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The Ondine Curse, False Suffocation Alarms, Trait-State Suffocation Fear, and Dyspnea-Suffocation Fear in Panic Attacks

Ronald Ley, PhD
Arch Gen Psychiatry. 1997;54(7):677. doi:10.1001/archpsyc.1997.01830190105011.
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In a reply to my criticisms of the false suffocationalarm theory of panic attacks,1 Klein2 stated that "Ley inexplicably ignores my discussion of Ondine's Curse." The explanation for this omission lies in my attempt to keep my letter within the 750-word limit recommended by the editor in his "Instructions for Authors," a limit that would have been grossly exceeded if I had used the same 600 words used in an earlier explanation3 of why the Ondine curse does not prove the existence of a suffocation alarm and why the curse is not the "pharmacological converse of panic disorders."4

My criticism might best be presented in the format of 2 questions. If the Ondine curse (the arrestation of breathing during sleep) proves that sleep free of suffocation depends on the existence of a suffocation alarm (presumably true alarms activated by the buildup of carbon dioxide) and if

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