Why would someone have difficulty taking a deep breath into the diaphragm (pit of stomach) and holding it?

From the Guidelines

Difficulty taking a deep breath into the diaphragm and holding it can be caused by various factors, including anxiety, respiratory conditions, or poor breathing technique, and practicing diaphragmatic breathing exercises daily can help strengthen breathing muscles. When considering the factors that contribute to this issue, it's essential to look at the most recent and highest quality studies, such as the joint EANM/SNMMI/ESTRO practice recommendations for the use of 2-[¹⁸F]FDG PET/CT external beam radiation treatment planning in lung cancer v1.0 1. This study highlights the importance of controlled breathing methods, including moderate or deep-inspiration breath-hold, which can significantly reduce respiratory tumor motion and changes internal anatomy. Some key points to consider when addressing difficulty taking a deep breath into the diaphragm include:

• Anxiety and respiratory conditions, such as asthma or COPD, can restrict deep breathing and may require medical treatment
• Poor breathing technique, which can be improved through practice and training
• Obesity or poor posture, which can physically restrict the diaphragm's movement
• The importance of proper breathing technique, which engages the diaphragm to create negative pressure in the chest cavity and draw air into the lungs. To improve deep breathing, it's recommended to practice diaphragmatic breathing exercises daily for 5-10 minutes, starting by lying down with one hand on the chest and another on the stomach, and focusing on breathing so that the stomach rises more than the chest. If breathing difficulties are accompanied by chest pain, dizziness, or persist despite practice, it's crucial to consult a healthcare provider as these could indicate a more serious condition requiring medical attention.

From the Research

Difficulty Taking a Deep Breath

• Someone may have difficulty taking a deep breath into the diaphragm (pit of stomach) and holding it due to various physiological and psychological factors, including anxiety and panic disorders 2.
• The pathophysiology of dyspnoea, or shortness of breath, is complex and involves the activation of several pathways that lead to increased work of breathing, stimulation of receptors, and excessive stimulation of the respiratory centre 3.
• Slow deep breathing can modulate cardiovascular control, and changes in heart rate variability (HRV) during slow deep breathing have been observed, with increases in parasympathetic activity and decreases in heart rate 4.

Physiological and Psychological Relief

• Deep breaths can have a psychological and physiological relief effect, with instructed deep breaths and spontaneous sighs compared to a control breathing maneuver showing increased self-reported relief and decreased physiological tension 5.
• Different slow, deep breathing techniques can have differential psychophysiological effects, with loaded breathing and pursed-lips breathing associated with enhanced cardiovascular effects and better emotional responses 6.

Potential Causes of Difficulty

• Anxiety and panic disorders can cause hyperventilation, leading to lower end-tidal pCO2 and making it difficult to take a deep breath 2.
• Dyspnoea can be caused by a range of disorders, from benign to serious and life-threatening entities, and the clinical evaluation and approach to management are directed by the clinical presentation and underlying cause 3.
• Individual differences in respiratory sinus arrhythmia, baroreflex function, and emotional state can also affect the ability to take a deep breath and hold it 6.