ABampinsp: abdominal amplitude during inspiration phase; DB: dysfunctional breathing; M: median values; NDB: non-dysfunctional breathing; RCampinsp: ribcage amplitude during inspiration phase; RR: respiratory rate; Te: expiration time; Ti: inspiration time; Ttot: total breath cycle duration. a: significant result at p < 0.01 after Bonferroni correction with adjusted alpha level.
Declarations
Acknowledgments
The author thanks the participants for their valuable contribution to this dataset. Also, the author thanks the funders for their financial support of the study, which was part of a series of clinical studies conducted for the successful completion of the author’s doctoral degree. The author thanks his supervisors, Prof. Anne Bruton (Emeritus Professor, University of Southampton) and Prof. Anna Barney (Professor of Biomedical Acoustic Engineering, Faculty of Engineering and the Environment, University of Southampton), for their meticulous guidance and contribution to the author’s PhD work that produced the dataset used for the current secondary analysis. Special thanks also go to Prof. Anna Barney for developing and providing the MATLAB algorithm used to extract the breathing pattern data during the author’s PhD work.
Author contributions
PS: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Software, Resources, Visualization, Writing—original draft. The author read and approved the submitted version.
Conflicts of interest
The author declares that he has no conflicts of interest.
Ethical approval
The study had been approved by the London-Queen Square Ethics Committee (Rec no: 17/LO/1640; IRAS ID: 230295). This study complies with the 2013 Declaration of Helsinki.
Consent to participate
All participants provided a written consent form prior to their participation in the study.
Consent to publication
Patients’ anonymous data were agreed to be published to maintain anonymity and protect individuals’ health data.
Availability of data and materials
The dataset used and analyzed during the current secondary analysis, as presented in the current manuscript, is available from the corresponding author (1st author of this manuscript) on reasonable request at psakkatos@upatras.gr.
Funding
The current study which was part of a series of clinical studies of the author’s doctoral research was funded by the British Lung Foundation and the Wessex Medical Trust [15501/01]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Open Exploration maintains a neutral stance on jurisdictional claims in published institutional affiliations and maps. All opinions expressed in this article are the personal views of the author(s) and do not represent the stance of the editorial team or the publisher.
References
Qaid EYA, Long I. Asthma unravelled: a comprehensive review of epidemiology, phenotypes, pathophysiology, and emerging therapies.Egypt J Bronchol. 2025;19:1–14. [DOI]
Zhang L, Jiang H, Yang G, Zhang J, Yuan S, Chen J, et al. Global, regional and national burden of asthma from 1990 to 2021: a systematic analysis for the Global Burden of Disease Study 2021.BMJ Open Respir Res. 2025;12:e003144. [DOI] [PubMed] [PMC]
D’Amato G, Vitale C, Molino A, Stanziola A, Sanduzzi A, Vatrella A, et al. Asthma-related deaths.Multidiscip Respir Med. 2016;11:37. [DOI] [PubMed] [PMC]
Thomas M, McKinley RK, Freeman E, Foy C, Price D. The prevalence of dysfunctional breathing in adults in the community with and without asthma.Prim Care Respir J. 2005;14:78–82. [DOI] [PubMed] [PMC]
Sedeh FB, Von Bülow A, Backer V, Bodtger U, Petersen US, Vest S, et al. The impact of dysfunctional breathing on the level of asthma control in difficult asthma.Respir Med. 2020;163:105894. [DOI] [PubMed]
Boulding R, Stacey R, Niven R, Fowler SJ. Dysfunctional breathing: a review of the literature and proposal for classification.Eur Respir Rev. 2016;25:287–94. [DOI] [PubMed] [PMC]
Vlemincx E. Dysfunctional breathing: a dimensional, transdiagnostic perspective.Eur Respir J. 2023;61:2300629. [DOI] [PubMed]
van Dixhoorn J, Folgering H. The Nijmegen Questionnaire and dysfunctional breathing.ERJ Open Res. 2015;1:00001-2015. [DOI] [PubMed] [PMC]
Todd S, Walsted ES, Grillo L, Livingston R, Menzies-Gow A, Hull JH. Novel assessment tool to detect breathing pattern disorder in patients with refractory asthma.Respirology. 2018;23:284–90. [DOI] [PubMed]
Krohn F, Novello M, van der Giessen RS, De Zeeuw CI, Pel JJM, Bosman LWJ. The integrated brain network that controls respiration.Elife. 2023;12:e83654. [DOI] [PubMed] [PMC]
Motamedi-Fakhr S, Iles R, Barney A, de Boer W, Conlon J, Khalid A, et al. Evaluation of the agreement of tidal breathing parameters measured simultaneously using pneumotachography and structured light plethysmography.Physiol Rep. 2017;5:e13124. [DOI] [PubMed] [PMC]
Sakkatos P. Recording and analysis of breathing patterns: a physiological marker in asthma management [dissertation]. Southampton (UK): University of Southampton; 2019.
