Breathing Regulation Training for Individuals With Panic Disorder
Condition: Panic Disorder
MeSH terms: Panic Disorder
Study type: Interventional

Summary: 
      This study will compare two different breathing regulation techniques to determine which is
      more effective in reducing the rate of panic attacks in people with panic disorder.
    

Detailed description: 
      PD is a serious condition characterized by episodes of rapid heart rate, difficulty
      breathing, and other symptoms of fear. Explanations for panic attacks have been proposed in
      two theories: suffocation alarm theory and hyperventilation theory. The suffocation alarm
      theory claims that panic attacks are due to a "suffocation monitor" in the brain, erroneously
      signaling a lack of useful air. The hyperventilation theory suggests that stressful events
      cause people to slightly hyperventilate; some people have panic attacks as a result of their
      overreaction to the dizziness and lightheadedness they feel from hyperventilation. Both
      theories note the role of carbon dioxide (CO2) in panic attacks; they suggest that rising CO2
      levels in arterial blood act as a panic stimulus. This study will compare two types of
      breathing regulation techniques based on the panic attack theories to determine which is more
      effective in reducing panic symptoms in people with PD.

      This study will last 4 weeks and will include both people with PD and those without the
      condition. Participants will be randomly assigned to one of three groups: raise-CO2
      breathing, lower-CO2 breathing, or a control group. Participants in both the raise-CO2 and
      lower-CO2 breathing groups will have five sessions of training in which they will learn
      specific breathing techniques. Participants in the raise-CO2 group will be taught techniques
      to recover from hyperventilation faster; participants in the lower-CO2 group will be taught
      techniques to reach hyperventilation levels, then switch to breathing techniques that reduce
      hyperventilation symptoms. Participants in the control group will not be taught any breathing
      techniques but will be included in all assessments.

      Participants will be assessed at study entry, during each breathing training session, and at
      Months 1 and 6 after the study. During each assessment, questionnaires and self-report scales
      will be used to measure cognitive, psychological, and physiological changes related to
      participants' breathing.
    

Intervention name(s): Raise-CO2 breathing regulation training; Lower-CO2 breathing regulation training; Control
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Reverse hyperventilation (defined by low arterial CO2) is often characteristic of individuals with panic disorder. Participants will be randomly assigned to one of three groups: raise-CO2 breathing, lower-CO2 breathing, or a control group. Participants in the raise-CO2 group will be taught techniques to recover from hyperventilation faster.; According to the false suffocation alarm theory, anxiety is experienced when an overly sensitive hypothalamic mechanism is triggered by rising pCO2. Participants in the lower-CO2 group will be taught techniques to reach hyperventilation levels, then switch to breathing techniques that reduce hyperventilation symptoms.; Participants in the control group will not be taught any breathing techniques but will be included in all assessments.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Hyperventilation; Breathing Exercises; Carbon Dioxide; Panic Attack