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The practice of slow-paced breathing (SPB) has been linked to a range of positive outcomes, such as decreasing symptoms of depression, anxiety, and stress, as well as increasing well-being. Among the suggested mechanisms of action, SPB has been shown to increase cardiac vagal activity (CVA). The present study aimed to investigate whether there is a...
Citations
... Furthermore, evidence indicates that HRV (e.g., RMSSD) does not significantly differ among various session durations (e.g., 5, 10, 15, and 20 minutes) during slow-paced breathing or the subsequent resting measurement [71]. A systematic review also supports the effectiveness of single short breathing sessions in improving mood [72], although sessions shorter than 5 minutes are generally not recommended. ...
... However, no study has focused on the dynamically physiological changes during the combined intervention. Studies suggested that SPB could exert an immediate influence on cardiac indices of ANS with vmHRV increasing in 5-min sessions (Gholamrezaei et al., 2019;Paprika et al., 2014;You, Laborde, Borges, et al., 2021). In contrast, a 5-min active tDCS stimulation at 2 mA may not be sufficient to induce observable changes in cardiac indices of ANS (Hamner et al., 2015), evidence that goes in line with the idea that neural modulation effects of prefrontal tDCS may manifest slowly (Vignaud et al., 2018). ...
... Our finding is consistent with previous studies examining the effect of SPB on vmHRV, which showed increases in vmHRV after 1 session or multi-session SPB intervention (Huang et al., 2022;Laborde et al., 2022;Turankar et al., 2013;Zhang et al., 2017). Furthermore, numerous studies have found that this physiological state characterized by lower HR, higher vmHRV, and lower systolic blood pressure holds significance for psychological well-being Castiglioni et al., 2007;Mather & Thayer, 2018;McCraty, 2022;Meule & Kübler, 2017;Sesso et al., 2000;Williams et al., 2015;You, Laborde, Borges, et al., 2021), which could explain the positive effects of SPB on mental and physical health. In findings from prior studies, SPB exerts its influence through a range of cardiac and peripheral physiological mechanisms, encompassing but not limited to respiratory muscle activity (Vostatek et al., 2013), ventilation efficiency (Bernardi et al., 1998), chemoreflex and baroreflex sensitivity (Lanfranchi & Somers, 2002;Pitzalis et al., 1998), respiratory sinus arrhythmia (Berntson et al., 1993), blood flow dynamics (Ovadia-Blechman et al., 2017), and cardiorespiratory coupling (Spyer, 1995). ...
... Together, the current evidence suggests that SPB is an effective and widely applicable measure that may be used to increase cardiac vagal tone and alleviate stress reactions in daily life contexts. Our results suggest, in line with previous studies (Gholamrezaei et al., 2019;Paprika et al., 2014;You, Laborde, Borges, et al., 2021), that a 5-min intervention may be enough to provoke acute increases in cardiac vagal tone, which has been related to better stress regulation (Pulopulos et al., 2018(Pulopulos et al., , 2020. Furthermore, from a long-term perspective, although the duration of a single session of SPB may not affect its effectiveness in enhancing vmHRV, multiple sessions of SPB training are beneficial in reducing daily breathing rates (You, Laborde, Zammit, et al., 2021). ...
Numerous studies have substantiated the efficacy of slow-paced breathing (SPB) in decreasing anxiety and increasing vagally-mediated heart rate variability (HRV). Given its effectiveness and simplicity, SPB is a promising candidate for a just-in-time adaptive intervention (JITAI). This study examined the efficacy of SPB, triggered by increased anxiety and perseverative cognition (PC), on reducing these symptoms and increasing HRV at macro, micro, and immediate levels. Eighty individuals with subclinical anxiety from the Flemish general population were randomized into experimental (EC) or passive control (CC) conditions. Anxiety symptoms were evaluated at baseline and after 15 days. Participants underwent a control period (CP; 6 days) and an intervention period (IP; 6 days), during which they reported momentary anxiety and PC via a mobile application while wearing a portable electrocardiogram. EC participants received SPB training between CP and IP and were prompted to use SPB exercises during IP when anxiety/PC increased. Analyses revealed a significant effect of SPB on reducing retrospectively reported anxiety, but not on average daily-life anxiety and PC or HRV assessed throughout the IP. Micro-level analyses indicated that SPB was associated with a decrease in PC but not anxiety at the subsequent daily-life assessment. Anxiety and PC decreased substantially from immediately before to immediately after SPB. The effect of SPB on HRV remains inconclusive due to methodological concerns in measuring HRV in ambulatory settings. The results provide mixed evidence for the efficacy of SPB as a JITAI, indicating the need for replication studies to further evaluate its potential.
