dysfunctional breathing test
Sixteen questions about the body sensations that come with breathing that has run away with itself. Scored right here; nothing goes anywhere.
This is the Nijmegen questionnaire, built to pull the scattered complaints of runaway breathing into one picture. It doesn’t replace being examined: several of these symptoms also come from heart or lung trouble, so see a doctor first.
scored in your browser · answers go nowhere
0 of 16 answered — the result appears on its own once everything is answered
your result
0 of 64
about this questionnaire
The scale was assembled in the Netherlands in 1985 from the sixteen complaints patients with hyperventilation syndrome reported most often. Each is rated by frequency from nought to four, giving a total between nought and sixty-four; above twenty-three is taken as suggestive.
Its main use is pulling scattered complaints into one picture. People spend years taking tingling fingers, chest tightness and dizziness to different appointments separately, and nobody puts them together.
What it can’t do matters more. It doesn’t separate overbreathing from illnesses that produce the same sensations: heart disease, asthma, an irregular heartbeat, low iron, thyroid problems. A high score doesn’t mean "it’s all nerves" — it means you have this particular set of symptoms.
One more caveat: some researchers argue the scale largely measures anxiety rather than breathing as such, since so many items are shared. That doesn’t remove its usefulness, but it explains why nobody diagnoses from it.
short answers
- Does a high score mean I definitely have hyperventilation syndrome?
- No. It means you have the set of symptoms typical of it. Several physical conditions produce the same set, and they get ruled out by tests, not by a questionnaire.
- Do my answers go anywhere?
- No. Everything is scored in your browser: neither your answers nor the result reach a server, we don’t ask for an email, and the result disappears with the tab. Like any site, we run web analytics; what it collects is set out in the privacy policy.
- What is hyperventilation syndrome, exactly?
- A state in which someone breathes faster and deeper than the body needs. Carbon dioxide in the blood drops below normal, and that brings dizziness, tingling, chest tightness and the feeling of not getting enough air. It feeds itself: the fear of suffocating makes you breathe harder, and the symptoms grow harder still.
- I was told to breathe into a paper bag. Is that right?
- No, and it’s a dangerous piece of advice: if the cause turns out to be your heart or lungs, a bag takes away oxygen you may already be short of. Slowing the out-breath does the same job safely.
- Can I retake it?
- Yes. After a month of working with your breathing the total is usually noticeably lower — one of the cases where the number is telling you about the problem rather than about you.
read next
can’t breathe properly can’t stop thinking about breathing diaphragmatic breathing
what we read
- van Dixhoorn J., Duivenvoorden H. J. Efficacy of Nijmegen Questionnaire in recognition of the hyperventilation syndrome. Journal of Psychosomatic Research, 1985;29(2):199–206 — the original scale and cut-off. pubmed
- van Dixhoorn J., Folgering H. The Nijmegen Questionnaire and dysfunctional breathing. ERJ Open Research, 2015;1(1):00001-2015 — what the scale measures and what it doesn’t. pubmed
The cluster of symptoms that marks hyperventilation syndrome isn’t showing here.
If breathing still feels hard at times, something else is likely behind it — which is all the more reason to see a doctor rather than to keep looking for the answer in a questionnaire.
The symptoms are there, just short of the mark where hyperventilation syndrome is usually discussed.
In practice that means one score isn’t enough and the circumstances matter. If all of this arrives with anxiety and settles on calm days, this is a familiar picture, and breathing is what to work on. If it comes on its own, unconnected to how you feel, that’s one for a doctor.
A total above twenty-three is where research starts talking about hyperventilation syndrome. But that isn’t where to start.
Bodily causes first. Half the items on this scale — palpitations, chest pain and tightness, breathlessness, tingling — also belong to heart disease, lung disease, thyroid trouble and anaemia. The questionnaire doesn’t separate them and can’t. So the first step is a doctor and the usual checks, not breathing exercises.
If physical causes have already been ruled out and this remains, then the cause has been found — it simply works through your breathing. What helps then isn’t breathing deeper but the opposite: slower, with a long exhale, a little every day.