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The role of hyperventilation in panic disorder: a response to Ley (1991)

C de Ruiter1, B Garssen, H Rijken

  • 1Department of Clinical Psychology, University of Amsterdam, The Netherlands.

Behaviour Research and Therapy
|November 1, 1992
PubMed

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Physiological Control of Respiration01:23

Physiological Control of Respiration

Introduction
Breathing, a seemingly passive process, is regulated by the respiratory center in the brainstem. This center coordinates the involuntary control of respirations, which means it occurs without conscious effort, ensuring a smooth and uninterrupted pattern.
Regulation of Ventilation
The body maintains ventilation by monitoring levels of carbon dioxide (CO2), oxygen (O2), and hydrogen ion concentration (pH) in the arterial blood. Among these factors, the level of CO2 plays a crucial...
Alterations in Respiration II01:30

Alterations in Respiration II

There are numerous types of normal and abnormal respiration. Based on ventilatory movements, breathing patterns are classified as regular, deep, or shallow. Examples include Biot's breathing, Cheyne-Stokes respiration, Kussmaul's breathing, hyperventilation, and hypoventilation. Each pattern is clinically significant and aids in evaluating patients.
In Biot's breathing, the respiratory rate and depth are irregular, alternating between periods of deep gasping and apnea. Common causes include...
Chemical Factors Affecting Respiration Centers01:31

Chemical Factors Affecting Respiration Centers

Chemical factors such as changing CO2, O2, and H+ levels in arterial blood play a critical role in influencing respiration depth and rates. These variations are detected by chemoreceptors—specialized sensors located in two primary body areas. Central chemoreceptors are found throughout the brain stem, including the ventrolateral medulla, while peripheral chemoreceptors are located in the aortic arch and carotid arteries.
CO2 has a potent influence on respiration and is strictly regulated. Under...
Other Factors Affecting Respiration Centers01:17

Other Factors Affecting Respiration Centers

Breathing is primarily an involuntary activity regulated by the brainstem respiratory centers. However, it can also be consciously controlled, allowing us to hold our breath or take deeper breaths when needed. This voluntary control is facilitated by the cerebral motor cortex, which bypasses the medullary centers to stimulate the respiratory muscles directly.
However, the ability to hold one's breath voluntarily is not limitless. When the CO2 concentration in the blood reaches a critical level,...
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Hyperpnea and Hyperventilation

Hyperventilation refers to a higher-than-normal rate and depth of breathing, often associated with anxiety attacks. This excessive breathing surpasses the body's need to expel CO2, leading to a condition known as hypocapnia - an unusually low level of carbon dioxide in the blood. Hypocapnia can constrict cerebral blood vessels, reducing blood flow to the brain, which may result in dizziness or fainting. Early signs include tingling and muscle spasms in the hands and face, caused by falling...
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Panic Disorder

Panic disorder is an anxiety disorder characterized by recurrent and sudden minutes-long episodes of intense fear, known as panic attacks. These attacks may feel like heart attacks and often happen without warning or a specific cause. They can include symptoms such as rapid heart rate, shortness of breath, chest pain, trembling, sweating, dizziness, and a sense of helplessness. During a panic attack, individuals may feel as though they are experiencing a heart attack or are in a...