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Capnometry Guided Respiratory Intervention (CGRI) is a digital therapeutic effective in panic disorder that measures and displays end-tidal carbon dioxide (EtCO<jats:sub>2<\/jats:sub>) and respiratory rate (RR) in real-time within a structured breathing protocol and may have benefit in PTSD by moderating breathing and EtCO<jats:sub>2<\/jats:sub> levels. We conducted a single-arm study of a CGRI system, Freespira\u00ae, to treat symptoms of PTSD. Participants with PTSD (n\u2009=\u200955) were treated for four weeks with twice-daily, 17-min at-home CGRI sessions using a sensor and tablet with pre-loaded software. PTSD and associated symptoms were assessed at baseline, end-of treatment, 2-months and 6-months post-treatment. Primary efficacy outcome was 50% of participants having \u2265\u20096-point decrease in Clinician Administered PTSD Scale (CAPS-5) score at 2-month follow up. Tolerability, usability, safety, adherence and patient satisfaction were assessed. CGRI was well tolerated, with 88% [95% CI 74\u201396%] having \u2265\u20096-point decrease in CAPS-5 scores at 2-months post-treatment follow up. Mean CAPS-5 scores decreased from 49.5 [s.d.\u2009=\u20099.2] at baseline to 27.1 [s.d.\u2009=\u200917.8] at 2-months post-treatment follow up. Respiratory rate decreased and EtCO<jats:sub>2<\/jats:sub> levels increased. Associated mental and physical health symptoms also improved. This CGRI intervention was safe, acceptable, and well-tolerated in improving symptoms in this study in PTSD. Further study against an appropriate comparator is warranted.<\/jats:p>\n          <jats:p><jats:italic>Trial registration<\/jats:italic> Clinicaltrials.gov NCT#03039231.<\/jats:p>","DOI":"10.1007\/s10484-021-09521-3","type":"journal-article","created":{"date-parts":[[2021,10,16]],"date-time":"2021-10-16T23:03:32Z","timestamp":1634425412000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Investigation of a Capnometry Guided Respiratory Intervention in the Treatment of Posttraumatic Stress Disorder"],"prefix":"10.1007","clinical-trial-number":[{"clinical-trial-number":"nct03039231","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0353-7535","authenticated-orcid":false,"given":"Michael J.","family":"Ostacher","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eileen","family":"Fischer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellie R.","family":"Bowen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihun","family":"Lyu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denishia J.","family":"Robbins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trisha","family":"Suppes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,9,1]]},"reference":[{"key":"9521_CR1","doi-asserted-by":"publisher","unstructured":"American Psychiatric Association. 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In the past 36\u00a0months he has received personal fees for advisory board membership for Alkermes, Janssen (Johnson & Johnson), and Sage Therapeutics. Dr. Suppes, in the past 36\u00a0months, has received grants from Merck, National Institute on Drug Abuse, National Institute of Health, VA Cooperative Studies Program, and VA OR&D PRIME Care, Palo Alto Health Sciences Inc., Stanley Medical Research Institute, Pathways Genomics; consulting fees from Allergan, Inc., Intracellular Therapies, Sunovion Pharmaceuticals, Inc., and Impel NeuroPharma, Inc.; honoraria from CME Institute (Physicians Postgraduate Press, Inc.) and CMEology; and royalties from American Psychiatric Association Publishing, Hogrefe Publishing, Jones and Bartlett, and Wolters Kluwer Health (UpToDate). Ms. Fisher, Ms. Bowen, Mr. Lyu, and Ms. Robbins have no conflicts of interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed Consent"}}]}}