Niamh Knightly

The Breathing Queen – Service Overview

The Breathing Queen is a specialised, breathing-focused physiotherapy service grounded in both clinical expertise and lived experience. My work is informed by my personal experience of anxiety and nervous system dysregulation, providing a deep understanding of how breathing patterns and underlying physiology can significantly drive psychological distress. This perspective underpins a compassionate, trauma-informed approach that prioritises safety, collaboration, and client autonomy.

I work with individuals experiencing PTSD, anxiety disorders, panic disorder, and chronic nervous system dysregulation—particularly where symptoms such as air hunger, hyperventilation, dizziness, chest tightness, fatigue, dissociation, and persistent physiological hyperarousal are present. Many clients I support have strong psychological insight but remain “stuck” in a heightened physiological state, limiting their ability to fully engage in therapy and daily life.

My role as a physiotherapist is to assess and address the physiological drivers contributing to this distress. I use a structured and comprehensive assessment process, including breathing pattern analysis (at rest and under load), respiratory rate and variability, CO₂ tolerance testing, breath-hold measures, symptom provocation and recovery patterns, and functional tolerance to everyday stressors. This allows identification of key patterns such as chronic hyperventilation, reduced CO₂ tolerance, suboptimal diaphragm function, and impaired autonomic recovery.

Intervention focuses on individualised, evidence-based breathing retraining and nervous system regulation strategies. Treatment is carefully paced and tailored to each client’s history, capacity, and goals. The emphasis is on restoring efficient, adaptable breathing, improving CO₂ tolerance, enhancing interoceptive awareness, and building overall autonomic flexibility—without reinforcing control-based or performance-driven approaches.

Clinically, outcomes are practical and therapy-supportive. Clients often experience reduced air hunger and panic symptoms, improved recovery from stress, increased tolerance of internal sensations, better energy and sleep, and a greater ability to remain regulated during emotionally challenging situations. By reducing baseline physiological threat, clients are typically able to engage more effectively in psychological therapy, facilitating deeper processing and integration.

I work collaboratively with psychologists and other health professionals, positioning this service as complementary to psychological care rather than overlapping. It is particularly well-suited to clients presenting with strong somatic symptoms, panic driven by bodily sensations, or ongoing dysregulation despite good therapeutic insight.

All sessions are delivered online, and I have extensive experience working with clients remotely. This format has proven to be highly effective, allowing for consistent, accessible care and excellent clinical outcomes across a wide range of presentations.

Referral Process

Referrals are welcome from psychologists, GPs, and other health professionals.

Please complete a referral and send it through. Once received, I will contact the client directly as soon as possible to arrange an initial appointment and ensure a smooth onboarding process.