From the Guidelines
Hyperventilation does not guarantee muscle twitching, though it can sometimes cause this symptom. When you hyperventilate, you breathe too rapidly or deeply, which lowers carbon dioxide levels in your blood, leading to respiratory alkalosis, as noted in the ats/accp statement on cardiopulmonary exercise testing 1. This condition can cause changes in calcium ion availability, leading to nerve excitability and muscle contractions in some people, which may appear as twitching, tingling, or even tetany (sustained muscle contractions). However, not everyone who hyperventilates will experience muscle twitching, as individual responses vary based on factors like the severity and duration of hyperventilation, underlying health conditions, and personal physiology.
Some key points to consider about hyperventilation syndrome include:
- Abnormal breathing patterns at rest and during exercise may be revealing and, in some circumstances, almost diagnostic 1
- CPET in subjects with hyperventilation syndrome often reveals impressive hyperventilation as evidenced by abnormal increases in Ve, Ve/Vco, and respiratory frequency, and respiratory alkalosis (decreased PetCO2 and Pa CO2) 1
- Other symptoms of hyperventilation may include lightheadedness, dizziness, chest pain, and numbness around the mouth or in the extremities, as well as ECG changes resembling ischemia in subjects with normal coronary arteries 1
If you experience frequent hyperventilation with muscle twitching, it's essential to consult a healthcare provider to rule out underlying conditions and learn proper breathing techniques to prevent future episodes. A complete, careful history and review of systems are essential for accurate interpretation, and identification of hyperventilation syndrome is crucial because appropriate treatment is usually successful 1.
From the Research
Hyperventilation and Muscle Twitching
- Hyperventilation is a common feature of many acute clinical conditions that can be benign or potentially catastrophic, and its symptoms are diverse and non-specific 2.
- The traditional definition of hyperventilation syndrome describes a syndrome characterized by a variety of somatic symptoms induced by physiologically inappropriate hyperventilation and usually reproduced by voluntary hyperventilation 3.
- Hyperventilation has rapid and far-ranging physiological effects via its alteration of pH and depletion of CO2 in the body, resulting in respiratory alkalosis, acute or chronic, and can cause a wide variety of symptoms such as pain, tension, disturbances of consciousness, circulatory problems, and cardiovascular effects 4.
- While hyperventilation can cause various symptoms, there is no direct evidence to suggest that it can guarantee muscle twitching.
- However, hyperventilation syndrome and panic disorder are both common, serious, and easily treatable disorders, and about 50 percent of patients in each group show evidence of both disorders, which may include symptoms such as tremor and paraesthesia 5.
- Breathing exercises are often used to treat dysfunctional breathing/hyperventilation syndrome, but there is no credible evidence regarding their effectiveness for the clinical symptoms of this condition, including muscle twitching 6.
Symptoms of Hyperventilation
- Hypocapnia and respiratory alkalosis can cause a range of symptoms, including:
- Pain
- Tension
- Disturbances of consciousness
- Circulatory problems
- Cardiovascular effects
- Tremor
- Paraesthesia
- These symptoms can be caused by physiological mechanisms such as low Pa,CO2, or the increased sympathetic adrenergic tone, as well as psychological mechanisms 3, 4.
Treatment of Hyperventilation
- Treatment should be directed at correcting the underlying clinical condition 2.
- Breathing exercises, relaxation techniques, and psychotherapy may be used to treat hyperventilation syndrome and panic disorder 3, 5.
- However, there is a need for further well-designed clinical trials to determine the effectiveness of these interventions for the clinical symptoms of dysfunctional breathing/hyperventilation syndrome, including muscle twitching 6.