Complaints & connections · borters.ch
Giemen · Stridor
On breathing out it comes from the airways, on breathing in from above — and breathlessness at rest is an emergency.
Also known as: wheezing · whistling breath · wheeze on breathing out · stridor
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
A whistle arises when air flows through a narrowing — and when you hear it tells you where the narrowing sits. Wheezing on breathing out comes from the small airways and is the typical sign of asthma; it appears in episodes, often at night or early morning, after exertion, in cold air or on contact with a trigger. A constant droning and wheezing in a long-term smoker with cough and phlegm points more to chronically narrowed lungs. In small children a wheeze during an infection belongs to the picture, as does a barking cough with indrawing — that is something different and should be seen quickly. A noise on breathing in comes from the upper airway, from larynx or windpipe, and has other reasons. And when a wheeze starts suddenly, especially in a child, a foreign body must be considered. The boundary is clear: breathlessness at rest, pale or blue lips, speaking only in single words, or a wheeze together with swelling and a rash — that is an emergency. If heavy drooling, a forward-leaning sitting posture and a muffled voice are added to the sound on breathing in, this is a different picture from croup: the throat is then not examined, and a hospital is gone to directly.
Time, trigger, in or out. This sorts more than any description after the fact.
Smoke, cold air, animal hair, dust — every avoided irritant is one episode fewer.
A simple test that separates asthma from chronic narrowing.
Breathlessness at rest, blue lips, speaking word by word: call for help at once.
A rescue inhaler widens the airways within five to fifteen minutes — if it does not work, that speaks against narrowed airways and for another cause: heart, vocal cords, foreign body. So the response itself is information. Inhaled cortisone does not work during an attack but preventively over days to weeks. Anyone who uses the inhaler only on bad days experiences it as ineffective — it is made for the attack, the cortisone for the time in between.
A rescue inhaler works within five to fifteen minutes and lasts four to six hours. If it is needed on more than two days a week, the asthma counts as inadequately treated — that is the measure the guidelines use. Peak flow varies by more than twenty per cent across the day in untreated asthma, lowest in the morning. Wheezing in a child under two with a cold is usually bronchiolitis and not asthma.
At night, after exertion, in cold air — the asthma pattern.
With long-term smoking this points to chronic narrowing.
Comes from above — larynx or windpipe — and has its own reasons.
Think of a foreign body; this is not a matter for waiting.
Low levels are common in chronic airway illnesses and go along with more infections. Correcting a deficiency is simple; for lung function itself it is no replacement for treatment.
Relaxes the smooth muscle of the airways — which is why it is also given as an infusion in an emergency. For everyday use the tablet replaces no inhaler.
Drinking enough keeps the mucus thin and easier to cough up. That is the simplest and most often overlooked lever with sticky sputum.
The breathing muscles are muscle too. With chronic breathlessness the need for energy and protein is raised, and a loss of weight clearly worsens what one can manage.
With asthma and a low starting value, studies showed fewer severe attacks. At a normal level no difference was seen — it does not replace a rescue inhaler.
Chemically related to the old asthma drug theophylline and mildly airway-widening, for 2–4 hours. Too weak for everyday use, but it distorts lung function tests: no coffee for 4 hours beforehand.
Effective when deficient; effects on sleep and stress plausible but moderate. Too much causes loose stool.
The body’s own cortisol is at its lowest between 3 and 5 in the morning, and the airways are narrowest then. That is why asthma complaints so often wake people in exactly that window — rhythm, not chance.
In a small share sulphites from wine and dried fruit trigger wheezing within minutes. More often night-time reflux lies behind it — then the gap between supper and bed helps.
Pursed-lip breathing keeps the small airways open on breathing out and eases the wheeze — immediately and without equipment. It does not replace the reliever inhaler.
AWMF nvl-002 · S3 · 2024-08 — in force
Nationale VersorgungsLeitlinie Asthma
In addition:
checked 2026-09