What is ‘air hunger’? And can it be treated?

Olga Pankova/Getty Can you hold your breath until you’re almost bursting to take another breath in? This urgent feeling that you need to get more air is called “air hunger”. You may feel this sensation when you exercise intensely and push to your limit. Your breath will usually return to normal quickly once you’ve stopped exerting yourself. But some people – such as those living with lung conditions or severe anxiety – experience air hunger frequently in their day-to-day lives. Air hunger, which is sometimes described as “drowning” or “suffocating” from a lack of air, can be incredibly distressing. And it can be hard not to panic. So, what helps if you experience air hunger? And when should you get help? What is air hunger? Many conditions can cause shortness of breath (also called dyspnoea). These commonly include heart diseases and lung conditions such as asthma, chronic obstructive pulmonary disease or long COVID. Although the terms are sometimes used interchangeably, air hunger is not the same as shortness of breath. Air hunger is an extreme and distinct feature of breathlessness: the feeling you can’t get enough air or take a full breath in. This sensation can make people take bigger breaths or breathe faster, to try and get more oxygen. But this can actually make the feeling of breathlessness worse. Some people may also find they yawn or sigh a lot as they try to get more air. For some people, an episode may be brief and resolve on its own. Others may pass out and need immediate medical attention to regain their breath. In addition to difficulty breathing, symptoms can include chest tightness, sweating, dizziness and coughing. If you experience any of these symptoms, especially for the first time, you should seek immediate medical attention by calling triple 0. Identifying the cause The key to treating air hunger is understanding what’s behind it. So a doctor will first try to identify the underlying cause. Air hunger may happen as part of an acute condition that causes breathlessness. For example, if you have a chest infection, you may struggle to breathe deeply and get enough oxygen. When you recover from the illness, you may no longer experience the feeling that you’re unable to fill your lungs. But air hunger can also be a feature of a chronic condition. Those who live with severe heart or lung conditions – such as congestive cardiac failures or interstitial lung diseases – may never feel they can breathe deeply or fully fill their lungs. This can significantly limit their ability to exercise or participate in everyday activities. Living with mental health conditions such as an anxiety or panic disorder can also mean frequent episodes of air hunger. Even when air hunger resolves by itself, you should still see your doctor for further assessment, to identify the cause and work out how to manage it. What a doctor will look at Your doctor will typically observe your breathing rate and ask about your symptoms, how often you experience air hunger, and how much distress it causes. They may also ask you to rate your shortness of breath using a Borg scale, which involves picking a number on the scale to best describe how short of breath you feel. Your doctor will also measure vital signs such as your pulse rate and oxygen saturation levels. Oxygen saturation means how much oxygen is actually making it into your bloodstream, and can be measured with a device called a pulse oximeter. If you’ve felt short of breath regularly over at least six weeks, you may need to do further testing. A lung function test or an exercise stress test can provide a comprehensive report on your lung capacity and how well your lungs and heart function under stress. Your doctor may also be refer you to a specialist. What helps? Depending on the cause, you may be prescribed medication, such as inhalers or oxygen for a lung condition. Opioids (morphine) or benzodiazepines (diazepam) may alleviate symptoms, but these would only be used in the short term, due to the risk of becoming dependent. Apart from medications, breathing and relaxation techniques may help some people manage the unpleasant sensation. These include: pursed lip breathing: pucker your lips and focus on blowing the air out slowly, until you are able to take a big breath in

mindful breathing: find a relaxed resting position where you can draw your attention to your breath and focus on regaining control of your rate of breathing

timed breathing: while moving, time your breath with your body. For example, focus on breathing out when stepping with your right leg and breathing in when you step out with your left

the cool fan technique: blow a fan (electric or hand-held) directly onto your face. The cool air stimulates the nerves in the face to reduce the sensation of breathlessness. A cool washer on your face may help create the same effect.

When to seek help To manage air hunger episodes, you should follow your health professional’s advice about how and when to take medications. Your doctor will also provide you with a management plan to guide you and your loved ones on what to do when you have an air hunger episode. Check in with your doctor regularly, as the plan may need updating if or when your condition changes. In an emergency, or if you are experiencing air hunger for the first time, always call triple 0.

Clarice Tang receives funding from NSW Health and Department of Health. Clarice is also a member of the Thoracic Society of Australia and New Zealand, the European Respiratory Society and the American Thoracic Society.