... However, no study has focused on the dynamically physiological changes during the combined intervention. Studies suggested that SPB could exert an immediate influence on cardiac indices of ANS with vmHRV increasing in 5-min sessions (Gholamrezaei et al., 2019;Paprika et al., 2014;You, Laborde, Borges, et al., 2021). In contrast, a 5-min active tDCS stimulation at 2 mA may not be sufficient to induce observable changes in cardiac indices of ANS (Hamner et al., 2015), evidence that goes in line with the idea that neural modulation effects of prefrontal tDCS may manifest slowly (Vignaud et al., 2018). ...
... Our finding is consistent with previous studies examining the effect of SPB on vmHRV, which showed increases in vmHRV after 1 session or multi-session SPB intervention (Huang et al., 2022;Laborde et al., 2022;Turankar et al., 2013;Zhang et al., 2017). Furthermore, numerous studies have found that this physiological state characterized by lower HR, higher vmHRV, and lower systolic blood pressure holds significance for psychological well-being Castiglioni et al., 2007;Mather & Thayer, 2018;McCraty, 2022;Meule & Kübler, 2017;Sesso et al., 2000;Williams et al., 2015;You, Laborde, Borges, et al., 2021), which could explain the positive effects of SPB on mental and physical health. In findings from prior studies, SPB exerts its influence through a range of cardiac and peripheral physiological mechanisms, encompassing but not limited to respiratory muscle activity (Vostatek et al., 2013), ventilation efficiency (Bernardi et al., 1998), chemoreflex and baroreflex sensitivity (Lanfranchi & Somers, 2002;Pitzalis et al., 1998), respiratory sinus arrhythmia (Berntson et al., 1993), blood flow dynamics (Ovadia-Blechman et al., 2017), and cardiorespiratory coupling (Spyer, 1995). ...
... Together, the current evidence suggests that SPB is an effective and widely applicable measure that may be used to increase cardiac vagal tone and alleviate stress reactions in daily life contexts. Our results suggest, in line with previous studies (Gholamrezaei et al., 2019;Paprika et al., 2014;You, Laborde, Borges, et al., 2021), that a 5-min intervention may be enough to provoke acute increases in cardiac vagal tone, which has been related to better stress regulation (Pulopulos et al., 2018(Pulopulos et al., , 2020. Furthermore, from a long-term perspective, although the duration of a single session of SPB may not affect its effectiveness in enhancing vmHRV, multiple sessions of SPB training are beneficial in reducing daily breathing rates (You, Laborde, Zammit, et al., 2021). ...
The neurovisceral integration model proposes that information flows bidirec- tionally between the brain and the heart via the vagus nerve, indexed by vagally mediated heart rate variability (vmHRV). Voluntary reduction in breathing rate (slow-paced breathing, SPB, 5.5 Breathing Per Minute (BPM)) can enhance vmHRV. Additionally, prefrontal transcranial direct current stimulation (tDCS) can modulate the excitability of the prefrontal region and influence the vagus nerve. However, research on the combination of SPB and prefrontal tDCS to increase vmHRV and other cardiac (heart rate (HR) and blood pressure) and peripheral (skin conductance) indices is scarce. We hypothesized that the combi- nation of 20 min of SPB and prefrontal tDCS would have a greater effect than each intervention in isolation. Hence, 200 participants were divided into four groups: active tDCS with SPB, active tDCS with 15 BPM breathing, sham tDCS with SPB, and sham tDCS with 15 BPM breathing. Regardless of the tDCS condition, the 5.5 BPM group showed a significant increase in vmHRV over 20 minutes and sig- nificant decreases in HR at the first and second 5-min epochs of the intervention. Regardless of breathing condition, the active tDCS group exhibited higher HR at the fourth 5-min epoch of the intervention than the sham tDCS group. No other effects were observed. Overall, SPB is a robust technique for increasing vmHRV, whereas prefrontal tDCS may produce effects that counteract those of SPB. More research is necessary to test whether and how SPB and neuromodulation ap- proaches can be combined to improve cardiac vagal tone.
