Naschitz, Jochanan E, Mussafia-Priselac, Renata, Kovalev, Yulia et al. · The American journal of the medical sciences · 2006 · DOI
This study looked at whether people with ME/CFS, fibromyalgia, and dizziness breathe too fast when standing up, causing them to exhale too much carbon dioxide (a condition called hypocapnia). Researchers tested 585 people using a tilt table that slowly raises the upper body while measuring breathing patterns. They found that 9-27% of people with these conditions showed abnormal breathing on the tilt test, compared to 0-2% of healthy controls, suggesting this may be a real but not universal feature of these illnesses.
ME/CFS patients commonly report breathing difficulties and dizziness during postural changes; this study provides objective evidence that abnormal breathing patterns occur in a meaningful subset of these patients. Identifying hypocapnia could lead to targeted interventions (e.g., breathing retraining) and suggests capnography should be incorporated into clinical evaluation protocols for ME/CFS and related conditions.
This study does not establish that hypocapnia *causes* ME/CFS symptoms or is required for disease pathogenesis—it only shows an association during tilt testing. The cross-sectional design cannot determine whether hyperventilation is a primary feature or a secondary response to other physiological abnormalities. The study also does not rule out that hypocapnia is an epiphenomenon in some patient subgroups, as the authors themselves suggest.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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