Hypercapnia (hypercarbia): Symptoms, causes, and treatment Health ConditionsHealth ConditionsAlzheimer's & DementiaAnxietyArthritisAsthma & AllergiesBreast CancerCancerCardiovascular HealthCOVID-19Dermatology & SkincareDiabetesEnvironment & SustainabilityExercise & FitnessEye HealthHeadache & MigraineHealth EquityHIV & AIDSHuman BiologyInflammatory Bowel DiseaseLeukemiaLGBTQIA+Men's HealthMental HealthMultiple Sclerosis (MS)NutritionParkinson's DiseasePsoriasisSexual HealthWomen's HealthDiscoverNewsLatest NewsOriginal SeriesMedical MythsHonest NutritionThrough My EyesNew Normal HealthPodcastsHow to understand chronic painWhat is behind vaccine hesitancy?The amazing story of hepatitis C, from discovery to cureNew directions in dementia researchCan psychedelics rewire a depressed, anxious brain?Why climate change matters for human healthToolsGeneral HealthDrugs A-ZHealth HubsHealth ToolsBMI Calculators and ChartsBlood Pressure Chart: Ranges and GuideBreast Cancer: Self-Examination GuideSleep CalculatorHealth ProductsAffordable Therapy OptionsBlood Pressure MonitorsDiabetic SuppliesFitness TrackersHome GymsGreen Cleaning ProductsHow to Shop for CBDQuizzesRA Myths vs FactsType 2 Diabetes: Managing Blood SugarAnkylosing Spondylitis Pain: Fact or FictionConnectAbout Medical News TodayWho We AreOur Editorial ProcessContent IntegrityConscious LanguageNewslettersSign UpFollow UsMedical News TodayHealth ConditionsDiscoverToolsConnectSubscribe What is hypercapnia or hypercarbia Medically reviewed by Darragh O'Carroll, MD — By Jayne Leonard — Updated on September 28, 2022Hypercapnia, also called hypercarbia, arises from having too much carbon dioxide in the blood. It typically happens with hypoxia, which is when there is not enough oxygen in the body. Hypercapnia happens when breathing problems make it difficult to take in oxygen and breathe out carbon dioxide. It is typically due to a disease that affects the lungs. Symptoms can range from mild to severe, and can include fatigue, headache, and confusion. Possible causes include the respiratory conditions chronic obstructive pulmonary disease (COPD) and asthma. This article discusses symptoms and causes of hypercapnia and outlines some treatment options. Symptoms Share on PinterestPongMoji/Getty ImagesSymptoms can be acute, meaning they start suddenly and last a short while. Or they can be chronic, meaning they last a long time. People with chronic hypercapnia may also experience a temporary worsening of symptoms. Symptoms can range from mild to severe. Mild symptoms A person with hypercapnia might notice:fatigueheadacheflushed skinshortness of breathnauseairritability These symptoms may arise from shorter periods of shallow or slow breathing, such as during deep sleep. The body can often balance carbon dioxide levels in the bloodstream and correct the symptoms by itself. However, if symptoms persist, a person should contact a doctor. Severe symptoms The symptoms of severe hypercapnia require immediate medical attention, as they can cause long-term complications. Some may even be fatal. Severe hypercapnia symptoms include:confusiondepression or paranoiaanxietynausea and vomitingseizurefaintingloss of consciousness or comapanic attackarrhythmiacardiovascular breakdown A person may also experience other symptoms related to an underlying disease such as COPD or asthma. Causes and risk factors Here are some possible causes of hypercapnia. COPD COPD is an umbrella term for several conditions that affect breathing. Common forms of COPD include chronic bronchitis and emphysema. Chronic bronchitis leads to inflammation and mucus in the airways, while emphysema involves damage to the alveoli (air sacs) in the lungs. Both conditions can cause increased levels of carbon dioxide in the bloodstream. The main cause of COPD is long-term exposure to lung irritants. According to the National Heart, Lung, and Blood Institute, cigarette smoke is the most common lung irritant that causes COPD in the United States. However, up to 30% of people with COPD have never smoked. Some have a genetic condition in which the liver does not produce enough alpha-1-antitrypsin (AAT). AAT is a protein that supports lung health. Having an AAT deficiency is a risk factor for COPD development. Air pollution and exposure to chemicals or dust may also cause COPD. Although not everyone with COPD will develop hypercapnia, a person’s risk increases as their COPD progresses. Which breathing exercises can help with COPD? Asthma Asthma causes the airways to become inflamed and narrowed. It may impact breathing and the levels of carbon dioxide in the body when it is unmanaged. People with asthma have a higher risk of hypercapnia. Doctors do not know precisely why asthma