Question: Hi, I'm a 45 year old male. I have a history of anxiety and panic disorders. Recently, I've developed what my doctor thinks is Hyperventilation Syndrome. Basically, he said that my shortness of breath and dizziness were due to over-breathing. All tests were normal, i.e. blood work, chest x-ray, ECG, Echo-cardiogram, oxygen pulse, and peak flow. Plus, auscultation was normal. My doctor says that to eliminate hyperventilation, I need to slow my breathing down and stop taking such deep, sighing breaths so often.

But I have several other questions, all related to Hyperventilation Syndrome that I forgot to ask the doctor, and I don't really want to go back again right away. So, here they are: Question 1: Does Hyperventilation Syndrome cause exercise intolerance? -- When I first wake up in the morning (after breathing normally all night) I can put on my shoes and take a walk without much trouble. It feels like my lungs are nice and open. But later in the day (presumably after over-breathing) my tolerance for exercise is greatly diminished. My lungs feel full and I get short of breath with just a short walk. Why would this be? Question 2: I don't just have shortness of breath, in general. I also have this weird sensation of needing to take a deep breath. But when I try, I can't seem to do it. I thought that I was just holding too much air in. But even when I make sure to exhale completely, I still can't take a deep breath. However, if I focus on doing slow, diaphragmatic breathing for a few minutes, then I CAN take a deep, satisfying breath. Why is this happening? -- Why would this be? Logically, I would think that if I exhaled completely, I would be able to take in a deep breath, right? Question 3: I researched Hyperventilation Syndrome on the internet and I'm very confused -- i.e. oxygen goes up, carbon dioxide goes down, hyperinflation, residual volume, etc. Please explain this to me a bit, and tell me what I'm doing wrong. I get the whole diaphragmatic breathing versus thoracic breathing, and slowing my respiratory rate down to about 12/min. -- but what exactly causes the problem? -- Should I try to breathe in longer and exhale shorter, or vice-versa. Should I try to breathe out as much as I can, or hold some back? -- Should I breathe out fast or slow? I just don't get what's going on and how to fix it. -- Is my carbon dioxide level going down because I'm breathing out too much or too fast, or because I'm breathing in too deeply, or too fast, or too slow? I'm so confused. Please briefly explain the science behind what's going on. Question 4: I know that the main goal is to slow my breathing down (diaphragmatic) and reduce the frequency of deep, sighing breaths. However, I know that (at least for awhile), I will need to take some deep breaths occasionally. So, if I've put off a deep breath as long as I can, and I really need to take one deep, satisfying breath, how can I do it in such a way that it won't perpetuate my Hyperventilation Syndrome? -- long/short inhale - long/short exhale -- fast/slow inhale, fast/slow exhale, etc. Question 5 (Last one): After I start breathing correctly, how long will it take to get completely back to normal? Are we talking days, weeks, months? I read online that it can take a couple of months, but that information wasn't from a doctor. Thank you in advance for your answers. I must say that, at forty-five years of age, I never thought that I would ever be asking anyone how to breathe! You would think that after forty-five years, it would just come naturally. But, oh well. Thanks again.