jim Lane during the COVID-19 pandemic in Arizona. He was condemned by local and state officials. Arizona Senator Martha McSally stated, "Despicable. This is a serious moment in history and it's disgusting you are mocking the dying words of a murdered man." Governor Doug Ducey said, "Just flat out wrong. Despicable doesn't go far enough. The final words of George Floyd should never be invoked like this. Anyone who mocks the murder of a fellow human has no place in public office. Period." Phillips later issued an apology.

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" I can't breathe" is a slogan associated with the Black Lives Matter movement in the United States. The phrase originates from the last words of Eric Garner, an unarmed black man who was killed in 2014 after being put in a chokehold by New York City Police.

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Knowledge Is Health And Health Is Wealth!

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Knowledge Is Health And Health Is Wealth!

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What to do if having a shortness of breathe and more! 👇🏻

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How to Help Someone Who Can't Breathe | First Aid Training

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First aid is for everyone, everywhere.

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The dolomite, which was used in the restoration of the Manila Bay shoreline, might cause health problems such as respiratory diseases.

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The Department of Health (DoH) said dolomite, which was used in the restoration of the Manila Bay shoreline, might cause health problems such as respiratory diseases.

Various groups have criticized the use of dolomite sand in the bay's rehabilitation, saying the money for the project should have been allotted instead for the coronavirus pandemic response.

Health Undersecretary Maria Rosario Vergeire said the department would study dolomite's effects on health.

She added that based on studies, dolomite dust might cause respiratory problems if a person breathes the small particles.

"Pero hindi po natin sinasabi na (But we are not saying that) when you go to Manila Bay, you'll get it at once," she said.

Dolomite dust can also irritate the eyes and can cause gastrointestinal problems when ingested, according to the Health official.

Vergeire, however, believes that the Department of Environment nd Natural Resources (DENR) studied the effects on the use of dolomite prior to its use. She reminded the public to observe health standards if they visit the bay to avoid the effects of dolomite.

"When you go to Manila Bay, kailangan po gagawin pa rin ang minimum health standards and when you wear your masks, ito pong (we should continue to do minimum health standards and when you wear your masks, the) inhalation effects can be prevented." Vergeire said.

Malacañang on Monday defended the decision to place dolomite sand on a stretch of Baywalk, saying it was also to prevent soil erosion.

"Itong ginawa po nila, ito po ay tinatawag na (What they did was) beach enhancement.
So, hindi lang po ito pagpapaganda (it was not merely beautification). Itong beach enhancement pong ito ay para po maiwasan ang soil erosion at para makatulong din po sa (the beach enhancement was to avoid soil erosion and for) flood control. So, although it is primarily beautification, it is a soil erosion project, it is part of an overall adaptation policy of the DENR," Palace spokesman Harry Roque Jr. said.

With Reina Tolentino

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Dolomite may cause health problems - DoH - The Manila Times

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The Department of Health (DoH) said dolomite, which was used in the restoration of the Manila Bay shoreline, might cause health problems such as respiratory diseases. Various groups have criticized the use of dolomite sand in the bay's rehabilitation, saying the money for the project should have been allotted instead for the coronavirus pandemic response.

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What should breathing feel like?

If you're breathing effectively, your breath will be smooth, steady, and controlled. You should feel relaxed and as though you're able to get enough air without straining.

It should feel easy to breathe, and your breath should be silent or quiet. Your abdomen area will expand with each inhalation and contract with each exhalation. You can also feel your ribs expand to the front, sides, and back with each inhalation.

Your diaphragm is the main muscle used for breathing. It's the dome-shaped muscle found below your lungs, separating your chest cavity from your abdominal cavity.

Your diaphragm tightens when you inhale, allowing your lungs to expand into the space in your chest.

Your intercostal muscles also help to create space in your chest by contracting to pull your rib cage upward and outward during inhalation.

