top of page

Symptom Tracker

This is one of the tools that we use in the Breath Retraining Course.  Do you notice any symptoms in yourself?


​If you have questions about this or your breathing, please email Jennifer.

Symptoms may seem unrelated to poor breathing.


For each symptom, rate yourself: 


0 — Does Not Apply

1 — Rarely

2 — Sometimes

3 — Often

4 — Very Often

1. Alleriges
0
1
2
3
4
2. Deep breathing
0
1
2
3
4
3. Rapid breathing
0
1
2
3
4
3. Rapid breathing
0
1
2
3
4
4. Short of breath
0
1
2
3
4
5. Upper chest breathing
0
1
2
3
4
6. Cold hands or feet
0
1
2
3
4
7. Poor concentration
0
1
2
3
4
8. Constipation
0
1
2
3
4
9. Diarrhea
0
1
2
3
4
10. Many cavities
0
1
2
3
4
11. Dry mouth
0
1
2
3
4
12. Depression
0
1
2
3
4
13. Waking up tired
0
1
2
3
4
14. Pounding heart
0
1
2
3
4
15. Skipped heart beat
0
1
2
3
4
16. Irritability
0
1
2
3
4
17. Lightheadedness
0
1
2
3
4
18. Excessive mucous
0
1
2
3
4
19. Blocked nose
0
1
2
3
4
20. Runny nose
0
1
2
3
4
21. Fatigue all day
0
1
2
3
4
22. Poor sense of smell
0
1
2
3
4
23. Sleep apnea
0
1
2
3
4
24. Daytime apnea
0
1
2
3
4
25. Waking at night
0
1
2
3
4
26. Up to urinate at night
0
1
2
3
4
27. Hot and sweaty
0
1
2
3
4
28. Throat clearing
0
1
2
3
4
29. Post-nasal drip
0
1
2
3
4
30. Trembling or tics
0
1
2
3
4
31. Bloated abdomen
0
1
2
3
4
32. Belching or burping
0
1
2
3
4
33. Mouth breathing
0
1
2
3
4
34. Holding your breath
0
1
2
3
4
35. Tight Chest
0
1
2
3
4
36. Colds or flu
0
1
2
3
4
37. Forgetfulness
0
1
2
3
4
38. Coughing
0
1
2
3
4
39. Yawning or sighing
0
1
2
3
4
40. Gum problems
0
1
2
3
4
41. Unsatisfactory breath
0
1
2
3
4
42. Grinding teeth
0
1
2
3
4
43. Headaches
0
1
2
3
4
44. High blood pressure
0
1
2
3
4
45. Itchy skin
0
1
2
3
4
46. Low sex drive
0
1
2
3
4
47. Low stamina
0
1
2
3
4
48. Insomnia
0
1
2
3
4
49. Snoring
0
1
2
3
4
50. Sweaty palms
0
1
2
3
4
51. Fear without reason
0
1
2
3
4
52. Anxiety
0
1
2
3
4
53. Tingling
0
1
2
3
4
54. Wheezing
0
1
2
3
4
Would you like Jennifer to email you with more information regarding your results and upcoming breath retraining courses?
Yes, Please
No, Thank You
bottom of page