Slow-Paced Breathing and Autonomic Function in People Post-stroke

Abstract

Purpose: To determine if acute slow breathing at 6 breaths/min would improve baroreflex sensitivity (BRS) and heart rate variability (HRV), and lower blood pressure (BP) in adults after stroke.Methods: Twelve individuals completed two randomized study visits where they performed a 15-min bout of breathing exercises at 6 breaths/min (slow) and at 12 breaths/min (control). Continuous BP and heart rate (HR) were measured throughout, and BRS, BRS response to elevations in blood pressure (BRSup), BRS response to depressions in blood pressure (BRSdown), and HRV were calculated and analyzed before (pre), during, and after (post) breathing exercises.Results: BRS increased from pre to post slow breathing by 10% (p = 0.012), whereas BRSup increased from pre to during slow breathing by 30% ( p = 0.04). BRSdown increased from pre to post breathing for both breathing conditions (p < 0.05). HR (control: Δ − 4 ± 4; slow: Δ − 3 ± 4 beats/min, time, p < 0.01) and systolic BP (control: Δ − 0.5 ± 5; slow: Δ − 6.3 ± 8 mmHg, time, p < 0.01) decreased after both breathing conditions. Total power, low frequency power, and standard deviation of normal inter-beat intervals (SDNN) increased during the 6-breaths/min condition (condition × time, p < 0.001), whereas high frequency increased during both breathing conditions (time effect, p = 0.009).Conclusions: This study demonstrated that in people post-stroke, slow breathing may increase BRS, particularly BRSup, more than a typical breathing space; however, paced breathing at either a slow or typical breathing rate appears to be beneficial for acutely decreasing systolic BP and HR and increasing HRV.

Induced Relaxation Enhances the Cardiorespiratory Dynamics in COVID-19 Survivors

“…Lachowska et al reported that HR and blood pressure responses decreased considerably with slow breathing exercises in heart failure patients with reduced ejection fraction and enhanced a variety of health-related scores of quality of life (QoL) [ 70 ], while another study exhibited improvement in the long-term cardiorespiratory capacity of these patients [ 71 ]. Post-stroke patients also seem to benefit from slow breathing, with increased baroreflex sensitivity, lower systolic blood pressure, and HR with increased HRV [ 72 ].…”

Acute effect of breathing exercises on muscle tension and executive function under psychological stress

“…A study using intracranial electroencephalogram demonstrated respiration-locked oscillations during attentive breathing (mindful breathing) with stronger power in the anterior cingulate cortex, premotor cortex, insula, and hippocampus (Herrero et al, 2018 ), which are regions supposed to be involved in executive function (Carter et al, 1999 ; Rizzolatti et al, 2002 ; Eichenbaum, 2004 ). SLOW (device-guided, 5–6 breaths/min) is currently a Federal Drug Administration-approved treatment indicated by the American Heart Association for relaxation (Larson et al, 2020 ). Generally, for a healthy person, increased heart rate variability (HRV) indicates a relaxed state.…”