... Segundo, identificar a las personas que se beneficiaban de la intervención psicosocial a distancia y aquellas que no lo hicieron. Tercero, evaluar la efectividad de la aplicación de diversas técnicas de relajación (respiración, imaginería guiada, relajación muscular y entrenamiento autógeno) y la regulación de cognitiva (respiración con atención plena y reestructuración cognitiva) sobre la tasa respiratoria, un indicador psicosomático de estrés (You, Laborde, Zammit, et al., 2021) a distancia en cuidadores informales. Cuarto, examinar el funcionamiento psicosocial mediante la asociación entre las variables mencionadas antes y después de la intervención. ...
Resumen Los cuidadores informales son aquellos que realizan el cuidado de personas con enfermedades crónicas degenerativas, quienes reorganizan su funcionamiento cotidiano presentando un elevado estrés. Estudios recientes proponen que los programas psicoeducativos de intervención grupal tienen efectividad para la disminución del estrés y sobrecarga. Sin embargo, la interrupción de actividades presenciales por COVID-19 la atención psicosocial se restringe a intervenciones a distancia, como se plantea en el modelo de telesalud para la salud mental. La presente investigación tuvo como objetivos explorar el efecto de una intervención remota sobre la ansiedad, depresión, sobrecarga del cuidador, estrés postraumático, apoyo social y percepción de salud; además, se identificó a los cuidadores que presentaban mejoría y aquellos que no. Se utilizó REVISTA DE PSICOLOGÍA DE LA UNIVERSIDAD AUTÓNOMA DEL ESTADO DE MÉXICO VOLUMEN 13, NÚMERO 37, FASCICULO. 2, enero-junio 2024 / ISSN: 2007-7149
... Different paced breathing techniques were shown to modulate both the parasympathetic and sympathetic nervous systems (sympathovagal balance) (Bernardi et al., 2001;Zaccaro et al., 2018) with several studies successfully exploring the effectiveness of slow-breathing exercises in promoting parasympathetic stimulation (Bae et al., 2021;Komori, 2018;Laborde et al., 2022;Laborde, Lentes, et al., 2019;Laborde et al., 2021;Magnon et al., 2021;You et al., 2021You et al., , 2022. However, it is still not yet completely understood to which extent the features of the paced breathing, other than respiratory rate, contribute to its effectiveness. ...
Paced breathing exercises with prolonged exhalation have been commonly used to reduce stress and anxiety by stimulating parasympathetic activity. However, increasing sympathetic activity may also provide benefits such as increased alertness and energy levels. In this work, we investigate the physiological impact of an 80-second breathing exercise with a prolonged inspiratory period of 6 seconds followed by 2 seconds of exhalation on the sympathetic system. We collected raw two-channel prefrontal electroencephalography and photoplethysmography signals of 19 subjects using EMOTAI’s headband while performing the proposed exercise every workday for 2 weeks straight. Physiological metrics such as heart rate, heart rate variability, and absolute power of the brain waves were extracted before and during the exercise to measure its effectiveness. A marked increase in beta wave power was observed, along with a significant increase in both heart rate and heart rate variability. The cardiovascular results indicate that the proposed exercise effectively raised sympathetic activity. Simultaneously, the observed neural activity is consistent with that seen during focused attention and heightened mental processing.
... This technique can also help to lower the respiratory rate. The exact instructions and detailed rationale for performing SPB this way can be found in previously published studies (e.g., Laborde et al., 2021a;You et al., 2021b). ...
