Bob spent years struggling to breathe and had to use his asthma inhaler eight times a

Tight chest and shoulders? Lethargy? Bloating? Palpitations? Feel like you just can’t take a deep breath?

If you can tick a few of these boxes, it’s possible you have dysfunctional breathing.

According to the NHS, around one in ten adults in the UK are affected by the problem – also known as breathing pattern disorder – which is linked to a host of health complaints.

With dysfunctional breathing, rather than breathing in a routine, comfortable and quiet way, someone’s breathing may be too fast, too hard or too much in the upper chest. It can also refer to mouth-breathing (rather than through the nose).

Yet as it is a habit that becomes ingrained gradually over months and years, often people don’t realise they are doing it, say experts.

‘Dysfunctional breathing is an interesting and common phenomenon,’ says Richard Russell, a professor of respiratory medicine at King’s College London and a consultant respiratory physician at the Hampshire and Isle of Wight Healthcare NHS Foundation Trust.

‘Normal breathing is relaxed, automatic, subconscious and easy – involving the diaphragm to help suck in more air, and therefore oxygen, into the deepest parts of our lungs.’

With dysfunctional breathing, he says, ‘you shallow breathe more in the upper chest. The rhythm is not steady and involves more muscles: you use shoulder muscles and the top of your chest.’

As dysfunctional breathing is an inefficient way to get air into the body, signs can include excessive sighing or yawning to make up for what feels like an uncomfortable shortness of breath, known as air hunger.

Dysfunctional breathing can occur in response to various illnesses.

‘It can happen in response to acute illness – Covid is an example – and can co-exist with established lung disease, asthma or COPD [chronic obstructive pulmonary disease – an umbrella term for conditions such as chronic bronchitis and emphysema],’ says Professor Russell.

It can also start following a trauma (a physical or emotional event) and as a result of pain.

‘For example, if you have back pain you might breathe more shallowly to avoid that pain,’ says Professor Russell. ‘That can then turn into a learned behaviour.’

Excess screen time is another trigger. Around 80 per cent of office workers hold their breath while looking at a screen, according to research in 2008 by a former Microsoft executive (who coined the term ‘screen apnoea’ to describe it), and which can contribute to dysfunctional breathing. This has since been associated with higher blood pressure.

There is no simple test to identify dysfunctional breathing – which means it often gets missed.

But identifying it is vital, says Professor Russell, as dysfunctional breathing can have a knock-on effect on multiple elements of your health – from your blood pressure to your digestive system.

‘Breathing can exacerbate gastrointestinal issues (such as heartburn, acid reflux, burping and hiatus hernia) and allergic rhinitis,’ says Professor Russell, ‘and is linked to hypertension [high blood pressure]’.

It can impact your emotions, too, as dysfunctional breathing ‘puts more ‘pressure on your body as a whole, so causing subconscious anxiety and stress’, he adds.

In fact, a study involving 300 people published in European Psychiatry in 2023 found 60 per cent of those with anxiety had dysfunctional breathing.

There is also a strong link to asthma. Almost a third of asthmatics have dysfunctional breathing, according to a 2016 paper in the journal European Respiratory Review – due to airways narrowing and learned habits which, doctors say, worsen symptoms.

This was the case with Bob Craven, 79, a former police detective inspector from Southend-on-Sea.

He was diagnosed with asthma in his 50s, a few years after leaving his job in the police force due to stress. For years he was unable to walk across a room without his asthma triggering coughing and breathlessness.

Bob had to use his reliever inhaler eight times a day to stave off the near-constant chest tightness, coughing, wheezing and shortness of breath. He took steroids to deal with flare-ups and was on antibiotics for chest infections every four to six weeks.

He was diagnosed with dysfunctional breathing by Dr Duncan Powrie, a respiratory consultant at Southend Hospital, a little over 10 years ago, and was put on a course of pulmonary rehabilitation.

Breathing exercises were his saviour, he says: ‘The breathing coaching has changed me as much as the medication. It has been tremendous.’

He now does exercises every day.

‘It has been amazing,’ says Bob.

‘I count to eight inhaling, then exhale for as long as I can without pushing too much or getting giddy. It does not stop my asthma but it enables me to be in control, read my danger signs and manage the issues.’

‘Breathing exercises are absolutely transformative,’ says Professor Russell.

‘It’s surprising dysfunctional breathing isn’t more widely corrected, especially if co-existing with a condition such as anxiety or asthma – and given how widely it affects our health.’

He adds: ‘Part of the difficulty is that dysfunctional breathing falls between respiratory medicine and mental health.

‘Doctors may look for problems with the heart or lungs, while anxiety and stress are often viewed as psychological issues. The breathing pattern itself can be over-looked.’

In 2018, award-winning science journalist James Nestor, author of Breath: The New Science Of A Lost Art, asked scientists from Stanford University in the US to help him test how quickly the body reacted to dysfunctional breathing.

To encourage mouth breathing, he corked up his nose using silicone for ten days while he slept, ate and exercised.

He quickly developed obstructive sleep apnoea (where breathing stops during sleep, as muscles in the throat relax too much); his blood pressure spiked; and his heart rate variability – the variation in time between heartbeats, which is a measure of nervous system balance – dived, showing his body was in a state of shock.

Encouragingly, these changes were righted by ten days of normal nasal breathing afterwards.

For anyone who thinks they have dysfunctional breathing, focusing on breathing steadily through the nose once or twice a day for ten minutes can help, says Professor Russell.

But he warns that it won’t stop an asthma attack if triggered by an infection or allergen such as pollen.

‘Controlled breathing is not going to solve that problem,’ he says. ‘Following the treatment and management plan given by your GP or specialist is critical.’

If you suspect you have dysfunctional breathing that’s detrimentally affecting you or your health, you can ask your GP to be referred for respiratory physiotherapy.

Respiratory physiotherapy – ie physical therapy for those with lung or breathing issues – ‘can help confirm whether you have a breathing pattern disorder and/or whether there is something else that needs treating, such as an anxiety disorder’, says Professor Russell.

But there are exercises you can practise at home to improve dysfunctional breathing, he adds.

‘It may also involve nose breathing or window breathing [also known as box breathing, which entails inhaling and exhaling for roughly four seconds and holding your breath for the same amount of time in-between] to help reset breathing patterns.

‘The key is to commit and work at it,’ says Professor Russell. ‘You’ll see improvements quickly – but resetting unconscious respiratory patterns may take months.’

Patrick McKeown, a breath training coach and author of The Breathing Cure, says: ‘Dysfunctional breathing is not new – but what is changing is our understanding of how closely breathing is connected with physical health, mental health and the way we live.’

It’s a sentiment Bob would agree with.

Having been barely able to cross the room a few years ago without breathlessness, he now regularly cycles and in 2023 completed a 40-mile charity walk up and down Southend Pier 15 times for the charity Asthma & Lung UK.

This year he has used his reliever inhaler just twice.

In 2024, Bob was prescribed an injection – benralizumab – every two months to treat his asthma, which has also helped – but he attributes much of the improvement in his health to regular slow, deep breathing.

‘Without it, to be quite honest, I would be most likely in a wheelchair or even dead,’ he says.