Wheezing
Wheezing is a high-pitched whistling or rattling sound you hear when breathing, usually when air struggles to pass through narrowed or partially blocked airways. It can be a temporary reaction to a cold or allergies, or it may signal a more serious health condition that requires medical attention.
Table of contents
- What is wheezing?
- What does wheezing sound like?
- How common is wheezing?
- What causes wheezing?
- How is wheezing diagnosed?
- Treatment and care
- When to see a doctor
What is wheezing?
Wheezing is a high-pitched whistling or squeaking sound that occurs during breathing when the airways become partially blocked or narrowed[1]. This sound happens because air has to squeeze through airways that are tighter than normal[2].
The narrowing of airways can occur for many reasons. Airways are the tubes that carry air in and out of your lungs. When these passages become swollen, filled with mucus, or constricted by muscle spasms, the space for air to pass through becomes smaller[1]. As air moves through these narrowed passages, it creates the characteristic whistling sound known as wheezing.
Wheezing can be a temporary problem that goes away on its own, such as when you have a cold. However, it can also be a symptom of a chronic health condition that needs ongoing management[1].
What does wheezing sound like?
Wheezing typically sounds like a high-pitched whistle or a musical tone that happens in rhythm with your breathing[5]. Some people describe it as similar to the sound of wind passing through a narrow opening or like a musical instrument such as a clarinet[1].
The sound is most obvious when you breathe out, though it can also occur when breathing in[1]. The pitch and tone of wheezing can vary depending on which part of your respiratory system (your breathing tubes and lungs) is narrowed. If the narrowing is in the upper airways near your throat, the wheeze may sound hoarser. If it happens lower down in your chest, it may have a more musical, higher-pitched quality[1].
Sometimes wheezing is loud enough to hear without any special equipment. Other times, it can only be detected when a healthcare provider listens to your chest with a stethoscope, a medical tool used to hear sounds inside your body[1][5]. You may not even realize you are wheezing until a doctor points it out during an examination[5].
Your breathing may also produce lower-pitched sounds that resemble snoring or gurgling, called ronchi. While people sometimes confuse these with wheezing, they are technically different sounds[5].
How common is wheezing?
Wheezing can affect anyone, from newborn babies to older adults[1]. It is particularly common in infants, with up to 25% to 30% of babies experiencing wheezing in their first year of life[1]. Babies may wheeze more often because their airways are naturally smaller. Children under two years old are also more likely to wheeze because they frequently catch viral infections that affect their breathing[1].
In children of preschool age, about one-third experience wheezing that comes back repeatedly[17]. Roughly one in three children will have at least one episode of wheezing before they turn three years old[6].
Among adults, people who smoke and those with certain lung conditions like emphysema or heart failure are more likely to experience wheezing[1]. People with asthma and allergies, whether children or adults, are also at higher risk of wheezing[1].
What causes wheezing?
Wheezing occurs when something blocks or narrows the small tubes in your chest called bronchial tubes, or when larger airways or vocal cords become obstructed[1]. The causes range from manageable conditions to serious diseases[1].
Lung and airway problems
Asthma is one of the most common causes of wheezing[1][5]. This is a long-term condition that causes spasms and swelling in your bronchial tubes. Things like pollen, mold, dust, or viral illnesses can trigger wheezing in people with asthma[1].
Chronic obstructive pulmonary disease (COPD) is another frequent cause of wheezing[5]. COPD involves inflammation and damage to the lining of your breathing tubes, most commonly from smoking cigarettes[1].
Bronchitis, which is inflammation of the lining inside your bronchial tubes, can also cause wheezing[1][2]. In young children, a virus called bronchiolitis causes inflammation and irritation in small airways and is a common cause of wheezing[1].
Pneumonia, an infection causing lung inflammation from viruses or bacteria, can lead to wheezing[1]. Respiratory syncytial virus (RSV), a seasonal lung infection common in children, is another viral cause[1].
Other lung-related causes include breathing in a foreign object or substance (called aspirating), bronchiectasis (damage to large airways), cystic fibrosis (a condition causing thick mucus to clog airways), and emphysema (a condition causing shortness of breath)[1].
Other causes
Vocal cord dysfunction can cause wheezing when your vocal cords close instead of opening during breathing, making it harder to move air in or out of your lungs[1].
GERD (gastroesophageal reflux disease), a condition involving chronic acid reflux from the stomach, can lead to wheezing[1].
