Learn To Improve Your Paradoxical Breathing In 4 Easy Steps!

demo lungs - paradoxical breathing

Paradoxical breathing is often the number one cause of short breaths and getting tired very often. It is often ignored but we must take it seriously.

Find out everything about paradoxical breathing and the easy ways to rectify it.

What Is Paradoxical Breathing?

Paradoxical breathing is a respiratory disorder where the synchronization between the movement of the chest wall and the ventilation process gets severely disrupted. It then leads to erratic and faulty breathing as a result.

The breathing process is primarily made up of two sub-processes:

  • Ventilation: The air (including oxygen) is taken inside the lungs. It goes through the external respiratory organs like the nose, nasal passage, windpipe, and lungs. This process is also called inhalation. Conversely, the co2 from the lungs exits out of the body. This part of ventilation is also called exhalation.
  • Respiration: The air (oxygen) reaches the lungs. An exchange process happens between the lungs and blood vessels in the lungs. The blood vessels take up the oxygen from the lungs and give co2 to the lungs.

Usually, during the inspiration process, the chest cavity and the abdominal cavity expands. And at the time of expiration, the chest cavity and the abdominal cavity contracts.

However, because of paradoxical breathing, this synchronization is reversed (hence the name Paradox). During inhalation, instead of expanding, the chest cavity contracts.  Subsequently, the abdominal cavity expands. It is the reverse of the normal cycle. Moreover, during exhalation, instead of contracting, the chest cavity expands and the abdominal cavity contracts.

The normal breathing synchronization between inhalation, exhalation, chest cavity and the abdominal cavity is disturbed. It is a severe issue. Hence, it should be set right as soon as possible.

The following table makes this more explicit.




deep look how paradoxical breathing look like

Because of paradoxical breathing, we can very clearly deduce two things from this:

  1. The chest cavity has lost its synchronization with inhalation and exhalation.
  2. The chest cavity and abdominal cavity, which were in unison before now, become opposed.

The changed behavior of the chest cavity poses many serious issues. These need to be understood and rectified in a reasonable time. Else, it blows up into some challenging situation.


The typical disturbed, erratic, and short breathing is the signature symptom of paradoxical breathing based on our research in verywellhealth. However, there are some other symptoms. These also indicate the onset/existence of paradoxical breathing.

The most prominent amongst them are:

  1. The chest wall and the abdominal wall uncharacteristically move opposite to each other during breathing. When the chest expands, the abdomen contracts and vice versa. Some refer to this as ‘seesaw’ movement of the chest and abdomen.
  2. There is a perceptible sense of giddiness/dizziness. Since the breath is erratic, the body is in short supply of oxygen. As a result, dizziness takes over.
  3. If the breath does not come correctly, the body is devoid of appropriate quantity oxygen. It weakens the body.
  4. The heart rate and the breath rate increase substantially in breathing more. This is termed as tachypnea. It is to get the required oxygen.
  5. Another symptom can be hypersomnia. That is excessive sleeping. Since the body gets weak due to lack of oxygen, it sleeps off.
  6. Dyspnea (short breath) is another symptom of paradoxical breathing. The inability of the chest to expand fully and breathe in fully.
  7. The person suffering from paradoxical breathing gets up frequently in the night. Shallow breath results in restlessness. Consequently, it results in sleep.

The above are some prominent tell-tale symptoms of paradoxical breathing. However, a person may exhibit one or more symptoms. The symptoms should be appropriately diagnosed by a medical professional. They will determine the existence of paradoxical breathing.


Several causes contribute to the existence of paradoxical breathing.

  1. Flail chest – The situation where three or more than three ribs get broken in more than two places. A section of the bone gets broken off the main rib cage and moves independently. Such extensive damage to the ribs would happen. It may be due to a head-on collision/accident. It is also possible if some blunt object hits the chest head-on.The rib cage is not rigid anymore. A portion of it hangs and flails in the opposite direction.
  2. Paralysis of the diaphragm – The diaphragm is a circular muscle that separates the chest cavity and the abdominal cavity. Along with the intercostal muscles, it helps expand and relax the chest cavity. A damaged diaphragm will make the expansion of the chest cavity very difficult. Consequently, this would not be easy for the intercostal muscles to handle.There are two ways in which the diaphragm damages. An injury or damage to the spinal cord affects the diaphragm. Another reason is some underlying medical causes. It could be a muscular issue or a problem with the nerves.

As the chest cavity expands, all organs from the abdomen tend to push into the chest cavity. As a result, it forms caving in of the abdomen and vice versa. In effect, as the chest expands the abdomen contracts. In the same way, when the abdomen expands, the chest contracts. This is the sign of paradoxical breathing. The chest and the abdomen move in a seesaw pattern.

Additional Causes According To HealthLine

  1. Electrolytic imbalance in the body can also give rise to paradoxical breathing. The imbalance may be because of diarrhea or some other reason. But the body tries to adjust the metabolic disturbances. In the process, paradoxical breathing may set in.
  2. In some cases, the body may be undergoing a hormonal shift. We do know that hormones play a significant role in the functions of the body. The hormonal disturbances may induce the erratic function of the diaphragm. Furthermore, it will lead to paradoxical breathing.
  3. Mineral deficiencies initiate the erratic behavior of muscles. If the levels of potassium, magnesium, and calcium are not optimum, muscle malfunction is the result. The paradoxical breathing sets in if this muscle happens to be a diaphragm.
  4. The upper airway in breathing comprises of nose, throat, the upper part of the windpipe. Any kind of air passage block in this path and parts can trigger paradoxical breathing.
  5. Some people suffer from sleep apnea. The sleeping person misses some breath or takes a short breath. It also is one of the causes of paradoxical breathing.
  6. The response and command network in the body is the nervous system. The brain controls the movement of the diaphragm. It controls through the phrenic nerves. Besides, the existence of any neurodegenerative disease like multiple sclerosis or muscular dystrophy will disrupt the normal functioning of diaphragm. It will lead to paradoxical breathing.
  7. Lung cancer is also one of the significant reasons for paradoxical breathing.
  8. Respiratory failure can be the cause, also the result of paradoxical breathing.


