Breathing Problems in Parkinson’s Disease

The troublesome neurodegenerative disorder Parkinson’s disease manifested by the symptoms of tremors, slowing of movements, rigidity and many more associated motor complications, caused by the loss of dopaminergic neurons in the nigrostriatal region of the brain is one of the most common cause of disability amongst the elderly population.

Parkinson’s breathing is a complicated issue. Normal aging should not cause breathing difficulty and people with Parkinson’s disease, although mostly elderly, should not have breathing problems unless there is some underlying cause. Getting out of breath on undertaking unaccustomed exercise is not really a cause for concern. Some people with Parkinson’s disease experience shortness of breath and undergo testing, but are found to have a healthy lung function.

It is quite possible, however, for a person with Parkinson’s disease to also suffer from some pre-existing lung or heart condition which may cause some amount of breathing difficulty. If shortness of breath, wheezing, cough or chest discomfort does develop, even without a known medical problem, careful assessment and treatment is definitely indicated. Shallow breathing starves the vital cells of body off oxygen, which exacerbates a myriad of unfavorable things including fatigue and constipation.

Causes of Breathing Difficulty in Parkinson’s Disease

Dyspnea, breathing difficulty, or shortness of breath – whatever you may choose to call it – can be very distressing, and even frightening, for the person who suffers with it, especially if there have been severe episodes. The causes could be any of the following :


  • Aspiration Pneumonia: It develops when the food particles lodges down the wrong pipe and settle in the lungs to cause infection. The Parkinson’s patient usually aspirates in the advanced stages due to marked motor impairment and muscle dystonia, which leads to swallowing difficulties and specific changes in the swallowing pattern. In fact, it is a well established fact that, aspiration pneumonia is the leading cause of death among the patients in Parkinson’s disease.
  • Although there has been limited research conducted on this topic, but some of these studies have found that the patients of Parkinson’s disease usually inhale a lower volume of air with each passing breath, as compared to the healthy people, which might aid to breathlessness.
  • It might also be possible that the rigidity of the muscles in the chest and abdomen, which is a symptom of motor impairment associated with Parkinson’s disease might lead to breathlessness.
  • Wearing off episodes: These episodes are usually experienced among people who have been taking the levodopa for several years as the medication for Parkinson’s disease The wearing off episodes manifest when the medication’s benefit wears off and the shortness of breath occurs before it’s time for the next dose.
  • Chronic lung diseases such as COPD (chronic obstructive pulmonary disease), chronic asthma, emphysema and chronic bronchitis or an acute exacerbation, can cause shortness of breath accompanied by wheezing, cough or chest discomfort.
  • Pneumonia: chest infections are more common in people with Parkinson’s disease, than in the general population.
  • Pulmonary embolism.
  • Pulmonary hypertension.
  • Heart failure and other heart conditions such as myocardial infarction (heart attack).
  • Stroke. The symptoms of a stroke may sometimes be missed in the late stages of Parkinson’s disease as caregivers may mistaken the presentation for the progression of Parkinson’s disease.
  • Choking on an object.
  • Severe anemia.
  • Allergic reactions. This should be monitored carefully to assess if the reaction is caused by any medication.
  • Common cold, sinusitis or other nasal problems.
  • High fever.
  • Associated diseases such as lung cancer or tuberculosis.
  • Anxiety or panic attacks. Parkinson’s disease patients often suffer from depression, anxiety disorders, dementia and other emotional problems. This could sometimes be the cause of hyperventilation and breathing problems. When all other causes have been excluded, this diagnosis should be kept in mind.

Shortness of breath could be due to any of the above causes or it may be a symptom of end stages of Parkinson’s disease.

Risk Factors

The associated risk factors may include :

  1. Air pollution.
  2. Smoking.
  3. High altitude.
  4. Obesity.


It is important to diagnose the cause of the breathing difficulty. If the patient has a known medical condition other than Parkinson’s disease, diagnosis becomes easy. Even so, a thorough physical examination will need to be conducted along with other tests if indicated. This may include :

  • Blood tests, including arterial blood gases, especially oxygen saturation.
  • Chest x-ray.
  • ECG.
  • Echocardiogram.
  • Pulmonary function tests.
  • Spirometry.
  • Methacholine challenge test.
  • Allergy tests.
  • CT scan.

