Hypoventilation Explained

Hyporventilation refers to a condition that causes shallow breathing and results in a reduced amount of air entering the alveoli, which are in the lungs. This condition is the opposite of hyperventilation and is particularly common during opioid withdrawal.

When individuals who are recovering from drug or alcohol addiction undergo a detox, it is likely that they will experience withdrawal symptoms. Detoxification refers to the slow reduction of substance intake until the individual can function mentally and physically without it. During this process, the body will react adversely, and the effects of this reaction are called withdrawal symptoms. Hypoventilation is a very common symptom of withdrawal from particular drugs.

What Is Hypoventilation?

The term hypoventilation refers to inadequate ventilation such as slow or shallow breathing, which results in diminished lung function. Hypoventilation limits the amount of air that reaches the alveoli in the lungs and consequently reduces the amount of oxygen in the blood. This causes respiratory acidosis, which is an increase of carbon dioxide in the blood. This condition often develops suddenly as a result of trauma or illness, although rarely hypoventilation conditions can be present from birth.

Hypoventilation can range from mild to severe and is a potentially very dangerous condition. Whilst it is not synonymous with respiratory arrest in which breathing stops entirely due to hypoxia, hypoventilation can be a precursor to hypoxia.

Types of Hypoventilation

Medics typically consider there to be four main types of hypoventilation: hypoventilation as a result of medical conditions or injury, opioid or drug-induced hypoventilation, congenital central hypoventilation syndrome and rapid-onset obesity with hypothalamic dysfunction, hypoventilation and autonomic dysregulation (ROHHAD).

Hypoventilation as a result of medical conditions or injury typically develops over time or occurs suddenly following an illness or trauma-inducing event. Hypoventilation caused by congenital central hypoventilation syndrome and ROHHAD are generally present from birth. Congenital central hypoventilation syndrome is often considered the most severe hypoventilation syndrome, and patients usually do not survive infancy.

However, opioid or drug-induced hypoventilation occurs as a direct result of either taking an overdose of a substance such as an opioid drug or abrupt withdrawal from that substance once the body is dependent on it.

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Causes of Hypoventilation

The cause of hypoventilation will usually depend on the type of hypoventilation a patient is experiencing. Some very common causes include strokes that affect the brainstem, neuromuscular diseases that weaken the muscles that control breathing and chest wall deformities that affect an individual’s ability to inhale and exhale. Brain injuries can also cause hypoventilation if the part of the brain that controls breathing is damaged.

Hypoventilation is very common in patients with chronic lung diseases such as cystic fibrosis as their airways can become blocked and stop air entering the lungs.

Opioid drugs also often cause hypoventilation as they affect the part of the brain that controls breathing. Their agonistic effects can result in respiratory depression, which is characterised by slow and inadequate breathing and subsequently an increase of carbon dioxide in the bloodstream.

Symptoms of Hypoventilation

The severity of the hypoventilation a patient is facing will impact the symptoms they experience. Mild to moderate symptoms can include unexplained tiredness, particularly during the daytime, shortness of breath and slow or shallow breathing.

However, as an individual’s carbon dioxide level increases, symptoms become more severe and may include seizures, confusion, headaches and blue-coloured fingers, toes or lips.

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