Unless you’re all tapped out from something intense like a HIIT class, your breathing is generally supposed to be as silent as the p in “pneumonia.” When it randomly starts to sound a little funny, like if you’re wheezing, it’s a clear sign that something’s up.
Wheezing, a high-pitched whistling sound when you breathe, is a pretty sure signal that you’re struggling to get air in or out, and it can be a really alarming thing to experience. Here’s what you need to know about why wheezing happens and what could be behind it.
Wheezing is evidence that there’s inflammation or constriction in any of the airways through which you breathe.
Your airways are basically pipes that carry oxygen-rich air into your lungs and carbon dioxide-rich air out of them, according to the National Heart, Lung, and Blood Institute (NHLBI).
As you breathe in that oxygen-heavy air, your nose or mouth wet and warm it to avoid irritating your system, the NHLBI explains. The air then travels through your windpipe, which divides into two tubes that feed into your lungs so they can pass oxygen into your blood. To allow your lungs to expand and fill with air, your diaphragm (the major muscle you use to breathe) tightens and moves downward.
Then, when you breathe out, your diaphragm relaxes. Air that contains a lot of carbon dioxide is forced out of your lungs and windpipe, then out of your nose or mouth, the NHLBI explains.
The wheezing can happen if any part of your airways is constricted, according to the Mayo Clinic. However, wheezing is usually worse when you breathe out, pulmonologist Ryan Thomas, M.D., director of the Multidisciplinary Severe Asthma Team at Michigan State University, tells SELF. “This is because when you breathe in, your chest wall expands and pulls the airways open a little bit, often enough to prevent wheezing,” he explains. “But when breathing out, the chest wall compresses the airways a little bit, making them more narrow.”
Although wheezing typically causes a high-pitched whistling noise that your ears can pick up on, it’s possible for it to be slight enough that you don’t realize it’s happening. It may be that your doctor discovers it while they’re listening to your breathing with a stethoscope, Dr. Thomas says.
Any condition that causes inflammation or constriction of your airways can lead to wheezing, including asthma and allergies.
Wheezing is most often due to asthma or chronic obstructive pulmonary disease (COPD), both of which can cause narrowing and spasms in the small airways of your lungs, the Mayo Clinic says.
With asthma, your body overreacts to a trigger such as animal dander or pollen. This can prompt your airways to swell and pump out extra mucus, and it can also make the muscles surrounding your airways constrict and spasm.
COPD is a chronic inflammatory lung condition that happens because of respiratory system damage, most often from smoking and two conditions that commonly result from it: emphysema and chronic bronchitis. It can cause wheezing in a few ways: Your airways can become inflamed, they can get plugged up with mucus, your airways and the air sacs inside your lungs can lose their elasticity, or the walls between your air sacs can become damaged, the NHLBI explains.
But technically, anything that inflames your airways can cause wheezing, Raymond Casciari, M.D., a pulmonologist at St. Joseph Hospital in Orange, California, tells SELF. That can include the cold or flu, allergic reactions, pneumonia, and a physical object that’s blocking your airways, like a tumor or something you accidentally inhaled, the Mayo Clinic says.
The cause and intensity of your wheezing determine whether or not you should see a doctor, and you may need to take some steps before then as well.
If you’re dealing with mild wheezing when you have symptoms of something like a cold, you’re probably OK to let it ride, the Mayo Clinic says. However, you might want to try using a humidifier or hanging out in a steamy shower to add moisture to the air you’re breathing, drinking warm liquids to help relax your airways and loosen up mucus, and avoiding tobacco smoke, which can irritate your respiratory system even more, the organization says.
If you know you have asthma and you’re wheezing, follow the steps in your asthma action plan, which should detail exactly what to do when symptoms flare up. This typically involves breathing in a quick-acting medication through an inhaler to open up your airways, Dr. Thomas says. If that doesn’t help, or the wheezing gets better but doesn’t completely go away, you need to see your doctor about adjusting your medication—and head to the emergency room if the wheezing is intense enough to scare you.
Finally, if you notice you’ve been wheezing lately and you’re not sure what’s behind it, you need to…drum roll, see a doctor. “That’s not normal and has to be checked out,” Dr. Casciari says. Getting an appointment ASAP is smart, since this is your breathing we’re talking about here. But you should forget the appointment part and head to the emergency room immediately if your wheezing came on suddenly after you were stung by a bee, took medication, accidentally ate a food you’re allergic to, or if your skin has a blue tint, the wheezing started after you choked on a small object or bit of food, or you’re simply having too much trouble breathing. These point to potentially severe issues like a serious allergic reaction or something getting lodged in your airway. The only way to make sure you’re out of the woods is to seek medical reinforcements, stat.