Respiratory dysregulation in anxiety, functional cardiac, and pain disorders - Assessment, phenomenology, and treatment

Respiration is a complex physiological system affecting a variety of physic al processes that can act as a critical I ink between mind and body. This r eview discusses the evidence for dysregulated breathing playing a role in t hree clinical syndromes: panic disorder, functional cardiac disorder, and c hronic pain. Recent technological advances allowing the ambulatory assessme nt of endtidal partial pressure Of CO2 (PCO2) and respiratory patterns have opened up new avenues for investigation and treatment of these disorders. The latest evidence from laboratories indicates that subtle disturbances of breathing, such as tidal volume instability and sighing, contribute to the chronic hypocapnia often found in panic patients. Hypocapnia is also commo n in functional cardiac and chronic pain disorders, and studies indicate th at it mediates some of their symptomatology. Consistent with the role of re spiratory dysregulation in these disorders, initial evidence indicates effi cacy of respiration-focused treatment.