Respiratory patterns in panic disorder reviewed: a focus on biological challenge tests
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Updated: Jun 22, 2026

Investigation into Deep Breathing through Measurement of Ventilatory Parameters and Observation of Breathing Patterns
Published on: September 16, 2019
V Niccolai1, M A van Duinen, E J Griez
1School of Mental Health and Neurosciences, Maastricht University, 6200 AB, Maastricht, the Netherlands.
Objective:
To provide a systematic review of studies investigating respiration in PD and comments on relative inconsistencies.
Method:
A Medline search of controlled studies focusing on pCO(2), respiratory rate, tidal volume, and minute volume in PD patients was conducted for baseline/resting condition, challenge, and recovery phase. Respiratory variability and comparisons between panickers and non-panickers were also examined.
Results:
Lower pCO(2) levels in PD subjects are a consistent finding during the baseline/resting condition, the challenge, and recovery phases. Tidal volume and minute volume are increased in PD subjects relative to controls during the baseline/resting condition. However, the most robust finding is a higher than normal respiratory variability, which appears to be a promising factor for the identification of respiratory etiopathological pathways in PD.
Conclusion:
Respiratory variability might be a candidate for a biological marker of PD: an abnormal breathing pattern as found in panic disorder (PD) patients compared with controls might indicate instability of the respiratory homeostasis.
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