What Is Labored Breathing?

Symptoms, Causes, and When to Seek Help

Table of Contents
View All

Labored breathing is a general term used to describe the physiological effects of being unable to breathe normally. It can feel like you are struggling for air and may make you feel worried and tired. It can be brought on temporarily through exercise or anxiety or as a result of a more serious medical problem. 

Although labored breathing is often used interchangeably with dyspnea (shortness of breath), the latter describes the sensation of breathlessness or suffocation. You can have both labored breathing and dyspnea at the same time or can experience them individually.

Labored breathing is characterized by its physical features, such as grunting and the use of accessory muscles to breathe. Sometimes you may hear labored breathing referred to as increased work of breathing or working hard to breathe.

Woman experiencing labored breathing
Maridav / iStock / Getty Images

Symptoms

Labored breathing is not an official medical term but can be characterized by several symptoms:

  • Hyperpnea: Another word for labored, abnormal breathing, hyperpnea can occur with or without shortness of breath (rapid breathing).
  • Tachypnea: This is fast, shallow breathing with an elevated respiratory rate.
  • Stridor: This very distinctive, high-pitched noise is caused when the upper airway is obstructed.
  • Intercostal retractions: This is a symptom of respiratory distress. Visually, you can see the skin pull in and out between the ribs with each breath—the more pronounced, the more severe the respiratory distress.
  • Nasal flaring: This is another sign of difficulty breathing where the nostrils widen and spread with each breath. It can be a sign of respiratory distress in children.
  • Grunting: might be heard on exhalation (breathing out) when a person is working hard to breathe. 

Other labored breathing symptoms can include wheezing, cyanosis (blue skin around the mouth, nose, or fingertips), gasping, or difficulty lying flat. 

Accessory Muscles

Using accessory muscles to breathe is a sign of labored breathing. Accessory muscles assist breathing but are not the primary breathing muscles. Muscles other than the diaphragm and intercostal muscles, such as the sternocleidomastoid, spinal, and neck muscles, are accessory muscles in breathing.

Causes

Labored breathing can occur for many reasons ranging from anxiety to a medical emergency. It may simply happen because you overexerted yourself during exercise to the point where you are gasping for air. It can be a single, short episode, or may persist.

Labored breathing can also be the result of an acute or chronic respiratory condition or a non-respiratory condition. Anxiety disorders, most especially panic disorder and post-traumatic stress disorder (PTSD), can also cause labored breathing symptoms that present in the same way. 

Examples of acute and chronic conditions that can cause labored breathing include:

Acute Conditions
  • Anaphylaxis

  • Carbon monoxide poisoning

  • Choking or asphyxiation

  • Chest or neck injury

  • Croup

  • Endocarditis

  • Heart attack

  • High altitudes

  • Near-drowning

  • Pericardial effusion

  • Pleural effusion

  • Pneumonia

  • Pneumothorax

  • Pulmonary thrombosis

  • Sepsis

  • Severe anemia

  • Whooping cough

Chronic Conditions
  • Amyotrophic lateral sclerosis (ALS)

  • Asthma

  • Congestive heart failure

  • COPD

  • Coronary artery disease

  • Cystic fibrosis

  • Guillain-Barre syndrome

  • Lung cancer

  • Myasthenia gravis

  • Pulmonary edema

  • Pulmonary sarcoidosis

  • Stable angina

  • Tuberculosis

  • Ventricular failure

When to Call 911

Call 911 for emergency medical attention if you experience labored breathing unrelated to exercise that does not subside within a few minutes.

Additional signs that labored breathing is a medical emergency include:

  • Inability to talk
  • Gasping for air
  • Wheezing
  • Drooling
  • Dizziness or fainting
  • Profuse sweating
  • Clammy skin
  • Turning blue (cyanosis)

Diagnosis

A medical professional will try to establish the cause of labored breathing through several diagnostics tests. These can include:

