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Symptoms list

Over the past few weeks, how often did you feel…

Emotional/physical symptoms

Tense

  • Never
  • Seldom
  • Sometimes
  • Often
  • Always

Anxious

  • Never
  • Seldom
  • Sometimes
  • Often
  • Always
Mental symptoms

A haze for the eyes

  • Never
  • Seldom
  • Sometimes
  • Often
  • Always

Dizziness

  • Never
  • Seldom
  • Sometimes
  • Often
  • Always

Confusion, or loss of sense of surroundings

  • Never
  • Seldom
  • Sometimes
  • Often
  • Always
Respiratory irregularities

Faster or deeper breathing

  • Never
  • Seldom
  • Sometimes
  • Often
  • Always

Respiratory distress

  • Never
  • Seldom
  • Sometimes
  • Often
  • Always

Unable to breath deep enough

  • Never
  • Seldom
  • Sometimes
  • Often
  • Always
Chest area

Chest pain

  • Never
  • Seldom
  • Sometimes
  • Often
  • Always

Cramped in and around chest

  • Never
  • Seldom
  • Sometimes
  • Often
  • Always

Palpitations

  • Never
  • Seldom
  • Sometimes
  • Often
  • Always
Limbs

Tingling of fingers or arms

  • Never
  • Seldom
  • Sometimes
  • Often
  • Always

Stiffness of fingers or arms

  • Never
  • Seldom
  • Sometimes
  • Often
  • Always

Cold hands or feet

  • Never
  • Seldom
  • Sometimes
  • Often
  • Always
Others

Bloating in abdomen

  • Never
  • Seldom
  • Sometimes
  • Often
  • Always

Stiffness around the mouth

  • Never
  • Seldom
  • Sometimes
  • Often
  • Always

This Symptoms List is a validated scientific list by van Doorn P, Colla P, Folgering H.

A questionnaire for hyperventilation complaints. The psychologist. 1983; 18 (10): 513-517

The Nijmegen Questionnaire and dysfunctional breathing, European Respiratory Journal, Open Research 2015;1:000-2015
Dr. Hans Folgering, Emeritus Professor Res-piratoire Fysiologie, Nijmegen. Co-author
of the Nijmeegse Quastionnaire, nestor hyperventilation research in the Netherlands and was a member of the ISARP.