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What are Hyperinflated Lungs and What Causes It?
Hyperinflation of the lungs occurs when damage to the lung tissue results in lungs that become less elastic.[1] When the lungs lose their elasticity, the expulsion of air becomes difficult and it gets trapped inside the lungs. Hyperinflation can also occur when patients begin to inhale before they’ve fully exhaled. Consequently, air gets trapped within the lungs with each successive breath causing them to overinflate.2
Patients with chronic obstructive pulmonary disease (COPD) often have some degree of hyperinflation of the lungs which can produce significant, detrimental effects on breathing.[2] In COPD, the lungs can be hyperinflated at rest (static hyperinflation) and/or during exercise (dynamic hyperinflation) when breathing requirements are increased and exhalation time is shortened.
Consequences of Lung Hyperinflation
Hyperinflation of the lungs contributes to the following consequences in COPD:
- Shortness of breath
- Exercise intolerance
- Impaired muscle function
- Heart dysfunction
- Reduced physical activity levels
Diagnosis of Lung Hyperinflation
A chest X-ray is the most common tool used to diagnose hyperinflation of the lungs. In some cases, however, the lungs may appear hyperinflated on a chest X-ray for reasons that have nothing to do with lung function. If your chest X-ray shows hyperinflation and the reasons for this aren’t clear, your primary health care provider may order additional testing.[3]
Treatments that Reduce Lung Hyperinflation
Patients with COPD are unable to fully exhale all their air which contributes to lung hyperinflation. Treatment approaches that allow faster exhalation or prolong the time available for exhalation will allow for fuller exhalation which will decrease lung hyperinflation and improve exercise tolerance.
The following therapies have been used to treat lung hyperinflation in COPD:
- Pursed lip breathing – pursed lip breathing reduces lung hyperinflation and improves exercise tolerance, breathing patterns and oxygen saturation levels in COPD patients during high intensity exercise.[4]
- Exercise training – exercise training has been shown to reduce lung hyperinflation and improve exercise tolerance in COPD.
- Oxygen therapy – a number of studies have shown that study participants who received oxygen, when compared to study participants on room air, showed consistent reductions in lung hyperinflation during exercise.
- Bronchodilators – long-acting bronchodilators have been shown to reduce lung hyperinflation both at rest and during exercise in patients with moderate to severe COPD.[5]
- Lung Volume Reduction Surgery (LVRS) – LVRS is a very dramatic method of reducing lung hyperinflation. It is an operation that removes the worst affected areas of your lungs so the healthier parts can work better. The operation can help relieve breathlessness, increase the ability to exercise and improve quality of life. LVRS is not for everyone. Patients only qualify for LVRS by meeting very strict criteria.
[1] M. Eichinger et. al. “Lung hyperinflation: foe or friend”? European Respiratory Journal Oct 2008, 32 (4) 1113-1116; DOI: 10.1183/09031936.00118807.
[2] Gary T. Ferguson “Why Does the Lung Hyperinflate?” Proceedings of the American Thoracic Society, Vol. 3, No. 2 (2006), pp. 176-179.
[3] Mayo Clinic. “A recent chest X-ray showed that I have hyperinflated lungs. What could cause this”? November 14, 2014.
[4] Cabral, L.F., et. al. “Pursed lip breathing improves exercise tolerance in COPD: a randomized crossover study”. Eur J Phys Rehabil Med. 2015 Feb;51(1):79-88. Epub 2014 Apr 2.
[5] O’Donnell, DE. “Hyperinflation, dyspnea, and exercise intolerance in chronic obstructive pulmonary disease”. Proc Am Thorac Soc. 2006 Apr;3(2):180-4.
By Deborah Leader RN, BSN, PHN
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Can this cause cough?
Hi Jackie,
I think it can.
I went for an x ray a few days ago and this showed hyper inflated lungs, as well as a flattened diaphragm. I have shortness of breath for the last four months, and pain in my back and shoulder. The dr told me she thinks its COPD. I have a mild cough-where it is like I am trying to clear my lungs. Is yours quite similar?I am quite scared, as I am not yet 30.
sam
Hi Sam, I have the same as you except for the collapsed diaphragm. I have been dealing with pain in my upper back and shoulder and it hurts to breathe and take a deep breath, my doctor just told me that i have hyper inflation of the lungs. Only thing i am on right now are inhalers and i am 45.
