Dr Lim Jin Lee

01/12/2025

低剂量CT筛查能早期发现肺癌

在临床上，我看到很多已经是晚期才被发现的肺癌。
低剂量CT（Low-Dose CT, LDCT）
是目前肺部早期筛查中最有效的工具之一。
如果您或家人符合条件，请务必及早筛查。

谁需要做低剂量CT筛查？
（NCCN 2025 指南 ）
✔ 年龄 50–80 岁
✔ 吸烟指数 ≥20 个包年（pack-years）
✔ 目前吸烟，或在过去 15 年内戒烟
这一组患者拥有最强的证据支持，
筛查能显著降低肺癌死亡率。

谁不建议做 LDCT？
✘ 年龄

16/11/2025

咳嗽是隐藏疾病的症状, 本身并不是疾病。
咳嗽药治标不治本, 但能起到暂时舒缓的作用。
咳嗽超过三周,并没有日趋好转的现象,请就医, 以对症下药。

Cough is a symptom, not a disease.
Cough syrup may provide temporary relief, but it does not treat the root cause.
If your cough lasts more than three weeks without improvement, please seek medical attention for a proper diagnosis and treatment.

感谢星洲日报采访.

15/10/2025

马来西亚正进入流感高峰期，目前已有数千名学生感染，多所学校被迫停课。
很多病人以为只是普通感冒，没想到检测一做，是流感。这一两周我已经见到好几位类似个案。
流感不像一般感冒那么轻，来得急、烧得高、身体酸痛无力，有时还会引起肺炎或心脏并发症。儿童、老人、孕妇及慢性病患者特别容易受到影响。所以，如果你最近也出现以上症状,别轻忽，也别拖。早点看医生、早点用药，才能早点康复。

流感疫苗仍然是最有效的防护措施。外出时戴口罩、勤洗手、避免拥挤、保持充足睡眠与营养，都是最基本的保护。

Malaysia is now in the midst of a flu outbreak, with thousands of students infected and several schools forced to close. Many patients initially thought they just had a common cold, but test results revealed influenza instead. Over the past couple of weeks, I’ve seen several similar cases.

Unlike an ordinary cold, influenza strikes suddenly, with high fever, body aches, and fatigue, and can sometimes lead to pneumonia or heart complications. Children, the elderly, pregnant women, and those with chronic illnesses are particularly vulnerable. So, if you’re having these symptoms, don’t ignore or delay—see a doctor early and start treatment promptly for faster recovery.

The flu vaccine remains the most effective protection. Wearing a mask in public, washing your hands frequently, avoiding crowds, and maintaining good rest and nutrition are also simple yet important steps to protect yourself and those around you.

https://www.straitstimes.com/asia/se-asia/around-6000-students-in-malaysia-infected-with-influenza-prompting-school-closures

02/10/2025

为什么一早醒来会头痛？
可能是睡眠呼吸中止症（OSA）

很多人以为早晨头痛只是枕头不合适、压力大或睡眠不足。但在临床上，我们常发现真正的原因可能是阻塞性睡眠呼吸中止症。

在 OSA 中，睡眠时咽喉肌肉塌陷，气道阻塞，空气进不去。结果血氧下降，二氧化碳（CO₂）在体内逐渐升高。大脑在感受到缺氧和高碳酸血症时，会触发微觉醒反应（arousal response），迫使人短暂苏醒、恢复气道通畅。虽然患者未必察觉，但整夜的睡眠被不断中断。CO₂的蓄积还会导致脑血管扩张，引起晨起头痛、睡眠不解乏、白天嗜睡等症状。

为了识别高风险人群，临床上常用几种问卷：
* STOP-BANG 问卷：从打鼾（Snoring）、白天疲倦（Tiredness）、目击呼吸暂停（Observed apnea）、高血压（Pressure）、BMI、年龄、颈围、性别八个方面评分。分数越高，风险越大。
* Epworth 嗜睡量表（ESS）：评估一个人白天在不同情境下打瞌睡的可能性（如坐车、看电视、开会时）。分数 >10 提示异常嗜睡。
* Berlin 问卷：从打鼾频率、白天嗜睡、以及合并高血压/肥胖三大领域来评估风险。
*
这些工具能帮助医生快速筛选出需要进一步睡眠检测（如多导睡眠监测 polysomnography）的患者。

