Klein · Archives of general psychiatry 1993 · theoretical review · n=?

False suffocation alarms, spontaneous panics, and related conditions. An integrative hypothesis.

Cited 1139 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Mechanism-based reasoning and theoretical review with no new empirical data

PubMed 8466392 · doi:10.1001/archpsyc.1993.01820160076009 · record verified 2026-08-26

What was done

The author formulated a theoretical model proposing that panic disorder results from a misfiring physiological suffocation alarm system. The hypothesis was conceptually evaluated by comparing panic disorder against conditions such as Ondine's curse, symptom profiles during respiratory challenge studies, sighing/yawning behaviors, nocturnal and relaxation-induced panic, pregnancy, pulmonary disease, and separation anxiety.

What was found

The abstract presents a conceptual hypothesis rather than experimental or statistical results and contains no quantitative data. It posits that a deranged suffocation monitor provokes sudden respiratory distress, brief hyperventilation, acute panic, and an urge to flee.

Why it matters

This paper introduced the suffocation false alarm theory of panic disorder, a major conceptual framework linking carbon dioxide hypersensitivity and respiratory abnormalities to the pathophysiology of spontaneous panic attacks.

Limits

The abstract describes a non-systematic theoretical review and narrative synthesis without primary clinical data, quantitative outcomes, or statistical testing. The proposed physiological mechanisms rely on hypothesis and indirect clinical parallels rather than direct experimental validation.

Cited by