Hi,

Thank you for your query.

1. I am assuming that you are referring to extra exhalation interrupting your normal breathing pattern.

2. I would rule out the following causes an investigate as follows.:
a. Stress.
b. Lung problems: COPD (Chronic Obstructive Lung Disease), Bronchitis, Emphysema. Get Chest X-rays and a Pulmonary Function Test done.
c. Acid Base Imbalance (Metabolic cause) or CO2 (carbon dioxide) build-up, making the blood acidic. This alters breathing to increase CO2 washout by involuntary exhalation. Get your Blood Gases checked. get routine blood tests done.
d. Diaphragmatic clonus (abnormal muscle movements) either due to irritation to the Vagus Nerve or the Phrenic Nerve.
e. Acid Reflux.
f. Lung circulation problems; Get a 2D Echo and a lung perfusion scan done.
g. Get a videolaryngosocpy done to rule out laryngospasm. Do you have any change in voice?
h. Drug interactions. Are you on any medication? Is your blood pressure normal.
i. An MRI brain to rule out central lesions and XXXXXXX Chiari malformations. Do you have any hearing problems.

3. A Sleep Study apparatus or Pulse Oximetry may help track your (O2) oxygen and CO2 (carbon dioxide) levels especially during the episodes of involuntary exhalation.

4. Kindly let me know the results of your investigations and your response to the medication. This will help decide further treatment.

I must emphasize that this is not life threatening. There may be multiple factors causing this altered breathing .

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.

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