develops, though it is likely due to a combination of genetic and environmental factors. Activities that can trigger an asthma attack include exercise and exposure to irritants, including cigarette smoke and air pollution. How can yoga help manage asthma? Sleep apnea Sleep apnea can present as shallow breathing or pauses in breathing during sleep. It can affect oxygen levels in the blood and the body’s balance of carbon dioxide and oxygen. Sleep apnea symptoms include:daytime sleepinessheadache upon wakingdifficulty concentratingsnoring Can surgery help with sleep apnea? Nerve disorders and muscular problems In some people, the nerves and muscles necessary for sufficient lung function may not work correctly. For example, muscular dystrophy can cause the muscles to weaken, eventually leading to breathing problems. Other disorders of the nervous or muscular systems that can contribute to hypercapnia include the following:amyotrophic lateral sclerosis, which affects nerve cells in the brain and spinal cordencephalitis, which is inflammation of the brainGuillain-Barré syndrome, which can result from an unusual immune responsemyasthenia gravis, which is a chronic disease that can weaken the skeletal muscles responsible for breathing Other causes Other causes of high blood levels of carbon dioxide include:activities that impact breathing, including diving and ventilator useCOVID-19 in some people who use a ventilatorbrain stem stroke, which can affect breathinghypothermia, which is severe heat loss from the body that often occurs with hypercapnia and hypoxiaobesity hypoventilation, which happens when having obesity makes it difficult to breathe deeply or quickly enough, according to older researchdrugs that can slow breathing, such as opioids Does wearing a face mask cause hypercapnia During the COVID-19 pandemic, some people had concerns that wearing a face mask could lead to hypercapnia. However, there is very little evidence to support this. Face masks are not airtight. The materials allow air, including carbon dioxide, to circulate rather than build up. Even with medical-grade masks, it is unlikely that significant levels will build up with short-term use. Additionally, thinner surgical and cloth masks are more porous and loose-fitting, allowing for even more air exchange. People who have difficulty breathing do not need to wear a face mask. Diagnosis Some tests used to diagnose hypercapnia include:Blood tests: Laboratory tests can check for anemia and assess sodium, potassium, and chloride levels.Thyroid stimulating hormone: Doctors use this hormone to test for thyroid problems.Arterial blood gas test: This measures the blood levels of carbon dioxide and oxygen.Spirometry test: This test involves blowing into a tube to assess how much air a person can move out of their lungs and how fast they can do it.X-ray or CT scan: These imaging tests can show the presence of lung damage and lung conditions. Treatment The treatment for hypercapnia will depend on the severity of the condition and the underlying cause. Options include: Ventilation Ventilation is typically the first line of treatment for hypercapnia. A doctor may use:Noninvasive ventilation: Airflow comes through a mouthpiece or nasal mask. This is helpful for people with sleep apnea to keep their airways open at night. It is also known as continuous positive airway pressure, or CPAP.Mechanical ventilation: A doctor will insert a tube through the mouth into the airway. This is called intubation. People with severe hypercapnia symptoms may need a ventilation device to help them breathe. Medication Certain medications can help manage breathing or address underlying problems:antibiotics can treat pneumonia or other respiratory infectionsbronchodilators can open the airwayscorticosteroids can reduce inflammation in the airway Oxygen therapy People who undergo oxygen therapy regularly use a device to deliver oxygen to the lungs. Oxygen therapy can help balance the levels of carbon dioxide in the blood. Lifestyle changes To reduce symptoms and avoid complications, a doctor may recommend: dietary changesincreased physical activityquitting or avoiding smokinglimiting exposure to chemicals, dust, and fumes, where possible Surgery Some people with lung or airway damage need surgery. Lung volume reduction surgery can remove damaged tissue. With lung transplantation, a surgeon replaces a damaged lung with a healthy lung from a donor. Prevention Methods for helping to prevent hypercapnia include:treating existing lung conditionsquitting or avoiding smokingreaching or maintaining a moderate weightfollowing an exercise planavoiding exposure to toxic fumes and chemicals Frequently asked questions Here are some answers to questions