What Is a Functional Respiratory Disorder?

Abstract

Functional respiratory disorders can be characterized as occurring in patients with persisting respiratory symptoms lacking an identifiable organic or physiologic basis, or symptoms in excess of what would be expected from just their physiologic cause. Such functional disorders typically have emotional or psychological associations. Common respiratory conditions that are thought to be functional include dyspnea/hyperventilation, habit cough, paroxysmal sneezing, throat clearing, and vocal cord dysfunction. These occur predominantly in children, ­adolescents, and young adults. Additionally, a functional component should be entertained as complicating existing diagnosed physical conditions, such as asthma, chronic obstructive pulmonary disease, and cystic fibrosis, which are diseases that affect patients of all ages. Treatment of functional respiratory disorders can include providing reassurance, biofeedback, breathing relaxation techniques, cognitive behavioral therapy, hypnosis, or speech therapy. Pharmacologic therapy for functional respiratory disorders occasionally may be helpful. Patients with functional respiratory disorders benefit from prompt identification and therapy, as this prevents perpetuation of the associated symptoms, development of further complicating sequelae, unnecessary medical investigations, and prescription of ineffective medical therapy that might have harmful side effects.