Can POTS Harm Breathing? - Power Over POTS

The principle function of breathing occurs in the lungs, delivering oxygen from air to red blood cells and removal of carbon dioxide (by-product of body metabolism) from red blood cells to room air. Red blood cells deliver life-giving oxygen to all the cells of the body and blood carries waste carbon dioxide back to the lungs to be exhaled. Calm relaxed breathing is primarily abdominal, dependent on the diaphragm muscles to move air in and out of the lungs. When stressed, involuntary brainstem signals tighten one’s muscles including the diaphragm muscles, forcing one to depend on the muscles of the rib cage for movement of air into the lungs.

Why Do POTS Patients Develop Hyperventilation?

Those with POTS who struggle with severe headaches, concentration difficulties, lightheadedness, chest discomfort, chronic fatigue and/or forgetfulness are at higher risk for psychological stress and breathing difficulties. This arousal may not always be outwardly visible, but “inside a psychological storm may be raging.” When individuals are psychologically aroused, either related to fear or apprehension, breathing tends to temporarily become more rapid, shallow and noisy. To speed-up the rate of breathing air in, the muscles that lift the ribs work harder to create negative pressure (partial vacuum) that encourages movement of air into the upper lungs. This abnormally rapid shallow chest breathing is known as HYPERVENTILATION. Hyperventilation (rapid chest breathing) requires more energy than relaxed breathing and is less efficient. Rapid breathing, when not exercising, causes excessive blowing off of carbon dioxide and worsening of POTS-related symptoms. For hyperventilators the duration of inspiration becomes prolonged and the duration of expiration is shortened, instead of being equal as is normal. While unhealthy hyperventilation occurs more commonly in the general population than in POTS subjects, both are rarely recognized, even when present.

Clues to recognition of unhealthy hyperventilation include:

Rapid breathing (16 or more breaths per minute) (12 is normal)
Chest breathing (utilization of rib cage rather than diaphragm to move air in and out of lungs)
Chest pain (sprained rib cage muscles and joints)
Erratic breathing
Spasmodic gasping breaths
Pre-speaking air sucking
Frequent large sighs
Sensation of breathlessness (feeling unable to obtain an adequate breath)
Sensation of “lump in throat”
Dizziness, faintness, light-headedness, weakness (due to blowing off excessive carbon dioxide)
Tingling, numbness, trembling, tremors (due to blowing off excessive carbon dioxide)
Apprehension, anxiety, phobia, panic
Palpitations, tachycardia

What to Do If Hyperventilation is Suspected?

Psychological-induced hyperventilation may be difficult to distinguish from hyperventilation induced by such medical conditions as heart, lung, brain, kidney and metabolic diseases like diabetes. Evaluation by a medical professional should be consulted to determine the cause of symptoms suggestive of hyperventilation.

When hyperventilation is finally recognized, Individuals are usually told, “You need to calm down, it’s all in your head,” without providing the necessary long-term skills to cope with unhealthy rapid shallow chest breathing. POWER over POTS – A family guide for managing POSTURAL ORTHOSTATIC TACHYCARDIA SYNDROME provides POTS hyperventilators with skills to learn healthy breathing and reduce anxiety.

Visit: www.poweroverpots.com

Dr. Scheldon Kress is a specialist in Internal Medicine with over 30 years of clinical experience caring for patients and pioneering behavioral management strategies to help patients make healthy lifestyle changes with respect to weight loss, stress management, diabetes management and smoking cessation. Passionate about helping patients manage difficult to diagnose medical conditions, he became interested in POTS when several family members and friends struggled with the symptoms, proper diagnosis and effective management of POTS.

Observing the challenges of POTS first-hand, he began to provide POTS patients and their families with a better understanding of causes and potential treatments, while at the same time teaching them how to utilize an effective behavioral change program to manage their POTS symptoms. This self-directed program is a must-read for patients and families dealing with POTS to empower them to take back their lives and achieve POWER over POTS.

Five Star Reviews

Extremely helpful and informative

My daughter has been suffering these symptoms for months. She, like many others, has been misdiagnosed with neurological diseases and mental illness. Even with her heart rate being 30 beats different and multitude of symptoms, doctor was still skeptical because of her blood pressure not changing. Doctors are not educated on this syndrome and it’s extremely hard to find one that is. This has brought a lot of stress to our family, however, as her mom, I persevered, held my own and kept on researching. I came across POTS, educated myself and now we know what’s wrong and how to fix it. This book was one of the books to help us get there. Thank you for publishing this extremely helpful information!

- Praha2014, Amazon

I would like to thank Dr. Kress for writing this book and bringing much needed attention to this illness. POTS is something I have struggled with for many years and I appreciate how thorough and descriptive the book is. The first part of the book expertly describes the ins and outs of finding a diagnosis and how to recognize POTS in a patient. The second section of the book is perfect for families trying to navigate the lifestyle changes that a patient and the rest of the family go through in order to make recovery easier. The book covers all the bases for someone who is looking for more information about POTS. I will most definitely be sharing this book with friends and family and continue spreading the word of this most amazing book.

- Mary Beth, Amazon

The Best POTS Book Available!

This book was extremely helpful in helping my family understand and navigate POTS. The medical information is outstanding and the explanations for the behavioral changes necessary to improve POTS symptoms are easy to understand. I would recommend this book to anyone who is interested in learning more about POTS or wants to lessen their POTS symptoms to feel better. It really is a fantastic book and I like that it is written by a medical doctor who really understands how POTS affects every aspect of a patient's life.

- Angelina, Amazon

This book was incredibly helpful in educating me and helping me manage my child's difficult medical condition.

- Karen, Goodreads

Additional Information

I hope you find my book to provide helpful information on the subjects discussed. The book is not meant to be used, nor should it be used, to diagnose or treat any medical condition. For diagnosis or treatment of any medical problem, consult your own physician. The publisher and author are not responsible for any specific health needs that may require medical supervision and are not liable for any damages or negative consequences from any treatment, action, application or preparation, to any person reading or following the information in this book. References are provided for informational purposes only and do not constitute endorsement of any websites or other sources. Readers should be aware that the websites listed in this book may change. The author is no longer in private practice and not in a position to respond to any medical inquiries.