Prevention and Treatment

There is no specific therapy to treat shortness of breath amongst patients of Parkinson’s disease. Various tips can come handy to cope with the breathing difficulties, provided the root cause is pre-determined.

  • Proper identification and treatment of the non-parkinson’s cause of dyspnea, such as a lung or a heart disease is usually the mainstay of treatment.


  • Simple breathing exercises: Breathe in and breathe out with a calm mind and practice simple meditation exercises. This method brings in an ample amount of oxygen possible. Also, the simple deep breathing exercises aligns the diaphragm to press down on the intestine, so as to relieve the Parkinson’s associated constipation, and the lungs function at a higher level to cleanse the toxins. Not only the breathing exercises brings in oxygen, but it also keeps the patient at calmer nerves and wards off anxiety, which in itself is an independant grave culprit for shortness of breath.
  • Regular exercise as appropriate, keeping in mind the condition of the patient suffering from Parkinson’s disease. Staying active improves the pulmonary function and increases the ability to take deep breaths. A structured exercise regime improvises the cardiorespiratory system.
  • Appropriate psychotherapy for the patients with anxiety including the medications, exercise and lifestyle changes is also a crucial determinant in the relief of Parkinson’s associated dyspnea.
  • Consult a speech-language pathologist, who can address the issues related to swallowing.
  • Giving up smoking is very important.
  • Immunization. Bed-ridden, depressed and immobile Parkinson’s disease patients are very susceptible to contracting infections because of their low immunity status. Appropriate vaccinations should be administered to prevent infections such as the flu and pneumonia.
  • A nutritious diet, including fruits and vegetables, help to build up the immune system. Vitamin and zinc supplements may also help. Avoid close contact with others who have a cold, flu or other infectious diseases.
  • Oxygen administration can help when breathing difficulty becomes severe. Hospitalization may become necessary at this stage.



  1. I am 69 yrs old. My world dramatically changed 10/29/08 when I knee replacement surgery. The Dr? missized the knee replacent causing it to be so loose that it caused me to fall. One which I broke a couple fo ribs and the other I tore a rotator cuff. Needless to say this caused a lot of stress. I then found another Dr? who basically did a cosmetic job on my knee on 10/6/09. After a long rehab I started having Parkinsons type systems. I was diagnosed at the Cleveland Clinic 10/10 that I did in fact have PD. I had all the Parkinsons symptons that are well published but in addition to those and are not even mentioned by the Parkinsons establishment are the breathing issues I have all my waking hrs. This plus stiffness in my lower jaw and neck. I’ve extensive pulmonary function tests at the Cleveland Cinic and Summa Hospital in Akron,O Prior to my third surgery 7/11/11 on my rt knee, which was done by a revision specialist at The Cleveland Clinic. I had 2 days of preoperative testing. Everything checked out good. I am seeing a psychiatrist for anxiety, ocd, and depression. That Dr’s solution is drugs which are not workig. So may I submit to you and this is my firm belief that this breathing issue is the direct result of my Parkinsons , which is the direct result of the stress of two botched surgeries. I do feel the cc got it right, But even now after 14+ weeks I have a lot of pain…… and frustration. Thank you for listening.

  2. I was diagnosed in 2003 at the age of 49 after having mild Parkinson’s symptoms and feel the breathing issues I have been experiencing are the affects of the disease. One of my first symptoms was a tightness in my chest after going on a 4 mile walk. This baffled me as I should have felt a surge in energy from this exercise with my lungs breathing deeply and efficiently. At the time I was walking, I had not yet been diagnosed.

    Anyway, I have experienced extreme stress in this past year with the decline in health of my elderly parents and the subsequent care of both of them added to my usual life’s stress. I will also add that the breathing issues have worsened these past few months with the symptoms of stiffness in my lower jaw and neck that you, Allen, describe.

