Unexplained Breathing Issues: Persistent Symptoms and Yawning Episodes

Persistent symptoms for two years, suddenly unable to take a full breath for a second, followed by continuous yawning?

Since November 2019, I have experienced symptoms where, during work or daily activities, I suddenly have a moment of normal breathing, but then it feels like I'm losing consciousness before I can fully inhale.
This symptom lasts only a brief moment, followed by persistent yawning.
In the first three months, I also had neck pain, numbness in my cheeks, hand numbness, and numbness in the back of my head.
I consulted three cardiologists, underwent echocardiography for mitral valve prolapse, abdominal ultrasounds for liver, gallbladder, and gastrointestinal assessment, colonoscopy, gastroscopy, kidney urine tests, breast ultrasound, EEG from a neurologist, and ENT evaluation (for nasal polyps and allergies).
Four doctors reviewed my cervical spine with X-rays and chest X-rays from a pulmonologist, all of which returned normal results.
Subsequently, a doctor suggested I see a specialist in autonomic nervous system disorders.
I visited two clinics and took medication for a year, gradually tapering off as per the doctor's instructions.
After three months off the medication, I felt normal, but in December of last year, the symptoms recurred.
During these episodes, I sometimes experience them while talking, working, riding a bike, watching TV, or eating; they occur as a sudden moment, followed by continuous yawning for about 15-20 seconds.
Occasionally, I struggle to yawn completely.
Recently, during these episodes, I have also felt a tightness in my chest, as if I can't catch my breath, leading to persistent yawning.

I started keeping a record:
- On February 21, 2021, at 21:41, while alone at home listening to music and singing, I suddenly felt that empty sensation again.
- On April 13, after a live stream, ten minutes later at 00:31, I suddenly felt a breathlessness, followed by that empty feeling again and then yawning.
During one yawn, I couldn't complete it while riding my bike, averaging a yawn every 15-20 seconds for over ten minutes.
- On April 14, around 16:00, I felt a tightness in my chest and yawned continuously for 20 seconds.
At 23:35, while organizing items, I felt a breath stuck in my chest, breathing normally but still feeling tight.
I hurried to tidy up, had diarrhea, and rode home, yawning once at 00:04 for 20 seconds.
- On April 16, at 17:03, while organizing items, I felt tightness in my chest for a few seconds.
I stood still, closed my eyes, and calmed down for about a minute before sitting down.
My breathing improved, but I started yawning again, averaging every 20 seconds for over two minutes, continuing to work until 17:07.
- On April 30, during my ten-minute ride home after work, I felt tightness in my left chest at 19:23 for about ten seconds.
After a minute, I rode to buy dinner, and unlike before, I started yawning two to three minutes later, with a frequency of about every 15-20 seconds.
At 19:53, I continued yawning, and at 19:58, I couldn't complete two yawns.
At 19:59, I burped, and at 20:05, I had a bowel movement that was soft but not diarrhea.
- On May 1, at 10:46, while talking at work during a discussion, I felt the onset of symptoms while speaking.
It felt like I was running out of oxygen while saying three to four words, followed by that empty sensation (about one second).
At 10:48, I passed gas audibly, and at 10:49, I started yawning again, with a frequency of about every 20 seconds.
At 10:55, I burped again and continued yawning.
By 11:18, I was still yawning, with intervals of 10 to 15 seconds between yawns.

Chou, 30~39 year old female. Ask Date: 2021/05/05

Dr. He Dongjin reply Cardiology

Hello, it still sounds like symptoms of autonomic nervous system disorder, and there may be arrhythmia.
It is advisable to see a cardiologist for further examination.
Ping An Changhua Hospital cares about you.

Reply Date: 2021/05/05

More Info

Your symptoms of unexplained breathing issues, persistent yawning episodes, and associated discomfort can be quite distressing and complex. Based on your detailed description, it appears that you have been experiencing a range of symptoms that include sudden interruptions in your breathing, feelings of chest tightness, and frequent yawning. These symptoms have persisted over a significant period, despite extensive medical evaluations that have ruled out various potential causes.

Understanding Your Symptoms
1. Breathing Difficulties: The sensation of not being able to take a full breath, or feeling as if you are "running out of air," can be associated with several conditions, including anxiety disorders, respiratory issues, or even cardiac concerns. However, given that you've undergone thorough examinations (including echocardiograms, chest X-rays, and neurological assessments) that returned normal results, it is less likely that a serious underlying physical condition is causing your symptoms.

2. Yawning Episodes: Frequent yawning can be a physiological response to a variety of factors, including fatigue, stress, or even a lack of oxygen. In some cases, excessive yawning can be linked to anxiety or panic attacks, where the body is in a heightened state of arousal, leading to hyperventilation and subsequent yawning as a compensatory mechanism.

3. Chest Discomfort: The feeling of tightness or pressure in the chest can be particularly concerning. While it can be related to anxiety, it is essential to ensure that it is not indicative of a cardiac issue, especially given your history of mitral valve prolapse. However, since your cardiac evaluations have been normal, this symptom may also be related to anxiety or muscle tension.

Potential Psychological Factors
Given the nature of your symptoms and the context in which they occur (e.g., during work, while speaking, or in relaxed settings), it is plausible that anxiety or panic disorder may be contributing to your experiences. Anxiety can manifest in various physical symptoms, including:
- Hyperventilation: This occurs when you breathe too quickly or deeply, leading to a decrease in carbon dioxide levels in the blood, which can cause feelings of lightheadedness, tingling, and even chest discomfort.

- Panic Attacks: These can present with sudden episodes of intense fear or discomfort, often accompanied by physical symptoms such as shortness of breath, chest pain, and a feeling of impending doom.

Recommendations for Management
1. Consult a Specialist: Since you have already seen multiple specialists, it may be beneficial to consult a psychiatrist or psychologist who specializes in anxiety disorders. They can provide a comprehensive evaluation and determine if your symptoms are indeed related to anxiety or panic disorder.

2. Cognitive Behavioral Therapy (CBT): This form of therapy is effective for managing anxiety and panic symptoms. It helps individuals identify and change negative thought patterns and behaviors that contribute to their anxiety.

3. Breathing Techniques: Learning and practicing controlled breathing techniques can help manage hyperventilation and promote relaxation. Techniques such as diaphragmatic breathing or the 4-7-8 breathing method can be beneficial.

4. Lifestyle Modifications: Regular physical activity, a balanced diet, and adequate sleep can significantly impact your overall well-being and help reduce anxiety symptoms.

5. Medication: If anxiety is confirmed as a contributing factor, medications such as selective serotonin reuptake inhibitors (SSRIs) or benzodiazepines may be prescribed to help manage symptoms.

6. Monitoring Symptoms: Keeping a detailed diary of your symptoms, including when they occur, their duration, and any associated triggers, can provide valuable insights for your healthcare provider.

Conclusion
Your symptoms are complex and multifaceted, and while they may be distressing, they are not uncommon in individuals experiencing anxiety or panic disorders. It is crucial to continue seeking support and exploring therapeutic options that can help you manage your symptoms effectively. Remember, you are not alone in this, and with the right approach, improvement is possible.

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