因此，如果你或身边的人经常晨起头痛、白天异常困倦、或打鼾严重，不要忽视。早期识别、正确诊断并治疗 OSA，能改善睡眠和生活质量，也能降低心血管风险。

Why Do You Wake Up With a Headache? It Could Be Obstructive Sleep Apnea (OSA)

Many people think morning headaches are simply due to the wrong pillow, stress, or poor sleep. But in clinical practice, we often find that the real cause may be Obstructive Sleep Apnea (OSA).
In OSA, the throat muscles collapse repeatedly during sleep, blocking the airway and preventing air from flowing in. As a result, oxygen levels drop while carbon dioxide (CO₂) builds up in the body. When the brain senses low oxygen and high CO₂, it triggers a micro-arousal response — a brief awakening that reopens the airway. Patients may not be aware of it, but their sleep is fragmented throughout the night. CO₂ retention can also cause blood vessels in the brain to dilate, leading to morning headaches, unrefreshing sleep, and excessive daytime sleepiness.
To identify high-risk individuals, several screening questionnaires are commonly used:
* STOP-BANG questionnaire: Considers Snoring, Tiredness, Observed apnea, high blood Pressure, BMI, Age, Neck circumference, and Gender. The higher the score, the greater the risk.
* Epworth Sleepiness Scale (ESS): Assesses the likelihood of dozing off in everyday situations (e.g., watching TV, sitting in a car, attending a meeting). A score >10 suggests abnormal sleepiness.
* Berlin Questionnaire: Evaluates risk based on snoring frequency, daytime sleepiness, and the presence of hypertension or obesity.
These tools help doctors quickly identify patients who may need further evaluation with a polysomnography (sleep study).
So, if you or someone you know often wakes up with headaches, feels unusually tired during the day, or snores heavily, don’t ignore it. Early recognition, proper diagnosis, and treatment of OSA not only improve sleep and quality of life but also reduce cardiovascular risks.

26/09/2025

Great evening exchanging knowledge with colleagues on protecting vulnerable adults from RSV.

A few points to share

1. RSV is not just a childhood virus — it can cause serious lung infections in adults ≥60 years, especially those with existing health problems.
2. In older adults, RSV can be as severe as, or even worse than influenza.
3. Unlike influenza, there is currently no specific anti-viral treatment once infected with RSV.
4. Prevention matters: vaccination is recommended for adults ≥50 years (especially with chronic conditions), and for caregivers/grandparents in close contact with young children.
5. AREXVY is approved in Malaysia and provides >80% protection against RSV-related lower respiratory tract infections (LRTI).
6. Protecting older adults means preserving independence, reducing hospitalizations, and easing caregiver burden.

与大家共同交流 RSV 相关知识，并分享如何保护高风险人群免受 RSV（呼吸道合胞病毒）的威胁

1. RSV 不只是儿童的病毒, 在 ≥60 岁的成年人，尤其是有慢性疾病的患者中，也会引起严重的肺部感染。
2. 在老年人中，RSV 的严重程度可与流感相当，甚至更严重。
3. 与流感不同，目前尚无针对 RSV 的特效抗病毒药物。
4. 预防最重要：建议 ≥50 岁的成年人（特别是有慢性病者），以及经常与小孩接触的照护者/祖父母接种疫苗。
5. AREXVY 已在马来西亚获批，可提供 超过 80% 的保护力，预防 RSV 相关的下呼吸道感染（LRTI）。
6. 保护老年人意味着维护他们的独立生活，减少住院风险，也减轻家属与照护者的负担。

26/09/2025

在日常门诊里，很多病人都会问我：“医生，我这种情况是不是一定要用吸入器？” 其实吸入器不是每个人都需要，但在几个常见的疾病里，它是非常重要的治疗方式。

第一类是 哮喘病人。哮喘的根本问题是气道的慢性炎症和高敏感，所以需要长期吸入类固醇来控制炎症，减少咳嗽和喘的发作。如果只靠止喘药而不用控制药，病情常常会反复。

第二类是 慢性阻塞性肺病（COPD），尤其是吸烟多年、常常咳嗽有痰、容易气喘的人。吸入器里的药物可以帮助扩张气道、减少急性加重，长期使用能改善呼吸质量。

第三类是 感染后气道高敏感。有些人在感冒或肺部感染痊愈后，还会持续咳嗽好几周，这往往是因为气道处于敏感状态。短期使用低剂量吸入类固醇，可以帮助气道尽快恢复正常。

当然，还有其他一些情况，例如支气管扩张症以及某些较少见的气道疾病，也可能需要吸入器，但需要根据个人的实际情况来决定。在这些病例中，医生会根据病人的症状、肺功能和整体健康状况，逐一评估并作出用药选择。

