Mancini, Donna M, Brunjes, Danielle L, Cook, Dane et al. · Frontiers in medicine · 2025 · DOI
Researchers studied how patients with ME/CFS breathe during exercise and found that many breathe abnormally in ways that healthy people do not. Specifically, 42% of ME/CFS patients showed irregular breathing patterns, and 32% were breathing too fast and too deeply (hyperventilation). These breathing problems were much more common in ME/CFS patients than in the healthy control group, suggesting that abnormal breathing may be contributing to the fatigue and breathlessness patients experience.
Abnormal breathing patterns are a potentially modifiable factor in ME/CFS that has received limited investigation independent of long COVID. If dysfunctional breathing and hyperventilation contribute to exertional symptoms, targeted respiratory interventions could represent a novel therapeutic approach for ME/CFS patients. This work highlights a physiological abnormality that deserves further investigation as a possible treatment target.
This study does not prove that abnormal breathing patterns cause ME/CFS symptoms or exertional symptom exacerbation—it only documents that they occur more frequently in ME/CFS patients. The cross-sectional design cannot establish whether breathing dysfunction develops as a primary ME/CFS feature, as a secondary adaptation, or as a coping mechanism. It also does not demonstrate whether correcting these breathing patterns would improve patient outcomes.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Mancini, Donna M, Brunjes, Danielle L, Cook, Dane, Soto, Tiffany, Blate, Michelle, Quan, Patrick, et al. (2025). Abnormal breathing patterns and hyperventilation are common in patients with chronic fatigue syndrome during exercise.. Frontiers in medicine. https://doi.org/10.3389/fmed.2025.1669036
BibTeX
@article{mecfsatlas-mancini-2025-abnormal-breathing,
author = {Mancini, Donna M and Brunjes, Danielle L and Cook, Dane and Soto, Tiffany and Blate, Michelle and Quan, Patrick and Yamazaki, Tadahiro and Norweg, Anna and Natelson, Benjamin H},
title = {Abnormal breathing patterns and hyperventilation are common in patients with chronic fatigue syndrome during exercise.},
journal = {Frontiers in medicine},
year = {2025},
doi = {10.3389/fmed.2025.1669036},
note = {PubMed: 41293716},
url = {https://www.mecfsatlas.com/evidence/mancini-2025-abnormal-breathing},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/mancini-2025-abnormal-breathing
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