Parkinson’s disease is often described as a movement disorder — one that causes tremors, stiffness, and slowed motion. But as researchers continue to learn more, it’s becoming clear that Parkinson’s disease affects far more than movement alone. It can touch nearly every system in the body, from digestion and sleep to speech and even breathing.
In recent years, scientists have begun to pay closer attention to how Parkinson’s disease changes the way we breathe — an area that has long been overlooked but can have a profound effect on quality of life.
Here, we’ll look at why is breathing hard in Parkinson’s disease, what research reveals about it, and what steps can help manage them.
Why Parkinson’s disease can affect breathing?
Emerging research is showing that Parkinson’s disease doesn’t just affect movement — it also involves the autonomic nervous system, which regulates automatic body functions such as heart rate, digestion, and, importantly, breathing. In Parkinson’s disease, the same loss of dopamine-producing neurons that disrupts motor control can also alter how the brain communicates with the muscles that support respiration, including the diaphragm, chest wall, and upper airway.
Over time, this can change the rhythm, depth, and coordination of breathing. For some people, it may feel like taking a full breath is harder; for others, breathing becomes shallow or irregular, especially during stress or “off” periods when medication effects wear off.
Here are some of the main ways Parkinson’s disease can influence breathing:
Reduced chest wall movement: Muscle rigidity and slowness (bradykinesia) don’t only affect the arms and legs — they can also stiffen the muscles between the ribs and around the diaphragm. This makes it more difficult for the chest to expand fully, leading to shallower breathing and a feeling of tightness.
Upper airway obstruction: The same changes in muscle tone that cause speech difficulties or swallowing issues can affect the throat and larynx (voice box). These muscles may not open and close smoothly, resulting in a sense of breathlessness, noisy breathing (stridor), or even brief pauses in airflow during sleep.
Impaired respiratory drive: Parkinson’s disease can affect the brainstem — the region responsible for automatically controlling breathing. This can lead to slower or irregular breathing patterns, especially during sleep, and may contribute to disorders such as sleep apnea.
Medication effects: Dopaminergic medications like levodopa can sometimes lead to fluctuations in breathing, especially during “off” times when the medication’s effect fades. Certain drugs may also cause shortness of breath or changes in respiratory rhythm as a side effect.
Beyond these physical factors, non-motor symptoms such as anxiety or dysautonomia (autonomic nervous system dysfunction) can further influence breathing, creating a complex picture that varies from person to person.
While studies estimate that approximately 40% of people with Parkinson’s disease experience some form of respiratory difficulty, these symptoms are often overlooked. They can easily be mistaken for anxiety, deconditioning, or heart problems, which means people may go years without realizing their breathing challenges are connected to Parkinson’s disease itself.
Recognizing this link is the first step toward better management and more targeted treatment strategies.
Recognizing the symptoms
Breathing changes in Parkinson’s disease can show up in many subtle ways — and because they often develop gradually, they’re easy to overlook or misinterpret. Some people describe a sense of “air hunger” — the feeling that no matter how deeply they try to breathe, they can’t get enough air. Others notice that their breathing becomes shallower, or that they tire more easily when talking, walking, or climbing stairs.
What makes respiratory symptoms in Parkinson’s disease tricky is that they don’t always look the same from day to day. They can fluctuate with medication timing, stress levels, or even posture. Understanding these patterns can help you identify when your breathing is being affected by Parkinson’s disease, rather than something else.
Here are some common signs and patterns to look out for:
- Shortness of breath at rest or during mild activity
- Feeling unable to take a deep breath
- Tightness or discomfort in the chest
- Shallow or rapid breathing
- Wheezing, throat tightness, or noisy breathing
- Coughing or difficulty clearing mucus
- Voice changes, such as a weak or breathy sound
For many people, these symptoms are most noticeable during medication “off” times or during sleep.
It’s also important to remember that breathing difficulties can sometimes be linked to anxiety or fatigue, which are common in Parkinson’s disease. However, that doesn’t mean the symptoms are “just anxiety.” In fact, the physical changes caused by Parkinson’s disease can make the body feel short of breath, which in turn can trigger anxious feelings — creating a frustrating cycle.
Caregivers often play a key role here. They may notice things like noisy breathing at night, pauses during sleep, or visible effort when the person breathes or speaks. Keeping track of when and how these symptoms appear can be very helpful for doctors trying to pinpoint the cause.
Recognizing these early signs matters because it allows for timely evaluation and targeted support. The sooner respiratory symptoms are identified, the easier it is to manage them — and prevent them from interfering with speech, sleep, or daily life.
The overlooked impact on daily life
Breathing might seem like the most natural thing in the world — something our bodies do automatically, without us even thinking. But when Parkinson’s disease begins to interfere with that process, it can quietly touch almost every part of daily life.
For many people, breathing changes begin subtly: a little more effort climbing stairs, a sense of tightness when talking for too long, or the need to pause and “catch their breath” more often. Over time, these small moments can add up, affecting independence, confidence, and even social engagement.
Physical impact
Breathing difficulty can make physical activity feel harder, even when the muscles themselves are strong. When the chest muscles are stiff or the diaphragm moves less freely, it takes more energy to breathe. Some people describe it as “running out of air faster,” even when their heart and lungs are otherwise healthy.
Shallow breathing also means less oxygen reaches the body’s tissues, which can contribute to fatigue, dizziness, and poor sleep quality. During the night, changes in breathing rhythm may lead to fragmented sleep or morning headaches, further lowering energy levels during the day.
Communication and swallowing
Because speaking and breathing share the same muscles and airflow, people may notice that their voice becomes weaker, breathier, or trails off mid-sentence. This can make communication more tiring and frustrating, especially in group settings or noisy places. Similarly, difficulty coordinating breathing and swallowing can make eating slower or increase the risk of coughing while drinking liquids.
Emotional and social effects
Breathing changes can also take an emotional toll. The sensation of not getting enough air can trigger anxiety or panic, which in turn makes breathing feel even more restricted. This cycle can discourage physical activity, lead to social withdrawal, or reduce participation in activities that once felt enjoyable.
For caregivers, these changes can be concerning. Watching a loved one struggle to catch their breath or worry that they might, often creates its own stress. It’s common for both the patient and their family to wonder whether these symptoms are a sign of heart or lung disease, or if they signal that the Parkinson’s disease is worsening.
Why awareness matters
Because respiratory symptoms are less visible than tremor or stiffness, they often go unmentioned during clinic visits. Yet they can significantly influence overall well-being and safety. Recognizing these challenges early allows for proactive support, whether that means adjusting medication schedules, adding breathing exercises, or referring to specialists like a speech-language pathologist or respiratory therapist.
Breathing well isn’t just about oxygen — it’s about energy, expression, and quality of life. Addressing these changes can help people with Parkinson’s disease stay more active, more vocal, and more connected to the world around them.
Coming next
In the next part of this series — “Breathing Easier: Research-Based Therapies and Practical Tips for Parkinson’s” — we’ll explore the latest research, proven therapies like EMST and LSVT LOUD®, and practical steps you can take to protect and strengthen your breathing.
Disclaimer: The information shared here should not be taken as medical advice. The opinions presented here are not intended to treat any health conditions. For your specific medical problem, consult with your healthcare provider.
