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Respiratory Dysregulation and Breathing Training in Anxious Outpatients

This study has been completed.
Information provided by (Responsible Party):
VA Office of Research and Development Identifier:
First received: April 14, 2005
Last updated: January 7, 2015
Last verified: January 2015
This study will explore respiratory dysregulation in anxious outpatients and examine the effect of breathing training with biofeedback for those anxious patients.

Condition Intervention
Behavioral: Breathing Training-Raise CO2
Behavioral: Breathing Training- Lower CO2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Respiratory Dysregulation and Breathing Training in Anxious Outpatients

Resource links provided by NLM:

Further study details as provided by VA Office of Research and Development:

Primary Outcome Measures:
  • Episodic Anxiety Scale [ Time Frame: 1 month ]
    Episodic Anxiety Scale (EAS) is a modification of the Panic Disorder Severity Scale (Shear et al., 1997) that includes 2 additional questions regarding acute anxiety episodes that may not meet full criteria for a panic attack. The EAS consists of 9 questions, each ranging from 0 (none) to 4 (worst possible). The EAS total score is the sum of all 9 items, such that the minimum total score = 0 (no anxiety symptoms) and maximum total score = 36 (worst possible anxiety symptoms).

Enrollment: 92
Study Start Date: April 2005
Study Completion Date: September 2010
Primary Completion Date: December 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Raise CO2
Raise CO2 - biofeedback-assisted breathing training to raise baseline pCO2
Behavioral: Breathing Training-Raise CO2
while breathing 9 breaths per minute, patients are instructed to raise CO2
Active Comparator: Lower CO2
Lower CO2 - biofeedback-assisted breathing training to lower baseline pCO2
Behavioral: Breathing Training- Lower CO2
while breathing 9 breaths per minute, patients are instructed to lower CO2
No Intervention: Waitlist
Waitlist - treatment as usual

Detailed Description:
In clinic testing and outside the clinic testing, we will assess the prevalence of respiratory dysregulation in a sample of 60 non-psychotic, not currently alcohol or drug abusing veteran outpatients from our MHC (Mental Hygiene Clinic) who experience episodic anxiety but who do not qualify and have never qualified for the diagnosis of PD (panic disorder). These patients will be compared to 30 patients who are not clinically anxious. Of these 60 anxious patients, 30 will be randomly assigned to a 4-week course of breathing training assisted by feedback of end-tidal pCO2 levels as an augmentation of their current treatment. They will be compared to 30 who simply will continue with their current treatment (TAU). The breathing training group will receive clinical and physiological assessments immediately before the treatment period, four weeks after the end of the treatment period, and at a 4-month follow-up. The TAU group will be assessed three times at equivalent intervals, and if they wish, may undergo breathing training after the third assessment. Treatment will take place mainly in the first two years, giving us adequate time for follow-up and data analysis. We expect that this therapy will be especially effective for treating anxiety in the patients with substantial respiratory dysregulation.

Ages Eligible for Study:   Child, Adult, Senior
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • Patients must be rated 2 or more on both Q1 and Q3, but they must not meet the full criteria for PD as determined by the Anxiety Disorders Interview Schedule for DSM-IV-Lifetime Version (ADIS).
  • In addition, they must be clinically stable enough that changes in the patients' anxiety levels can be attributed to the breathing training rather than to other new treatment initiatives during the training and 1-month evaluation periods or to spontaneous fluctuations in anxiety levels. Thus, potential participants taking SSRIs or other antidepressants, or benzodiazepines have to have been on a stable dose of these medicines for at least the previous two months.

Exclusion Criteria:

  • Potential participants taking short-acting benzodiazepines such as alprazolam in excess of 2.0 mg/day or the equivalent on any day in the past month are excluded, because improvement might show up only in terms of reduction of medication dosage and not on the evaluation measures planned.
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Please refer to this study by its identifier: NCT00108277

United States, California
VA Palo Alto Health Care System
Palo Alto, California, United States, 94304-1290
Sponsors and Collaborators
VA Office of Research and Development
Principal Investigator: Walton Roth, MD VA Palo Alto Health Care System
  More Information

Responsible Party: VA Office of Research and Development Identifier: NCT00108277     History of Changes
Other Study ID Numbers: MHBA-028-04S
Study First Received: April 14, 2005
Results First Received: December 16, 2014
Last Updated: January 7, 2015

Keywords provided by VA Office of Research and Development:
Breathing Training
Respiratory Dysregulation

Additional relevant MeSH terms:
Respiratory Aspiration
Respiration Disorders
Respiratory Tract Diseases
Pathologic Processes processed this record on May 25, 2017