Breathlessness is a symptom, not a diagnosis
Most people experience breathlessness at some point in their lives. It can occur during exercise, illness, periods of stress or anxiety, or as a result of underlying health conditions.
Breathlessness, sometimes called shortness of breath, is the sensation that breathing requires more effort than usual. Some people describe feeling unable to get enough air, needing to take deep breaths, chest tightness, or feeling that breathing has become difficult or uncomfortable.
Although breathlessness can be frightening, the sensation itself does not automatically mean that something serious is happening.
What causes breathlessness?
Breathlessness can occur for many different reasons. Common causes include:
- Asthma
- Chronic obstructive pulmonary disease (COPD)
- Chest infections
- Heart conditions
- Anaemia
- Deconditioning
- Excess body weight
- Breathing Pattern Disorder
- Anxiety and panic
In many people, several factors may contribute at the same time.
For example, someone may have mild asthma but also become less physically active because of their symptoms. Over time, reduced fitness can make everyday activities feel more difficult, increasing the sensation of breathlessness.
Why does breathlessness feel so frightening?
Breathing is something most people rarely think about until it becomes difficult.
When breathing suddenly feels uncomfortable, the brain naturally interprets this as a potential threat. This can trigger a stress response that increases alertness and prepares the body for action.
As a result, breathing may become faster, muscles may tense, and attention becomes focused on breathing sensations. Although these responses are normal, they can sometimes make breathlessness feel worse.
This can create a cycle where increasing concern about breathing leads to worsening symptoms, which in turn increases concern further.
Breathlessness is not always related to oxygen levels
Many people assume that feeling breathless means their body is not getting enough oxygen. In reality, the sensation of breathlessness is far more complex.
The brain continuously receives information from the lungs, breathing muscles, heart, blood vessels and nervous system. The feeling of breathlessness is created by the brain's interpretation of these signals.
This means it is possible to feel very breathless even when oxygen levels are completely normal. Many people who attend specialist breathlessness services have normal oxygen levels despite experiencing significant symptoms.
When tests are normal but breathlessness continues
Some people continue to experience significant breathlessness despite normal scans, blood tests and lung function tests.
This does not mean the symptoms are imagined or unimportant.
Breathlessness can be influenced by many factors including breathing patterns, physical fitness, stress, previous illness, confidence in movement and how the brain processes breathing sensations.
Understanding these factors is often an important step towards recovery.
Breathlessness affects more than breathing
Breathlessness is often thought of as a problem affecting only the lungs or heart. In reality, the experience of breathlessness is influenced by several interconnected factors.
Breathlessness can affect how we breathe, how we think, and how we go about our daily activities. Changes in one area often influence the others.
For example, feeling breathless may lead to worry or frustration. These feelings can increase awareness of breathing and make symptoms feel more prominent. Some people may begin avoiding activities that trigger symptoms, which can gradually lead to reduced fitness and make everyday tasks feel more demanding.
