Systematic review and meta-analysis show breathing training improves pCO2 and respiratory rate in patients with panic disorder, suggesting a viable treatment option.
PURPOSE: The purpose of this systematic review and meta-analysis was to investigate effectiveness of breathing training applied to patients with panic disorder.METHODS: Across 9 qualified studies, we acquired 25 comparisons for data synthesis. Individual effect sizes (standardized mean difference: SMD) were estimated by comparing changes in following physiological and psychological variables between breathing training and control conditions: (a) partial carbon dioxide (pCO₂), (b) number of respiratory per minute (RR), (c) panic disorder severity scale (PDSS), (d) anxiety severity index (ASI).RESULTS: The random-effects model meta-analysis showed significant improvements in physiological and psychological variables after breathing training. For physiological variables, increased pCO₂ levels (SMD=0.338; SE=0.137; 95% CI=0.070 to 0.607; Z=2.473; p<.013) and decreased RR (SMD=0.342; SE=0.144; 95% CI=0.059 to 0.624; Z=2.372; p<.018) were observed. For psychological variables, breathing training significantly reduced PDSS (SMD=1.250; SE=0.347; 95% CI=0.570 to 1.930; Z=3.604; p<.001) and ASI scores (SMD=3.822; SE=1.430; 95% CI=1.019 to 6.625; Z=2.672; p<.008).CONCLUSIONS: Breathing training is considered to be a method with both physiological (pCO₂, RR) and psychological (PDSS, ASI) effectiveness and practicality for patients with panic attacks and panic disorders. Studies on the application of breathing training as a treatment method for reducing panic disorder and panic attack are insufficient. Therefore, future studies should that a large-scale, long-term study applying breathing training to patients with panic disorder and panic attack in Korea is necessary.
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Hwang et al. (2025) studied this question.