Stress plays a major role in the etiology and pathogenesis of anxiety and depression. Relaxation therapies, such as breathing exercises, can reduce stress and increase relaxation. This study has two aims. First, it aims to personalize and optimize breathing protocols. Second, it aims to tailor breathing protocols to subgroups based on prediction models of expected efficacy. Three different breathing protocols, varying solely in their instructed breathing frequency with 40 percent (A), 60 percent (B), and 80 percent (C) of the interindividual spontaneous breathing frequency, are tested in a randomized, counterbalanced crossover trial. Other parameters, such as breathing quality (i.e., nasal and diaphragmatic), rhythm (i.e., prolonged exhalation without instructed pauses) and depth (i.e., increased depth due to slower breathing frequency) as well as contextual factors (e.g., posture, video-based instructions, type of pacer, etc.) are invariant between protocols. First, this study hypothesizes a difference in the relaxation response between breathing protocols A, B, and C. This study looks at the relaxation response from three different angles (1) self-report, (2) autonomic arousal, and (3) central nervous system arousal. Second, this study explores prediction models of expected efficacy based on the interindividual variance in characteristics (i.e., depressive, anxious and stress symptoms as well as expertise in relaxation therapies) and biomarkers (e.g., heart rate variability, peripheral temperature, skin conductance, etc.). Prediction models can tailor breathing protocols to subgroups to increase expected efficacy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
42
A breathing exercise is a relaxation technique (or therapy) to increase relaxation (induces a relaxation response) and decrease stress (reduces a stress response).
Technical University of Munich
Munich, Bavaria, Germany
Relaxation Sum Score
Measured with the German Version of the Relaxation State Questionnaire; Sum scores range from 10 to 50 (higher scores indicate greater relaxation).
Time frame: Immediately after each 5-minute breathing exercise
Current Perceived Stress Level
Measured on a visual analog scale ranging from 0 to 100, where zero is absolutely no stress and 100 is extreme stress.
Time frame: Immediately after each 5-minute breathing exercise
Heart Rate Variability
Measured via blood volume pulse with a finger clip on the middle finger
Time frame: During each 5-minute breathing exercise
Peripheral Temperature
Measured via temperature sensor on the small finger
Time frame: During each 5-minute breathing exercise
Skin Conductance
Measured via skin conductance sensor on the index and ring finger
Time frame: During each 5-minute breathing exercise
Power in Frequency Bands
Measured via four channel EEG with linked earlobe reference and active electrode placement on F3, F4, F7, and F8 according to the international 10-20 system
Time frame: During each 5-minute breathing exercise
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.