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Hyperventilation and panic attacks

B Garssen¹, M Buikhuisen, R van Dyck

¹Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, The Netherlands.

The American Journal of Psychiatry

|April 1, 1996

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Hyperventilation is not a primary cause of panic attacks. This study found minimal evidence of hyperventilation during panic episodes in panic disorder patients, challenging previous theories.

Area of Science:

Psychiatry
Psychophysiology

Background:

Hyperventilation has been suggested as a key mechanism in panic attack symptom generation.
Previous research indicated voluntary hyperventilation could induce panic symptoms in patients with panic disorder.

Purpose of the Study:

To investigate the role of hyperventilation in panic disorder under naturalistic conditions.
To directly assess the co-occurrence of panic symptoms and hyperventilation using ambulatory monitoring.

Main Methods:

Ambulatory transcutaneous arterial carbon dioxide pressure (PCO2) was monitored over extended periods in 28 panic disorder patients.
Patients self-reported panic attacks by pressing a button during fear-provoking situations.

Main Results:

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A significant decrease in PCO2, indicative of hyperventilation, was observed in only one of 24 panic attacks lasting at least 3 minutes.

The observed hyperventilation during panic attacks was minimal and not substantial.

Conclusions:

The findings do not support the hypothesis that hyperventilation is a significant symptom-producing mechanism in panic disorder.
The theory linking hyperventilation as a primary driver of panic attacks may be dismissed based on this evidence.