The breathing muscles are located near the lungs and help them to expand and contract. These muscles include the:

Your lungs and blood vessels bring oxygen into your body and remove carbon dioxide. The airways transport oxygen-rich air into your lungs and carbon dioxide out of your lungs. These airways include:

bronchial tubes (bronchi) and their branches

larynx

mouth

nose and nasal cavities

trachea

Effective use of the respiratory system ensures that we're breathing well and to our maximum capacity.

There are several diaphragm breathing exercises and techniques that you can do at home. This will help you to use your diaphragm correctly. It's best that you do this technique when you're feeling rested and relaxed. Regularly performing these diaphragmatic breathing practices may help you to:

decrease the amount of oxygen needed

slow down your breathing rate to make breathing easier

strengthen your diaphragm

use less exertion and energy to breathe

Always talk to your doctor before starting any breathing exercises, especially if you have any medical conditions that have an effect on your breathing or if you are on any medications.

You can practice the diaphragmatic breathing at home on your own. When you're first getting started, aim to do about 5 to 10 minutes of this exercise three to four times per day.

You may find that you get tired while doing this exercise since it takes more effort to use your diaphragm correctly. But once you get used to diaphragmatic breathing, it will feel more natural and be easier to do.

Slowly increase the duration of time you spend each day. You can place a book on your abdomen to increase the difficulty of the exercise or to help you focus.

Diaphragm breathing exercise lying down

1. Lie on your back with your knees bent and a pillow under your head.

2. Place a pillow under your knees to support your legs.

3. Put one hand on your upper chest and the other below your rib cage so you can feel the movement of your diaphragm.

4. Inhale slowly through your nose, feeling your stomach expand to press into your hand.

5. Keep the hand on your chest as still as possible.

6. Engage your stomach muscles and draw them toward your spine as you exhale using pursed lips.

7. Again, keep the hand on your upper chest as still as possible.

8. Continue breathing like this for the duration of your exercise session.

After you learn this breathing technique lying down, you may wish to try it while sitting in a chair. This is slightly more difficult.

Diaphragm breathing exercise in a chair

1. Sit in a comfortable position with your knees bent.

2. Relax your shoulders, head, and neck.

3. Put one hand on your upper chest and the other below your rib cage so you can feel the movement of your diaphragm.

4. Inhale slowly through your nose so that your stomach presses against your hand.

5. Keep the hand on your chest as still as possible.

6. Engage your abdominal muscles as you exhale through pursed lips, keeping the hand on your upper chest still.

7. Continue breathing like this for the duration of your exercise session.

Once you're comfortable with both of these positions, you can try incorporating diaphragmatic breathing into your daily activities. Practice this breathing when you:

There are other things that effect how you breathe and tips to improve breathing.

Your breath is also affected by air quality, sudden changes in the weather, and extreme weather conditions. While these changes may be noticeable if you have a respiratory condition, they can affect all people. You may notice that it's easier to breathe in certain weather conditions or temperatures.

Hot and humid weather can affect your breathing. This may be because breathing in hot air has been shown to cause airway inflammation and exacerbate respiratory conditions.

Hot, humid weather also affects people with asthma, since the inhaled air causes airway constriction. Plus, there is more air pollution during the summer months.

In summertime and humid conditions, the Lung Association in Canada recommends drinking plenty of water, staying indoors if you're able to be in an air-conditioned space with good air quality, and to stay aware.

That means knowing what your warning signs are if you have a condition like asthma or COPD and checking air quality indexes like AirNow.

Cold, dry air often accompanying cold weather can also affect your lungs and breathing patterns. Dry air, regardless of the temperature, often aggravates the airways of people with lung conditions. This can cause wheezing, coughing, and shortness of breath.

To breathe easier in cold or extremely dry conditions, consider wrapping a scarf around your nose and mouth. This can warm and humidify the air you inhale.

Be consistent with your doctor-prescribed medications or inhalers. They will help to control inflammation, making you less sensitive to temperature changes.

