Out-of-the-blue panic attacks aren't without warning — body sends signals for hour before

Research by SMU Psychology Professor Alicia E. Meuret has discovered waves of significant physiological instability for at least 60 minutes before patients' awareness of the panic attacks.

A study based on 24-hour monitoring of panic sufferers while they went about their daily activities captured panic attacks as they happened and discovered waves of significant physiological instability for at least 60 minutes before patients' awareness of the panic attacks, said psychologist Alicia E. Meuret at Southern Methodist University in Dallas.

In a rare study in which patients were monitored around-the-clock, portable recorders captured changes in respiration, heart rate and other bodily functions, said Meuret, lead researcher on the study.

The new findings suggest sufferers of panic attacks may be highly sensitive to — but unaware of — an accumulating pattern of subtle physiological instabilities that occur before an attack, Meuret said. Monitoring data also showed patients were hyperventilating on a chronic basis.

"The results were just amazing," Meuret said. "We found that in this hour preceding naturally occurring panic attacks, there was a lot of physiological instability. These significant physiological instabilities were not present during other times when the patient wasn't about to have a panic attack."

It is notable that patients reported the attacks as unexpected, lacking awareness of either the coming attack or their changing physiology.

"The changes don't seem to enter the patient's awareness," Meuret said. "What they report is what happens at the end of the 60 minutes — that they're having an out-of-the blue panic attack with a lot of intense physical sensations. We had expected the majority of the physiological activation would occur during and following the onset of the panic attack. But what we actually found was very little additional physiological change at that time."

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