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Am J Psychiatry 1995; 152:1168-1173
Copyright © 1995 by American Psychiatric Association
Irregular breathing during sleep in patients with panic disorder
MB Stein, TW Millar, DK Larsen and MH Kryger
Department of Psychiatry, University of Manitoba, Winnipeg, Canada.
OBJECTIVE: The authors examined the nocturnal breathing patterns of
patients with panic disorder to determine whether these individuals had
respiratory irregularities at a time when anxiety was not manifest. METHOD:
Respiratory polysomnography was conducted on 14 medication-free patients
with panic disorder and 14 healthy comparison subjects. Semiautomated
indices of ventilatory variability were calculated for representative
3-minute, artifact-free sleep samples, and manually scored indices of
irregular breathing were rated (blind to diagnosis) for the entire last 2
nights of sleep. RESULTS: Patients with panic disorder had evidence of
abnormal sleep breathing as indicated by increased irregularity in tidal
volume during REM and an increased rate of microapneas (i.e., brief
[5-10-second] pauses in breathing). A subgroup of patients (including some
with recent sleep panic attacks) had indices of subtle disorders in
breathing during sleep that were above the 95th percentile for the
comparison subjects. CONCLUSIONS: These findings extend the observations in
the awake state that patients with panic disorder breathe more irregularly
than healthy comparison subjects. The irregularities may be attributable to
altered brainstem sensitivity to CO2 or to other as yet unexplained
factors. A possible relationship between irregular nocturnal breathing and
sleep panic attacks is discussed.
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