Breathing techniques, particularly slow-paced breathing (SPB), have gained popularity among athletes due to their potential to enhance performance by increasing cardiac vagal activity (CVA), which in turn can help manage stress and regulate emotions. However, it is still unclear whether the frequency of SPB affects its effectiveness in increasing CVA. Therefore, this study aimed to investigate the effects of a brief SPB intervention (i.e., 5 min) on CVA using heart rate variability (HRV) measurement as an index. A total of 75 athletes (22 female; Mage = 22.32; age range = 19–31) participated in the study, attending one lab session where they performed six breathing exercises, including SPB at different frequencies (5 cycles per minute (cpm), 5.5 cpm, 6 cpm, 6.5 cpm, 7 cpm), and a control condition of spontaneous breathing. The study found that CVA was significantly higher in all SPB conditions compared to the control condition, as indexed by both root mean square of the successive differences (RMSSD) and low-frequency HRV (LF-HRVms2). Interestingly, LF-HRVms2 was more sensitive in differentiating the respiratory frequencies than RMSSD. These results suggest that SPB at a range of 5 cpm to 7 cpm can be an effective method to increase CVA and potentially improve stress management and emotion regulation in athletes. This short SPB exercise can be a simple yet useful tool for athletes to use during competitive scenarios and short breaks in competitions. Overall, these findings highlight the potential benefits of incorporating SPB into athletes’ training and competition routines.
... Voluntary control of breathing, significantly a decrease in rate, originated in Eastern traditions and has been used for thousands of years as an essential part of meditation and relaxation [11,12]. Slower than spontaneous breathing can activate the parasympathetic nervous system [13,14], and lower blood pressure upon awakening [15]. According to Kario et al. [16], a ten mmHg increase in home systolic blood pressure (SBP) at night is associated with a 20% increased risk of cardiovascular disease, independent of the day office and morning home blood pressures. ...
Blood pressure(BP) during sleep is a risk factor for cardiovascular disease. Poor sleep quality leads to hypertension. Sleep quality decreases with media device use and increases with deep breathing. Our objective was to examine the acute effects of slow breathing and refraining from using media devices on cardiac autonomic function and blood pressure during sleep. Fifteen healthy male participants were randomly assigned to one of three conditions: (a) slow breathing (BT) condition (12 consecutive breaths of 4 s of inhalation through the nose, 4 s pause, and 8 s of exhalation, approximately 3 min per breath), (b) a BT condition (BT+Non-LED) in which slow breathing was performed and the use of light-emitting devices (LED; smartphones, tablets, computers, etc.) was prohibited 1 hr before bedtime, and (c) a control condition (CON) in which slow breathing was not performed, and the use of LED was permitted. Blood pressure was measured by oscillometric method at baseline and 2 and 4 o'clock at bedtime. Autonomic function was measured by heart rate variability for 24 hours.
... 35 Also, slow-paced breathing with prolonged exhalation increases cardiac vagal activity which creates a relaxing effect on the heart with a parasympathetic effect. 32,34,36,39,40 A frequency of about 6 breath cycles per minute is thought to trigger the largest increases in baroreflex stimulation, resonance effects, and cardiac vagal activity. 36,37,41 Tharion et al 42 examined the effect of deep-slow breathing exercises on spontaneous breathing rate and heart rate variability in healthy individuals, and deep-slow breathing exercises were practiced for 30 minutes, 6 breath cycles/minute (4 seconds inhale and 6 seconds exhale) every day for a month and the control group received no intervention. ...
... To optimize relaxation, participants are encouraged to be in a comfortable, supported position and to exert as little effort as possible during Coherent Breathing paced at 5-6 cpm (cycles per minute). This gentle cyclical breathing (without breath pauses or holds) has calming effects, reduces SNS activity, increases PNS activity, lowers blood pressure, and induces synchronized alpha waves across large areas of cerebral cortex (17,19,20,(36)(37)(38)(39). In the resulting psychophysiological state, the individual feels both calm and alert. ...
... 1. Changing the pattern of breathing changes afferent interoceptive messages from the respiratory system (mechanoreceptors, chemoreceptors, and baroreceptors) that ascend through the vagus nerves to brainstem nuclei and from there to the main central regulatory areas, including the limbic system, hypothalamus, thalamus, interoceptive (insular) cortex, prefrontal cortex, and anterior cingulate cortex (16,17,(46)(47)(48)(49). 2. Slow breath exercises, particularly Coherent Breathing, balances the autonomic nervous system by reducing the overactivity of the sympathetic branch, as occurs in anxiety disorders and PTSD, and by boosting the underactivity of the parasympathetic branch (13,38,50,51). This is consistent with the changes perceived stress and psychophysiological state. ...
