Treating Hyperventilation Syndrome With a Paper Bag

This solution may not help—and, in fact, may be harmful in some cases

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girl breathing into a paper bag
Breathing into a paper bag is not the right way to treat hyperventilation.

You may seen this in real life or while watching television. A person starts hyperventilating, pulls out a paper bag, and starts breathing in and out of it. After doing this, their symptoms stop. It is possible that breathing into a paper bag can help with hyperventilation, but it is not as helpful as deep breathing exercises. Furthermore, breathing into a paper bag when you think you are hyperventilating, but are instead experiencing similar symptoms that are related to another condition, can put your health and life at risk.

Here is what you need to know about this popular myth.

Hyperventilation Syndrome

Hyperventilation syndrome is usually associated with panic disorders. It is a psychological or emotional condition that causes a person to breathe too much. Breathing too deep and too fast causes the body to lose carbon dioxide (CO2), the byproduct of metabolism in our exhaled air. While CO2 is a byproduct, we still need a minimum amount in the bloodstream to maintain the proper pH balance in our bodies.

When a person loses a significant amount of CO2, some body tissues start to malfunction. First, numbness develops in certain areas -- typically the lips, fingers and toes. After a while, the muscles of the hands and feet begin to cramp.

Additional symptoms of hyperventilation may last up to 30 minutes and may include:

  • Dizziness
  • Chest pain
  • Lightheadedness
  • Sweating
  • Muscle spasms
  • Palpitations
  • Shortness of breath
  • Fatigue
  • Confusion

Anyone who suffers from frequent panic attacks and anxiety may be suffering from a chronic case of hyperventilation and should talk to their doctor about evaluation and further testing. 

Paper Bag Myth

Paper bags have been used for years to treat hyperventilation syndrome. Breathing in the bag allows you to re-breathe the same air again.  This air contains carbon dioxide (CO2) and helps in getting more CO2 in the blood, although not as quickly or as effectively as many doctors previously thought. This method may work because hyperventilation is caused by the lack of CO2 getting into the blood. It is also not about the paper bag; breathing into anything similar, such as a protective mask, might help.

Safety

The problem with the paper bag method is that there hasn't been enough evidence to show breathing in one helps with hyperventilation. No research has shown it to hurt either. What paper bags do hurt are serious medical conditions that share similar symptoms to hyperventilation.

Breathing into a paper bag restricts the fresh air you are able to get. Without fresh air, too little oxygen is in the air you're inhaling. So, breathing into a paper bag dangerously lowers the amount of oxygen in your bloodstream. For example, a person experiencing a heart attack may incorrectly think they are hyperventilating and potentially worsen their situation by breathing into a paper bag.

To make matters worse, several studies now show a link between high concentrations of CO2 and panic attacks. This means that artificially increasing CO2 in inhaled air is likely to trigger more feelings of panic in patients who suffer from anxiety.

In addition to emotional stress, hyperventilation symptoms can be triggered by other serious conditions that could be worsened by using a paper bag for breathing. These may include:

Head Injuries

If a person experiences a head injury, it can lead to changes in breathing. Without the presence of physical symptoms, a head injury can go undetected if hyperventilation is the only cause considered. Additional symptoms of a head injury are headache, confusion and severe nausea, which arrant emergency medical attention.

Lung Conditions

Lung conditions, such as chronic obstructive pulmonary disease (COPD) and asthma, make breathing difficult. Additional symptoms, such as wheezing, cough and chest pain distinguish these conditions from hyperventilation.

Diabetic Ketoacidosis

Diabetic ketoacidosis can cause hyperventilation. Additional symptom include nausea, excessive thrist and frequent urination. Go to the emergency room if you are throwing up for more than 2 hours, your breath smells fruity, you are confused and tired, and/or if you are struggling to breathe.

High Altitude

At high altitudes, there is less oxygen available, which can cause problems for people with lung conditions. Even in people without breathing problems, high altitude can lead to hyperventilation. With high altitudes, it is best to assess and treat symptoms appropriately rather than attempting to use a paper bag to combat them, so as to avoid further breathing complications.

Treatment

Treatment for hyperventilation aims to slow down fast breathing and return breathing back to normal. The best and safest treatment for a hyperventilation episode is to stay calm and practice breathing slowly and not too deeply. Calmness and breathing exercises have just as much success as paper bag breathing, but with no risk to your health.

Researchers from Brunel University, Uxbridge, United Kingdom, confirmed this when they sought to compare relaxation therapy versus breathing therapy for management of hyperventilation. What they found was significant reduction in frequency and severity of hyperventilation attacks in the breathing exercise group.  

Breathing exercises are not your only options. Doctors will attempt to treat underlying causes of hyperventilation to keep it from occurring in the future. Because it is often related to psychological stress from fear, anxiety and panic attacks, treatment options include:

When To Seek Help

There are times where it will be difficult to determine if hyperventilation is the result of stress or another health condition. If hyperventilation is severe or if you are experiencing it for the first time, it is best to seek medical attention. 

In addition, if you experience the following symptoms with hyperventilation, seek urgent medical attention:

  • Chest pain
  • Blue lips, skin or fingers
  • Fainting
  • Confusion
  • Fever

These are symptoms that may not be related to hyperventilation and could indicate a serious, life-threatening condition and should not be ignored. 

A Word From Verywell

Using a paper bag for hyperventilation is usually not dangerous. It can be dangerous, however, if a person mistakes hyperventilation for another serious medical condition.  Moreover, the paper bag myth only helps in mild to moderate cases where hyperventilation is an psychological response, i.e., such as panicking while on a plane. If you suffer from panic attacks, talk to your doctor before considering using a paper bag to help with breathing. He or she can direct you to exercises that may be better situated for your situation and to help you stay calm. 

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