Paradoxical breathing is a severe sickness. Therefore, we need to investigate it thoroughly and be sure of its status. Some practical ways to diagnose it are:

  • Visual Inspection: Make the patient lie down on his back. Then, ask him to take a deep breath as he can. Watch his chest and abdomen. If they move opposed to each other, chances of paradoxical breathing exist.
  • Fluoroscopy, a type of x-ray, can detect the existence of paradoxical breathing.
  • We had seen earlier that hormonal imbalance could be one of the reasons for paradoxical breathing. The blood test confirms it.
  • The vital capacity test checks the function of exhalation.
  • Pulmonary Function Test: These are a non-invasive test to judge the working of the lungs. Furthermore, it measures the capacity of the lungs (volume), rate of flow of air, and oxygen/co2 exchange efficiency.

Additional Diagnostic Methods

  • Maximal Static Inspiratory Pressure (MIP): This test precisely measures the inhalation abilities and strength of the respiratory system. Besides, it can indicate ventilatory failure or the existence of any lung disease. It gauges muscle strength as well.
  • Sniff Nasal Inspiratory Pressure Test (Sniff Test): The test judges the effectiveness of the diaphragm. Additionally, the performance of diaphragm under normal breathing and sudden sniff noted, and that indicates the flexibility and performance of the diaphragm.
  • Electromyography of diaphragm: It measures the health and condition of the diaphragm. Furthermore, it is available in the needle and ECG pad version. The needle version is a little dangerous. So, better is the ECG pad version. It is non-invasive and safe.
  • Computer tomography: A complete imaging of the lungs and surrounding areas must be done to look out for any irregularities.
  • MRI: The images of the organs developed using magnetic fields and gradients. Moreover, it provides useful information about the structure and health of the internal organs to the doctors.


Prevention is always better than cure. Some lifestyle changes can help avoid paradoxical breathing. So before we get into the treatment, let us see how to prevent it.

Simple Steps To Avoid This Malady

You can take these steps to help protect your lungs from injury or disease according to nhlbi.nih.gov:

  • Always eat a proper and balanced diet. Since the micronutrients and hormones play a crucial role in healthy lung functions. Moreover, a balanced diet keeps the nutrients in good supply and avoids any malnutrition.
  • Keep your weight in the healthy zone. Being overweight and obese stress the heart and lungs unduly. Before it becomes too late, please control your weight and get it in a healthy zone.
  • Strengthen the core muscle. The inhalation and exhalation are all play of various muscles. The diaphragm is most important of all. It is very imperative to keep the muscles healthy and strong. After all, a strong core will aid the diaphragm and lungs in its functions. So go ahead and start building your core.
  • Avoid smoking and drinking alcohol. Firstly, it does no good for the body. Secondly, apart from being a socializing norm, it does not have any medical benefits. Hence, if possible, kick the habit. If not, reduce it considerably and limit it to only social events.

healthy ways to improve breathing

The Treatment

Once confirmed that paradoxical breathing exists, it needs treatment at the earliest. Do not stall the treatment for any reason. Moreover, aggravated situations are challenging to rectify.

The treatment can be to do away with the underlying medical cause, if any, or treat the symptoms and gradually reduce them.

There are three general areas of treatment to try.

  1. Compensate for the deficit of oxygen by external means.
  2. Fix any damage to the ribs or other parts.
  3. Set the air pathway. Keep it clear and wide. Moreover, to reduce the stress on the diaphragm and the lungs.

Some Specific Way To Do This

The most straightforward treatment is to make the patient use an aided oxygen mask. Since the patient is unable to inhale and exhale forcefully, the supported equipment forces the oxygen in and pulls out the co2. It is the indeed symptomatic treatment of the symptom.

It can be useful for patients who are old or fragile. Also, to those who cannot withstand invasive treatments or strong medications.

The next best thing to do is Tracheotomy. Instead of an oxygen mask, a breathing tube inserted in the trachea or the windpipe. Oxygen, then supplied through this tube. So there is an advantage over the mask. The face does not get covered, and the person can be involved in some activity.

We have seen that electrolyte imbalance can also lead to paradoxical breathing. Hence, Intravenous Electrolytic solutions are injected into the body to correct the discrepancy.

Further Treatment 

  1. Surgery and other corrective remedies applied to take care of the ‘Flail Chest.’ Similarly, the diaphragm also repaired and rectified, surgically, or by any other modern means. The idea is to repair any physical damage in the system.
  2. External breathing support is used for the night to manage the ‘Sleep Apnea’ (one of the causes of paradoxical breathing). It takes sleep apnea.  Consequently, the paradoxical breathing because of this gets settled.
  3. At times the blocked air pathways are also a reason for this disorder. Surgically or otherwise, these blockages get removed.
  4. The phrenic nerves control the diaphragm muscles. Also, phrenic pacing tunes the disorder of the phrenic nerves. It regulates the working and performance of the phrenic nerves. Eventually, the breathing gets reset to a healthy zone.

The type of treatment will depend on the cause of paradoxical breathing. So once the diagnosis performed, the treatment can begin.


Though complicated and severe disorder, paradoxical breathing can be set right. Proper understanding of the disease and the rectifying process can help manage this.

Therefore, it is imperative to diagnose it and treat it at the earliest. We cannot take this issue lightly.


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