Hyperventilation Test for CFS

Dr. Natelson has recently found that some chronic fatigue syndrome (ME/CFS) patients breathe normally when they’re lying down but they unconsciously start hyperventilating when they stand. This suggests they may have a problem with the part of their nervous system – called the autonomic nervous system – that governs their rate of breathing when they stand. A small percentage of ME/CFS patients may hyperventilate when they are lying down as well. This hyperventilation is not associated with anxiety or other psychological factors.

Hyperventilation or shallow rapid breathing increases the amount of CO2 released into the air. Because low blood levels of CO2 are associated with fatigue, pain and other symptoms of chronic fatigue syndrome (ME/CFS), a shallow rapid breathing pattern could contribute to the disease.

Two Tests For Hyperventilation – items needed: a watch

A Very Simple Test For Chronic Hyperventilation

  • Take a breath and hold it: if you can only hold for your breath for 35 seconds or less you may be a chronically hyperventilator. Most people can hold their breath for 45 seconds or more.

A Simple Test for Hyperventilation When Standing

  • Stand up straight for 8 minutes.
  • If you start to feel ill stop and rest for a while.
  • Repeat the test. This time breathe into a paper bag held across your nose and your mouth. If the symptoms you had without the bag don’t show up when you are breathing into the bag then you may be unconsciously hyperventilating. This kind of hyperventilation is called Postural Orthostatic Syndrome of Hyperventilation (POSH). It’s presence in ME/CFS was uncovered by Dr. Benjamin Natelson.

Natelson, B. 2008. Your Symptoms Are Real: Overcoming Pain, Fibromyalgia, Chronic Fatigue, IBS and Morel. Wiley Press.



Elaine August 1, 2012 at 2:29 am

I had a pituitary tumour but lots of post op and post medication problems which left me disabled for life. However, have classic symptoms of ME. More recently medics who were all charming and empathtic and kindly spent a lot of NHS money on me doing extensive tests, (including endorcinologist, CFS specialist and lung specialist ) were almost certain I had emphasema as I collapsed in street etc but tests proved lungs were clear so have just been left to deal with it. I have had to double the steroids and have improved enough to dress and hopefully leave my home soon, but still have breathing difficulties. I have no idea why none of them realised it was probably a side effect of CFS/ME.

Lesley June 14, 2013 at 7:18 am

As part of my tests for CFS/ME I was referred to the lung ‘hot’ clinic ar BRI. I was diagnosed with hyperventilation syndrome with CFS/ME. I have been referred for pysio for the hyperventilation syndrome. The specialist there informed me that he had come across a number of patients with CFS also showing symptoms of hyperventilation

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