Respiratory distress is the suffering that results from asphyxiation, and is characterized by observable behaviors. Standard measures of dyspnea rely on the patient’s ability to self-report. However, not all patients who experience dyspnea are able to self-report because of temporary impairments or declining cognition, making them vulnerable to under-recognition and undertreatment of their distress. Hence, there is a need for a multidimensional behavioral assessment of respiratory distress. A synthesis of scientific literature contributed to the development of this model of respiratory distress behaviors.