Chronic fatigue syndrome (CFS) often leaves people completely drained and struggling to think. Their symptoms can get worse after even mild exercise, a reaction called post-exertional malaise.
Now, researchers studying people with CFS have found that many of them may also have problems with the way they breathe.
These breathing problems, known as dysfunctional breathing, might be linked to a condition called dysautonomia, which affects how nerves control muscles and blood vessels.
Scientists hope that by helping people breathe better, they might be able to reduce some of the worst symptoms of chronic fatigue.
According to Dr. Benjamin Natelson of the Icahn School of Medicine, nearly half of the people with chronic fatigue in the study had abnormal breathing. This finding may lead to new treatments focused on improving breathing, with the goal of reducing fatigue and other symptoms.
The study included 57 people diagnosed with CFS and 25 healthy people of similar age and fitness level. Everyone did two days of heart and lung exercise tests. During the tests, researchers measured things like heart rate, blood pressure, how well oxygen was used, and how the participants were breathing.
Dysfunctional breathing can show up as deep sighs, fast breathing, forceful breaths using the belly, or breathing mostly with the chest instead of the diaphragm. This prevents the lungs from fully expanding and can make breathing less efficient. Sometimes the chest and belly muscles are not well coordinated.
Dr. Donna Mancini, another author of the study, said that people may have dysfunctional breathing without realizing it, and it can even happen when they’re at rest.
Although both the chronic fatigue group and the healthy group used similar amounts of oxygen, 71% of the CFS group had abnormal breathing. Almost half had irregular breathing, about one-third hyperventilated, and nine people had both problems. These issues were rare in the healthy group.
Both hyperventilation and dysfunctional breathing can cause symptoms that look like chronic fatigue: dizziness, trouble focusing, shortness of breath, and tiredness. When both happen together, they can also cause chest pain, heart palpitations, and anxiety.
The researchers think these breathing problems may make chronic fatigue worse or even cause the post-exertional crashes that many people with CFS experience. One possible cause is dysautonomia, which is common in people with chronic fatigue. This condition can raise heart rate when someone is upright and not moving, which may lead to faster, less efficient breathing.
The good news is that there may be ways to help. The researchers plan to study more about how these breathing problems work. In the meantime, they suggest some ideas that might help: yoga breathing exercises, gentle exercise that focuses on breath control like swimming, or biofeedback to help people learn to breathe more normally.
For example, a device can measure the amount of carbon dioxide someone breathes out. If the number is too low, it may mean they are breathing too deeply or too often. Patients can then practice breathing more gently to bring the number back to normal.
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The study is published in Frontiers in Medicine.
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