Slow breathing for reducing stress: The effect of extending exhale

Birdee, Gurjeet S.; Nelson, Katrina; Wallston, Ken; Naan, Hui; Diedrich, André; Paranjape, Sachin Y.; Abraham, Robert L.; Gamboa, Alfredo

doi:10.1016/j.ctim.2023.102937

Cited by 4 publications

(5 citation statements)

References 38 publications

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“…Even though a variety of pharmacological treatments exist to reduce these negative stressors, they are often ineffective, require regular monitoring and dose modification by a specialist, and have significant harmful effects and economic burdens. By contrast, psychotherapeutic treatments like meditation and deep breathing exercises have gained popularity as healthy, simple, cheap, and efficient lifestyle changes to counter anxiety and depression 12,37 …”

Section: Discussionmentioning

confidence: 99%

“…By contrast, psychotherapeutic treatments like meditation and deep breathing exercises have gained popularity as healthy, simple, cheap, and efficient lifestyle changes to counter anxiety and depression. 12,37 Stress is not only a result but also a possible risk factor/ cause of glaucoma. Acute and chronic stress has been shown to increase IOP.…”

Section: Effect On Stressmentioning

confidence: 99%

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Effect of “365 Breathing Technique” on Intraocular Pressure and Autonomic Functions in Patients With Glaucoma: A Randomized Controlled Trial

Dada,

Gwal,

Mahalingam

et al. 2024

Journal of Glaucoma

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Precis: Primary open angle glaucoma patients were advised to follow ‘365 breathing technique’ for 6 weeks in addition to their pharmacological glaucoma treatment. It helped to reduce IOP, stress biomarker- cortisol and improve autonomic dysfunction. Purpose: To study the effect of ‘365 breathing technique’ on intraocular pressure(IOP), autonomic functions and stress biomarkers in patients with primary open angle glaucoma(POAG). Methods: In this randomised, controlled, interventional trial: after randomisation, forty subjects in intervention group followed “365 breathing” ( 3times a day, breathing rate: 6cycles/min for 5 min) in addition to their pharmacological glaucoma treatment and forty subjects in control group continued only with their pharmacological glaucoma treatment. IOP, serum cortisol, heart rate variability(HRV) and heart rate response to deep breathing test(DBT) were recorded at pre-intervention and 6weeks post-intervention. Results: The mean IOP, serum cortisol, parameters of HRV test and DBT were comparable between two groups at baseline. At 6weeks follow-up, in the intervention group: mean IOP was significantly lower(16.09±2.24 mmHg vs. 18.38±1.58 mmHg, P-value=0.03) and serum cortisol was significantly lower(13.20±3.11 mcg/dl vs. 14.95±2.60 mcg/dl, P=0.038) compared to control group. In the HRV test Time domain analysis showed a significant difference in root mean square of successive difference between RR interval value between both groups at 6weeks(P=0.015) pointing towards higher post-intervention parasympathetic activation in intervention group. In frequency domain analysis(HRV-test), ratio of low-frequency component to high-frequency component was significantly lower in intervention group at 6weeks(1.65 vs. 1.79, P-value=0.019) indicating a shift in sympatho-vagal balance towards greater vagal modulation. There was a significant increase in delta heart rate(P-value=0.019) and Expiratory:Inspiratory ratio(P-value=0.011) in intervention group at 6weeks when compared to baseline values, indicating improved parasympathetic reactivity to DBT. Conclusion: 365 breathing technique can reduce IOP, serum cortisol and improve autonomic dysfunction in glaucoma patients.

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Section: Discussionmentioning

confidence: 99%

Section: Effect On Stressmentioning

confidence: 99%

Effect of “365 Breathing Technique” on Intraocular Pressure and Autonomic Functions in Patients With Glaucoma: A Randomized Controlled Trial

Dada,

Gwal,

Mahalingam

et al. 2024

Journal of Glaucoma

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“…Subjects were studied in the morning after at least 30 minutes of quiet rest in the supine position, to allow for familiarization with the study procedures and the laboratory environment. Autonomic function was assessed by standardized autonomic testing as previously described 13,14 . This included a standing stress test, respiratory sinus arrhythmia, and Valsalva maneuver.…”

Section: Page 4/16mentioning

confidence: 99%

“…This is especially true in early-stage hypertension before secondary end-organ damage 13 . We have previously conducted a clinical trial among healthy adults (n = 99) who performed slow breathing exercises for 12 weeks to examine effects on psychological and physiological stress 14 . We observed signi cant changes in psychological stress as measured by PROMIS-Anxiety, but non-signi cant changes physiological stress measured as heart rate variability.…”

