How Can I Be Short of Breath When My Oxygen Is Normal?

Being short of breath isn’t always easily explained by COPD alone. Here are other situations that might cause this frustrating symptom.

“How can I have shortness of breath when my oxygen levels are normal?” This is a question I’ve asked many times. While I have had major oxygen drops, I’ve also had incidents where I felt extremely short of breath, and my oxygen was 95 or over. 

I questioned my pulmonologist about this, and he said we should do the Medicare test to see if I need oxygen at home. Neither of us liked the qualification test, but it brought up a discussion. My oxygen didn’t go below 94 during the test, yet I was out of breath after the first 2 minutes.

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What is shortness of breath?

Shortness of breath, which is also called dyspnea by healthcare professionals, feels like you can’t get enough air in your lungs. You might also feel a tightness in your chest as you gasp for air.

In COPD, shortness of breath is a common symptom that you might notice when climbing stairs, exercising, or engaging in other types of physical activity.

What causes shortness of breath?

Shortness of breath can be sudden for some people and long-lasting (chronic) for others. You might experience it suddenly if you have an illness or are exposed to smoke or a chemical. Chronic shortness of breath keeps coming back because of a continuing health condition, such as COPD.

My doctor explained that there are many other reasons for difficulty breathing. That’s why having a pulse oximeter in your home is important. You can quickly check your level, and if it’s below 90 and stays there while you’re sitting, you know it’s time to use oxygen.

Here are some things that could be causing shortness of breath beyond a drop in oxygen:

Heart problems

It’s not uncommon for people with COPD to have heart issues, such as congestive heart failure, angina, or atrial fibrillation. If you find yourself frequently short of breath and your oxygen isn’t low, it’s time to talk with a cardiologist.

Anxiety or stress

The mind-body connection has been studied for years. What’s going on in our heads affects our organs. When I’m stressed, I feel the change in my heart rate and heart palpitations, leading to labored breathing. I manage this with deep breaths, exercise, and meditation.

Blood clots

Blood clots, especially those that occur in your lungs (pulmonary embolism), can interfere with breathing and even cause death for some. According to the American Lung Association, the symptoms of a pulmonary embolism include dizziness, fainting, irregular heartbeat, sweating, and coughing.

There is nothing you can do for a pulmonary embolism on your own. If you have the symptoms, you need to get to a hospital.

Fluid in your lungs

Heart conditions, stroke, kidney or liver failure, and other health conditions are all possible reasons for fluid buildup in your lungs. Oxygen is not the problem. You need to decrease the fluid under a doctor’s care. Symptoms such as shallow breathing and more difficulty catching your breath when lying down could mean that you have fluid in your lungs.

Cancer

Tumors in your lungs can cause shortness of breath, according to the Centers for Disease Control and Prevention (CDC). And if you’re undergoing cancer treatment, such as chemotherapy and radiation, that can also cause breathing to become more difficult.

Carbon monoxide poisoning

Carbon monoxide has no smell, but it can be deadly. One of the symptoms is shortness of breath. According to the CDC, the symptoms can include headache, nausea, and confusion.

Experts recommend placing carbon monoxide detectors on every floor of your house. If you suspect that the carbon monoxide level in your home might be high and that it’s causing health issues, go outside and call 911 immediately. The fire department can send personnel with hand detectors to check the levels.

Broken ribs

Your ribs protect your lungs. If you break a rib, it can cause shortness of breath. This can happen even with a bad muscle strain in your chest.

Costochondritis is a condition that causes inflammation in the cartilage that connects your chest wall (sternum) and your ribs. I’ve had it quite a few times. It’s very painful and can make my breathing more difficult.

My doctor told me to press on my chest. If you have costochondritis, you’ll feel worsening pain when pressing that you don’t usually feel with a heart or lung issue.

High blood pressure

High blood pressure makes your heart work harder than usual. This can put a strain on your breathing, according to the National Institutes of Health (NIH).

The best way to deal with this is to work with your doctor to keep your blood pressure as normal as possible, which can result in less shortness of breath.

Anemia

Oxygen won’t help with your shortness of breath if you live with anemia. According to the NIH, anemia can cause symptoms such as fatigue, chills, headache, and dizziness. If you have these symptoms, ask your doctor about running blood work. Anemia needs to be treated, usually with iron supplements, to correct red blood cell and hemoglobin levels.

The bottom line

I still have moments when I have shortness of breath and I’m really not sure of the cause. I make sure I lie down and rest for a little while, and it almost always gets better. When it doesn’t, I know it’s time to use my rescue inhaler or nebulizer (sometimes both) and call my doctor if that doesn’t work.

If you ever have sudden shortness of breath, especially with chest pain, please call 911. Don’t try to guess what’s causing it.