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class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%B3%D9%86%D8%AF%D8%B1%D9%85_%D9%87%D8%A7%DB%8C%D9%BE%D8%B1%D9%88%D9%86%D8%AA%DB%8C%D9%84%DB%8C%D8%B4%D9%86_HVS" title="سندرم هایپرونتیلیشن HVS – Persian" lang="fa" hreflang="fa" data-title="سندرم هایپرونتیلیشن HVS" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Spasmophilie" title="Spasmophilie – French" lang="fr" hreflang="fr" data-title="Spasmophilie" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EA%B3%BC%ED%99%98%EA%B8%B0_%EC%A6%9D%ED%9B%84%EA%B5%B0" title="과환기 증후군 – Korean" lang="ko" hreflang="ko" data-title="과환기 증후군" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Sindrome_da_iperventilazione" title="Sindrome da iperventilazione – Italian" lang="it" hreflang="it" data-title="Sindrome da iperventilazione" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E9%81%8E%E6%8F%9B%E6%B0%97%E7%97%87%E5%80%99%E7%BE%A4" title="過換気症候群 – Japanese" lang="ja" hreflang="ja" data-title="過換気症候群" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Hyperventilasjonssyndrom" title="Hyperventilasjonssyndrom – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Hyperventilasjonssyndrom" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%A5%D0%B8%D0%BF%D0%B5%D1%80%D0%B2%D0%B5%D0%BD%D1%82%D0%B8%D0%BB%D0%B0%D1%86%D0%B8%D0%BE%D0%BD%D0%B8_%D1%81%D0%B8%D0%BD%D0%B4%D1%80%D0%BE%D0%BC" title="Хипервентилациони синдром – Serbian" lang="sr" hreflang="sr" data-title="Хипервентилациони синдром" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B8%81%E0%B8%A5%E0%B8%B8%E0%B9%88%E0%B8%A1%E0%B8%AD%E0%B8%B2%E0%B8%81%E0%B8%B2%E0%B8%A3%E0%B8%AB%E0%B8%B2%E0%B8%A2%E0%B9%83%E0%B8%88%E0%B9%80%E0%B8%A3%E0%B9%87%E0%B8%A7%E0%B8%81%E0%B8%A7%E0%B9%88%E0%B8%B2%E0%B8%9B%E0%B8%81%E0%B8%95%E0%B8%B4" title="กลุ่มอาการหายใจเร็วกว่าปกติ – Thai" lang="th" hreflang="th" data-title="กลุ่มอาการหายใจเร็วกว่าปกติ" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target"><span>ไทย</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Hiperventilasyon_sendromu" title="Hiperventilasyon sendromu – Turkish" lang="tr" hreflang="tr" data-title="Hiperventilasyon sendromu" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a 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role="note" class="hatnote navigation-not-searchable">Not to be confused with <a href="/wiki/Hypoventilation" title="Hypoventilation">Hypoventilation</a>.</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition involving hyperventilating</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox infobox-has-images-with-white-backgrounds"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Hyperventilation syndrome.</th></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Psychiatry" title="Psychiatry">Psychiatry</a>, <a href="/wiki/Neurology" title="Neurology">neurology</a>, <a href="/wiki/Pulmonology" title="Pulmonology">pulmonology</a> <span class="penicon autoconfirmed-show"><span class="mw-valign-text-top" typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q2251578?uselang=en#P1995" title="Edit this on Wikidata"><img alt="Edit this on Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></span></td></tr></tbody></table><style data-mw-deduplicate="TemplateStyles:r1236303919">@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-has-images-with-white-backgrounds img{background:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-has-images-with-white-backgrounds img{background:white}}</style> <p><b>Hyperventilation syndrome</b> (<b>HVS</b>), also known as <b>chronic hyperventilation syndrome</b> (<b>CHVS</b>), <b>dysfunctional breathing hyperventilation syndrome</b>, <b>cryptotetany</b>,<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> <b>spasmophilia</b>,<sup id="cite_ref-researchgate.net_3-0" class="reference"><a href="#cite_note-researchgate.net-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Toruńska_653–664_4-0" class="reference"><a href="#cite_note-Toruńska_653–664-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Bongi_89–95_5-0" class="reference"><a href="#cite_note-Bongi_89–95-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> <b>latent tetany</b>,<sup id="cite_ref-Toruńska_653–664_4-1" class="reference"><a href="#cite_note-Toruńska_653–664-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Bongi_89–95_5-1" class="reference"><a href="#cite_note-Bongi_89–95-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> and <b>central neuronal hyper excitability syndrome</b> (<b>NHS</b>),<sup id="cite_ref-researchgate.net_3-1" class="reference"><a href="#cite_note-researchgate.net-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> is a respiratory disorder, psychologically or physiologically based, involving breathing too deeply or too rapidly (<a href="/wiki/Hyperventilation" title="Hyperventilation">hyperventilation</a>). HVS may present with <a href="/wiki/Chest_pain" title="Chest pain">chest pain</a> and a tingling sensation in the fingertips and around the mouth (<a href="/wiki/Paresthesia" title="Paresthesia">paresthesia</a>), in some cases resulting in the hands 'locking up' or <a href="/wiki/Cramp" title="Cramp">cramping</a> (<a href="/wiki/Trousseau_sign_of_latent_tetany" title="Trousseau sign of latent tetany">carpopedal spasm</a>, also known as Trousseau sign).