Noisy breathing describes any unusual sounds heard during respiration that are audible without the aid of a stethoscope. These sounds arise from air moving through airways that are narrowed or partially obstructed. While some instances of noisy breathing may be harmless, others can indicate underlying health issues requiring attention. The characteristics of these sounds often provide clues about their origin within the respiratory system.
Identifying Different Sounds
Stridor is a high-pitched, harsh sound often heard during inhalation. This sound indicates an obstruction or narrowing in the upper airway, such as the voice box (larynx) or windpipe (trachea). Stridor can also be heard during exhalation or both phases of breathing, depending on the location and severity of the blockage.
Wheezing presents as a high-pitched, whistling sound, often heard during exhalation. This sound suggests narrowing of the lower airways, specifically the small bronchial tubes within the lungs. While often heard on breathing out, wheezing can sometimes occur during inhalation as well.
Rhonchi are characterized by low-pitched, rumbling, or snoring sounds. These continuous sounds indicate the presence of secretions, like mucus, in the larger airways of the lungs. Rhonchi can clear or change after a person coughs, as the secretions shift.
Crackles, also known as rales, are short, popping, or crackling sounds. These sounds can be fine and high-pitched, similar to the sound of hair rubbing together, or coarser and lower-pitched. Crackles occur when air passes through fluid in smaller airways or when collapsed air sacs in the lungs suddenly open.
Stertor is a noisy, snorting, or gurgling sound. This low-pitched noise originates from a partial obstruction in the upper airway, specifically above the voice box, often in the nasal passages or the back of the throat. It resembles the sound of nasal congestion or snoring.
Underlying Causes
Stridor results from conditions that narrow the upper airway. In children, croup, a viral infection causing airway swelling, is a common cause. Other causes include epiglottitis, a severe bacterial infection of the epiglottis, foreign objects lodged in the airway, and congenital abnormalities like laryngomalacia, where floppy tissues obstruct the airway. Adults may experience stridor due to vocal cord paralysis, swelling from allergic reactions, or trauma to the airway.
Wheezing is a symptom of conditions that narrow the lower airways. Asthma, a chronic inflammatory condition, is a primary cause, where airways swell and produce extra mucus, making breathing difficult. Bronchitis, an inflammation of the bronchial tubes, and bronchiolitis, a viral infection common in infants, can also lead to wheezing. Allergies, which can cause significant airway inflammation, and even heart failure, can also result in wheezing.
Rhonchi and crackles stem from conditions involving fluid or secretions in the airways. Colds and influenza cause rhonchi due to increased mucus production in the larger airways. Pneumonia, an infection that fills lung air sacs with fluid or pus, is a cause of crackles. Heart failure can also lead to crackles due to fluid buildup in the lungs.
Stertor arises from partial blockages in the nasal or throat regions. Enlarged tonsils or adenoids can contribute to this sound. Nasal congestion from colds, allergies, or sinus infections can also cause stertor. Chronic snoring is a form of stertor caused by relaxed throat muscles during sleep.
When to Consult a Professional
Certain signs and symptoms accompanying noisy breathing warrant immediate medical attention. These include significant difficulty breathing, such as struggling for air, visible pulling in of the skin around the ribs or collarbone, and rapid breathing. A bluish tint to the lips, face, or fingernails indicates low oxygen levels and requires emergency care.
Sudden onset of noisy breathing, especially if it worsens quickly, or if it occurs alongside fever, lethargy, or drooling, should prompt an emergency visit. An inability to speak or cry due to breathing difficulties is also a serious emergency. These signs suggest a potentially severe airway obstruction.
For less immediate but concerning situations, consulting a healthcare provider is advised. This includes persistent noisy breathing that does not improve, or noisy breathing that worsens over time. Other accompanying symptoms like a persistent cough, unexplained weight loss, or feeding difficulties also indicate a need for medical evaluation.
General Management and Care
For mild cases of noisy breathing, some general home care measures can offer relief. Using a humidifier can moisten the air, which may help soothe irritated airways and loosen secretions. Ensuring adequate hydration by drinking plenty of fluids can also help thin mucus. For nasal congestion contributing to noisy breathing, saline nasal drops can provide relief.
It is helpful to avoid irritants such as smoke, strong perfumes, and known allergens, which can exacerbate airway inflammation. These measures primarily offer supportive care and may alleviate symptoms in less severe situations.
When professional help is sought, a doctor will conduct an examination and gather medical history to diagnose the underlying cause of the noisy breathing. This diagnostic process may involve imaging tests like X-rays or blood tests to assess oxygen levels. Based on the diagnosis, treatment could range from medication to reduce swelling or treat infections, to lifestyle adjustments, or medical procedures to clear blockages.