There are several things you can do to improve your breathing. Here are a few ways you can breathe more easily and efficiently:

1. Adjust your sleeping position. Your sleeping position may also affect your breathing. You could try sleeping on your side with your head elevated by pillows and a pillow between your legs. This helps keep your spine aligned, which in turn helps to keep your airways open and may prevent snoring. Or sleep on your back with bent knees. Place a pillow under your head and your knees. However, sleeping on your back may cause your tongue to block your breathing tube. It's not recommended if you have sleep apnea or you snore.

2. Consider lifestyle changes. Keep your lungs healthy by making positive lifestyle changes. Maintain a healthy weight and eat nutritious foods, including foods rich in antioxidants. Get the flu vaccine and pneumonia vaccine to help to prevent lung infections and to encourage lung health. Avoid smoking, inhaling secondhand smoke, and environmental irritants. Improve indoor air quality by using air filters and reducing irritants such as artificial fragrances, mold, and dust.

3. Meditate. Practice meditation regularly. This can be as simple as taking the time to focus on your breath without trying to control it. Added benefits may include mental clarity, peace of mind, and less stress.

4. Practice good posture. Practicing good posture helps to ensure that your chest and the thoracic region of your spine are able to fully expand. Your rib cage and diaphragm will also be able to fully expand and increase the range of motion on the front side of your body. Overall, by practicing good posture, you'll be able to breathe more effectively and efficiently, allowing for more ease in both your daily and physical activities.

5. Sing it out. You may consider taking up singing to improve your breathing and improve lung function. People with chronic obstructive pulmonary disease (COPD) who sing regularly reduce their shortness of breath and are able to better manage their symptoms. They also feel more in control of their breathing. Singing helps people with lung conditions by teaching them to breathe more slowly and deeply as well as strengthening the breathing muscles. The British Lung Foundation recommends singing to enhance your ability to breathe, help to improve your posture, and increase the strength of your voice and diaphragm.

6. Stretch and flex. Take steps to relieve any tightness in your shoulders, chest, and back. You can do exercises that focus on flexibility, resistance, and stretching to improve posture. This can help you to be able to fully expand your ribcage in all directions when you breathe. You can do stretches or go for massages to help loosen up any areas of tightness. It's also a good idea to engage in activities that keep you active. These can include swimming, rowing, or any activity that gets you moving.

There are lots of different breathing techniques you can practice. Doing these exercises on a regular basis may help you to gain more awareness and control of your breath. You may experience other benefits such as deep feelings of relaxation, better sleep, and more energy.

Examples of breathing exercises include:

Breathing comes naturally to a lot of people, and it may not be something you think about a lot. There are lots of body parts that are used during respiration. Because of this, some postures and patterns are more effective for comfortable breathing than others.

Breathing practices may help to enhance the effectiveness of your breathing. For some people with conditions that affect their lung function, bringing this awareness to daily routines may help improve the sensation of breathing and, as a result, their daily activities.

Speak to a doctor about any questions you may have about your own breathing as well as breathing exercises you'd like to try.

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How to Breathe and Ways to Breathe Better

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When you're breathing effectively, your breath is steady and controlled. Your abdomen area expands and contracts with each inhalation and exhalation. You're relaxed and getting enough air without straining. If that's not your experience, read on to learn exercises and tips that can help you breathe more effectively.

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Now Is The Time To Breathe Yourself Better!

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Now Is The Time To Breathe Yourself Better!

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Do Breathe, is an app that helps busy people with complicated lives to calm down, find focus, and live with more purpose and less stress, less anxiety.

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We help busy people with complicated lives to calm down, find focus, and live with more purpose and less stress.

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Monks at Zen center in the South of France regarded a ringing telephone as a “bell of mindfulness”. When the phone rang, they would pause and breathe deeply several times before answering, to bring their attention to the present.

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The Hear and Now app guides you through deep breathing exercis.