people often ask about hypercapnia. What is hypercapnia Hypercapnia, also called hypercarbia, is when there is too much carbon dioxide in the blood. It happens when not enough carbon dioxide leaves the lungs. Typically, at the same time, there is not enough oxygen entering the lungs. What causes hypercapnia Health conditions that affect breathing, such as COPD and asthma, can cause it. Other factors include using a ventilator, diving, and having a neurological condition that affects breathing. Exposure to tobacco smoke increases the risk of conditions that lead to hypercapnia. Is hypercarbia the same as hypercapnia Yes, people use these terms interchangeably. They both refer to a condition in which there is too much carbon dioxide in the blood. At the same time, there will not be enough oxygen in the blood. This is called hypoxemia. Summary Hypercapnia is when there is too much carbon dioxide in the blood. Addressing the underlying cause is key to managing symptoms and improving a person’s quality of life. Anyone who has symptoms that may indicate hypercapnia should consult a doctor. The symptoms may be a sign of an underlying condition that needs treatment. Last medically reviewed on September 28, 2022COPDRespiratoryBlood / Hematology 19 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Chapman, K., et al. (2022). Hypercarbia.https://www.ncbi.nlm.nih.gov/books/NBK559154/Chau, E. H. L., et al. (2012). Obesity hypoventilation syndrome: A review of epidemiology, pathophysiology, and perioperative considerations.https://pubs.asahq.org/anesthesiology/article/117/1/188/11249/Obesity-Hypoventilation-SyndromeA-Review-ofChowdhuri, S., et al. (2017). Control of ventilation in health and disease [Abstract].http://journal.chestnet.org/article/S0012-3692(16)62589-8/fulltextDorst, J., et al. (2019). Non-invasive ventilation and hypercapnia-associated symptoms in amyotrophic lateral sclerosis [Abstract].https://pubmed.ncbi.nlm.nih.gov/30394534/Dunworth, S. A., et al. (2017). Hypercapnia in diving: A review of CO₂ retention in submersed exercise at depth [Abstract].https://pubmed.ncbi.nlm.nih.gov/28779577/Gioia, M. R., et al. (2019). Neurological evaluation in patients undergoing non-invasive mechanical ventilation for acute hypercapnic encephalopathy: Comparison of two different scores [Abtract].https://erj.ersjournals.com/content/54/suppl_63/PA2319Hashmi, M. F., et al. (2022). Asthma.https://www.ncbi.nlm.nih.gov/books/NBK430901/Kozak, H. H., et al. (2016). Myasthenia gravis with acute respiratory failure in the emergency department.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5121269/Michaelidis, B., et al. (2005). Effects of long-term moderate hypercapnia on acid–base balance and growth rate in marine mussels Mytilus galloprovincialis [Abstract].http://www.jstor.org/stable/24868542?seq=1#page_scan_tab_contentsNin, N., et al. (2017). Severe hypercapnia and outcome of mechanically ventilated patients with moderate or severe acute respiratory distress syndrome.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5630225/Rawat, D., et al. (2022). Hypercapnea.https://www.ncbi.nlm.nih.gov/books/NBK500012/Rhee, M. S. M., et al. (2021). Carbon dioxide increases with face masks but remains below short-term NIOSH limits.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8049746/Sivakumar, K., et al. (2018). Central hypoventilation: A rare complication of Wallenberg syndrome.https://www.hindawi.com/journals/crinm/2018/4894820/Slowik, J. M., et al. (2022). Obstructive sleep apnea.https://www.ncbi.nlm.nih.gov/books/NBK459252/Steynor, M., et al. (2015). Always consider the possibility of opioid-induced respiratory depression in patients presenting with hypercapnic respiratory failure who fail to improve as expected with appropriate therapy.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4393892/Strapazzon, G., et al. (2021). Effects of hypothermia, hypoxia, and hypercapnia on brain oxygenation and hemodynamic parameters during simulated avalanche burial: A porcine study.https://journals.physiology.org/doi/full/10.1152/japplphysiol.00498.2020Tsonas, A. M., et al. (2022). Clinical characteristics, physiological features, and outcomes associated with hypercapnia in patients with acute hypoxemic respiratory failure due to COVID–19---insights from the PRoVENT–COVID study.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8947815/Use and care of masks. (2022).https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.htmlWhat is COPD? (2022).https://www.nhlbi.nih.gov/health/copdFEEDBACK:Medically reviewed by Darragh O'Carroll, MD — By Jayne Leonard — Updated on September 28, 2022 Latest newsWhat sets 'SuperAgers' apart? 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