My twin sister, Janet, had a chronic cough, sore throat, and trouble speaking above a whisper. She was diagnosed with asthma and given an inhaler. Now, two years later, her chest x-ray shows she has hyper inflated lungs. This is a condition that is a direct result of asthma that is not managed well. She was given a second inhaler to help with her asthma symptoms. She always took care of herself with a healthy diet and exercise. Nowadays, there is so much pollution in the air and some people's lungs are irritated by this. Try to stay away from people that are smoking or wearing perfume. Get a second opinion and a treatment plan from another doctor. My sister takes brisk walks with her dog and rides her exercise bike every evening after work. Judy
When young doc's said I had asthma, then broncicitus, now I'm old they say COPD.Just had heart and lung cath to test pressure in my lungs,(open heart next), Also had CT scan & breathing test. Results; hyperplasia airtrapping, & hyperinflated lung fields impaired diffusion.I have had pulmonary rehab w/group meetings and that was great. Laying put 4 lb. weight on diaphragm for 20 min. several times a day. ankle weights
My ct scan results show severe emphysema yet my spirometry results show my lungs are fine who do I listen to
Hi Lynn, Both test results are important but the spirometry test is used most often by doctors to diagnose lung disease. This is not to say that a CAT scan is not important. You should go by the diagnosis that your primary care doctor gave you based on your signs and symptoms, your history of exposure to airway irritants including smoking and your test results. If you're not comfortable with what your doctor is telling you, you should go to a pulmonary specialist for a second opinion.
I've had a cough for over 2 months that started with a virus. My Dr. sent me for a chest x-ray to check for any infection which there wasn't. But it showed my lungs were hyper inflated. I have no symptions of this. Shes now sending me for a spirometry test to check further. I am 53 years old and consider myself healthy. I excercise daily without any breathing problems. Kind of strange to me.
Hi Shari, It sounds like you have a really good, diligent doctor working on your behalf. He or she wants to do a through examination so that they can diagnosis your symptoms. If it is something more serious, they will be catching it early. Early detection often results in higher outcomes. Even though you are healthy and exercise daily, smoking as a teenager or exposure to pollutants can lead to adverse effects later in life.
I have had 3 chest xrays. 1 in march 2017 which was normal, the second in August, 2017 which showed hyper inflated lungs with flattened diaphragm and the 3rd in October 2017 with the same result. The last 2 were done by separate radiologist and both impression was copd. My pulmonologist doesn't see that in the films and my spirometry test was very good. I do have severe difficulty breathing. Should i be concerned! I am 60 years old.
Hi Wendy, The bad news is COPD is a life-long condition. The good news is with proper diet, exercise, and medical treatment, COPD can be managed. There are 5 stages to COPD and it sounds like you may be Stage One. For more information on COPD stages, please visit: https://www.inogen.com/resources/living-with-copd/copd-symptoms/
Thank you for your reply. I do not smoke. I walk 4 to 5 miles a day. I eat healthy due to my coronary disease. I am 115 pounds, 5'5' tall, so not over weight. How could I have COPD??
Hi. I smoked Neil I was 35 y.o., and have been quit for 30 years. I lived for 17 years at 7,500 ft. elevation, routinely spent an hour exercising on an elliptical trainer, and frequently hiked and climbed, often with a 50 lb. paraglider on my back. My lab blood work showed high red blood cell count, attributed to living at elevation. Three years ago we moved to the Pacific Northwest, and I have been sick for most of the winter all three years (I might have gotten sick 3 times in the 17 years in Colorado). I continue to exercise regularly on my elliptical trainer.
I went to the doctor recently due to tightness in my chest and a cough, even though I continued to exercise. (I can spend an hour on my elliptical with no problem! but walking up a steep hill caused me to be short of breath). I was diagnosed with bronchitis, and the x-rays showed evidence of hyper inflated or hyper expanded lungs. Could this be the result of the years spent living at elevation, or could the three winters in the cold and damp climate have already affected my lungs.
Also, would a warm and damp climate (like the Pacific coast of Mexico) also be bad for lung problems such as bronchitis.
Thank you so much for any information, as my local GP doesn't have experience with such issues.