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A meditation teacher once told me that monks at a Zen center in the South of France regarded a ringing telephone as a "bell of mindfulness." When the phone rang, they would pause and breathe deeply several times before answering, to bring their attention to the present. Callers knew the monks wouldn't pick up immediately.
Dealing with excessive stress is an issue for a lot of people, compounded by the fact that we are not always aware when we are stressed. Wouldn't it be great if we had our own bell of mindfulness to remind us to stop and breathe? And better yet, to show us how to breathe most effectively to reduce stress?

I recalled the telephone bell of mindfulness when I tried Hear and Now (free, iOS). It works as a bell by sending prompts to users via their mobile phone. Users are then guided through deep breathing exercises to reduce stress. Afterward, the app will tell them how effective the exercise was.

When a reminder comes, users hold an index finger over the phone's camera and flash so the app can read their heartbeat. It then guides you through a series of deep breaths. The idea is to match the app's breathing pattern as closely as possible.

During the exercise, users see and hear a pulse that mimics their heartbeat in soft tones, along with relaxing background sounds and a voice guide. Any or all of the sounds may be silenced if preferred.

The app then rates the quality of your breathing exercise based on changes in heart rate that indicate a drop in stress levels (the more variablity in the rate the better). Users can get deep into the data by tracking markers provided by the app, such as their sympathovagal balance index (editor's note: for those who feeling a bit sympathovagally unbalanced ...), one of several measures of heart rate variation, if they choose.

After the exercise, the data is stored so users can monitor their progress.

Can an app really help to reduce stress? With deadlines looming, The Myanmar Times team put it to the test

Charlotte Rose
Weekend editor
I've been using this app for a few days now and, to begin with, I thought the reminders were mildly irritating. But as the Weekend deadline loomed closer, taking time out to do some deep breathing definitely had a calming effect. The heart beat sounds are a bit weird at first, but they work!
Rating: 5/5

RJ Vogt
Pulse editor
Although I felt a bit silly looking at a "calming river" stock photo, the deep breathing did make me undeniably calmer. Once I received the results, however, my stress levels didn't seem much different. My STI was 76 percent? Now its 35pc? What does it all mean? Should I go to the doctor? I need a cigarette.
Rating: 3/5

Myo Satt
Lifestyle reporter
The deep breathing made me feel a bit calmer and the nature sounds are relaxing, but the heart rate sound is a bit annoying. I wasn't that stressed to begin with, but I suppose it could work for people who are super-stressed.
Rating: 3/5

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Need a reminder to breathe? There's an app for that

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A meditation teacher once told me that monks at a Zen center in the South of France regarded a ringing telephone as a "bell of mindfulness." When the phone rang, they would pause and breathe deeply several times before answering, to bring their attention to the present.

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Read more about how remote counseling works Dr. Allen Telephone & Video Sessions

You might also be interested in reading my article that discusses 5 Deep Breathing Techniques & Why They Work.

One of the tools I teach my clients to utilize when they feel anxious is called Grounding. When your mind is racing mind, grounding brings you back to the here-and-now and is very helpful in managing overwhelming feelings or anxiety. It is a great way to calm down quickly.

Grounding basically means to bring your focus to what is happening to you physically, either in your body or in your surroundings, instead of being trapped by the thoughts in your mind that are causing you to feel anxious. It helps you stay in the present moment instead of worrying about things that may happen in the future or events that have already happened but you still find yourself going over and over them in your head.

There are many ways to ground yourself when you feel anxious and overwhelmed and I decided to describe the 7 grounding techniques that I have found work best for myself and my clients.

Why Grounding Works To Calm You Down

Before I start describing some grounding techniques let's talk about why grounding works and the science behind it. When we start to think about something stressful, our amygdala, a section of the brain located in the temporal lobe, goes into action. The amygdala, simply put, is the part of our brain that is responsible for our emotional responses, especially fear. It is great for preparing for emergency events but sometimes it kicks in to action and detects a threat where there really isn't any.

