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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 may be due to a life-threatening condition.

Risks

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"
  • gastroesophageal reflux disease (GERD), which occurs when stomach contents go backward. Stomach acid may flow backward all the way up into the throat and mouth and affect breathing.
  • sleep apnea, 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.

Prevention

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 apnea. Taking medications as prescribed can prevent noisy breathing due to congestive heart failure, gastroesophageal reflux disease, or asthma.

Diagnosed

How is the condition diagnosed?

Sometimes the diagnosis is obvious from the history and physical exam. In other cases, further tests may be needed, depending on the suspected cause. A chest x-ray is commonly done to look for infections, tumors, and lung or heart diseases. Strokes, and some tumors, can be better seen on a CT or MRI scan.
If sleep apnea is suspected, a sleep study may be done. In some cases, a procedure called 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 healthcare professional to see the inside of the throat and airways. This test is useful to detect conditions such as vocal cord paralysis, or a tumor or cancer in the throat or lungs.

Long Term Effects

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.

Other Risks

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.

Treatments

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. Sleep apnea is often treated with a device called continuous positive airway pressure (CPAP). This device keeps an individual's airway open during sleep.
Gastroesophageal reflux disease can often be treated with medications that reduce stomach acid. Someone with cancer may need surgery, chemotherapy, or radiation therapy.

Side Effects

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. Surgery may be complicated by bleeding, infection, or an allergic reaction to the anesthetic.

After Treatment

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.

Monitor

How is the condition monitored?

Any new or worsening symptoms should be reported to the healthcare professional. 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.

Sources

Harrison's Principles of Internal Medicine, 1998, Fauci et al.

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