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Cited by 10Asthma and respiratory diseasesRespiratory and Cough-Related ResearchTracheal and airway disorders

Paroxysmal dyspnoea in asthma: Wheeze, ILO or dysfunctional breathing?

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Crawford, A. L., Blakey, J. D., Baumwol, K.·2022·Frontiers in Allergy
DOI 10.3389/falgy.2022.1054791PMC PMC9712793
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Abstract

Paroxysms of dyspnoea in the general population are commonly reported and are frequently assumed to be asthma-related, especially if this diagnostic label has been previously applied. Often, this is not the case. Inducible Laryngeal Obstruction (ILO) and Dysfunctional Breathing (DB) are common comorbid conditions that go unrecognised in many difficult-to-treat asthmatics. On average, these patients have a delay in diagnosis of almost 5 years. This delay, along with ineffective, inappropriate escalation of asthma therapy, frequent hospital presentations for uncontrolled symptoms, and even intensive care admissions, magnifies patient morbidity and poor quality of life. ILO and DB have similar presentations and triggers to asthma. Differentiating between them can be challenging, especially in centres that do not have access to multidisciplinary subspecialty asthma services. Objectively confirming the diagnosis can likewise be challenging as symptoms fluctuate, and gold-standard investigations require extensive experience. This mini-review will summarise the clinical features of ILO and DB, with particular focus in the context of individuals treated for asthma. This narrative review will define each condition, highlight poignant aspects of the history and describe elements of the diagnostic pathway to gain objective confirmation.

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  • The predominant symptom associated with DB is dyspnoea, either at rest or during exercise.

    “The predominant symptom associated with DB is dyspnoea, either at rest or during exercise (12) which may occur with or without other commonly reported respiratory symptoms such as breath-holding, air hunger, and rapid mouth breathing (4,13).”

    From How is dysfunctional breathing characterised in the clinical literature? A scoping review (2026) · cites this paper as [12]

    The Dysfunctional breathing section identifies dyspnoea as the predominant symptom, and The history describes breathlessness associated with exertion. The paper does not clearly state that dyspnoea from dysfunctional breathing also occurs at rest. (LLM, conf=0.82)

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Authors
Crawford, A. L., Blakey, J. D., & Baumwol, K.
Affiliations
  • Sir Charles Gairdner Hospital (AU)
  • The University of Western Australia (AU)
Corresponding author
Blakey, J. D.
ORCID
Venue
Frontiers in Allergy
Publisher
Frontiers Media SA
Published
2022-11-17
Volume
3
Pages
1054791-1054791
ISSN
2673-6101 (ISSN-L)
DOI
10.3389/falgy.2022.1054791
PMC
PMC9712793
OpenAlex
W4309607764
Cited by
10
References
38
Citations by year
2026: 2 · 2025: 3 · 2024: 3 · 2023: 2
FWCI
0.28
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Allergy (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory and Cough-Related Research
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Tracheal and airway disorders
Keywords
asthma, inducible laryngeal obstruction, dysfunctional breathing, wheezing, asthma comorbidity, delayed diagnosis, differential diagnosis, objective diagnosis

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