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noisy breathing in adults

Definition
Noisy breathing in adults is a common condition, usually caused by a blockage in the air passages.

What is going on in the body? 
Noisy breathing generally occurs when a blockage somewhere in the breathing passages produces abnormal airflow. The blockage can be anywhere from the mouth to deep inside the lungs. Noisy breathing may be harmless or a life-threatening condition.

What are the signs and symptoms of the condition? 
When a person complains of noisy breathing, the doctor will want to know:
  • what the breathing sounds like
  • when the noisy breathing started
  • whether it is constant or only occurs sometimes
  • whether it goes away or gets worse during sleep
  • whether the breathing is affected by changes in position
  • if there are signs of an infection, such as a cough, fever, or runny nose
  • whether the person snores during sleep
  • whether the person smokes or drinks alcohol
  • if there is a family history of noisy breathing
  • what other medical conditions the person has, if any
  • what medications or drugs a person takes, if any
  • other symptoms the person may be having
Other questions may also be asked as well.

What are the causes and risks of the condition? 
There are many causes of noisy breathing in adults, including:
  • anatomic defects or conditions, such as a deviated nasal septum, which divides the two nostrils unequally
  • respiratory infections, such as influenza or flu, acute bronchitis, pneumonia, and the common cold
  • asthma, a condition that results in reversible narrowing of the airways
  • chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis
  • smoking, which can cause COPD, a hoarse voice, and a "smoker's cough"
  • gastro-esophageal reflux disease, which occurs when stomach contents go backward. Stomach acid may flow backward all the way up into the throat and mouth. This may affect breathing.
  • sleep apnoea, a condition that results in a blockage of the airway in the throat during sleep. This is also a common cause of snoring.
  • lung cancer or throat cancer, which can partially or fully block the airways
  • nervous system problems or damage, which may affect the ability to breathe. An example is paralysis of a vocal cord from a stroke, or brain attack.
  • heart conditions, such as congestive heart failure, which can cause an accumulation of fluid in the lungs
  • other lung conditions, such as inflammation of the lungs from autoimmune disorders. These are conditions in which a person's immune system attacks his or her own body.
Other causes are also possible.

What can be done to prevent the condition? 
Many cases cannot be prevented. Avoidance of smoking could prevent some cases, such as those due to COPD and lung cancer. Avoidance of obesity can prevent some cases of sleep apnoea. Taking medications as prescribed can prevent noisy breathing due to congestive heart failure, gastro-oesophageal reflux disease, or asthma.

How is the condition diagnosed? 
Diagnosis begins with the history and physical examination. This may be all that is needed in some cases. For others, further tests may be needed.

Different tests may be ordered, depending on the suspected cause. A chest x-ray is commonly done to look for infections, tumours, and lung or heart diseases. Special x-rays such as a chest CT scan will look for tumours, and a cranial MRI can detect a stroke. If sleep apnoea is suspected, a sleep study may be done.

In some cases, a procedure called endoscopy or bronchoscopy may be used. A small tube is inserted through the mouth and into the throat and windpipes. The tube has a light and camera on the end of it. This allows the doctor to see the inside of the throat and airways. This test is useful to detect conditions such as vocal cord paralysis, or a tumour or cancer in the throat or lungs.

What are the long-term effects of the condition? 
Long-term effects are related to the cause. For example, cases due to infection often go away and have no long-term effects. Cancer can result in death. Cases due to nervous system conditions may sometimes be permanent.

What are the risks to others? 
Noisy breathing itself is not contagious. If the cause is an infection, such as pneumonia, the infection may be transmitted to others.

What are the treatments for the condition? 
Treatment is directed at the cause. A person with an infection may need antibiotics. Noisy breathing caused by anatomic defects, such as a deviated nasal septum, can sometimes be corrected with surgery. gastro-oesophageal reflux disease can often be treated with medications that reduce stomach acid. Someone with cancer may need surgery, chemotherapy, or radiation therapy.

What are the side effects of the treatments? 
Side effects are related to the treatments used. Antibiotics and medications used to treat reflux may cause allergic reactions or stomach upset. Any surgery carries a risk of bleeding, infection, or allergic reaction to the anaesthesia.

What happens after treatment for the condition? 
A person with asthma often has occasional "flares" and may need treatment for many years. Someone with an infection usually gets better and needs no further treatment after recovery. An individual with cancer may die if treatment is not successful.

How is the condition monitored? 
Any new or worsening symptoms should be reported to the doctor. Other monitoring is related to the cause. For example, someone with cancer may need repeated blood tests or x-rays to monitor the effects of treatment.

Author: Adam Brochert, MD
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 20/09/2004
Contributors
Potential conflict of interest information for reviewers available on request
 


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