Checking respiratory rate is simple: count the number of times your chest or abdomen rises over the course of one minute. A normal adult respiratory rate at rest falls between 12 and 18 breaths per minute. Here’s how to get an accurate count and what the numbers mean.
How to Count Breaths Accurately
Sit down in a chair or upright in bed and try to relax for a minute or two before you begin. Breathing naturally is key, because the moment you start thinking about your breathing, you tend to change it. This is one reason healthcare providers often count a patient’s breaths without telling them, sometimes pretending to check a pulse while watching the chest rise and fall.
Once you’re settled, watch or feel your chest or abdomen rise. Each rise counts as one breath. Count for a full 60 seconds using a clock or timer. Some guides suggest counting for 30 seconds and multiplying by two, but a full minute gives you a more reliable number, especially if your breathing rhythm is uneven.
If you’re checking someone else’s rate, the best approach is to do it while they’re at rest and ideally unaware you’re counting. Place your hand lightly on their chest or watch the movement of their abdomen. Avoid saying “I’m going to count your breaths now,” since that almost always makes people breathe differently.
What the Numbers Mean
For a healthy adult sitting at rest, 12 to 18 breaths per minute is the normal range. Rates consistently above 20 breaths per minute in an adult suggest something is off, and rates above 24 breaths per minute may indicate a serious problem that needs medical attention.
Breathing that is abnormally slow is called bradypnea. Breathing that is abnormally fast is called tachypnea. Neither one is a diagnosis on its own, but both are signals worth paying attention to, especially when they show up alongside other symptoms like chest pain, confusion, or fever.
Children breathe faster than adults. Newborns typically take 30 to 60 breaths per minute, toddlers around 24 to 40, and school-age children roughly 18 to 30. The rate gradually decreases as children grow, settling into the adult range by the teenage years.
What Can Change Your Breathing Rate
Your respiratory rate isn’t fixed. It shifts throughout the day based on what your body is doing and what it’s dealing with. Stress and anxiety activate your body’s fight-or-flight response, which produces rapid, shallow breathing. Pain does the same thing, triggering faster breathing as a reflexive response to perceived threat. This is why a resting measurement taken when you’re calm gives the most useful baseline.
Caffeine, alcohol, and other substances can also push your rate higher. Fever increases it too, since your body speeds up breathing to help cool itself and meet the higher oxygen demand of an elevated metabolism. Exercise, of course, raises it dramatically, which is why respiratory rate is only meaningful as a vital sign when measured at rest.
Abnormal Breathing Patterns to Recognize
Sometimes it’s not just the speed of breathing that matters but the pattern. Two patterns are worth knowing about because they look distinctive and can signal specific problems.
One is rapid, deep breathing at a steady, relentless pace. Unlike normal heavy breathing after exercise, this pattern doesn’t slow down with rest. It’s associated with conditions that cause a buildup of acid in the blood, such as uncontrolled diabetes or kidney failure.
The other is a cycling pattern: a stretch of fast, shallow breaths that gradually slow into deeper breaths, followed by a complete pause where breathing stops for several seconds before the cycle starts again. This waxing-and-waning rhythm can occur with heart failure, stroke, or brain injuries, and is also sometimes seen near the end of life.
Signs of Respiratory Distress
A high respiratory rate is one clue that someone is struggling to breathe, but there are visible signs that tell you more. Nasal flaring, where the nostrils spread wide with each breath, means the person is working harder than normal to pull air in. Retractions are another red flag: the skin visibly sinks in just below the neck, under the breastbone, or between the ribs with each inhale as the body recruits extra effort to expand the lungs.
Color changes are the most urgent sign. A bluish tint around the mouth, inside the lips, or on the fingernails means the body isn’t getting enough oxygen. The skin may also appear pale or gray. In people with darker skin tones, check the nail beds, gums, and the inside of the lips, where color changes are easier to spot. Any combination of these signs alongside a fast or irregular breathing rate calls for immediate medical help.