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A recent study led by researchers at the Icahn School of Medicine at Mount Sinai has identified dysfunctional breathing as a common and potentially aggravating factor in chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME). Conducted in 2025 and published in Frontiers in Medicine, the research suggests that addressing abnormal breathing patterns could offer relief to millions suffering from this debilitating condition characterized by persistent exhaustion and cognitive difficulties.
Key Findings and Developments
The study involved 57 patients diagnosed with CFS and 25 healthy matched controls who underwent cardiopulmonary exercise testing across two days. While peak oxygen uptake (VO2 max) was similar between groups, 71% of the CFS patients showed evidence of breathing abnormalities, including hyperventilation and dysfunctional breathing. Nearly half of the patients exhibited erratic breathing patterns compared to only a few controls. These dysfunctional patterns included rapid shallow breaths, deep sighing, and poor coordination between chest and abdominal muscles—impairing lung expansion and oxygen delivery.
Such breathing disorders can produce symptoms overlapping with those of CFS, such as dizziness, cognitive impairment (brain fog), shortness of breath, fatigue, chest pain, palpitations, and anxiety. The co-occurrence of hyperventilation and dysfunctional breathing in some patients suggests a complex interplay that may worsen chronic fatigue symptoms and contribute directly to post-exertional malaise—the worsening of symptoms following physical or mental exertion.
Expert Perspectives
Dr. Benjamin Natelson, senior author and neurologist at Icahn, remarked, “Nearly half of our chronic fatigue subjects had some disorder of breathing — a totally unappreciated issue, probably involved in making symptoms worse. Identifying these abnormalities will lead researchers to new strategies to treat them, with the ultimate goal of reducing symptoms”.
Dr. Donna Mancini, first author of the study, added, “We are sure patients can have dysfunctional breathing without being aware of it. Dysfunctional breathing can occur even at rest and may worsen symptoms.” She also highlighted the role of dysautonomia—a disorder affecting autonomic nervous system control of blood vessels and muscles, often seen in CFS patients—which may trigger irregular breathing and hyperventilation.
Context and Background Information
Chronic fatigue syndrome affects millions worldwide and is characterized by profound fatigue, cognitive difficulties, unrefreshing sleep, pain, and worsening symptoms after exertion. Dysautonomia, including orthostatic intolerance, is a recognized component, complicating symptom management. Respiratory symptoms like shortness of breath, though often reported, have received limited study focus until now.
Dysfunctional breathing is well established in asthma but less studied in systemic illnesses like CFS. Typical dysfunctional breathing involves abnormal respiratory muscle activity and breathing patterns that impair efficient gas exchange. Hyperventilation, characterized by excessive ventilation beyond metabolic needs, can cause hypocapnia (low blood CO2), leading to symptoms such as dizziness and palpitations.
Implications for Public Health and Treatment
This study opens a promising new avenue for managing chronic fatigue syndrome by targeting respiratory irregularities. Therapeutic strategies under consideration include pulmonary physiotherapy, breathing retraining exercises, yoga, biofeedback, and gentle conditioning exercises emphasizing breath control like swimming. Monitoring exhaled CO2 via devices may help identify patients with hyperventilation for tailored interventions.
Such non-pharmacological therapies could supplement existing symptom management approaches and offer meaningful relief by improving breathing coordination, reducing fatigue, and mitigating post-exertional malaise. However, further research is needed to establish standardized protocols and confirm efficacy.
Potential Limitations and Conflicting Viewpoints
The study’s sample size was relatively modest, and the breathing abnormalities detected may not apply universally to all CFS patients. The relationship between dysfunctional breathing, dysautonomia, and chronic fatigue remains complex and bidirectional, requiring deeper exploration. Some experts caution against attributing too much causality to breathing disorders alone, emphasizing that CFS is multifactorial with overlapping immunological, neurological, and metabolic components.
Practical Takeaways for Readers
For individuals experiencing chronic fatigue symptoms, awareness of potential breathing irregularities can be empowering. Simple breathing exercises focusing on diaphragmatic breathing, mindfulness, and paced respiration may be beneficial alongside guidance from healthcare professionals. Patients should consult physicians or physiotherapists experienced in pulmonary rehabilitation before starting any new intervention.
Medical Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making any health-related decisions or changes to your treatment plan. The information presented here is based on current research and expert opinions, which may evolve as new evidence emerges.
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