Here is a typical process; we have a negative thought about a situation (remember a thought doesn't necessarily mean it is real), our amygdala says "emergency! emergency!" and initiates changes in our body such as increased muscle tension, rapid heartbeat and faster breathing. The amygdala then interprets these body changes as further evidence that something is actually wrong which of course further activates it and creates a vicious cycle where you become more and more anxious and physically and emotionally overwhelmed.

Thankfully, we can use grounding techniques to break out of this vicious cycle. By re-focusing on your body and what you're physically feeling, you get out of your head and divert your mind away from anxious or stressful thoughts and into the moment.

7 Grounding Techniques

I am going to describe seven different grounding techniques. Practice them when you are slightly stressed or anxious so they will become familiar and then you will be able to launch into the technique that works best for you next time you are feeling stressed, overwhelmed or stuck in an anxiety attack.

Sit down in a comfortable chair, one where your feet reach the floor. Close your eyes and focus on your breath. Breathe in slowly for the count of three, then out slowly. Bring your mind's focus to your body. How does your body feel sitting in that chair? Scooch your bum right into the back of the seat so the whole length of your back is pressing into the back of the chair. Can you feel the contact between your body and the chair's surface? If the chair has arms, touch it, is the material smooth or textured? Press your arms down the length of the chair arm, notice how your hands hang off the end. If your chair doesn't have arms, touch the material on the seat, how does that feel?

Next push your feet into the ground, imagine the energy draining down from your mind, down through your body and out through your feet into the ground. I picture it as a color filling my body as it goes from top to toe, but this is your image so choose whatever you want your energy to look like. As the energy drains from your head, feel how heavy each body part becomes, your torso feels heavy and now your arms as you relax those muscles. Lastly, feel the heaviness go down your legs, through your feet and down into the ground.

This second technique gets you to use all your five senses to help you to get back to the present. It starts with you sitting comfortably, close your eyes and taking a couple of deep breathes. In through your nose (count to 3), out through your mouth (to the count of 3).

Now open your eyes and look around you. Name out loud:

5 - things you can see (you can look within the room and out of the window)

4 - things you can feel (the silkiness of your skin, the texture of the material on your chair, what does your hair feel like? What is in front of you that you can touch? A table perhaps?)

3 - things you can hear (traffic noise or birds outside, when you are quiet and actually listening things in your room constantly make a noise but typically we don't hear them).

2 - things you can smell (hopefully nothing awful!)

1 - thing you can taste (it might be a good idea to keep a piece of chocolate handy in case you are doing this grounding exercise! You can always leave your chair for this one and when you taste whatever it is that you have chosen, take a small bite and let it swill around your mouth for a couple of seconds, really savoring the flavor).

Take a deep breath to end.

I keep gems and crystals in my office just for this purpose but look around your house for things that have a texture or are pretty or interesting to look at.

Hold an object in your hand and really bring your full focus to it. If I was looking at one of my gems I would see the patterns that run through it, see the color variances. Some have veins of different colors going through the or sparkly bits. Look at where shadows may fall on parts of it or maybe there are shapes that form within the object. Feel how heavy or light it is in your hand and what the surface texture feels like under your fingers.

This can be done with any object you have lying around or if you know you are going into a stressful situation, take one of your favorite small objects and put it in your pocket or purse so you can do this calming exercise on the go.

When we are anxious our thoughts about our worries go around and around in our mind. Never ending and building on each other until we feel drained by them so we try not to worry. Whenever you try not to do something it is guaranteed to make you do it more so instead, observe your thoughts like you are an outside looking in. Just watch your thoughts for a minute. Imagines leaves floating on the surface of a stream. For each thought that comes to mind, allow that thought to take its place on a leaf and watch it blow away in the wind. Or allow the thought to turn into a fish and watch it float away down the stream. Allow those thoughts to come and go, you don't need to respond to them.

There are several ways to distract your mind so it stops thinking about whatever it is that is worrying you and focuses on something that isn't emotionally driven. Here are my favorite two quick ways to do it.

