Nijmegen Questionnaire

Breathing Pattern Disorder Screening

The Nijmegen Questionnaire is a 16-item validated screening tool for breathing pattern disorder (BPD), also called hyperventilation syndrome. It is widely used in respiratory physiotherapy and primary care. A score of 23 or above suggests BPD is likely.

This is not a diagnostic tool. A high score suggests breathing pattern disorder may be present, but this needs to be assessed clinically. Breathing symptoms can have multiple causes, including autonomic dysfunction, which can present similarly to BPD. Discuss results with your doctor. Based on: van Dixhoorn J, Duivenvoorden HJ. Efficacy of Nijmegen Questionnaire in recognition of the hyperventilation syndrome. J Psychosom Res. 1985;29(2):199–206.

Your Nijmegen score

— out of 64

Item breakdown

Symptom	Your response	Score
Total

About the Nijmegen Questionnaire

Scoring: Each of the 16 items is scored 0–4 (never to very often). Maximum possible score is 64. A score of 23 or above is the validated threshold suggesting breathing pattern disorder is likely present.

Context for post-viral patients: There is significant symptom overlap between breathing pattern disorder and autonomic dysfunction. Both can cause breathlessness, dizziness, chest tightness, and palpitations. A high Nijmegen score does not rule out an autonomic cause for your symptoms — it means disordered breathing is also likely present, which may itself be secondary to autonomic dysfunction. The two conditions can coexist and may reinforce each other.

What to do with a high score: Discuss with your GP. Respiratory physiotherapy (specifically breathing retraining) is the primary treatment for BPD. Even if your breathlessness has an autonomic root cause, breathing retraining is often helpful and low risk.