Slow breathing for reducing stress: The effect of extending exhale |
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Affiliation: | 1. Osher Center for Integrative Health, Department of Physical Medicine & Rehabilitation, Vanderbilt University School of Medicine, Nashville, TN, USA;2. School of Nursing, Vanderbilt University Medical Center, Nashville, TN, USA;3. Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA;4. Vanderbilt Autonomic Dysfunction Center, Vanderbilt University Medical Center, Nashville, TN, USA;5. Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA;6. Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA;7. Department of Biomedical Engineering (A.D.), Vanderbilt University, Nashville, TN, USA;8. Department of Medicine, Cardiovascular Division, Vanderbilt University Medical Center, Nashville, TN, USA |
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Abstract: | IntroductionSlow breathing techniques are commonly used to reduce stress. While it is believed by mind-body practitioners that extending the exhale time relative to inhale increases relaxation, this has not been demonstrated.MethodsWe conducted a 12-week randomized, single-blinded trial among 100 participants to compare if yoga-based slow breathing with an exhale greater inhale versus an exhale equals inhale produces measurable differences in physiological and psychological stress among healthy adults.ResultsParticipants mean individual instruction attendance was 10.7 ± 1.5 sessions out of 12 offered sessions. The mean weekly home practice was 4.8 ± 1.2 practices per week. There was no statistical difference between treatment groups for frequency of class attendance, home practice, or achieved slow breathing respiratory rate. Participants demonstrated fidelity to assigned breath ratios with home practice as measured by remote biometric assessments through smart garments (HEXOSKIN). Regular slow breathing practice for 12 weeks significantly reduced psychological stress as measured by PROMIS Anxiety (−4.85 S.D. ± 5.53, confidence interval −5.60, −3.00], but not physiological stress as measured by heart rate variability. Group comparisons showed small effect size differences (d = 0.2) with further reductions in psychological stress and physiological stress from baseline to 12 weeks for exhale greater than inhale versus exhale equals inhale, however these differences were not statistically significant.ConclusionWhile slow breathing significantly reduces psychological stress, breath ratios do not have a significant differential effect on stress reduction among healthy adults. |
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Keywords: | Slow breathing Yoga Mind-body practices Stress Relaxation techniques |
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