Ramakers, Indra, Van Den Houte, Maaike, Van Oudenhove, Lukas et al. · Applied psychophysiology and biofeedback · 2023 · DOI
This study looked at how people with ME/CFS, fibromyalgia, burnout, and panic disorder breathe differently compared to healthy people. Researchers measured carbon dioxide levels in participants' breath while they rested and during a breathing challenge. They found that people with chronic conditions like ME/CFS showed less active stress responses in their breathing, while those with acute stress conditions showed overactive breathing patterns.
This study provides objective physiological evidence that ME/CFS involves distinct respiratory regulation patterns that differ from acute stress disorders, potentially supporting a biological mechanism underlying ME/CFS symptoms. Understanding these differences helps distinguish ME/CFS from panic disorder and stress-related conditions, which is clinically important since patients are sometimes incorrectly diagnosed with anxiety disorders.
This study does not prove that abnormal CO₂ regulation causes ME/CFS symptoms or is the primary mechanism of disease—it only shows an association. The cross-sectional design cannot establish causality, temporal relationships, or whether respiratory dysregulation is a cause or consequence of the condition. It also does not establish whether this pattern would be useful for diagnosis or treatment.
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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