  • Physical exam: During a physical exam, a medical professional will listen to your lungs, count your breaths per minute, monitor your pulse, and look for visible physical symptoms such as retractions or cyanosis. 
  • Blood tests: Blood tests such as an arterial blood gas can measure how much oxygen you have in your blood, and a complete blood count (CBC) can check for anemia.
  • Imaging studies: A chest X-ray, computerized tomography (CT) scan, or magnetic resonance imaging (MRI) scan may be done. A medical professional will examine the images to look for labored breathing causes such as pneumonia, fluid on the lungs, a heart problem, or a blockage.
  • Pulmonary function tests: These tests measure how well your lungs work by assessing lung flow, lung size, lung volume, and gases such as oxygen and nitric oxide in your blood. Examples of pulmonary function tests include spirometry, lung diffusion capacity, or fractional exhaled nitric oxide tests.
  • Electrocardiogram: Also known as an ECG or EKG, it is a non-invasive test that assesses for heart disease and problems. 

The types of tests that your doctor will decide to do will depend on their preliminary findings and what they suspect the cause of labored breathing is. For example, an electrocardiogram, echocardiogram, and cardiac stress test might be requested if heart failure or a heart disorder is suspected.

In comparison, a doctor might order pulmonary function tests, a six-minute walk test, and arterial blood gases if a diagnosis of chronic obstructive pulmonary disease (COPD) is suspected. Therefore, the types of tests performed to diagnose the cause of labored breathing will differ for each individual patient. 

Treatment

Labored breathing can occur for many reasons, the treatment of which can vary based on the underlying cause. Labored breathing may also require immediate medical intervention even if the underlying cause is not yet known. Examples of primary medical treatments include:

  • Short-acting beta-agonists (e.g., albuterol): These provide quick relief of shortness of breath and wheezing by relaxing the lungs' smooth muscles. They are commonly delivered via an inhaler or nebulizer but can also be given in the form of a pill or injection.
  • Epinephrine injection: This is used in an emergency to treat anaphylaxis (a severe allergic reaction). It reduces swelling of the airway while stimulating the heart and increasing blood pressure. 
  • High-dose corticosteroids: These drugs rapidly reduce inflammation, which can occur with conditions such as asthma or COPD, causing the airways to swell. They can also help to reduce mucus secretions. 
  • Oxygen therapy: It can be administered through a face mask or nasal cannula to help increase oxygen levels in the blood. 
  • Intubation with mechanical ventilation: This is a procedure where a tube is placed into the airway, and a ventilator assists with breathing. It is done when a patient cannot breathe by themselves or keep their airway open. 
  • Anxiolytic medications: Anti-anxiety drugs are used to help treat anxiety-related disorders and associated symptoms.

These are just a few examples of treatments for labored breathing. Due to the wide range of conditions that can cause labored breathing, treatment will differ for each individual.

A Word From Verywell

Labored breathing is rarely considered "normal." It is essential to seek medical attention if labored breathing occurs for no apparent reason. If you could attribute it to an existing medical condition, an episode still should be reported to your medical team so any treatments can be adjusted, if needed.

While labored breathing can occur with extreme physical activity, it should be looked at if it happens with mild or moderate physical activity. If labored breathing does not resolve once the physical activity has ceased and you have rested, it should also be investigated.

It is essential to seek emergency care if labored breathing develops spontaneously with no physical cause and doesn't resolve within a few minutes.

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Tulaimat A, Trick W. DiapHRaGM: A mnemonic to describe the work of breathing in patients with respiratory failurePLoS One. 2017;12(7):e0179641. doi:10.1371/journal.pone.0179641

  2. Sharma S, Hashmi MF, Badireddy M. Dyspnea on exertion. StatPearls. Updated September 10, 2020.

  3. Reuter S, Moser C, Baack M. Respiratory distress in the newbornPediatr Rev. 2014;35(10):417-429. doi:10.1542/pir.35-10-417

  4. Sarkar M, Bhardwaz R, Madabhavi I, Modi M. Physical signs in patients with chronic obstructive pulmonary diseaseLung India. 2019;36(1):38. doi:10.4103/lungindia.lungindia_145_18

  5. National Heart, Lung, and Blood Institute. Pulmonary function tests.

  6. Griebel G, Holmes A. 50 years of hurdles and hope in anxiolytic drug discoveryNature Reviews Drug Discovery. 2013;12(9):667-687. doi:10.1038/nrd4075