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Paper Bag Rebreathing

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Paper bag rebreathing has long been known to help lessen some of the panic attack symptoms and is used widely by sufferers, however there is a lot of controversy surrounding this technique, so much so that many people become anxious about using this method. This in itself is self defeating, so we decided to find out the facts in order to help you better understand the pro’s and con’s.

At the foot of this page are a number of links to other pages in this site, which contain abstracts from some of the studies conducted into paper bag rebreathing in more depth.

As part of the mechanism creating panic attack symptoms; hyperventilation in particular, a sharp fall in blood carbon dioxide levels occurs. The theory behind rebreathing your exhaled air through a paper bag is that you are able to reabsorb the carbon dioxide back into the bloodstream that you would otherwise have lost in breathing out.

The controversial aspect in all this is that the academic community has made a number of contradictory statements about the chemistry behind this technique and in the process created confusion amongst those suffering panic attack symptoms.

The main theory is that depleted carbon dioxide in the blood stream alters the bloods pH, making it more alkaline, moving towards a state known as alkalosis. Higher alkalinity of the blood, can give rise to dizziness, tunnel vision, fainting and some of the other panic attack symptoms. Paper bag rebreathing reverses this carbon dioxide deficiency and so alleviates this situation.

Some scientists have however stated that during alkalosis, a situation known as alkalotic oxygen clamping occurs. The theory here is that the blood holds on tighter to its oxygen resulting in the body’s cells becoming oxygen starved, thus causing the other panic attack symptoms to occur. Rebreathing into a paper bag, limits the amount of fresh oxygen inhaled (about 16% in rebreathed air, instead of the usual 21% found in fresh air), making the situation worse.

A third argument is that as long as paper bag rebreathing is done promptly, alkalosis never really occurs and so alkalotic oxygen clamping never becomes an issue. And that as the bloodstream is nearly always near 100 % saturated with oxygen, rebreathing lower levels of oxygen should not be an issue.

Perhaps the most important concern with paper bag rebreathing however is that hyperventilation may be caused by a medical condition other than panic attacks. The fact that some of these are life threatening makes paper bag rebreathing dangerous in some circumstances, heart attacks, head injuries or drug overdoses to name a few.

Compounding things some studies have linked high blood carbon dioxide levels with panic attacks, stating that paper bag rebreathing can actually trigger the panic attack symptoms!

One of the challenges with science and research is that until absolute concrete and repeatable evidence is obtained, things remain unproven and as such speculative. This of course gives rise to uncertainty and in this case anxiety from those who need a bed rock upon which to rely.

Part of the problem lies in the fact that it is very difficult to standardize any tests. Everybody is different, we have different metabolic rates, different efficiencies at doing different things and we also all think differently and quantum physics is now showing this to be critically important in everything we do, as it actually affects the observed outcome of any test.

Research by the Limburg University in Holland, bears this out and suggests that the mechanics of paper bag rebreathing are sound, and it is of critical importance that you also believe that paper bag rebreathing will help you, if you are to receive maximum benefit (see here).

The advice really as with so many other things is ask your doctor first! Paper bag rebreathing certainly works, but you must use caution and only do it if your doctor says its OK.

Links to Abstracts

Hypoxic hazards of traditional paper bag rebreathing in hyperventilating patients
Rebreathing to cope with hyperventilation: experimental tests of the paper bag method
Oxygen desaturation following voluntary hyperventilation in normal subjects
Carbon Dioxide Inhalation Induces Dose-Dependent and Age-Related Negative Affectivity


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