Breathing and Respiratory Difficulties

Some people with Parkinson’s disease (PD) report having shortness of breath. Yet little research has been done on what causes this experience.

In fact, many people with PD who experience shortness of breath and undergo testing appear to have healthy lung function. Among the limited research conducted, some studies have found that people with PD inhale a lower volume of air with each breath compared to healthy peers. Others suggest that weakness or rigidity of the muscles in the chest and abdomen may lead to a feeling of breathlessness. It’s also important to remember that breathing difficulties may stem from medical conditions that have nothing to do with PD.

It is important to identify the causes of breathing difficulties in order to treat them and put your mind at ease.

Symptoms

People with PD can have breathing difficulties for a variety of reasons, including:

  • “Wearing off” episodes: a common experience among people with PD who have been taking levodopa for several years. “Wearing off” episodes occur when the medication benefit wears off and Parkinson’s symptoms (including shortness of breath) return before it’s time for the next dose.
  • Respiratory dyskinesia: an occurrence of irregular and rapid breathing when levodopa medications reach their peak effect. These are accompanied by involuntary body movements typically experienced as dyskinesia.
  • Anxiety: this common PD symptom may also exacerbate a feeling of shortness of breath. Anxiety is a common symptom of wearing off and it can be difficult to distinguish between anxiety and other causes of shortness of breath that occurs as the drug effect wears off.
  • Non-PD health issues: such as asthma, allergies, lung disease and heart disease may cause shortness of breath.
  • Aspiration pneumonia: pneumonia that develops after food or liquid “goes down the wrong pipe” and lodges in the lungs. For those with advanced PD, swallowing difficulties can increase risk for aspiration pneumonia and choking.

Therapies

Treating breathing difficulties depends on identifying their cause. There is no specific therapy for shortness of breath among people with PD and again, your tests may show that everything is normal, but it may help to discuss your medications with your doctor so that “on” time during the day can be optimized.

Tips for Coping With Breathing Difficulties

  • With your doctor, identify and treat any non-PD causes of shortness of breath, such as lung disease, heart disease or lack of physical conditioning and endurance.
  • Exercise as much as possible. Shortness of breath may lead a person to move less, and less physical activity, in turn, further reduces the ability to take deep breaths, while staying active can improve pulmonary function.
  • Take steps to cope with anxiety. Talk with your doctor to figure out what sets off anxiety and find treatments (medications, exercise, lifestyle changes) and techniques that work for you.
  • Give up smoking.
  • Speak to your doctor about getting an evaluation performed by a speech-language pathologist (SLP) who can help you address issues related to swallowing.