Breathing Questionnaire

The Nijmegen Questionnaire1 consists of 16 brief questions evaluating breathing disfunction related to stress, respiration and anxiety.  Consider the period over the last 30 days.  The questionnaire takes around 5 minutes to complete.  

The Breathing Test (opens in new tab) provides a quantitative measure of dysfunctional breathing, this questionnaire provides a qualitative measure that will help us zero-in on specific issues.

We will email you the results.

Breathing Test Questionnaire
Your breath hold time from the Breathing Test or your latest Morning CP
In the last month (30 days) have you suffered from any of the following?
1. Chest pain
2. Feeling tense
3. Blurred vision
4. Dizzy spells
5. Feeling confused
6. Faster or deeper breathing
7. Short of breath
8. Tight feeling in chest
9. Bloated feeling in stomach
10. Tingling fingers
11. Unable to breath deeply
12. Stiff fingers or arms
13. Tight feelings around mouth
14. Cold hands or feet
15. Palpitations
16. Feelings of anxiety
We will send a copy of the results to your email address. Thank you.

1 Reference: van Dixhoorn, J. & Folgering, H. (2015). The Nijmegan Questionnaire and dysfunctional breathing.  ERJ Open Research 2015 1

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