<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> HVS may accompany a <a href="/wiki/Panic_attack" title="Panic attack">panic attack</a>. </p><p>People with HVS may feel that they cannot get enough air. In reality, they have about the same oxygenation in the arterial blood (normal values are about 98% for hemoglobin saturation) and too little <a href="/wiki/Carbon_dioxide" title="Carbon dioxide">carbon dioxide</a> (<a href="/wiki/Hypocapnia" title="Hypocapnia">hypocapnia</a>) in their blood and other tissues. While oxygen is abundant in the bloodstream, HVS reduces effective delivery of that oxygen to vital organs due to low-CO<sub style="font-size: 80%;vertical-align: -0.35em">2</sub>-induced <a href="/wiki/Vasoconstriction" title="Vasoconstriction">vasoconstriction</a> and the suppressed <a href="/wiki/Bohr_effect" title="Bohr effect">Bohr effect</a>. </p><p>The hyperventilation is self-promulgating as rapid or deep breathing causes carbon dioxide levels to fall below healthy levels, and <a href="/wiki/Respiratory_alkalosis" title="Respiratory alkalosis">respiratory alkalosis</a> (high blood <a href="/wiki/PH" title="PH">pH</a>) develops. This makes the symptoms worse, which causes the person to breathe even faster, which then, further exacerbates the problem. </p><p>The respiratory alkalosis leads to changes in the way the <a href="/wiki/Nervous_system" title="Nervous system">nervous system</a> fires and leads to the <a href="/wiki/Paresthesia" title="Paresthesia">paresthesia</a>, dizziness, and perceptual changes that often accompany this condition. Other mechanisms may also be at work, and some people are physiologically more susceptible to this phenomenon than others.<sup id="cite_ref-Edward_Newton_7-0" class="reference"><a href="#cite_note-Edward_Newton-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p><p>The mechanism for hyperventilation causing <a href="/wiki/Paresthesia" title="Paresthesia">Paresthesia</a>, lightheadedness, and fainting is: hyperventilation causes increased blood pH (see <a href="/wiki/Respiratory_alkalosis" title="Respiratory alkalosis">Respiratory alkalosis</a> for this mechanism), which causes a decrease in free ionized calcium (<a href="/wiki/Hypocalcaemia" class="mw-redirect" title="Hypocalcaemia">Hypocalcaemia</a>), which causes paresthesia and symptoms related to hypocalcaemia. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Causes">Causes</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hyperventilation_syndrome&action=edit&section=1" title="Edit section: Causes"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Hyperventilation syndrome is believed to be caused by psychological factors.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> It is one cause of <a href="/wiki/Hyperventilation" title="Hyperventilation">hyperventilation</a> with others including infection, blood loss, <a href="/wiki/Heart_attack" class="mw-redirect" title="Heart attack">heart attack</a>,<sup id="cite_ref-titleHyperventilation_9-0" class="reference"><a href="#cite_note-titleHyperventilation-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Hypocapnia" title="Hypocapnia">hypocapnia</a> or <a href="/wiki/Alkalosis" title="Alkalosis">alkalosis</a> due to chemical imbalances, decreased cerebral blood flow, and increased nerve sensitivity.<sup id="cite_ref-Brad_McKechnie_10-0" class="reference"><a href="#cite_note-Brad_McKechnie-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p><p>In one study, one third of patients with HVS had "subtle but definite lung disease" that prompted them to breathe too frequently or too deeply.<sup id="cite_ref-isbn0-300-07401-8_11-0" class="reference"><a href="#cite_note-isbn0-300-07401-8-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p><p>A study, found that 77% of patients with <a href="/wiki/Empty_nose_syndrome" title="Empty nose syndrome">empty nose syndrome</a> have hyperventilation syndrome.<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> Empty nose syndrome can appear in people having done nose surgery like cauterization, turbinectomy, turbinoplasty, etc.<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p><p>Many people with <a href="/wiki/Panic_disorder" title="Panic disorder">panic disorder</a> or <a href="/wiki/Agoraphobia" title="Agoraphobia">agoraphobia</a> will experience HVS. However, most people with HVS do not have these disorders.<sup id="cite_ref-Edward_Newton_7-1" class="reference"><a href="#cite_note-Edward_Newton-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hyperventilation_syndrome&action=edit&section=2" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Hyperventilation syndrome is a remarkably common cause of dizziness complaints. About 25% of patients who complain about dizziness are diagnosed with HVS.