Respiratory biofeedback-assisted therapy in panic disorder

The authors describe a new methodologically improved behavioral treatment f or panic patients using respiratory biofeedback from a handheld capnometry device. The treatment rationale is based on the assumption that sustained h ypocapnia resulting from hyperventilation is a key mechanism in the product ion and maintenance of panic. The brief 4-week biofeedback therapy is aimed at voluntarily increasing self-monitored end-tidal partial pressure of car bon dioxide (PCO2) and reducing respiratory rate and instability through br eathing exercises in patients' environment. Preliminary results from 4 pati ents indicate that the therapy was successful in reducing panic symptoms an d other psychological characteristics associated with panic disorder. Physi ological data obtained from home training, 24-hour ambulatory monitoring pr etherapy and posttherapy, and laboratory assessment at follow-up indicate t hat patients started out with low resting PCO2 levels, increased those leve ls during therapy, and maintained those levels at posttherapy and/or follow -up. Partial dissociation between PCO2 and respiratory rate questions wheth er respiratory rate should be the main focus of breathing training in panic disorder.