Why People Breathe Into a Paper Bag When Hyperventilating

Scott 1
Hunter asks: Why do people breathe into a paper bag when they get really excited?

paper-bagIt’s all about pH balance. No, not the skin pH that keeps some deodorants “strong enough for a man but pH balanced for a woman”- rather the pH within the body.  The human body has two main mechanisms for controlling pH, one involves the kidneys, the other involves breathing. When our body is working, or not, it requires a specific amount of oxygen to maintain that level of work. When the body receives more oxygen than it needs, the result can be what’s known as respiratory alkalosis (high pH). One of the most common causes is hyperventilating. The point of breathing into a bag is to “re-breathe” your exhaled carbon dioxide (CO2) in the hopes of bringing your body back to a normal pH level.

The “potential of hydrogen”, or “power of hydrogen” depending on what historian you read, (pH) is a measurement of the amount of hydrogen ions within a substance- basically measuring how acidic or “basic” something is. The scale ranges from 0-14 with 7 being neutral. Anything lower than 7 is more acidic, anything higher, is more basic. Unlike some scales that are linear, this one is logarithmic. This means that a pH of 3 is 10 times more acidic than a pH of 4, and a pH of 2 is 100 times more acidic than 4.

Like almost everything within the human body, your pH needs to be in a very narrow range to maintain the many chemically mediated processes within it, like cellular metabolism, cardiac and other organ functions. The normal range for pH in humans is 7.35 to 7.45, with a pH of 7.4 considered average.

The pH is maintained, in this slightly basic state, by what is known as the “acid-base balance” or “acid-base homeostasis”. The body has many natural ways to keep this level appropriate, known as buffering systems, with the two main such mechanisms involving your kidneys and breathing rate. In an effort not to go give a lecture on kidney function, I will just say the kidneys can either absorb or release more bicarbonate (a base) and/or secrete more hydrogen ions depending on its needs at the time. This process can take quite a while to change the overall pH of the body, so is more affective at controlling chronic pH levels.

If the body needs to adjust pH more quickly, it can do it through your breathing rate. If your body becomes too acidic, it will cause you to breathe faster. This releases more CO2 on exhalation, and raises the overall pH to become more basic. If you breathe slower, or re-breathe excessive CO2, your pH will drop and become more acidic. Hold your breath and see if, after a minute or so, you don’t feel like there’s acid running through your veins, begging you to breathe again and release it. ;-)

Now that you know what happens when you breathe faster, let’s talk about the effects this will have on your body if you do this when it doesn’t need too. Let’s say you are sitting on the couch, watching television, when Brad Pitt and Angelina Jolie’s movie “Mr. and Mrs. Smith” comes on. All the men, and women in the room, begin to breathe heavier than their bodies need. The resulting hyperventilation syndrome will cause what is known as respiratory alkalosis or hypocapnia. This more basic state begins to affect electrolyte levels. Just like pH levels, electrolyte levels must be maintained in a narrow range, for all of your body’s systems to function appropriately. Alkalosis will result in potassium and phosphate levels that are lower than they should be. Calcium will then start to bind to a class of proteins (albumin) that creates a low calcium level. All of this will result in some very unwanted side effects.

Some neurological effects include numbness and tingling in your fingers, toes, lips, and other extremities; muscle tetany that leaves you with an uncontrolled cramp known as a carpopedal spasm; decreased pressure within your head due to a constriction of your blood vessels; and an inhibition of your breathing (which isn’t so bad in this case, as you are breathing too fast anyway). Cardiac effects can include abnormal heart rhythms and a decrease in the force of your heart beat, causing low blood pressure. Some other symptoms include chest pain, confusion, dizziness, dry mouth, and weakness. One potentially problematic symptom is the feeling of being short of breath. This can cause the person to breathe even faster, and thus make the problem worse.

Hyperventilation syndrome can be caused by a few different things. There are several different disease processes that cause it like high blood sugars (hyperglycemia), bleeding excessively, becoming overly excited, chronic respiratory issues and cardiac problems. The most common cause, however, is anxiety, also known as panic disorder. It accounts for approximately 25% of all cases of hyperventilation.

The idea behind breathing into a paper bag is that you will begin to breathe in more CO2 than if you were inhaling normal air. This will then help bring your body’s pH back to a normal range. Hopefully this will also help with the feeling of being short of breath, and the person will then begin to breathe normally again.

Breathing into a paper bag is not, however, the most recommended method to control your hyperventilation. Should you think you are having an anxiety attack and are actually having a diabetic or cardiac problem or are having an asthma attack, breathing more CO2 will make the problem worse, and hasten death. Instead, doctors will generally advise you on breathing techniques that help. Should those be ineffective, there are a few different classes of drugs they can prescribe. While breathing into a bag is effective, in the end, should you feel like you’re hyperventilating, seek advice from a medical professional before you reach for your kid’s lunch sack. Or not. What’s life without a little risk!  And, hey, I’d be out of a job if nobody ever needed emergency medical aid, so it’s like a bonus for me. ;-)

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Bonus Facts:

  • The idea of a pH scale, was introduced by a Danish chemist Soren Sorensen in 1909. (what an easy name to go through school with). He was working on effects of ion concentration when analyzing proteins. Invention being the mother of necessity, at the time, there was no widely accepted way of expressing the concentrations of hydrogen ions. The most widely used was a color code system that measured a change in the color of a material based on how acidic or basic it was when using electrical methods.
  • 18.1% of the population in the United States has been diagnosed with anxiety disorder. 22.8% of those are said to be serious cases. Women are 60% more likely to be diagnosed than men, and is most common in people between the ages of 15 and 55. Black people are 20% and Hispanics 30% less likely than whites to be diagnosed.
  • 42.2% of people diagnosed with anxiety disorder are currently seeking some sort of treatment for their condition. It accounts for 10% of patients seen at their primary care physician. The ratio of women to men who seek treatment can be as high as 7:1.

[Image via Shutterstock]

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