(1) Regular. The normal breathing rhythm (pattern) is: inhalation, pause,
exhalation, pause. The exhalation phase of the cycle usually lasts about twice as long
as the inhalation phase. The cycles are repeated at a steady pace.
(2) Irregular. A change from the normal breathing pattern is an irregular
pattern. An irregular breathing pattern may indicate the presence of illness. It is not
unusual for painful breathing to be associated with an irregular breathing pattern. Some
irregular patterns are given below.
(a) Cheyne-Stokes. Cheyne-Stokes breathing is a pattern in which the
breathing increases and decreases in depth with regularly recurring periods when the
patient does not breathe at all. Cheyne-Stokes breathing is usually associated with
severe head trauma that interrupts the breathing center in the brain, causing the
irregular breathing pattern. It can also be seen in acute mountain sickness as the body
tries to compensate for the lower oxygen levels at higher altitudes.
(b) Kussmaul. Kussmaul breathing pattern is a compensatory
mechanism that is often seen in diabetic patients. This breathing pattern is very deep
and rapid as the body attempts to lower the acid levels that are created in diabetic
ketoacidosis. It is also associated with crush syndrome (renal failure following the
crushing of a large muscle mass).
(c) Agonal. Agonal breathing is the body's last attempts to save itself.
The patterns of occasional gasping breaths that can often occur after the heart has
stopped are not effective in moving air. This is a primal reflex that is seen as a patient
d. Quality. Breathing can be of normal or abnormal quality.
(1) Normal. Normal breathing does not require conscious effort. It is
automatic, regular, and even. It produces no noise, discomfort, or pain.
Abnormal. Breathing that is not normal is abnormal.
(a) Pain. Injuries to the chest and certain diseases can cause pain
(b) Labored breathing. Labored breathing occurs when the person is
trying to get as much air into his lungs as possible. It is also called "air hunger" and
"dyspnea." Labored breathing is normal when due to vigorous work or athletic activity.
(c) Wheezing. Wheezing is difficult breathing accompanied by
whistling sounds on exhalation. Wheezing often occurs in patients with asthma
(difficulty in breathing caused by spasms in the bronchial tubes and excessive mucous
production) and emphysema (a condition caused by damaged lung tissue).