Pick a color. How many things in different shades of that color can you see around the room or out of the window? Still feeling stressed? Pick another color.

Count backwards by 7, starting at 100. It isn't that easy and needs you to concentrate. This one can also be helpful to do when you are finding it hard to sleep.

Place your feet on the ground and in your imagination pick your favorite color to draw an outline around each foot. Start at the heel and using your imaginary pencil slowly go up the side of your foot to your pinky toe and then make sure you draw around each toe and then go back towards the heel. Repeat on the other foot.

Another quick way to focus on your feet when you are in a stressful situation is just wiggle your toes inside your shoe. Pay attention to the sensation as you move each separate toe. Do some move independently of the others? Tense up your whole foot then stretch it out. Now do the other foot.

As you can see, grounding helps you get out of your brain and bring your focus to your body. Try them all when you are only slightly worried about something and then chose the ones that you like best and practice them so they are easy to remember when you really need them.

Get Your Adrenaline-Fueled Energy Out

Sometimes my clients tell me that they just can't concentrate enough to do any of these grounding exercises because their body seems too pumped full of adrenaline fueled energy. If this is happening to you, it is good to kick-start the calming down process by doing something physical first to get that pent-up energy out and then come back to your favorite grounding techniques.

Run on the treadmill/elliptical if you have one at home

Run up and down the stairs

Take a brisk walk or run outside

Cleaning up the kitchen, house or backyard channels that extra energy into something useful

Dance around the house while listening to loud music

When you are physically spent, you can return to trying these techniques to calm down your mind.

Which one of these grounding techniques works best for you? Maybe different ones help at different times. Whichever one you choose, once you have calmed down and your mind stops racing, you are then able to look at the situation more rationally and challenge the thoughts that made you anxious in the first place.
The Number One Question That Helps Reduce Worrying.
You might also be interested in reading my article Take a Deep Breath: How Deep Breathing Helps Combat Anxiety!
Five Best Anxiety Treatment Blog Posts
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To find out more about coping with anxiety and worrying download my free booklet Simple Steps To Overcome Anxiety & Worrying use the sign up form below the book.

When clients first come in to see me, the main concerns that come up again and again are:

1. How can I feel less stressed, angry and overwhelmed?

2. What should I do if I feel panicky?

3. How can I stop worrying about everything: my children, partner, friends, work, my "to do" list....

So I put together a booklet with some strategies I am always giving to my clients to help them begin to feel less anxiety and to worry less.

I hope that you will find it helpful too.

Add your first name and email address in the box below and you will be sent the steps to download your FREE book.

If after reading my blog posts or booklet you feel ready to start working on reducing your anxiety but need support, I can help you overcome worrying in one-on-one individual counseling sessions.

In a supportive environment with a therapist who has over 20 years experience you can learn how to reduce worrying by:

Learning a variety of relaxation and breathing strategies which can help you reduce your overall levels of stress and help you face anxiety-provoking situations.

Learning how to distinguish between worries that require your attention and worries that are unnecessary.

Learning skills to manage anxious thoughts and to tackle fears that may have been holding you back.While all your worries won't disappear, you will be given strategies to manage them better and tools to reduce the impact they have on your life.

If you would like to work with me and learn more ways to reduce overthinking and other coping strategies that reduce anxiety, please phone me at 847 791-7722 or email me below.

Dr. Allen has over 25 years experience and specializes in helping people treat their anxiety. If you would like to read more about her please visit her About Sarah page Dr. Sarah Allen Bio . To read media articles she was been interviewed for visit her Media Interviews page. She works remotely via phone or video session s with clients who live in Illinois & Florida.

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7 Simple Grounding Techniques For Calming Down Quickly

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Anxiety specialist describes how Grounding Techniques are a great way to calm down quickly when anxious. Dr. Sarah Allen Chicago, IL & FL.

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If by gaining knowledge we destroy our health, we labour for a thing that will be useless in our hands.
- John Locke