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Effects of Breathing Training on Voluntary Hypo- and Hyperventilation in Patients with Panic Disorder and Episodic Anxiety

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Abstract

Anxiety disorders are associated with respiratory abnormalities. Breathing training (BT) aimed at reversing these abnormalities may also alter the anxiogenic effects of biological challenges. Forty-five Panic Disorder (PD) patients, 39 Episodic Anxiety patients, and 20 non-anxious controls underwent voluntary hypoventilation and hyperventilation tests twice while psychophysiological measures were recorded. Patients were randomized to one of two BT therapies (Lowering vs. Raising pCO2) or to a waitlist. Before treatment panic patients had higher respiration rates and more tidal volume instability and sighing at rest than did non-anxious controls. After the Lowering therapy, patients had lower pCO2 during testing. However, neither reactivity nor recovery to either test differed between patients and controls, or were affected by treatment. Although the two treatments had their intended opposite effects on baseline pCO2, other physiological measures were not affected. We conclude that baseline respiratory abnormalities are somewhat specific to PD, but that previously reported greater reactivity and slower recovery to respiratory challenges may be absent.

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Notes

  1. In the following, we will refer to the different groups as “Panic”, “Episodic”, and “Controls”.

  2. In the following, we will refer to this group as “Raise”.

  3. In the following, we will refer to this group as “Lower”.

  4. Subjects who reacted contrary to the instruction of the initial VHO, i.e., who decreased rather than increased their pCO2, were also excluded from the analyses of the psychophysiological data.

  5. More detailed information can be obtained from the first author.

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Acknowledgments

This research was supported by grants to Dr. Roth as principal investigator from the National Institute of Health (RO1 MH-66953) and the Department of Veterans Affairs (ROT-42825).

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA

    Eileen Wollburg, Walton T. Roth & Sunyoung Kim

  2. Veterans Affairs Health Care System, Palo Alto, CA, USA

    Eileen Wollburg, Walton T. Roth & Sunyoung Kim

  3. Department of Psychology, Dresden University of Technology, Dresden, Germany

    Eileen Wollburg

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  1. Eileen Wollburg
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Correspondence to Eileen Wollburg.

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Wollburg, E., Roth, W.T. & Kim, S. Effects of Breathing Training on Voluntary Hypo- and Hyperventilation in Patients with Panic Disorder and Episodic Anxiety. Appl Psychophysiol Biofeedback 36, 81–91 (2011). https://doi.org/10.1007/s10484-011-9150-5

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