2022 GINA Report, Global Strategy for Asthma Management and Prevention [Internet].GINA; c2026 [cited 2018 Apr 16]. Available from: https://ginasthma.org/gina-reports/
Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis.J Clin Epidemiol. 1996;49:1373–9. [DOI] [PubMed]
Freeman A, Abraham S, Kadalayil L, Varkonyi-Sepp J, Ainsworth B, Hudson-Colby JJ, et al. Associations of Breathing Pattern Disorder and Nijmegen Score With Clinical Outcomes in Difficult-to-Treat Asthma.J Allergy Clin Immunol Pract. 2024;12:938–47.e6. [DOI] [PubMed]
Sakkatos P. Evaluation of a digital fully-contactless optical device to quantify and record breathing pattern components at rest and after exercise.Explor Digit Health Technol. 2025;3:101156. [DOI]
Niérat M, Dubé B, Llontop C, Bellocq A, Layachi Ben Mohamed L, Rivals I, et al. Measuring Ventilatory Activity with Structured Light Plethysmography (SLP) Reduces Instrumental Observer Effect and Preserves Tidal Breathing Variability in Healthy and COPD.Front Physiol. 2017;8:316. [DOI] [PubMed] [PMC]
Dolatabadi A, Heydari M, Hashempour B, Asadiof F, Radmehr S. Linear And Nonlinear Analysis of Multimodal Physiological Data for Emotion Recognition.J Artif Intell Syst Model. 2025;3:105–15. [DOI]
Courtney R, Greenwood KM, Cohen M. Relationships between measures of dysfunctional breathing in a population with concerns about their breathing.J Bodyw Mov Ther. 2011;15:24–34. [DOI] [PubMed]
Knöpfel G, Baty F, Uhl F, Kern L, Brutsche M. Quantification of breathing irregularity for the diagnosis of dysfunctional breathing using proportional tidal volume variation: a cross-sectional, retrospective real-world study.BMJ Open. 2024;14:e083401. [DOI] [PubMed] [PMC]
Bruton A, Lee A, Yardley L, Raftery J, Arden-Close E, Kirby S, et al. Physiotherapy breathing retraining for asthma: a randomised controlled trial.Lancet Respir Med. 2018;6:19–28. [DOI] [PubMed] [PMC]
Vidotto LS, Carvalho CRF, Harvey A, Jones M. Dysfunctional breathing: what do we know?J Bras Pneumol. 2019;45:e20170347. [DOI] [PubMed] [PMC]
Möbus SF, Harding CJ, Taylor CL, Sylvester KP, Fuld JP. Characterization of dysfunctional breathing using cardiopulmonary exercise testing.Physiol Rep. 2025;13:e70388. [DOI] [PubMed] [PMC]
Tiotiu A, Ioan I, Poussel M, Schweitzer C, Kafi SA. Comparative analysis between available challenge tests in the hyperventilation syndrome.Respir Med. 2021;179:106329. [DOI] [PubMed]