What should you know about respiratory depression?

Warning signs include unusual sleepiness, difficulty waking, confusion, weak or shallow breaths, pauses in breathing, snoring or gurgling in an unresponsive person, and blue or grey lips. The person may not complain of breathlessness because reduced alertness can develop first. This is different from emotional symptoms such as [Feeling Anxious](/symptoms/feeling-anxious/) or [Fatigue](/symptoms/fatigue/), which do not by themselves show that breathing has slowed.

Alcohol and combinations of medicines can increase sedation. A clinician will consider what was taken, when it was taken, existing lung or sleep conditions, and the person’s breathing, pulse, alertness, and oxygen level. [Daytime Sleepiness](/symptoms/daytime-sleepiness/) can have many causes and is not the same as sudden reduced responsiveness.

Call emergency services immediately if someone is difficult to wake, breathing abnormally, or has stopped breathing. Keep the airway open, place a normally breathing unconscious person on their side, and stay with them. If they are not breathing normally, follow the dispatcher’s instructions for resuscitation. Do not give food, drink, or another medicine, and do not make them vomit.

Take medicine packets or names to the emergency team if safe to do so. Do not let the person drive. After recovery, arrange a medication review and discuss safer storage, dosing, alcohol use, and any [Difficulty Sleeping](/symptoms/difficulty-sleeping/) or other symptoms that may have led to self-medication.

Emergency care is needed for slow, shallow, irregular, or paused breathing; blue or grey skin; a seizure; collapse; severe confusion; or inability to wake the person. Treat a suspected overdose as urgent even when the person appears to be breathing, because the condition can worsen. Never wait for a routine appointment to assess these signs.

Ask which medicines or combinations may slow breathing, how to take them safely, and whether a reversal medicine or emergency plan is appropriate. Discuss sleep symptoms, alcohol, lung disease, and any [Difficulty Concentrating](/symptoms/difficulty-concentrating/) or mood symptoms that affect medicine use. Confirm who to contact after an accidental extra dose.