Fast Breathing (Rapid Breathing)

What counts as fast breathing

Count breaths for a full 60 seconds while the person is resting and unaware you are counting. One rise and fall of the chest is one breath.

The thresholds for children under 5 are those the World Health Organization uses to flag possible pneumonia.

Tachypnea vs hyperventilation

These terms are often mixed up:

• Tachypnea means a fast rate. Breaths may be shallow. It describes what you see, whatever the cause.
• Hyperventilation means breathing more air than the body needs, so carbon dioxide levels fall. It can be fast, deep or both. Low carbon dioxide causes tingling around the mouth and fingers, light-headedness and chest tightness.
• Hyperpnea means deeper breaths, as during exercise or in metabolic acidosis.

Panic attacks cause hyperventilation. But hyperventilation can also be the body correcting a serious problem, such as acid buildup in diabetic ketoacidosis, so it should not be assumed to be anxiety without checking.

Reasons for fast breathing

Normal or harmless causes

• Exercise, climbing stairs, excitement
• High altitude, where air holds less oxygen
• Heat and dehydration
• Pregnancy, especially late pregnancy
• Pain

Lung causes

• Asthma and COPD flares: fast breathing with wheezing, cough and tight chest.
• Pneumonia: fever, cough, sometimes chest pain on breathing in. In young children, fast breathing may be the main sign.
• Bronchiolitis: a viral infection in babies under 2, with fast breathing, wheeze and poor feeding.
• Pulmonary embolism: a clot in the lung. Sudden breathlessness, fast breathing and heart rate, sharp chest pain. More likely after surgery, long travel, pregnancy or with a swollen leg.
• Collapsed lung (pneumothorax): sudden one-sided chest pain and breathlessness, often in tall young men or people with lung disease.

Heart causes

Heart failure causes fluid to back up into the lungs. Breathing becomes fast and shallow, especially lying flat, with ankle swelling and tiredness. Heart attacks and fast heart rhythms can also cause rapid breathing.

Whole-body and metabolic causes

• Fever and infection: each degree of fever increases the body's oxygen demand.
• Sepsis: a breathing rate of 22 or more is one of the warning signs doctors use for sepsis, alongside confusion and low blood pressure.
• Diabetic ketoacidosis: deep, fast breathing (Kussmaul breathing), fruity breath, thirst, vomiting.
• Anemia: fewer red blood cells to carry oxygen.
• Poisoning: aspirin overdose and some toxic alcohols stimulate breathing.

Anxiety and panic

Fast breathing during anxiety is real and uncomfortable but not dangerous in itself. It typically comes with a pounding heart, tingling hands, a sense of dread and a feeling that you cannot get enough air, and peaks within 10 minutes.

Accompanying symptoms and what they suggest

Snoring-like sounds with fast breathing

Rapid breathing with a snoring or rattling sound while awake can come from mucus in the throat, a blocked nose (especially in babies), or partial blockage of the upper airway. In someone who is very drowsy or unconscious, snoring breathing means the airway may be obstructed: roll them onto their side and call 911 or your local emergency number.

How doctors find the cause

The doctor counts the breathing rate, checks oxygen saturation with a finger probe, listens to the chest and checks pulse, temperature and blood pressure. Depending on the picture, tests include a chest X-ray, blood tests (blood count, infection markers, blood sugar, ketones, blood gases), an ECG and, if a clot is possible, a D-dimer blood test or CT scan of the lungs.

Treatment and what you can do

Treatment targets the cause: inhalers and steroids for asthma, antibiotics for bacterial pneumonia, blood thinners for clots, diuretics for heart failure, fluids and insulin for ketoacidosis, and oxygen when levels are low.

If you know your fast breathing is from anxiety and doctors have ruled out other causes:

1. Sit upright and drop your shoulders.
2. Breathe in through your nose for 4 seconds, then out slowly through pursed lips for 6 seconds.
3. Continue for a few minutes, focusing on making the out-breath longer than the in-breath.

Do not breathe into a paper bag. It can lower oxygen levels and is unsafe if the cause is actually heart or lung disease.

Frequently asked questions

What is a normal breathing rate for an adult?

A healthy adult at rest breathes about 12 to 20 times a minute. A resting rate above 20 is considered fast, and above 24 in someone who is unwell is a warning sign. Count for a full minute while the person is not aware you are counting.

What is the difference between tachypnea and hyperventilation?

Tachypnea simply means breathing faster than normal. Hyperventilation means breathing more air than the body needs, so carbon dioxide levels fall, causing tingling and light-headedness. Hyperventilation can be fast or deep. Anxiety commonly causes it, but so can acid buildup in the blood.

Why am I breathing fast at rest?

Common reasons are fever, anxiety, an asthma flare or a chest infection. Less common but serious reasons include a blood clot in the lung, heart failure, anemia, sepsis and diabetic ketoacidosis. Any fast breathing at rest that is new and unexplained should be checked by a doctor.

When is fast breathing in a child an emergency?

Call 911 or your local emergency number if a child is breathing fast with ribs sucking in, grunting, flaring nostrils, blue lips, pauses in breathing, or is too breathless to feed or speak. Fast breathing with fever needs same-day medical review.

Can anxiety cause rapid breathing?

Yes. Anxiety and panic trigger rapid breathing, a racing heart, tingling fingers and chest tightness. Episodes usually peak within 10 minutes and settle with slow breathing. Get checked if it is the first episode, if you have chest pain, or if you have heart or lung disease.