The Nijmegen Questionnaire and dysfunctional breathing
Open accessAbstract
The Nijmegen Questionnaire was introduced over 30 years ago as a screening tool to detect patients with hyperventilation complaints that could benefit from breathing regulation through capnographic feedback [1]. It was validated against the Hyperventilation Provocation Test [2], on the assumption at the time that hypocapnia was causally related to complaints. In later studies, the correlation between Nijmegen Questionnaire scores and carbon dioxide tensions appeared highly variable. The diagnosis of hyperventilation syndrome (HVS) was questioned and slowly disappeared. Nevertheless, the Nijmegen Questionnaire has remained in use and we have noticed even a recent increase in studies in clinical medicine as well as requests for permission to use the Nijmegen Questionnaire in new studies. We would like to formally declare here that the Nijmegen Questionnaire is not copyrighted and is free to use. It has been or will be translated, as far as we know, into Greek, Farsi, Finnish, Norwegian, Swedish, Spanish, Filipino and Chinese. However, the validity of the Nijmegen Questionnaire is often a point of discussion and we would like to make a few comments on that issue [3]. The Nijmegen Questionnaire is useful to quantify and assess the normality of subjective sensations <http://ow.ly/MBJj1>
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The study's sample size was justified: assuming an expected average Nijmegen score of 34, aiming to reduce to 23, expected difference 11 points, with SD 21.5, alpha 5%, beta 10%, required 41 patients; to account for 10% missing/withdrawals, 46 patients needed to be included.
“Assuming an expected average Nijmegen score of 34 among patients with HVS,43 and aiming to reduce the score of these same patients to the normal range (i.e., score of 23), the expected difference was set at 11 points.”
From Physiotherapy Education and Breathing Retraining for Patients With Hyperventilation Syndrome: An Observational Study (2026) · cites this paper as [43]
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A Physiotherapy Framework to Managing Long COVID: A Clinical Approach
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Use of the Nijmegen Questionnaire in asthma
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- Authors
- van Dixhoorn, J., & Folgering, H.
- Venue
- ERJ Open Research
- Publisher
- European Respiratory Society (ERS)
- Published
- 2015-05
- Volume
- 1
- Issue
- 1
- Pages
- 00001-2015
- ISSN
- 2312-0541 (ISSN-L)
- PMC
- PMC5005127
- OpenAlex
- W2152691399
- Cited by
- 161
- References
- 22
- Citations by year
- 2026: 13 · 2025: 25 · 2024: 22 · 2023: 21 · 2022: 18 · 2021: 17 · 2020: 15 · 2019: 10 · 2018: 7 · 2017: 7 · 2016: 4 · 2015: 2
- FWCI
- 5.42
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- ERJ Open Research (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory and Cough-Related Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- Nijmegen questionnaire, hyperventilation syndrome, dysfunctional breathing, screening tool, questionnaire validity, hypocapnia, carbon dioxide tension, respiratory control
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