很多病人一听到吸入器里有类固醇，就会很担心副作用。其实我要强调，吸入类固醇和口服或打针的类固醇有所不同。吸入的剂量非常低，而且药物主要在肺部发挥作用，进入血液的比例很少，所以几乎不会导致发胖、脸肿或骨质疏松。最常见的副作用是口腔或喉咙不适，这通常只要记得用药后漱口就能避免。

不过，医学上确实有研究发现，长期使用吸入类固醇会让某些病人 增加患肺炎的风险。这个风险一般不高，而且通常发生在年纪较大、有长期吸烟史、或者本身肺功能差的患者身上。对比之下，如果不用吸入器，哮喘和COPD更容易频繁发作，甚至导致严重缺氧和住院，那反而是更大的风险。

所以我常跟病人说：吸入类固醇不是百分之百没有风险，但它带来的好处超过潜在的不良反应。关键在于：医生会为你挑选合适剂量，并且定期复查，确保用到最少的药，得到最大的好处。 这是一个利弊权衡的过程，而不是盲目用药。

In daily clinic practice, many patients ask me: “Doctor, do I really need to use an inhaler for my condition?” The truth is, not everyone needs an inhaler, but for several common diseases, it is a very important treatment option.

The first group is asthma patients. The root problem in asthma is chronic airway inflammation and hypersensitivity, so long-term inhaled steroids are needed to control inflammation and reduce attacks of cough and wheeze. If patients only rely on reliever medication without using controller treatment, the disease often comes back again and again.

The second group is patients with Chronic Obstructive Pulmonary Disease (COPD), especially those with a long smoking history, frequent cough with phlegm, and shortness of breath. Inhaler medications can help open up the airways, reduce flare-ups, and improve breathing quality over time.

The third group is people with post-infectious airway hypersensitivity. Some patients continue to cough for weeks even after a flu or lung infection has resolved. In such cases, a short course of low-dose inhaled steroids can help the airways return to normal faster.

Of course, there are also other conditions such as bronchiectasis and certain less common airway diseases, where inhalers may be used depending on individual needs. In these cases, the decision is very much on a case-by-case basis, guided by the patient’s symptoms and lung function.
Many patients worry when they hear that inhalers contain steroids, fearing that it will “damage the body” or cause “addiction.” I always emphasize that inhaled steroids are different from oral or injected steroids. The dose is very low, and the medicine mainly works in the lungs. Only a small amount enters the bloodstream, so it rarely causes side effects like weight gain, moon face, or osteoporosis. The most common issue is throat irritation or oral discomfort, which can usually be avoided by rinsing the mouth after use.

That said, medical studies have found that long-term use of inhaled steroids may increase the risk of pneumonia in some patients. This risk is generally low, and is mainly seen in older patients, those with a long history of smoking, or those with very poor lung function. On the other hand, if patients do not use inhalers, asthma and COPD tend to flare up more frequently, sometimes leading to severe hypoxia and hospitalization — which is a far greater risk.
So I often tell my patients: inhaled steroids are not completely without risk, but the benefits usually outweigh the potential downsides. The key is that your doctor will choose the right dose for you and review your condition regularly, making sure you use the minimum amount of medication to achieve the maximum benefit. It’s always a balance of risks and benefits, not blind or unnecessary treatment.



23/09/2025

很多人一旦出现胸口疼痛，就会担心是不是心脏病。其实，胸痛的原因很多，其中一种常见但相对良性的情况叫 肋软骨炎。

肋软骨炎是指肋骨与胸骨连接处的软骨发生炎症。疼痛常见于胸骨两侧，多为刺痛或钝痛，活动、深呼吸或用手按压时会更明显。有些患者甚至觉得像心脏痛，因此容易引起焦虑。

引起肋软骨炎的原因包括：反复用力或提重物、剧烈咳嗽或呼吸道感染、胸口外伤或撞击。有些情况下则找不到明确诱因。
医生在处理胸痛时需非常谨慎。首先要排除心脏或肺部等严重问题，可能需要做心电图、X 光或抽血检查。一旦确认是肋软骨炎，大多数情况属于良性，不会危及生命。

治疗方面主要是 休息并治疗主要诱因，同时可使用止痛药缓解不适。热敷或轻柔伸展也能帮助减轻症状，也要避免过度运动与控制咳嗽.