Background
During the COVID-19 pandemic, healthcare workers endured prolonged stress affecting their psychological well-being. Objectives: (1) Evaluate the effects of the Breath-Body-Mind Introductory Course (BBMIC) on COVID-related stress among employees of the Regional Integrated Support for Education, Northern Ireland, (2) Reduce the risk of adverse effects from COVID-related stress, and (3) Evaluate the effects of BBMIC on indicators of psychophysiological states and the consistency with hypothesized mechanisms of action.
Methods
In this single group study, a convenience sample of 39 female healthcare workers completed informed consent and baseline measures: Perceived Stress Scale (PSS), Stress Overload Scale-Short (SOS-S), and Exercise-Induced Feelings Inventory (EFI). Following the online BBMIC 4 h/day for 3 days and the 6 week solo (20 min/day) and group practice (45 min weekly), repeat testing plus the Indicators of Psychophysiological State (IPSS) and Program Evaluation were obtained.
Results
Baseline (T1) mean PSS score was significantly elevated compared to a normative sample: PSS = 18.2 vs. 13.7 (p < 0.001) and improved significantly 11 weeks post-BBMIC (T4). SOS-S mean score declined from 10.7(T1) to 9.7 at 6 week post-test (T3). The SOS-S proportion of High Risk scores found in 22/29 participants (T1), dropped to 7/29 (T3). EFI mean subscale scores improved significantly from T1 to T2 and T3 for Revitalization (p < 0.001); Exhaustion (p < 0.002); and Tranquility (p < 0.001); but not Engagement (p < 0.289).
Conclusion
Among RISE NI healthcare workers affected by COVID-related stress, participation in the BBMIC significantly reduced scores for Perceived Stress, Stress Overload, and Exhaustion. EFI Revitalization and Tranquility scores significantly improved. More than 60% of participants reported moderate to very strong improvements in 22 indicators of psychophysiological state, e.g., tension, mood, sleep, mental focus, anger, connectedness, awareness, hopefulness, and empathy. These results are consistent with the hypothesized mechanisms of action whereby voluntarily regulated breathing exercises change interoceptive messaging to brain regulatory networks that shift psychophysiological states of distress and defense to states of calmness and connection. These positive findings warrant validation in larger, controlled studies to extend the understanding of how breath-centered Mind-body Medicine practices could mitigate adverse effects of stress.
... From the linear analysis of PRV, we found that slow-paced breathing (Phase 4) significantly increases cardiac parasympathetic activity and global variability, depicted by SDNN and RMSSD-PP values (Table A2, Appendix A). This finding is consistent with You et al. [54], who found an increase in the RMSSD during slow-paced breathing at six breaths per minute compared to the baseline condition in healthy subjects. In the frequency analysis, we found that slow-paced breathing increased the LF power band and decreased the HF power band in Phase 4 compared to previous phases (Table A2). ...
Most COVID-19 survivors report experiencing at least one persistent symptom after recovery , including sympathovagal imbalance. Relaxation techniques based on slow-paced breathing have proven to be beneficial for cardiovascular and respiratory dynamics in healthy subjects and patients with various diseases. Therefore, the present study aimed to explore the cardiorespiratory dynamics by linear and nonlinear analysis of photoplethysmographic and respiratory time series on COVID-19 survivors under a psychophysiological assessment that includes slow-paced breathing. We analyzed photoplethysmographic and respiratory signals of 49 COVID-19 survivors to assess breathing rate variability (BRV), pulse rate variability (PRV), and pulse-respiration quotient (PRQ) during a psy-chophysiological assessment. Additionally, a comorbidity-based analysis was conducted to evaluate group changes. Our results indicate that all BRV indices significantly differed when performing slow-paced breathing. Nonlinear parameters of PRV were more appropriate for identifying changes in breathing patterns than linear indices. Furthermore, the mean and standard deviation of PRQ exhibited a significant increase while sample and fuzzy entropies decreased during diaphragmatic breathing. Thus, our findings suggest that slow-paced breathing may improve the cardiorespiratory dynamics of COVID-19 survivors in the short term by enhancing cardiorespiratory coupling via increased vagal activity.