The Implications of the Diving Response in Reducing Panic Symptoms.

Peter Kyriakoulis,Antonio Egidio Nardi,Rafael C Freire,Michael Kyrios,Mark Schier

doi:10.3389/fpsyt.2021.784884

Abstract

Increased CO2 sensitivity is common in panic disorder (PD) patients. Free divers who are known for their exceptional breathing control have lower CO2 sensitivity due to training effects. This study aimed to investigate the immediate effects of cold facial immersion (CFI), breath holding and CO2 challenges on panic symptoms. Healthy participants and patients with PD were subjected to four experimental conditions in a randomly assigned order. The four conditions were (a) breath-holding (BH), (b) CFI for 30 s, (c) CO2 challenge, and (d) CO2 challenge followed by CFI. Participants completed a battery of psychological measures, and physiological data (heart rate and respiration rate) were collected following each experimental condition. Participants with PD were unable to hold their breath for as long as normal controls; however, this finding was not significant, potentially due to a small sample size. Significant reductions in both physiological and cognitive symptoms of panic were noted in the clinical group following the CFI task. As hypothesized, the CFI task exerted demonstrable anxiolytic effects in the clinical group in this study by reducing heart rate significantly and lessening self-reported symptoms of anxiety and panic. This outcome demonstrates the promise of the CFI task for clinical applications.

Highlights

According to DSM-5, panic disorder (PD) is a severe and persistent anxiety disorder characterized by spontaneous and recurrent panic attacks (PAs) [1, 2]
The current study aimed to investigate the immediate effects of breath holding and CO2 challenge on panic symptoms based on Klein’s theory of false suffocation alarm, the principal findings of the current investigation do not support Klein’s false suffocation alarm theory, which suggests that the brain’s suffocation detector incorrectly signals a lack of useful air and increases vulnerability to false suffocation alarms and PAs
The study findings indicate that there were no significant differences in breath-hold durations among the clinical and control participants

Summary

Introduction

According to DSM-5, panic disorder (PD) is a severe and persistent anxiety disorder characterized by spontaneous and recurrent panic attacks (PAs) [1, 2]. CO2 hypersensitivity theory proposes that PD sufferers have a lower physiological threshold for detecting CO2 levels [5] It is proposed the existence of an evolved suffocation alarm system that helps the brain monitor useful air, consistent with the lowered threshold for detecting CO2 levels [6]. According to this model, PAs occur when the brain mistakenly detects a lack of useful air (increased CO2), triggering the suffocation alarm system. PAs occur when the brain mistakenly detects a lack of useful air (increased CO2), triggering the suffocation alarm system This maladaptive response makes PD sufferers vulnerable to “false suffocation alarms,” PAs

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