肋软骨炎虽然会引起明显胸痛，但多属自限性，可逐渐好转。不过，如果胸痛伴随呼吸困难、冒冷汗或运动后加重，应立即就医，排除心脏问题。

Many people worry about heart disease whenever they experience chest pain. In fact, chest pain has many possible causes. One common but relatively benign condition is costochondritis.
Costochondritis refers to inflammation of the cartilage where the ribs join the breastbone (sternum). The pain is often felt on both sides of the chest, usually sharp or aching in nature. It tends to worsen with movement, deep breathing, or when pressing on the area. Some patients even describe it as “heart pain,” which can cause anxiety.
Causes of costochondritis include repetitive strain or heavy lifting, frequent coughing or respiratory infections, and chest injury or trauma. In some cases, no clear trigger can be identified.
When doctors assess chest pain, they must be very cautious. The first step is to rule out serious problems such as heart or lung disease, which may require tests like an ECG, chest X-ray, or blood work. Once costochondritis is confirmed, it is generally benign and not life-threatening.
Treatment focuses on rest and addressing underlying triggers. Pain relievers can help ease discomfort, and warm compresses or gentle stretching may provide additional relief. Avoiding overexertion and controlling cough are also important.
Although costochondritis can cause significant chest pain, it is usually self-limiting and improves over time. However, if chest pain is accompanied by shortness of breath, cold sweats, or worsens with exertion, urgent medical evaluation is needed to rule out heart disease.

22/09/2025

因为临近新加坡的关系，我经常接到来自新加坡医院或诊所的转介病人，他们都是在办理工作准证体检, 多数人身体健康、没有症状，但胸部X光却发现异常.安全起见,他们会被转介给肺科专科以排除肺痨的可能性.

在大多数情况下，我发现的往往是肺尖纤维化、钙化点（肉芽肿）或无症状的肺囊肿, 这些通常是过去感染后已痊愈留下的痕迹。

我的责任，是分辨这些变化到底只是旧伤, 还是真的有疾病。这需要更细致的检查：详细病史、CT扫描，验痰, 有时还需要支气管镜，以确保不会漏诊肺结核（TB）。

大部分人在评估后可以顺利通过，并获得提交给雇主的医疗证明。但也有极少部分人在此过程中被确诊为活跃性肺结核。虽然这会让他们的准证申请受到影响甚至延迟，但从医学角度看,我为他们感到庆幸, 因为如果没有这次体检，疾病可能会被忽视而发展到更严重的阶段，并在不知不觉中传染给家人和朋友。

给大家的提醒：
1. 肺结核是可治愈的疾病。
2. 早发现、早治疗，保护自己，也保护身边的人。

所以,这不只是为了通过体检，更是为了自己和家人的健康.

As a respiratory physician in Johor Bahru, I often receive referrals from Singapore hospitals or clinics for applicants undergoing work permit medical checks. Many are asymptomatic but have an abnormal chest X-ray, often raising concern for tuberculosis (TB).

In most cases, I find apical fibrotic changes, granulomas, or asymptomatic lung cysts, usually old, healed infections. CT scan may be warranted, to determine whether the changes are clearly old scarring or have features suggestive of active disease. If active infection is suspected, further tests such as sputum analysis or bronchoscopy lavage are performed.

The majority are eventually cleared and issued a medical letter for their employer. A small minority are diagnosed with active TB during this process. While this can be disappointing for applicants due to permit delays, it is actually fortunate, without the medical check-up, the disease might have gone undetected, progressed to a more severe stage, and unknowingly spread to loved ones.

The good news is that TB is curable with the right treatment. Complete the full course of therapy, get well, have your family protected, and you can reapply in the future.

22/09/2025

Same me, just a new place.
Thank you for your trust and patience during this move. Here’s to new beginnings.

Gleneagles Hospital Johor is proud to welcome Dr. Lim Jin Lee, our resident Consultant in Internal Medicine specialising in Respiratory Medicine.

