Noisy Breathing (Breath Sounds): Types and What Causes It

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Noisy breathing can be an annoying occurrence, especially when it happens at night. The odd breath sounds may be the result of a mild case of congestion during an episode of the common cold, or an indication of a serious underlying health condition. Noisy breathing in adults may present as a low- or high-pitched whistle or a deep, sharp noise during an exhale or inhale. Constant noisy breath sounds can be linked to a specific cause depending on the type of sound itself.

When we breathe, air is exchanged in the lungs, taking in oxygen and forcing out carbon dioxide. The upper airways, comprising the nasal cavities, the pharynx, and the larynx, works with the lower airways, otherwise known as the section containing the trachea, bronchi, and the lungs.

Types of Noisy Breathing in Adults

1. Rales

This noisy breathing sound is described as a rattling, bubbling, or clicking noise. These lung sounds may be sporadic when breathing and can be compared to the sound of cellophane being crinkled.

2. Rhonchi

Rhonchi often refer to snoring sounds with noisy breathing. These present as low-pitched sounds with a rattle-like noise while breathing. They may disappear once the throat is cleared or after a cough.

3. Stridor

The high-pitched sound of stridor can be described as the harsh vibration of a blockage of the trachea. As the airway passage is obstructed, the force of the breath may be heard in a musical tone.

4. Wheezing

As one of the more common noisy breathing sounds, wheezing presents as an abrasive whistle. It may occur continuously while breathing or just on the exhale. Wheezing is seen when the bronchial tubes become inflamed, as with asthma, or narrow from an obstacle.

Causes of Noisy Breathing (Breath Sounds)

1. Rales

Rales may be heard with heart disease and various medical conditions originating in the lungs. This crackling noise is often present with a lung infection such as bronchitis. Inflammation and damage to the airway may trigger the production of excess mucus and force the rale noise. Acute bronchitis may present a persistent, wet cough.

An infection that invades the air sacs in the lungs is pneumonia. This condition sees a collection of mucus and pus within the sacs, resulting in the crackling noise when breathing.

Rales may also be associated with heart failure, obstructive pulmonary diseases, interstitial lung disease, and other lung-related medical conditions.

2. Rhonchi

Noisy breathing that creates the rhonchi sound may be caused by an airway obstruction with upper respiratory conditions such as pneumonia, chronic bronchitis, and cystic fibrosis.

While thickened mucus in the air sacs attributes to pneumonia, the secretions of the mucus into the inflamed bronchial tubes develop into chronic bronchitis. The obstruction with cystic fibrosis occurs with excessive production of thick mucus. This is an inherited condition that also causes nasal congestion, lung infections, and activity-induced breathing difficulties.

3. Stridor

The high-pitched wheezing sound of stridor may appear with airway obstruction either by swelling or the presence of a foreign object. This sound may also be present during activities like inhaling smoke or consuming a throat-irritant substance.

Inflammation within the lungs, airway, or lymph nodes, as seen with tonsillitis, may also cause stridor. The effects of surgical procedures on the neck and throat or paralysis of the vocal cords may produce the stridor sound as well.

4. Wheezing

The familiar wheezing sound is common whenever the airways become narrowed. It is most common with the asthma condition. It may also arise with pneumonia, bronchitis, and the life-threatening anaphylaxis shock.

Other health conditions that may attribute to wheezing include heart failure, chronic obstructive pulmonary disease (COPD), emphysema, sleep apnea, gastroesophageal reflux disease (GERD), vocal cord dysfunction, and lung cancer.

How to Evaluate Noisy Breathing

Aside from noting the obvious sounds of noisy breathing, the doctor will review the patient’s medical history and perform a physical exam. A review of recent, past, and current medication use may also occur.

Further testing may be required for cases that do not present an obvious cause. Imaging tests may help doctors check for any infections or tumors in the heart and lungs. A computerized tomography scan and a magnetic resonance imaging scan may also be ordered.

Doctors may perform more invasive testing to view the airway passages in greater depth. These may include an endoscopy or bronchoscopy, wherein a tiny camera is inserted with use of a tube to have a close look at the inner throat.

How to Treat Noisy Breathing

Noisy breathing can be alleviated or ended, depending on the underlying cause. Treatment may focus on the cause, as well as the noisy breathing symptom.

Prescribed medications and medical devices may be used to open congested airway passages. Any infection, blockage, or fluid-on-the-lung conditions may require specialized care in a hospital setting.

For example, noisy breathing because of a common condition such as asthma, bronchitis, or COPD may require a management plan that includes the use of an inhaler.

When to Visit a Doctor

Noisy breathing or abnormal sounds may require medical attention if it affects the ability to breathe. Seek advice from a doctor if:

Experiencing an odd noise while breathing can be concerning, especially if it occurs suddenly and without any apparent cause. Most times, noisy breathing is caused by an ailment such as nasal congestion or blockage of the airways by excess mucus production.

More serious medical conditions such as sleep apnea, heart failure, or the onset of anaphylaxis may also cause the crackling, wheezing, or clicking sound when breathing. Obstruction by an unfamiliar object can also be associated with the noisy sounds.

Treatment of noisy breathing depends on the cause behind the noise. Any troubling sounds with a severe change in breathing patterns or accompanied by shortness of breath should be immediately checked by a professional.

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Article Sources (+)

“Rales,” Easy Auscultation; https://www.easyauscultation.com/rales, last accessed November 3, 2017.
Carter, L., “Rhonchi Lung Sounds: Definition, Causes & Treatment,” Study; http://study.com/academy/lesson/rhonchi-lung-sounds-definition-causes-treatment.html, last accessed November 3, 2017.