Fear of suffocation in patients hospitalized with chronic respiratory disease: Results from a flashmob trial

Background: In patients suffering from chronic respiratory diseases, the prevalence of comorbid anxiety disorder is higher compared to controls. A specific form of anxiety in respiratory patients is fear of suffocation. This fear has been explored in qualitative studies on the experience of dyspnea in chronic obstructive pulmonary disease (COPD) and interstitial lung disease. However, its prevalence in respiratory patients is unknown. Aim: We aimed to assess the prevalence of fear of suffocation among patients with respiratory disease. Design: Flashmob research (prospective data collection by a large group of researchers within a short time frame). Participants were asked if they had ever been afraid of suffocation in relation to their disease, and whether they had discussed this fear with their healthcare provider. Setting/participants: Thirty hospitals across the Netherlands included hospitalized adults diagnosed with COPD, asthma, lung cancer, or interstitial lung disease on a single day. Exclusion criteria were language barriers, impaired cognition, or if the staff deemed the interview too stressful at that time. Results: Out of 246 eligible patients, 163 (66%) participated. Of these patients, 58% had COPD, 17% asthma, 4% interstitial lung disease, and 21% had lung cancer. Most patients had experienced fear of suffocation (57%), with the highest prevalence among those with COPD (63%) and asthma (64%). Notably, only 38% of patients who experienced this fear had discussed this with a healthcare provider. Conclusions: This study underscores the high prevalence of fear of suffocation among patients with respiratory disease and highlights the potential value of clinician awareness.