Among the many conditions Dr. Lim manages are:

- Asthma (Chronic Inflammatory Airway Disease)
- Chronic Obstructive Pulmonary Disease (COPD)
- Pneumonia (Lung Infection)
- Tuberculosis
- Lung Cancer (Primary or Secondary)
- Obstructive Sleep Apnoea (OSA)

We’re excited to have her on board to enhance patient care and provide support at every step of the journey.

For more information, contact our Hotline: 07-560 1000

21/09/2025

咳嗽超过三周，就称为“久咳”。它的原因非常多，不单单是肺部的问题。常见呼吸道相关疾病包括：哮喘、慢性支气管炎、结核或其他感染, 甚至肺癌, 肺纤维化等等。

但除此之外，我也常见到一些“非呼吸道”的原因，例如，胃酸倒流（GERD）会导致胃酸刺激咽喉，引起长期咳嗽；部分降血压药（如 ACEI 抑制剂）也会让人持续干咳；鼻后滴流（post nasal drip）, 就是鼻腔分泌物倒流到咽喉，刺激气道，引发长期咳嗽，常伴随晨起喉咙有痰、需要清喉; 甚至心理因素或习惯性清喉咙，也可能是久咳的因素。
因此，久咳的 鉴别诊断（differential diagnosis）非常广。
在评估时，我们必须详细问诊：咳嗽多久？是否有痰、带血？伴随气喘、胸闷、体重下降或夜间盗汗？再结合肺部检查与辅助检查（如 X 光、肺功能、胃食道评估等等），一步步找出真正病因。
久咳并非小事，也不一定只是肺有问题。若超过三周仍未好转，应及时就医，让医生全面排查并对症治疗。

A cough lasting more than three weeks is considered a chronic cough. Its causes are varied and not limited to lung problems. Common respiratory conditions include asthma, chronic bronchitis, tuberculosis, other infections, and even lung cancer and lung fibrosis.

Beyond that, several non-respiratory causes should also be considered. For example, gastroesophageal reflux disease (GERD) can cause acid to irritate the throat, leading to persistent coughing. Certain blood pressure medications (such as ACE inhibitors) are known to trigger a chronic dry cough. Post-nasal drip. in which nasal secretions flow down the throat and irritate the airways is another common cause, often accompanied by morning throat clearing or phlegm. Psychological factors or habitual throat clearing can also contribute.

This is why the differential diagnosis of chronic cough is broad. When assessing a patient, doctors will start with a detailed history: How long has the cough lasted? Is there phlegm or blood? Are there associated symptoms like wheezing, chest tightness, weight loss, or night sweats? These are then combined with examinations and investigations such as chest X-rays, lung function tests, or gastrointestinal evaluations to determine the underlying cause.

Chronic cough is not a trivial matter, and it is not always just a “lung problem.” If your cough lasts longer than three weeks, it is important to see a doctor for a thorough evaluation and appropriate treatment.

16/09/2025

近日在一名孕妇在餐馆内因要求隔壁桌男子停止吸烟而遭到攻击。这件事再次提醒我们，吸烟问题不仅是个人习惯，更是关系到公共健康与安全的大事。

烟草与电子烟的烟雾中含有数千种有害化学物质，其中不少是致癌物,长期接触可导致肺癌、心脏病、中风及慢性呼吸道疾病；对于孕妇而言，二手烟更可能危害胎儿健康，增加早产和低体重风险；儿童与老人则更容易受到伤害。

在公众场合吸烟,等于强制身边的人吸二手烟。就像你把垃圾往别人餐桌上倒，强迫他们也得吃。

我鼓励公众积极举报, 通过 JomLapor，每个人都能出一份力：只需进入 jomlapor.com/jom-lapor-sekarang，
选择违规类型（如禁烟区吸烟、向未成年人售卖烟品、非法广告等），上传相关证据，填写地点与情况说明，然后提交表格，相关单位便会跟进调查。

Recently, a shocking incident occurred in which a pregnant woman was attacked in a restaurant after she asked a man at the next table to stop smoking. This case highlights a serious issue: smoking is not just a personal habit, but a matter of public health and safety.
To***co and e-cigarette smoke contain thousands of harmful chemicals, many of which are carcinogenic. Long-term exposure increases the risk of lung cancer, heart disease, stroke, and chronic respiratory illness. For pregnant women, second-hand smoke is especially dangerous, raising the risk of premature birth and low birth weight. Children and the elderly are also particularly vulnerable to these harms.

