Balancing Unbalanced Breathing: The Clinical Use of Capnographic Biofeedback
Dysfunctional breathing, primarily in the form of overbreathing or hyperventilation, has been reported to play a major role for some individuals with anxiety and panic disorders. This is due to the decrease in carbon dioxide, a state called hypocapnia, which results from hyperventilation. The author reviews the physiological effects of hypocapnia and describes how carbon dioxide levels are measured with capnography. In addition, she introduces the use of capnography as a form of biofeedback and outlines ways to incorporate capnography into a clinical setting. Capnographic biofeedback enables individuals to become aware of the impact dysfunctional breathing has on their symptoms and assists them in learning more balanced, healthy breathing patterns. Use of this type of biofeedback training has been found to decrease panic symptoms and may be useful in improving physiological functioning in other medical and psychiatric disorders as well.

Illustration showing the phases of the capnography waveform (Brandt, 2010).

Example of capnography waveform during hyperventilation compared with normal (Brandt, 2010).

Andrea Meckley
Contributor Notes