<sup id="cite_ref-Brad_McKechnie_10-1" class="reference"><a href="#cite_note-Brad_McKechnie-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p><p>A 1985 study, <i>Efficacy of Nijmegen Questionnaire<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> in recognition of the hyperventilation syndrome</i>, stated: "It is concluded that the questionnaire is suitable as a screening instrument for early detection of HVS, and also as an aid in diagnosis and therapy planning."<sup id="cite_ref-Dixhoorn_15-0" class="reference"><a href="#cite_note-Dixhoorn-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hyperventilation_syndrome&action=edit&section=3" title="Edit section: Treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>One review of research, published in 2013, concluded "The results of this systematic review are unable to inform clinical practice, based on the inclusion of only 1 small poorly reported RCT [randomised controlled trial] ... Therefore, no recommendations for clinical practice can be made."<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p><p>While traditional intervention for an acute episode has been to have the patient breathe into a paper bag, causing <a href="/wiki/Rebreathing" class="mw-redirect" title="Rebreathing">rebreathing</a> and restoration of CO₂ levels, this is not advised.<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> The same benefits can be obtained more safely from deliberately slowing down the breathing rate by <a href="/wiki/Counting" title="Counting">counting</a> or looking at the second hand on a <a href="/wiki/Watch" title="Watch">watch</a>. This is sometimes referred to as "7-11 breathing", because a gentle inhalation is stretched out to take 7 seconds (or counts), and the exhalation is slowed to take 11 seconds. This in-/exhalation ratio can be safely decreased to 4-12 or even 4-20 and more, as the O₂ content of the blood will easily sustain normal cell function for several minutes at rest when normal blood acidity has been restored. </p><p>It has also been suggested that breathing therapies such as the <a href="/wiki/Buteyko_method" title="Buteyko method">Buteyko Breathing</a> method may be effective in reducing the symptoms and recurrence of the syndrome. </p><p><a href="/wiki/Benzodiazepine" title="Benzodiazepine">Benzodiazepines</a> can be prescribed to reduce stress that provokes hyperventilation syndrome. <a href="/wiki/Selective_serotonin_reuptake_inhibitors" class="mw-redirect" title="Selective serotonin reuptake inhibitors">Selective serotonin reuptake inhibitors</a> (SSRIs) can reduce the severity and frequency of hyperventilation episodes.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hyperventilation_syndrome&action=edit&section=4" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The original traditional treatment of breathing into a paper bag to control psychologically based hyperventilation syndrome (which is now almost universally known and often shown in movies and TV dramas) was invented by New York City physician (later <a href="/wiki/Radiologist" class="mw-redirect" title="Radiologist">radiologist</a>), Alexander Winter, M.D. [1908-1978], based on his experiences in the <a href="/wiki/Medical_Corps_(United_States_Army)" class="mw-redirect" title="Medical Corps (United States Army)">U.S. Army Medical Corps</a> during <a href="/wiki/World_War_II" title="World War II">World War II</a> and published in the Journal of the American Medical Association in 1951.<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> Because other medical conditions can be confused with hyperventilation, namely <a href="/wiki/Asthma" title="Asthma">asthma</a> and <a href="/wiki/Myocardial_infarction" title="Myocardial infarction">heart attacks</a>, most medical studies advise against using a paper bag since these conditions worsen when CO<sub>2</sub> levels increase.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hyperventilation_syndrome&action=edit&section=5" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> 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David; Le Baudour, Chris (2009). "Chapter 9: Caring for Medical Emergencies". <i>First Responder</i> (8 ed.). New Jersey: Pearson Prentice Hall. p. 262. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-13-614059-7" title="Special:BookSources/978-0-13-614059-7"><bdi>978-0-13-614059-7</bdi></a>. <q>Do not use a paper bag in an attempt to treat hyperventilation. These patients can often be cared for with low-flow oxygen and lots of reassurance</q></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Chapter+9%3A+Caring+for+Medical+Emergencies&rft.btitle=First+Responder&rft.place=New+Jersey&rft.pages=262&rft.edition=8&rft.pub=Pearson+Prentice+Hall&rft.date=2009&rft.isbn=978-0-13-614059-7&rft.aulast=Bergeron&rft.aufirst=J.