When someone smokes in public spaces, they are essentially forcing others to inhale second-hand smoke. This is an extremely selfish act that puts innocent people at risk.

I encourage the public to take action by reporting such violations through JomLapor. steps attached.

07/08/2025

过去有好几位病人找我看诊，都是年轻人，主要症状“呼吸不过来”、“胸口闷呼吸不顺”、“一直想深呼吸但吸不饱”，甚至觉得自己是不是心脏或肺出了问题。他们看起来焦虑，症状也非常真实。于是我们做了详细的检查：胸部X光、肺功能测试、CT thorax、心电图、甚至心脏专科评估，全都正常。

接着，我让他们填写了一个叫 Nijmegen问卷 的评估表，发现分数都偏高，可能是 过度换气综合征(Hyperventilation Syndrome, HVS）。这是一种呼吸功能紊乱，常常和压力或焦虑有关，症状可以和严重疾病非常相似。

我们有时会进一步安排 动脉血气分析（ABG） 来辅助判断。ABG 检查常见的结果是 呼吸性碱中毒：二氧化碳（PaCO₂）偏低、pH 值偏高，以及碳酸氢盐（HCO₃⁻）正常或稍低。这意味着患者虽然感觉“吸不到气”，其实是呼吸过快、过深，把体内的二氧化碳排出太多，导致体内酸碱平衡被打破。这种不平衡会引发头晕、手脚发麻、胸口闷等症状，加重呼吸困难的感觉，形成恶性循环。这并不是“假装不舒服”，而是一种真实存在的生理反应。
但也要注意：如果患者在检查时没有症状发作，ABG 可能会呈现正常结果，这并不代表问题不存在，而是因为症状具有间歇性.

不过也要提醒大家,包括医生们：HVS 是一个 排除性诊断，必须先排除其他器质性疾病，才可以放心下这个结论。很多时候，病人的症状也会随着时间演变，因此也需要持续观察、定期追踪，不能掉以轻心,以避免误诊.

治疗方面，呼吸训练 放松练习、认知行为疗法 或冥想等方法，能有效打破恶性循环。建议大家试试看一些免费的呼吸训练工具，例如 Nijmegen问卷（连结）、手机APP如 The Breathing App 或 Breathe2Relax，对调节呼吸节奏有帮助。

In the past, I’ve seen quite a few patients, mostly young and otherwise healthy, coming in with symptoms like “I can’t breathe properly,” “my chest feels tight,” or “I keep trying to take deep breaths, but it’s never enough.” They often appear anxious, and their symptoms are very real. So we run a thorough workup: chest X-ray, lung function tests, CT thorax, ECG, and sometimes even referral to a cardiologist and all results come back normal.

Next, I have them fill out something called the Nijmegen Questionnaire, and many of them score high. This points to the possibility of Hyperventilation Syndrome (HVS) — a functional breathing disorder commonly associated with stress or anxiety. The symptoms often resemble those of more serious diseases.

We sometimes go a step further and perform arterial blood gas (ABG) analysis to support the diagnosis. A typical finding in HVS is respiratory alkalosis: low carbon dioxide (PaCO₂), slightly elevated pH, and normal or slightly low bicarbonate (HCO₃⁻). This suggests that although the patient feels like they can’t breathe, in reality they are breathing too fast or too deeply, causing excessive CO₂ loss and disrupting the body’s acid–base balance. This imbalance can lead to dizziness, tingling, chest discomfort, and worsened breathlessness, forming a vicious cycle. This is not “imagined illness”, it is a real, measurable physiological reaction. However, it’s important to note that if the patient is not actively symptomatic during the test, the ABG may appear normal. That doesn’t mean the problem isn’t there, it just reflects the intermittent nature of the symptoms.

That said, it’s crucial for both patients and doctors to remember that HVS is a diagnosis of exclusion. Other organic diseases must be ruled out before we can confidently make this diagnosis. And since symptoms may evolve over time, patients require ongoing monitoring and regular follow-up to avoid missing a more serious underlying cause.

In terms of treatment, breathing retraining, relaxation techniques, cognitive behavioural therapy (CBT), and even mindfulness or meditation can help break the vicious cycle. I encourage patients to explore free breathing tools such as the Nijmegen Questionnaire or apps like The Breathing App and Breathe2Relax, which are great for restoring proper breathing rhythm.