Apneustic breathing is a type of abnormal breathing pattern. It involves long, gasping inhalations and insufficient, irregular exhalations. It often stems from a brain injury but there may be other causes.

Treatment for apneustic breathing depends on the underlying cause, which is often some form of brain injury.

Read on for more information about apneustic breathing and other abnormal breathing patterns. We also cover treatment options and when to seek help below.

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The clinical term for normal breathing is eupnea. There are many types of normal and abnormal breathing patterns. Doctors can use breathing patterns to evaluate a person’s condition.

Apneustic breathing is an abnormal breathing pattern that is very rare in humans.

The brain is an important organ for breathing. Part of the brainstem called the pons has two areas that control breathing: the pneumotaxic and apneustic centers.

Overstimulating the apneustic center causes an abnormal breathing pattern known as apneustic breathing.

The apneustic center stimulates the neurons associated with inhalation in the medulla, the bottom part of the brain that connects the brain and spinal cord, and inhibits the neurons associated with exhalation.

Stimulating the pneumotaxic center ends and controls the duration of inhalation.

Weak signals from the pneumotaxic center increase inhalation time, increasing how much air moves in or out of the lungs with each breath cycle, known as tidal volume.

Doctors can identify apneustic breathing by its distinct sound created by the abnormal breathing pattern.

A person with this abnormal breathing pattern takes long, inward gasping breaths and sporadic, insufficient outward breaths.

When a person has sudden onset breathing difficulty, it is usually the result of a life threatening condition that needs immediate medical intervention.

When a person struggles to breathe, healthcare professionals will give them supplemental oxygen and attach them to an oxygen and heart monitor. However, the exact treatment a doctor prescribes depends on the underlying cause of the breathing difficulty.

If the person is at risk of respiratory failure, a doctor may insert a tube into their airway through their nose or mouth. This keeps a supply of vital oxygen flowing to their lungs.

Once the person is stable, the doctor can then work to diagnose and treat their underlying condition.

Overstimulating the brain’s apneustic center causes apneustic breathing.

This can happen due to a stroke or other type of trauma that causes injury to the pons. Apneustic breathing is often a clear indicator of a severe brain injury.

Researchers have identified a wide range of abnormal breathing patterns to help doctors make diagnoses.

Agonal breathing

A person with agonal breathing takes very shallow, slow, and irregular breaths as a result of a brain injury due to a lack of oxygen.

Depending on the underlying cause, agonal breathing can develop into apnea.


Apnea is when a person temporarily stops breathing, typically while asleep. There are two forms of sleep apnea: obstructive and central. Obstructive sleep apnea happens when something, such as the tongue, prevents air from reaching the lungs. Central sleep apnea occurs because of a problem with the brain.

Biot respiratory pattern

Camille Biot, a French physician, first observed this breathing pattern in 1876 while studying the Cheyne-Stokes breathing pattern (mentioned below).

This breathing pattern occurs when a person takes regular, deep breaths interspersed with apnea episodes.

Damage to the pons due to stroke or trauma causes the Biot respiratory pattern. As the damage to the pons worsens, the person’s breathing pattern becomes irregular. Opiate overdose can also cause the Biot respiratory pattern.


Bradypnea is when a person’s breathing rate is lower than is typical for their age.

Central neurogenic hyperventilation

This breathing pattern occurs when a person demonstrates frequent hyperventilation, or over-breathing, usually due to head trauma or a severe lack of oxygen to the brain.

Central neurogenic hypoventilation

This means a person is not breathing enough because the respiratory centers in their medulla are not responding to normal stimuli.

This may be due to head trauma, a severe lack of oxygen to the brain, or breathing suppression due to drug intoxication.


John Cheyne, a British physician, and William Stokes, an Irish physician, first described this breathing pattern.

In people with a Cheyne-Stokes breathing pattern, their breathing gradually increases and decreases while they sleep. This is known as crescendo-decrescendo breathing. The person’s breathing then stops and starts again, which is known as apnea.

While sleep apnea can cause heart failure, a Cheyenne-Stokes breathing pattern may be a symptom of heart failure.


Dyspnea is when a person feels they are having difficulty breathing.


Hyperpnea happens when a person has an increased tidal volume, with or without an increased breathing rate, but has typical levels of oxygen and carbon dioxide in their blood.


Hyperventilation is when a person breathes above the rate needed for them to eliminate carbon dioxide (CO2) from their body. High levels of CO2 disrupt the pH balance of the blood. A buildup of acid in the body due to kidney failure or kidney disease can cause hyperventilation.


This is when a person breathes below the rate needed to eliminate CO2 from their body. When this happens, the body cannot maintain a normal pH balance.

Kussmaul respirations

Kussmaul respirations involve deep, sighing breaths.

Dr. Adolf Kussmaul first observed this breathing pattern in 1874 in comatose people with diabetes, who were in the late stages of diabetic ketoacidosis. Dr. Kussmaul described this breathing pattern as “air hunger.”


Orthopnea occurs when a person is unable to breathe comfortably while lying flat. They may need to sit or prop themselves up to breathe normally. Doctors see this breathing pattern in people with heart failure.

Paroxysmal nocturnal dyspnea

This breathing pattern involves episodes of severe shortness of breath that wake a person from their sleep, forcing them to sit up to catch their breath. This breathing pattern can be a symptom of heart failure.


Tachypnea occurs when a person’s breathing rate is greater than usual for their age.

If a person suddenly develops serious difficulty breathing or stops breathing, people should consider it a medical emergency. Brain cells can begin to die within 5 minutes without oxygen.

When someone stops breathing, it may be necessary to give them CPR to keep them alive while waiting for emergency medical support.

Apneustic breathing is a rare, abnormal breathing pattern. A person with this breathing difficulty takes long, gasping inhalations, with sporadic and insufficient exhalations.

A stroke or other injury to the pons in the brain can cause apneustic breathing. The exact type of treatment a person needs depends on the underlying cause of their breathing difficulty.