Breathing retraining: effect on anxiety & depression scores in behavioural breathlessness

Thirty-six patients underwent assessment of behavioural

breathlessness which included monitoring of breathing patterns

and end tidal CO2 concentration and completion of

questionnaires relating to hyperventilation (HV), anxiety and

depression. Twenty-two patients had a positive assessment and

underwent breathing retraining. Assessments were repeated

immediately after re-training and 2 months later. Ten of the

patients (Group A) had behavioural breathlessness either as

the primary problem or secondary to an established clinical

condition, and twelve (Group B) in association with chronic

fatigue. Before re-training, resting end-tidal PCO2 was

significantly lower in Group A than Group B (p < 0.05), but
there was no significant difference in mean scores for

HV-related symptoms, anxiety or depression. Following

breathing retraining, both groups showed improvements in

breathing patterns, end tidal CO2 levels and scores for

HV-related symptoms which were sustained. In Group A the mean

score for anxiety decreased (p < 0.01) and the score for
depression was significantly lower than in Group B (p < 0.05).
Although mean scores for anxiety and depression in Group B did

not change significantly, some individuals in the group did

show sustained improvement. There was no improvement in

symptoms associated with chronic fatigue in Group B.

In behavioural breathlessness, breathing retraining is of

benefit, not only in restoring more normal patterns of

breathing but also in reducing anxiety, particularly in

patients without the complication of chronic fatigue.

Tweeddale PM, Rowbottom I, McHardy GJ

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