Paul
Hi Paul, If your primary care doctor is unable to advise you, you may want to ask him or her to refer you to a specialist like a pulmonologist. Pulmonologists are specialized doctors that are trained in lung diseases, symptoms, and treatments.
im 56 yrs old just got told i have hyperinflation lungs
(mild) probably from second hand smoke but in previous statments i read exercise walking never a issue BUT i like to ski would that be ok if so then im going 3 times a wk
Hi Sean, Before starting a new exercise plan, we always advise that you consult your primary care doctor. You should make an appointment with your primary care physician and ask him or her to evaluate your health and at that time, you should ask him or her if you are fit enough to ski up to 3 times a week.
I have copd and have been doing great, MY lungs got irritated from an air conditioner and I got hyperinflated lungs, am on steroids, will this condition ease up? Thank You
Hi Jane, The improvement of your condition is dependent on your age, your medical history, and your lifestyle choices. We are not familiar with your background so it's hard for us to say whether or not your condition will get better. Please consult your primary care doctor for a diagnosis.
My chest x-ray says that my lungs show hyperinflation with flattening of the hemidiaphrams. New linear scarring or atelectasis at left base. I'm afraid I don't have an appointment with a specialist for two more months and wondering if you could help to interpret what this means. My recent diagnosis shows Connective Tissue disease, Sjogren's and ILD. Would be the only other info I can provide you with, at this time. My family doctor tries but isn't the most forthcoming person but great doc otherwise. Your help might help me ask the correct questions. Thanks for your time.
Hi Bob, Since we are not your primary care doctor and we do not have access to your medical history, we can not give you medical advice. There are multiple types of Interstital Lung Disease (ILD) so it's hard for us to say what your recent chest x-ray means. For more information on ILD, please visit: https://www.inogen.com/blog/interstitial-lung-disease/
I have never smoked at all. I have been coughing a lot lately. It is a different cough then the one I have while eating. I have had it for over 20 years, this one is different it is dry and often. Went to Dr. after him treatment with no results, he sent me to a gastroenterology, a respiratory therapist, an allergy and asthma Doctors and a sleep study testing. Results from all was I had a acid reflux, out of control, put on meds, need to wear a cpap at night for mild sleep apnea, no allergies and no asthma. But after 3 x rays one showed I had over inflated lungs. Said it may be COPD. I go Thursday to a Pulmonology dr. to be checked for COPD. I have seen a heart dr and had complete heart work up, heart is fine. I still have the coughing, shortness of breath, feel like I am smothering, chest pain and upper back pain, sometimes when talking my voice goes out and I feel I can't breathe. Three times during an episode, I have had a panic attack cause I feel I can't breathe. I walk 4 miles a day and eat healthy meals. I am 58 years old. Does any of this sounds like COPD?
Hi Mary, Although smoking puts you at risk for COPD, COPD can be caused by a variety of factors including genetics, occupational exposure, increased age, and indoor/outdoor air pollution. If you have symptoms of COPD, such as shortness of breath, cough and sputum production, and a history of exposure to risk factors, please take a moment to review this 5 Question COPD Risk-Screener brought to you by the COPD Foundation: http://www.drive4copd.org/AreYouAtRisk/TaketheScreener.aspx
Be sure to print out your results and take them to your doctor. For more information about COPD, please visit: https://www.inogen.com/resources/living-with-copd/are-you-at-risk-for-copd/
When I was being xrayed recently, the technician asked me to inhale while I was still exhaling from the previous request. Could that have caused the subsequent diagnosis of "overinflated lungs"?
Hi Mark, As we wrote in the blog post, hyperinflation can occur when patients begin to inhale before they’ve fully exhaled.
I'm 60 years old. Went to the ER for the 2nd time in 2 weeks last night. X-Rays show 2 weeks ago show "a little COPD" and another x-ray last night showed lung hyperinflation. I was put on ventolin 2 weeks ago (2 puffs every 6 hours) and today was put on Flovent 220, 2 puffs twice a day.
Oxygen levels are very good (99-100), my main issue is coughing which is making my left chest area feel tight or a kind of pulling sensation. I have a appointment with a pulmonary doctor near the end of this month.
This whole thing has me emotionally spent. Crying spells from worry, scared, etc. It's very rough. It's real hard to hang in there. Thanks for listening.
Tom
Hi Tom, We're sorry to hear you've been feeling unwell and we understand how challenging respiratory disease can be. Thank you for sharing your story with us. We hope you feel better soon.
can smokers get hyperinflated lungs?
Hi Samantha, Oftentimes smokers develop conditions like COPD or emphysema. Both COPD and emphysema can result in hyperinflated lungs, so yes smokers can get develop hyperinflated lungs.
