Depth of respirations refers to how much air moves in and out of the lungs with each breath, and it’s described using three basic terms: shallow, normal (or unlabored), and deep. Unlike respiratory rate, which you can measure with a number, depth is a qualitative observation based on how much the chest rises and falls, how much effort the person uses, and whether the breathing pattern looks adequate for the situation.
The Three Standard Descriptors
When documenting respiratory depth, you’re choosing from a short vocabulary. Normal depth means the chest rises and falls in a visible but effortless pattern, moving roughly 500 mL of air per breath in an average adult (about 400 mL in women). The person doesn’t appear to strain, and the breathing looks comfortable and rhythmic.
Shallow breathing means the chest barely moves with each breath. Less air enters the lungs than expected, and the breaths often look quick and inadequate. You might notice that only the upper chest moves slightly, with little visible expansion of the lower ribs or abdomen. Shallow breathing often pairs with a faster rate, a pattern called tachypnea.
Deep breathing involves a noticeably large chest expansion. The ribs visibly spread, the abdomen may push outward, and each breath draws in significantly more air than usual. Deep breathing can be normal (after exercise, for example) or a sign that the body is compensating for a metabolic problem.
How to Observe Depth at the Bedside
You assess respiratory depth primarily by watching the chest. Stand where you can clearly see the person’s chest and abdomen, then observe how far the ribcage expands with each inhalation and how fully it returns on exhalation. In a normal breath, you should see gentle, symmetrical movement of the chest wall. If you need a closer look, placing your hands lightly on either side of the lower ribcage lets you feel the degree of expansion directly.
Look beyond the chest itself. The neck and shoulder muscles can tell you a lot. When someone breathes normally, the diaphragm does most of the work invisibly. When breathing depth increases because of distress, accessory muscles kick in. The muscles along the front of the neck (the sternocleidomastoid, running from behind the ear to the collarbone) become visibly active, pulling upward to lift the sternum and expand the chest further. You may also see the muscles between the ribs pulling inward, or the nostrils flaring. These signs indicate that extra effort is being used to draw deeper breaths, and they should be documented alongside your description of depth.
In infants and young children, the assessment looks slightly different. An infant’s ribs sit more horizontally and the diaphragm inserts at a flatter angle, so normal breathing in babies is more abdominal than chest-based. Watching the belly rise and fall gives you a better picture of depth than watching the chest alone.
What Shallow Breathing Looks Like
Shallow respirations produce minimal chest movement and move less air than the body typically needs. A long list of conditions can cause this pattern: asthma, COPD, pneumonia, blood clots in the lung, heart failure, and anxiety or panic attacks, among others. In restrictive lung diseases, where the lungs or chest wall can’t expand fully, the body adapts by taking rapid, shallow breaths because deeper breaths require too much effort against stiff tissue.
When documenting shallow breathing, note what you actually see. “Respirations shallow with minimal chest excursion” is more useful than “breathing looks off.” If you also notice an elevated rate, document both together: “Respirations 28 and shallow” paints a clearer picture than either observation alone.
What Deep Breathing Looks Like
Deep respirations are marked by exaggerated chest expansion, often with visible abdominal movement as the diaphragm contracts fully. In obstructive lung diseases like emphysema, the body compensates by taking deep, slow breaths to maximize how much air actually reaches functioning lung tissue.
The most well-known pathological deep breathing pattern is Kussmaul respiration, which is deep, rapid, and labored. It occurs when the body tries to blow off excess carbon dioxide to correct metabolic acidosis, a dangerous buildup of acid in the blood often seen in uncontrolled diabetes. The breaths are noticeably large and can sound sighing or gasping. If you observe this pattern, the depth is the defining feature: these are conspicuously deep breaths at a fast rate, not just fast breathing.
Patterns Where Depth Changes Cyclically
Some abnormal breathing patterns involve depth that rises and falls in a repeating cycle. The most recognized is Cheyne-Stokes respiration, where breaths gradually get deeper and deeper (crescendo), then gradually get shallower and shallower (decrescendo), followed by a pause where breathing stops entirely for several seconds. The cycle then repeats. This creates a wave-like pattern in chest movement that is distinctive once you’ve seen it.
Cheyne-Stokes breathing typically occurs during sleep or in people with heart failure or neurological damage. The cycling happens because the brain’s breathing control center overreacts to changing carbon dioxide levels: it drives hard breathing that drops CO2 too low, then shuts off breathing until CO2 builds back up, then overreacts again. When describing this pattern, the key detail is that depth isn’t fixed. It oscillates, and the pauses between cycles are part of the observation.
How to Document Depth Clearly
Good documentation of respiratory depth combines your observation with context. A complete respiratory assessment note typically includes rate, rhythm, depth, and effort. For depth specifically, stick to the standard terms (shallow, normal, or deep) and add what you physically observed to support your assessment.
- Normal example: “Respirations 16, regular rhythm, normal depth, unlabored. No accessory muscle use.”
- Shallow example: “Respirations 26 and shallow with minimal chest excursion bilaterally.”
- Deep example: “Respirations 32, deep and labored. Visible sternocleidomastoid use with each breath.”
- Cyclic example: “Cheyne-Stokes pattern noted during sleep, with alternating periods of progressively deeper breathing and apnea lasting approximately 10 seconds.”
The goal is to give anyone reading your note a mental picture of what the breathing actually looked like. Depth, rate, and effort together tell a far more complete story than any one measurement alone. A respiratory rate of 20 means something very different if the breaths are deep and effortful versus shallow and comfortable.