Wheezing can also occur because of allergic reactions, including severe reactions called anaphylaxis[2][6]. Seasonal allergies, food allergies, and reactions to insect stings can all trigger wheezing[1][5].
Heart failure is a less common but serious cause of wheezing, sometimes referred to as cardiac asthma[2][6].
Certain medications, such as aspirin, can cause wheezing in some people[2]. Smoking and exposure to secondhand smoke are also risk factors[2].
How is wheezing diagnosed?
Wheezing itself is a symptom, not a disease. To find out what is causing your wheezing, a doctor will need to assess your current symptoms, review your medical history, and perform a physical examination[6].
Your healthcare provider will ask questions about your wheezing, such as when it started, how long it has lasted, whether it comes and goes, and what might trigger it[2][4]. They will want to know if you have other symptoms like shortness of breath, fever, cough, or if you produce mucus when coughing[4]. Information about your smoking history and any exposure to allergens or irritants is also important[4].
During the physical exam, the doctor will listen to your lungs with a stethoscope to hear how well air moves in and out and to detect wheezing[2][4]. They may also examine your heart, nose, throat, and skin[4].
Your doctor may order tests to determine the cause of wheezing. These can include a chest X-ray, blood tests, pulmonary function tests (which measure how well your lungs work), and pulse oximetry (a simple test that measures oxygen in your blood)[2][6]. Other tests might include measurement of peak airflow to see how fast you can breathe out, or more specialized tests if needed[4].
Treatment and care
Treatment for wheezing depends on what is causing it[1]. Many treatments are available, and your healthcare provider may recommend seeing a specialist such as a pulmonologist (a doctor who specializes in lung conditions) or an allergist (a doctor who specializes in allergies) if your symptoms persist or are due to a chronic condition[1].
Medications
The most common treatment for wheezing involves medicines you breathe in using an inhaler, a small handheld device that delivers medication directly to your airways[8]. These medicines help open up narrowed breathing passages.
If you have asthma, your doctor may prescribe different types of inhalers. Some are used only when you have symptoms (called reliever inhalers), while others are used every day to prevent symptoms from occurring (called preventer inhalers)[8].
For severe wheezing, doctors may give corticosteroids (anti-inflammatory medicines) through an IV or by mouth[8]. Other medications may be prescribed depending on the underlying cause of your wheezing.
Home care
For mild wheezing related to a cold or upper respiratory infection, you may not need medical treatment[7]. Some self-care measures that may help include sitting in an area with moist, heated air, such as running a hot shower or using a vaporizer[2]. Drinking warm liquids can help relax your airways and loosen mucus[14].
It is important to take all prescribed medicines exactly as your doctor instructs[2]. If you smoke, quitting is one of the most important steps you can take, as tobacco smoke can worsen wheezing[14].
Avoiding things that trigger your wheezing is also important. Common triggers include allergens like pollen, dust, mold, and pet dander, as well as cold air, exercise, and irritants like smoke or strong smells[1].
When to see a doctor
Mild wheezing that occurs with a cold and does not bother you much may not require a doctor visit if it goes away on its own[7]. However, you should contact your healthcare provider if wheezing occurs for the first time, keeps coming back without explanation, or is caused by an allergic reaction[2].
See a doctor if wheezing is accompanied by significant shortness of breath, if you are unable to do things you could do just weeks or months before, or if your breathing gets fast[2][7].
Seek immediate emergency care by calling for an ambulance if you experience any of these warning signs[2][14]:
- Wheezing occurs with severe shortness of breath or difficulty breathing
- Your skin turns blue or gray
- You experience confusion or changes in mental state
- Wheezing begins suddenly during a severe allergic reaction
- Fast breathing or using a lot of chest muscles to breathe
- Wide or flaring nostrils when breathing
- Wheezing occurs after choking on a small object or food
If you have existing wheezing that suddenly stops, this can also be serious. An abrupt disappearance of wheezing may mean that a partial blockage has become a complete blockage, which is a medical emergency[7].
For children, go to the emergency department immediately if your child has wheezing along with any of these signs: wheezing sound when breathing in (not just breathing out), fast breathing, using a lot of chest muscles to breathe, wide nostrils when breathing, or blue color around the lips[8].
If you have asthma and have had an asthma attack, it is important to see a doctor within two days, even if you feel better. This visit helps discuss your treatment and get advice to prevent another attack[14].