    The stress in my life this year has been so extreme that I have also been diagnosed with having anxiety attacks. I feel this exacerbates the symptoms I experience with my breathing and Parkinson’s Disease. There doesn’t seem to be much written about this topic and I appreciate you bringing it up in this blog.

  3. I have had this Hyperventilating type breathing from my Parkinsons for about 6 months. The first time it happened I went to the emergency room. I was told I was hyperventilatig. I was told to take Ativan or breathe into a paper bag. I tried both suggestions and neither worked. A Doctor I was seeing suggested it could be that the muscles around the lungs are being compressed possibly from anxiety. I received a prescription for Vicodin which I took 1 pill every 8 hours. The results have been very good. I get about 3 to 4 hours relief out of each 8 hours. This equals 12 hours of relief for the day. Try it! You have nothing to lose.

  4. Two years ago, former Syracuse punter Rob Long was diagnosed with a brain tumor. The two-time captain had been suffering incurable headaches and nausea and his girlfriend encouraged him to see team trainers about the problem. On Dec. 2, 2010, after a multitude of tests, doctors told Long they had found malignant cells in his brain.

  5. I was diagnosed with Parkinson’s in 2011. I was told that I had asthma and chronic bronchitis. In 2013 I had a sleep study done because I felt so exhausted. They did not find apnea. What they did find is Nocturnal Hypoxemia. My pulmonary dr. (new) said I showed none of the traditional signs of asthma but in the past month I’ve had two bouts of tracheal bronchitis. I’m short of breath and exhausted. I’m on O2 at night for the hypoxemia. My pulmonary dr. feels it’s somehow related to my PD. I’m trying to find more information about this.

  6. My mother-in-law was diagnosed with PD in 2011. She has the wheezing, asthma-like symptoms. She had asthma when she was little, one doctor said she currently has asthma but her asthma doctor said it’s not asthma. She takes alburerol chloride around 3x a day but the medicine seems to wear out quickly now unlike the first time she started using it which was 2 weeks. Can anybody tell if her breathing problem is PD related (she’s got a lot of medication) or her asthma is just getting worst. Thanks!

  7. Hi my husband as been told he as PD he to as wheezing he thinks its the medication he is taking for is PD he had no problems Before taking his medication

  8. My husband was diagnosed 20+ years ago with PD..7 yrs ago he had a DBS..deep,brain,stimulator implanted….his quality of life increased considerably. In the last 2 years he has developed breathing difficulties ranging from constant clearing his throat, as it felt like something was lodged; shortness of breath when walking or sitting; and the most frightening was not being able to breathe…he said it was as if he were breathing thru a small straw….his face was sallow and the color around his mouth and eyes were white. He was very frightened. I called the EMS and transported him to the ER…..after 12 hours of testing; intermittent use of a nebulizer&albuterol;oxygen use..he seem to breath a little better. He was seen by our family practitioner, ER Doctors; his neurologist and NP for DBS….with all in reports in non-conclusive…”it could be asthma or showing symptoms of asthma…..” He was released with a hand-held puffer…. After I read about asthma and that we could administer home treatments of albuterol via a nebulizer at home….the Doctor ordered and we are NOW using. Although the results are not Ideal, but with anything that MIGHT be PDS related we WILL and DO try…..I try to remember always that today is the best day we may have … SMILE and Pray that God gives us our direction as caregivers……because there are so few People with PDS symptoms alike…..thank you for reading this I truly hope we all can help one another…..Blessings

  9. Restrictive Lung Disease is not at all uncommon with Parkinson’s. I have it. A spirometer test in your Dr office will tell you right away if its from compromised chest muscles. Albuterol inhalers etc will not change the test results if its PD.

  10. My late mother had Parkinson’s Disease, and a pulmonary specialist told me that respiratory issues are extremely common in advanced cases of PD. The chest muscles become too weak to cough, swallow, and clear your throat. Fluid settles in the lungs and patients are at risk of choking and developing aspiration pneumonia. I have been told that respiratory issues are the most common primary cause of death for PD patients.

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