I am a retired RN. I worked as a visiting nurse and got sinusitis even winter which even with treatment sometimes became bronchitis and occasionally pneumonia. I had smoked less than 1/2 a pack of filtered cigarettes for less than 10 years back in my teens and early 20's. I have had bladder cancer and am cancer free but still on the treatment period for prevention. I had never heard of hyper extended lungs and went through all of my anatomy and physiology books. I am 66 years old diagnosed with this and now I've kicked cancer don't want to have COPD.
Had chest x-ray and in Doctor's report it said I had large inspiratory volume. What does that mean??
Hi Katherine, Lung capacities are determined by genetics, gender, height, and medical history. At maximal capacity, an average lung can hold almost six liters of air, but lungs do not usually operate at maximal capacity. Since we are not familiar with your health history and we are not your primary care doctor we are not able to provide you with a diagnosis. However, for more information on lung volumes and capacities, please visit:
https://courses.lumenlearning.com/wm-biology2/chapter/breathing-capacity/
https://www.inogen.com/blog/forced-vital-capacity/
https://www.inogen.com/blog/fvc/
i have the same symptoms but i previusly had fluid on the lungs removed and that solved my breathing problem….
HI… I have had a cough for a couple of years. In january 2017, I ended up with pneumonia (severe case). It took a while to clear up therefore several CT scans were conducted. Each showed a small nodule on my left lung. Doctors seemed to think it was residual from the pneumonia. I have had breathing issues since then. Two weeks ago, i developed more severe symptoms. Shortness of breath, coughing up lots of junk, mouth tingling, dizziness. Finally went to Dr. Chest X-ray shows over inflated lungs indicating COPD. Blood work for last 3 months have shown High RBC, HCT, HBG. I am truly concerned. Hard to breath. Break out in sweats with the slightest exertion. Dr prescribed prednisone, and inhaler. I am only 55 and about to panic.
Dear Donna, Thank you for sharing. I hope you feel better soon and please feel free to contact us to discuss whether oxygen therapy might be helpful for you. Please call us at 800-374-9038.
I have COPD and I also cough up blood why and what do I do?
Hi Paul, That sounds painful. I suggest you bring this up to your doctor immediately. Best of luck!
I've had a couple chest x-rays come back with hyperinflation of lungs. I have asthma and allergies really bad, but well controlled by meds and inhalers. X-ray shows hyperinflation, yet my diaphragm is arced, not flattened, as with emphysema. My Pulmonologist put me on a different inhaler, and says is called COPD, but is not emphysema. Any suggestions as to what it may be? I get short of breath with exercise and with prolonged speaking. (I'm a teacher.) Thank you.
Lived in FL for 10 years. Moved back to PA for 4 years and now back in FL. When my husband and I returned to FL we became very sick with sinus, bronchitis and flu symptoms. It continued to hit us for 3 mos. My husband worse and had 2 Z Pak prescriptions before he felt better. I got over it with one, and chest x ray came back good. My husband's showed hyperinflation in lung and they said it was COPD. He saw a pulmonologist and they said he was ok after doing lung function test.
He got better but developed the same symptoms again….another x ray showed same as first mild hyperinflation, but this time the saids no infection. He is a man that exercises, never smoked and very active 66 year old. Any clues as to what could be the cause or diagnosis? What next steps should medical sources be ordering for him. ?
I developed breathing problems all of the sudden. One morning as I was taking my shower I started gasping for air and since then my breathing is affected on a daily basis and it has been 20 years. Many trips to the ER, many visits to different pulmonologists, went to Mayo Clinic. Had tones of tests done, PFT, VQ. Scan, echocardiogram at rest and exercise… all came up normal. However, all my xrays show hyperinflation of the lungs but since all my other tests always come up normal they don’t seem to be concerned about the hyperinflated lungs. I went to UCLA to consult with a specialist of emphysema (he also does a lot of research on this disease to find a cure), he said that I have no signs of emphysema and I might just have been born with bigger lungs. Now when it come to my breathing most of all doctors say that it is anxiety and panic attacks. What are your thoughts on that?
Hi Syl, Thank you for reaching out to us. While I am not a medical professional, I would definitely take whatever the medical professionals suggest into consideration and see if it helps. This article might help you https://www.inogen.com/blog/copd-breathing-exercises/. I hope you begin to feel better soon.