The Nijmegen Questionnaire: What Your Breathing Symptoms Might Be Telling You

If you’ve ever been told “your tests are normal” but you still don’t feel like you can breathe properly, you’re not imagining it—and you’re not alone.

Many people experience real, frustrating breathing symptoms that don’t show up on standard medical tests. Things like air hunger, chest tightness, frequent sighing, or feeling like you can’t get a full breath.

One simple tool that can help make sense of these symptoms is called the Nijmegen Questionnaire.

What is the Nijmegen Questionnaire?

The Nijmegen Questionnaire is a short self-check list that looks at common symptoms linked with changes in breathing patterns.

It was originally designed to help identify what is now often called breathing pattern dysfunction. In simple terms, this means your breathing has become inefficient or overworked, not necessarily “wrong,” but less coordinated than it should be.

This can happen for many reasons, including stress, pain, injury, illness, or even habit.

Why would I take it?

You might consider doing the questionnaire if you experience things like:

• Feeling like you can’t take a satisfying breath
• Frequent sighing or yawning
• Chest tightness or pressure
• Lightheadedness or dizziness
• Tingling in fingers or around the mouth
• A sense of “air hunger”
• Feeling short of breath even when tests are normal
• Racing heart or awareness of your heartbeat
• Feeling anxious or on edge without a clear reason

These symptoms can feel scary, but they are often linked to how the body is breathing and responding to stress or load, rather than a serious structural problem.

How it works

The questionnaire has 16 simple questions.

For each symptom, you rate how often you experience it:

• 0 = Never
• 1 = Sometimes
• 2 = Often
• 3 = Very often

At the end, you add up your score for a total out of 64.

The Nijmegen Questionnaire

Rate the following symptoms from 0-4, then add up your total score. 

1. Chest Pain
2. Feeling Tense 
3. Blurred Vision
4. Dizzy Spells 
5. Feeling Confused
6. Faster or Deep Breathing 
7. Short of Breath
8. Tight Feelings in the Chest 
9. Bloated Feelings in the Stomach 
10. Tingling Fingers
11. Unable to Breathe Deeply
12. Stiff Fingers or Arms 
13. Tightness Around the Mouth
14. Cold Hands or Feet
15. Palpitations 
16. Feelings of Anxiety 

What your score might mean

Here’s a general guide:

• Under 20: Your symptoms are less likely to be related to a breathing pattern issue
• 20–23: A borderline range, worth exploring further
• Above 23: Your symptoms may be strongly influenced by your breathing pattern

But here’s the most important part:

👉 This is not a diagnosis
👉 It is a starting point for understanding your symptoms

Your score doesn’t define you, it simply helps highlight whether your breathing may be playing a role in how you feel.

What if my score is high?

A higher score doesn’t mean something is “wrong” with you.

It usually means your body may have adapted a breathing pattern that is a little out of balance—and that pattern can often be improved.

The next step is not to panic, but to get curious.

A physiotherapy assessment may look at:

• How your ribs and chest move when you breathe
• Whether your breathing is coming from your chest, belly, or both
• How your posture and movement affect your breath
• Whether stress or tension is influencing your breathing pattern
• How your breathing changes during activity or exercise

Can This Be Treated?

Yes. Breathing pattern issues are very treatable.

Common approaches include:

• Learning how to use your diaphragm more efficiently
• Reducing overuse of neck and chest muscles
• Improving rib and upper back mobility
• Practicing calmer, more efficient breathing strategies
• Gradually rebuilding confidence with exercise and exertion

The goal is not to “breathe perfectly”, it’s to help your breathing feel easier, more natural, and less effortful again. Learn more about how Physiotherapy can help.

Final Thoughts

If you take the Nijmegen Questionnaire and notice that many of the symptoms feel familiar, that information is worth paying attention to. It doesn’t mean anything dangerous is happening—but it may suggest that your breathing pattern is contributing to how you feel day to day.

The encouraging part is that breathing patterns are not fixed. With the right guidance, they can be retrained and improved. Many people find that once their breathing becomes more efficient, symptoms like chest tightness, air hunger, dizziness, and that constant “can’t get a full breath” feeling begin to ease. This is where having the right support can make a real difference. 

At Move Authentically Physiotherapy, our physiotherapists are trained in assessing and treating Breathing Pattern Dysfunction. We look beyond just the symptoms and help you understand how your breathing, posture, rib cage movement, stress response, and daily habits may all be connected. Learn more about how we may be able to help you with your breathing.

If you’re in or near Kingston, Ontario, Canada and you’ve been struggling with unexplained breathing symptoms, even after being told everything is “normal”, we are here to help.

You don’t have to keep guessing or pushing through it on your own. A proper assessment can help clarify what’s going on and give you a clear, step-by-step plan to start feeling better.

👉 If this sounds like you, you can book an appointment with our physiotherapy team to get your breathing assessed and start working toward easier, more comfortable breathing again.