Respiratory Alkalosis

Written by Krista O'Connell | Published on June 14, 2012
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP

What is Respiratory Alkalosis?

Respiratory alkalosis is a condition that changes the balance of carbon dioxide and oxygen in the blood.

When you breath, oxygen (which is needed by the body to function properly) is inhaled into the lungs and carbon dioxide (a waste product) is exhaled. Normally, these two gases are kept in balance by the respiratory system.

Respiratory alkalosis occurs when carbon dioxide levels drop too low. This causes the pH of the blood to rise and become too alkaline.

This condition is basically the opposite of respiratory acidosis, when the blood becomes too acidic.

Hyperventilation and Respiratory Alkalosis

Hyperventilation is typically the underlying cause of respiratory alkalosis. Hyperventilation is also known as overbreathing. When someone is hyperventilating, they tend to breathe very deeply or very rapidly.

Causes of Hyperventilation

According to the National Institutes of Health, the most common causes of hyperventilation are panic attacks and anxiety (NIH, 2011). A person experiencing it for the first time, however, should not assume that these are the causes. There are also other possible explanations, including:

  • heart attack
  • pain
  • drug use
  • asthma
  • fever
  • chronic obstructive pulmonary disease (COPD)
  • infection
  • pulmonary embolism
  • pregnancy

Symptoms of Respiratory Alkalosis

Overbreathing itself is a sign that respiratory alkalosis is likely to develop. Low carbon dioxide levels in the blood also have a number of physical effects. These include:

  • dizziness
  • bloating
  • feeling light-headed
  • numbness and/or muscle spasms in the extremities (hands and feet)
  • discomfort in the chest area
  • confusion
  • dry mouth
  • tingling in the arms
  • heart palpitations
  • feeling short of breath

Finally, an affected person may have a seizure. However, the NIH states that the risk of seizures is very low. They only occur in the most severe cases (NIH, 2011).

Treatment for Respiratory Alkalosis

Panic and Anxiety-Related Causes

Treating the condition is a matter of raising carbon dioxide levels in the blood.

The following strategies and tips are useful for respiratory alkalosis caused by overbreathing due to panic and anxiety:

  • Breathe into a paper bag. This is a very simple strategy. It can also be very effective. Fill the bag with carbon dioxide by exhaling into it. Then, breathe the exhaled air from the bag back into the lungs. Doing this several times can give the body the carbon dioxide it needs to bring levels back up to where they should be. A mask can also be used in place of a paper bag.
  • Get reassurance. The symptoms of respiratory alkalosis can be quite frightening. This often causes faster and deeper breathing, making things worse. Having a calm loved one close by to provide reassurance can help the individual get his/her breathing under control.
  • Restrict oxygen intake into the lungs. Some possible ways to do this are breathing while pursing the lips or breathing through one nostril. For the second approach to be useful, the mouth and the other nostril need to be covered.

Other Causes

The above strategies are very simple ways to address respiratory alkalosis. For people who know they have overbreathing problems due to panic and anxiety, they can often even be used at home.

When causes are more serious, treatment will be focused on addressing the medical emergency. It could be a heart attack or a blood clot that has traveled to the lung.

Anyone experiencing overbreathing and the symptoms of respiratory alkalosis for the first time should go to the hospital right away. The strategies described in the previous section should only be used if a doctor has confirmed the exact cause of overbreathing.

Recovering From Respiratory Alkalosis

The recovery process depends on the cause of the respiratory alkalosis. Those who develop it because of overbreathing caused by conditions such as anxiety can usually expect to recover fully. Once carbon dioxide levels in the blood are brought back to normal, the symptoms should disappear within a short period of time.

In other cases, the explanation is a true medical emergency. At these times, the outlook can be more uncertain.

How Can Respiratory Alkalosis Be Prevented?

Prevention is a matter of addressing the cause of the hyperventilation. Clearly, this will not be feasible in all cases. For instance, there is no sure way to avoid infection, which is a possible cause.

However, the most common causes are psychological. These include stress, panic, and anxiety, all of which a person can adjust to and learn to control. Good coping strategies for these types of issues are crucial. They can help lower the risk of hyperventilation and the resulting respiratory alkalosis. They can also help you function better overall in everyday life.

Working with a therapist may help. Breathing exercises can also be effective, as can meditation and regular exercise.

Medication may be needed in some cases.

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