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Cited by 131Respiratory and Cough-Related ResearchAsthma and respiratory diseasesTracheal and airway disorders

Getting to grips with ‘dysfunctional breathing’

Barker, Nicki, Everard, Mark L.·2015·Paediatric Respiratory Reviews
DOI 10.1016/j.prrv.2014.10.001
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Abstract

Dysfunctional breathing (DB) is common, frequently unrecognised and responsible for a substantial burden of morbidity. Previously lack of clarity in the use of the term and the use of multiple terms to describe the same condition has hampered our understanding. DB can be defined as an alteration in the normal biomechanical patterns of breathing that result in intermittent or chronic symptoms. It can be subdivided into thoracic and extra thoracic forms. Thoracic DB is characterised by breathing patterns involving relatively inefficient, excessive upper chest wall activity with or without accessory muscle activity. This is frequently associated with increased residual volume, frequent sighing and an irregular pattern of respiratory effort. It may be accompanied by true hyperventilation in the minority of subjects. Extra thoracic forms include paradoxical vocal cord dysfunction and the increasingly recognised supra-glottic 'laryngomalacia' commonly seen in young sportsmen and women. While the two forms would appear to be two discreet entities they often share common factors in aetiology and respond to similar interventions. Hence both forms are considered in this review which aims to generate a more coherent approach to understanding, diagnosing and treating these conditions.

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Crossref · 10.1016/j.prrv.2014.10.001

Cites

9 of 9 references verified0 citation errors · 0 not checkable

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  • The most cited definition of DB was that proposed by Barker and Everard (25%).

    “The definition proposed by Barker and Everard was the most cited in the literature (16).”

    From How is dysfunctional breathing characterised in the clinical literature? A scoping review (2026) · cites this paper as [16]

  • This lack of clarity may lead to inappropriate management and reduced quality of care, including the overprescription of corticosteroids when symptoms experienced during DB exacerbations are misattributed to an underlying organic respiratory condition.

    “It has been suggested that this may lead to inappropriate management and reduced quality of care, including the overprescription of corticosteroids when symptoms experienced during DB exacerbations are misattributed to an underlying organic respiratory condition (16).”

    From How is dysfunctional breathing characterised in the clinical literature? A scoping review (2026) · cites this paper as [16]

  • There is little consensus in the literature and in clinical practice on how DB is defined, assessed and managed.

    “Despite its potentially significant prevalence, there is little consensus in the literature and in clinical practice on how DB is defined, assessed and managed (8,16).”

    From How is dysfunctional breathing characterised in the clinical literature? A scoping review (2026) · cites this paper as [16]

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Authors
Barker, N., & Everard, M. L.
Affiliations
  • Sheffield Children's Hospital (GB)
  • The University of Western Australia (AU)
Corresponding author
Everard, Mark L.
ORCID
Venue
Paediatric Respiratory Reviews
Publisher
Elsevier BV
Published
2015-01
Volume
16
Issue
1
Pages
53-61
ISSN
1526-0542 (ISSN-L)
DOI
10.1016/j.prrv.2014.10.001
OpenAlex
W2043470021
Cited by
131
References
9
Citations by year
2026: 10 · 2025: 19 · 2024: 16 · 2023: 13 · 2022: 18 · 2021: 11 · 2020: 13 · 2019: 11 · 2018: 7 · 2017: 3 · 2016: 7 · 2015: 2 · 2013: 1
FWCI
0.68
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Paediatric Respiratory Reviews (publishedVersion)
  • PubMed (publishedVersion)
  • UWA Profiles and Research Repository (UWA) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory and Cough-Related Research
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Tracheal and airway disorders
Keywords
dysfunctional breathing, thoracic breathing, hyperventilation, residual volume, sighing, breathing pattern, athletes, diagnosis, treatment
MeSH terms
Diagnosis, Differential, Female, Humans, Male, Respiration Disorders, Respiratory Physiological Phenomena, Thoracic Wall

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