+David&rft.au=Le+Baudour%2C+Chris&rfr_id=info%3Asid%2Fen.wikipedia.org%3AHyperventilation+syndrome" class="Z3988"></span></span> </li> <li id="cite_note-18"><span class="mw-cite-backlink"><b><a href="#cite_ref-18">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite class="citation web cs1"><a rel="nofollow" class="external text" href="http://emedicine.medscape.com/article/807277-medication">"Hyperventilation Syndrome Medication"</a>. Medscape<span class="reference-accessdate">. Retrieved <span class="nowrap">31 December</span> 2013</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=Hyperventilation+Syndrome+Medication&rft.pub=Medscape&rft_id=http%3A%2F%2Femedicine.medscape.com%2Farticle%2F807277-medication&rfr_id=info%3Asid%2Fen.wikipedia.org%3AHyperventilation+syndrome" class="Z3988"></span></span> </li> <li id="cite_note-19"><span class="mw-cite-backlink"><b><a href="#cite_ref-19">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFWinter1951" class="citation journal cs1">Winter, A (1951). <a rel="nofollow" class="external text" href="http://jama.ama-assn.org/search?fulltext=alexander+winter+hyperventilation&submit=yes&x=0&y=0">"A Rapid Emergency Treatment for Hyperventilation Syndrome"</a>. <i>J Am Med Assoc</i>. <b>147</b> (10): 990. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1001%2Fjama.1951.03670270080028">10.1001/jama.1951.03670270080028</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=J+Am+Med+Assoc&rft.atitle=A+Rapid+Emergency+Treatment+for+Hyperventilation+Syndrome.&rft.volume=147&rft.issue=10&rft.pages=990&rft.date=1951&rft_id=info%3Adoi%2F10.1001%2Fjama.1951.03670270080028&rft.aulast=Winter&rft.aufirst=A&rft_id=http%3A%2F%2Fjama.ama-assn.org%2Fsearch%3Ffulltext%3Dalexander%2Bwinter%2Bhyperventilation%26submit%3Dyes%26x%3D0%26y%3D0&rfr_id=info%3Asid%2Fen.wikipedia.org%3AHyperventilation+syndrome" class="Z3988"></span></span> </li> <li id="cite_note-20"><span class="mw-cite-backlink"><b><a href="#cite_ref-20">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFAnahad_O'Connor2008" class="citation web cs1">Anahad O'Connor (2008-05-13). <a rel="nofollow" class="external text" href="https://www.nytimes.com/2008/05/13/health/13real.html">"The Claim: If You're Hyperventilating, Breathe Into a Paper Bag"</a>. <i><a href="/wiki/New_York_Times" class="mw-redirect" title="New York Times">New York Times</a></i><span class="reference-accessdate">. Retrieved <span class="nowrap">2014-02-09</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=New+York+Times&rft.atitle=The+Claim%3A+If+You%27re+Hyperventilating%2C+Breathe+Into+a+Paper+Bag&rft.date=2008-05-13&rft.au=Anahad+O%27Connor&rft_id=https%3A%2F%2Fwww.nytimes.com%2F2008%2F05%2F13%2Fhealth%2F13real.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3AHyperventilation+syndrome" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hyperventilation_syndrome&action=edit&section=6" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output 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dd:last-child::after,.mw-parser-output .hlist dt:last-child::after,.mw-parser-output .hlist li:last-child::after{content:none}.mw-parser-output .hlist dd dd:first-child::before,.mw-parser-output .hlist dd dt:first-child::before,.mw-parser-output .hlist dd li:first-child::before,.mw-parser-output .hlist dt dd:first-child::before,.mw-parser-output .hlist dt dt:first-child::before,.mw-parser-output .hlist dt li:first-child::before,.mw-parser-output .hlist li dd:first-child::before,.mw-parser-output .hlist li dt:first-child::before,.mw-parser-output .hlist li li:first-child::before{content:" (";font-weight:normal}.mw-parser-output .hlist dd dd:last-child::after,.mw-parser-output .hlist dd dt:last-child::after,.mw-parser-output .hlist dd li:last-child::after,.mw-parser-output .hlist dt dd:last-child::after,.mw-parser-output .hlist dt dt:last-child::after,.mw-parser-output .hlist dt li:last-child::after,.mw-parser-output .hlist li dd:last-child::after,.mw-parser-output .hlist li dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /></div><div role="navigation" class="navbox" aria-label="Navbox32" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q2251578" class="extiw" title="d:Q2251578">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: R06.4 or F45.33</li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a></b>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=306.1">306.1</a></li><li><b><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a></b>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb31118.htm">31118</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a></b>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/emerg/270-overview">emerg/270</a></li></ul></div></div></td></tr></tbody></table></div>    </div><noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?useformat=desktop&type=1x1&usesul3=0" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div class="printfooter" data-nosnippet="">Retrieved from "<a 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