Section: Introductionmentioning

confidence: 99%

12-weeks of Slow Breathing Exercises Reduces Blood Pressure among Healthy Normotensive Subjects

Gamboa,

Nian,

Smith

et al. 2024

Preprint

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Slow breathing exercises are a key component to many mind-body practices and have been shown to reduce blood pressure acutely. Long-term effects on blood pressure and autonomic tone are not well documented. We studied 99 healthy participants (41 ± 4 years, 76% female) who performed slow breathing exercises for 12 weeks and examined the effect of slow breathing on systolic blood pressure, diastolic blood pressure, and autonomic tone. At baseline average BP was 105 ± 11/67 ± 8 mmHg. Among the 11 participants with elevated blood pressure, BP was 126 ± 11.0/ 80 ± 5 mmHg. SBP and DBP decreased significantly (-2.4 ± 7.3 and − 1.6 ± 5.5 mmHg, respectively) at 12 weeks among all participants. Blood pressure among slow breathing participants with elevated baseline SBP > 120 mmHg and/or DBP > 90mmHg reduced further ( -10.3 ± 7.9 and − 3.8 ± 5.5 mmHg, respectively). In our regression model, baseline SBP was associated with further decreases in SBP from baseline to 12 weeks. No significant changes were observed from baseline to 12 weeks in autonomic tone as measured with spectral analyses, catecholamines, standing stress test, respiratory sinus arrhythmia, and Valsalva maneuver. Nor were there any observed correlations between changes in blood pressure and autonomic tone. In conclusion, 12-weeks of slow breathing exercises resulted in clinically significant reduction of blood pressure in the absence of statistically significant changes in autonomic tone. Further research into the mechanisms of slow breathing on blood pressure regulation and efficacy for hypertension.

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“…While automatic breathing is presumptively generated by brainstem-related mechanisms operating outside conscious awareness, voluntary breathing is predicated on the individual’s conscious awareness and control of respiration and is a core component of yoga and other meditative practices (Anālayo, 2019; Peng et al, 2004). Some forms of voluntary respiration, such as slow breathing, are widely considered an important means of quickly reducing anxiety or stress (Balban et al, 2023; Birdee et al, 2023), whereas other forms such as rapid breathing (so called “breath of fire”) are sometimes considered to quickly increase energy levels (Peng et al, 2004). Despite increasing studies on the effects of voluntary breathing on the body and mind (Herrero et al, 2018; Zaccaro et al, 2018), the neural mechanisms underlying voluntary breathing control remain unclear.…”

Section: Introductionmentioning

confidence: 99%

Sensing, Feeling, and Regulating: Investigating the Association of Focal Brain Damage with Voluntary Respiratory and Motor Control

Bischoff,

Kovach,

Kumar

et al. 2023

Preprint

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Breathing is a complex, vital function that can be modulated to influence physical and mental well-being. However, the role of cortical and subcortical brain regions in voluntary control of human respiration is underexplored. Here we investigated the influence of damage to human frontal, temporal, or limbic regions on the sensation and regulation of breathing patterns. Participants performed a respiratory regulation task across regular and irregular frequencies ranging from 6 to 60 breaths per minute (bpm), with a counterbalanced hand motor control task. Interoceptive and affective states induced by each condition were assessed via questionnaire and autonomic signals were indexed via skin conductance. Participants with focal lesions to the bilateral frontal lobe, right insula/basal ganglia, and left medial temporal lobe demonstrated significantly lower performance than individually matched healthy comparisons during the breathing and motor tasks. They also reported significantly higher anxiety during the 60-bpm regular and irregular breathing trials than healthy participants. Correlations between task performance, anxiety, and difficulty varied across experimental conditions and groups. This study demonstrates that damage to frontal, temporal, or limbic regions is associated with abnormal voluntary respiratory and motor regulation and tachypnea-related anxiety, highlighting the role of the forebrain in affective and motor responses during breathing.

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Slow breathing for reducing stress: The effect of extending exhale

Cited by 4 publications

References 38 publications

Effect of “365 Breathing Technique” on Intraocular Pressure and Autonomic Functions in Patients With Glaucoma: A Randomized Controlled Trial

Effect of “365 Breathing Technique” on Intraocular Pressure and Autonomic Functions in Patients With Glaucoma: A Randomized Controlled Trial

12-weeks of Slow Breathing Exercises Reduces Blood Pressure among Healthy Normotensive Subjects

Sensing, Feeling, and Regulating: Investigating the Association of Focal Brain Damage with Voluntary Respiratory and Motor Control

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