The prevalence of dysfunctional breathing in adults in the community with and without asthma
Open accessAbstract
Functional breathing problems, including symptomatic hyperventilation, may impair quality of life. Symptoms associated with functional breathing disorders have been reported as being common in secondary care settings, and can affect 29% of adults with current asthma in the community. The prevalence of dysfunctional breathing in the general adult population is unknown. The Nijmegen Questionnaire has been reported to have useful sensitivity and specificity for diagnosing dysfunctional breathing. A cross-sectional postal survey of adults without current asthma was undertaken in a single UK general practice. The results were analysed in conjunction with a previously described survey of adults with current asthma from the same population. The questionnaire was posted to a random sample of 300 people aged 16-65 without current asthma, and 69% were returned. 8% (95% confidence intervals 4-12%) had positive screening scores. Positive screening scores were more common in women (14%, 7-20%) than men (2%, 0-5%, p=0.003). Comparison with the previous survey showed that the prevalence of positive screening scores was higher in those with current asthma than those without (29% vs. 8%, p<0.001). Dysfunctional breathing may affect up to one in 10 people, and is more common in women and in people with asthma.
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Most data are available for HVS; prevalence is estimated at 6-10% in the general population, rising to 29% in asthmatics.
“Most data are available for HVS, the prevalence of which is estimated to be in the region of 6–10% in the general population, rising to 29% in asthmatics [5, 12].”
From Dysfunctional breathing: a review of the literature and proposal for classification (2016) · cites this paper as [12]
The Results report 9.5% positive screening scores in the overall adult population and 29% among people diagnosed and treated for asthma, consistent with the quoted estimates. But the Methods and Discussion describe these as Nijmegen Questionnaire scores suggesting dysfunctional breathing, not confirmed HVS diagnoses; the paper also does not establish that most available data concern HVS. No page numbers are available in our copy. (LLM, conf=0.85)
Experimental — accuracy not yet measuredAround 29% to 64% of asthma patients exhibit HVS.
“Indeed, around 29% to 64% of asthma patients exhibit HVS,31,54–56”
From Physiotherapy Education and Breathing Retraining for Patients With Hyperventilation Syndrome: An Observational Study (2026) · cites this paper as [55]
The Results report positive Nijmegen screening scores in 29% of people diagnosed and treated for asthma, supporting the lower end of the range. The Discussion says the questionnaire was not validated for diagnosing symptomatic hyperventilation in asthmatic populations. Our copy does not report 64% or establish that all patients with positive scores had HVS. (LLM, conf=0.89)
Experimental — accuracy not yet measuredPrevalence of BPD has been demonstrated in a number of different conditions including asthma, COPD, anxiety, Postural Orthostatic Tachycardia syndrome and post-COVID syndrome, with papers commonly reporting higher breathlessness scores or reduced function/quality of life.
“Prevalence of BPD has been demonstrated in a number of different conditions including patients with asthma, 21 COPD, 22 anxiety, 23 Postural Orthostatic Tachycardia syndrome 24 and in post- COVID syndrome 7 with papers commonly reporting higher breathlessness scores or reduced function/quality of life.”
From Physiotherapy assessment of breathing pattern disorder: a qualitative evaluation (2023) · cites this paper as [21]
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Cites
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Cited by
Sorted by citations
Dysfunctional breathing: a review of the literature and proposal for classification
Boulding, R., Stacey, R., Niven, R., & Fowler, S. J. (2016) · European Respiratory Review · doi:10.1183/16000617.0088-2015 · Cited by 372 · see citing works
Holloway, E. A., & West, R. J. (2007) · Thorax · doi:10.1136/thx.2006.076430 · Cited by 170 · see citing works
The Nijmegen Questionnaire and dysfunctional breathing
van Dixhoorn, J., & Folgering, H. (2015) · ERJ Open Research · doi:10.1183/23120541.00001-2015 · Cited by 161 · see citing works
Hyperventilation in panic disorder and asthma: Empirical evidence and clinical strategies
Meuret, A. E., & Ritz, T. (2010) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2010.05.006 · Cited by 118 · see citing works
Courtney, R., Greenwood, K. M., & Cohen, M. (2011) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2010.06.004 · Cited by 96 · see citing works
Reilly, C. C., Floyd, S. V., Lee, K., Warwick, G., James, S., Gall, N., & Rafferty, G. F. (2020) · Autonomic Neuroscience · doi:10.1016/j.autneu.2019.102601 · Cited by 48 · see citing works
Mitchell, A. J., Bacon, C. J., & Moran, R. W. (2016) · Applied Psychophysiology and Biofeedback · doi:10.1007/s10484-015-9316-7 · Cited by 40 · see citing works
Physiotherapy assessment of breathing pattern disorder: a qualitative evaluation
Grillo, L., Russell, A.-M., Shannon, H., & Lewis, A. (2023) · BMJ Open Respiratory Research · doi:10.1136/bmjresp-2022-001395 · Cited by 27 · see citing works
Thomas, M., Bruton, A., Little, P., Holgate, S., Lee, A., Yardley, L., George, S., Raftery, J., Versnel, J., Price, D., et al. (2017) · Health Technology Assessment · doi:10.3310/hta21530 · Cited by 25 · see citing works
Self-citationLe syndrome d’hyperventilation
Dubreuil, C., & Prosper, M. (2014) · Réanimation · doi:10.1007/s13546-014-0909-6 · Cited by 4 · see citing works
Beaumont, M., Selleron, B., Passard, G., Karsandi, K., Proffit, M., Valentin, R., & Poncin, W. (2026) · Physiotherapy Canada · doi:10.3138/ptc-2024-0066
- Authors
- Thomas, M., McKinley, R. K., Freeman, E., Foy, C., & Price, D.
- Affiliations
- University of Aberdeen (GB)
- University of Leicester (GB)
- Corresponding author
- Thomas, Mike
- Venue
- Primary Care Respiratory Journal
- Published
- 2005-04-01
- Volume
- 14
- Issue
- 2
- Pages
- 78-82
- ISSN
- 1471-4418 (ISSN-L)
- 1475-1534
- PMC
- PMC6743552
- OpenAlex
- W1965384430
- Cited by
- 166
- References
- 2
- Citations by year
- 2026: 10 · 2025: 19 · 2024: 13 · 2023: 13 · 2022: 12 · 2021: 8 · 2020: 8 · 2019: 9 · 2018: 7 · 2017: 6 · 2016: 8 · 2015: 4 · 2014: 9 · 2013: 8 · 2012: 13
- FWCI
- 1.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Primary Care Respiratory Journal (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory and Cough-Related Research
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- dysfunctional breathing, asthma, prevalence, hyperventilation, Nijmegen questionnaire, screening, sex differences, quality of life, general practice
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