Nature and evaluation of dyspnea in speaking and swallowing.

Dyspnea (breathing discomfort) is a serious and pervasive problem that can have a profound impact on quality of life. It can manifest in different qualities (air hunger, physical exertion, chest/lung tightness, and mental concentration, among others) and intensities (barely noticeable to intolerable) and can influence a person's emotional state (causing anxiety, fear, and frustration, among others). Dyspnea can make it difficult to perform daily activities, including speaking and swallowing. In fact, dyspnea can cause people to change the way they speak and swallow in their attempts to relieve their breathing discomfort; in extreme cases, it can even cause people to avoid speaking and eating/drinking. This article provides an overview of dyspnea in general, describes the effects of dyspnea on speaking and swallowing, includes data from two survey studies of speaking-related dyspnea and swallowing-related dyspnea, and outlines suggested protocols for evaluating dyspnea during speaking and swallowing.