A video is received of a region of a subject where a signal corresponding to respiratory function can be registered by a video device. Pixels in the region in each of the image frames are processed to identify a respiratory pattern with peak/valley pairs. A peak/valley pair of interest is selected. An array of optical flow vectors is determined between a window of groups of pixel locations in a reference image frame corresponding to a peak of the pair/valley pair and a window in each of a number of image frames corresponding to the respiratory signal between the peak and ending at a valley point. Optical flow vectors have a direction and a magnitude. A ratio is determined between upwardly pointing optical flow vectors and downwardly pointing optical flow vectors. Based on the ratio, a determination is made whether the respiration phase for that peak/valley pair is inspiration or expiration.