The relaxation effect of prolonged expiratory breathing

Vagally Mediated Heart Rate Variability and Mood States in Patients with Chronic Pain Receiving Prolonged Expiration Regulated Breathing: A Randomized Controlled Trial

Reduced vagally mediated heart rate variability (VmHRV) has been reported in patients with chronic pain. In healthy persons, breathing with longer expiration relative to inspiration increases VmHRV at 12 breaths per minute. The present study aimed to determine the immediate effect of breathing with longer expiration relative to inspiration on VmHRV and mood states in patients with chronic pain. Fifty patients with chronic pain aged between 20 and 67 years were prospectively randomized as two groups with an allocation ratio of 1:1. The interventional group practiced breathing with metronome based visual cues, maintaining an inspiration to expiration ratio of 28:72 (i/e ratio, 0.38) at a breath rate of 12 breaths per minute. The average i/e ratio they attained based on strain gauge respiration recording was 0.685 (SD 0.48). The control group, which looked at the metronome without conscious breath modification had an average i/e ratio of 0.745 (SD 0.69). The VmHRV, respiration and self-reported mood states (using the Brief Mood Introspection Scale (BMIS)) were assessed. There was a significant increase in HF-HRV and RMSSD during low i/e breathing (repeated measures ANCOVA, Bonferroni adjusted post-hoc test, p < 0.05; in all cases). Self-reported mood states changed as follows: (i) following low i/e breathing positive-mood states increased while the aroused mood state decreased whereas (ii) following the control intervention the aroused mood state increased (repeated measure ANOVA, p < 0.05; in all cases). Hence breathing with prolonged expiration is possibly useful to increase VmHRV and improve self- reported mood states in patients with chronic pain.

Acute cardiac autonomic and hemodynamic responses to resistive breathing: Effect of loading type and intensity

OBJECTIVES

This study aimed to assess the acute impact of distinct loading breathing types and intensities on cardiac autonomic function and hemodynamic responses in healthy young adults.

METHODS

A randomized, crossover trial involved 28 participants who underwent inspiratory resistive breathing, expiratory resistive breathing (ERB) and combined resistive breathing, each at 30% and 60% of maximal respiratory pressures. Data on heart rate variability (HRV) and hemodynamic parameters were collected during each trial.

RESULTS

The study revealed significant main and interaction effects for both the performed task and the intensity across all measured variables (all p < 0.001). ERB at 60% load demonstrated significantly higher HRV values in the standard deviation of normal-to-normal RR intervals, the square root of the mean squared difference of successive normal-to-normal RR intervals and high-frequency power, as well as significantly lower values in heart rate, stroke volume, stroke volume index, cardiac output, cardiac index, end-diastolic volume and end-diastolic volume index, compared to other loaded protocols (all p < 0.001).

CONCLUSION

These findings highlight the acute effect of type-specific and load-dependent resistive breathing on cardiac autonomic and hemodynamic functions, where ERB at 60% intensity showed the most significant cardiovagal modulation while causing the least hemodynamic alterations.

The Stress Phenotyping Framework: A multidisciplinary biobehavioral approach for assessing and therapeutically targeting maladaptive stress physiology

Although dysregulated stress biology is becoming increasingly recognized as a key driver of lifelong disparities in chronic disease, we presently have no validated biomarkers of toxic stress physiology; no biological, behavioral, or cognitive treatments specifically focused on normalizing toxic stress processes; and no agreed-upon guidelines for treating stress in the clinic or evaluating the efficacy of interventions that seek to reduce toxic stress and improve human functioning. We address these critical issues by (a) systematically describing key systems and mechanisms that are dysregulated by stress; (b) summarizing indicators, biomarkers, and instruments for assessing stress response systems; and (c) highlighting therapeutic approaches that can be used to normalize stress-related biopsychosocial functioning. We also present a novel multidisciplinary Stress Phenotyping Framework that can bring stress researchers and clinicians one step closer to realizing the goal of using precision medicine-based approaches to prevent and treat stress-associated health problems.

Cerebral Hemodynamics and Vagally Mediated HRV Associated with High- and Low-frequency Yoga Breathing: An Exploratory, Randomized, Crossover Study

Background

Volitionally modifying respiration leads to changes in middle cerebral arterial (MCA) blood flow. The effect of changes in breath rate on MCA blood flow has not been reported.

Aims and Objectives

To determine the effect of slow (bumblebee yoga breathing) and fast (high frequency yoga breathing) yoga breathing techniques on MCA blood flow and vagally mediated heart rate variability.

Materials and Methods

Thirty participants (mean age ± standard deviation, 27.3 ± 4.2 years) were assessed on 2 separate days practicing either high frequency yoga breathing (HFYB, breath frequency 54.2/min) or slow frequency bumblebee yoga breathing (BBYB, breath frequency 3.8/min) in random order to determine the effects of changes in breath frequency on MCA hemodynamics. Assessments included transcranial Doppler sonography, vagally mediated heart rate variability (VmHRV), and respiration.

Results

Both HFYB and BBYB (i) reduced MCA flow velocities, i.e., peak systolic, end diastolic, and mean flow velocities, and (ii) increased MCA pulsatility indices. There was an increase in VmHRV during BBYB based on increased power in high frequency (HF) and low frequency (LF). LF reflects VmHRV for slow breath frequencies. In BBYB the average breath rate was 3.8 breaths/min. In contrast, VmHRV decreased during HFYB (based on reduced HF power; repeated measures analysis of variance, P < 0.05, all cases).

Conclusion

Hence, irrespective of the differences in breath frequency, both HFYB and BBYB appear to reduce MCA flow velocities and increase the resistance to blood flow bilaterally, although the VmHRV changed in opposite directions. MCA velocity and pulsatility changes are speculated to be associated with low global neural activity during yoga breathing.

Breath Phase Durations, Affect, and Attention: A Pilot Randomized Crossover Trial

Objectives

Previously, yoga volitional breathing with low inspiration to expiration ratios (i/e) (as in bhramari pranayama) improved cognition and reduced state anxiety. This study compared the effects of low, high and equal i/e ratio breathing on affect and attention.

Material and Methods

Affect, vigor and attention were assessed in forty healthy participants (group mean age± SD; 22.58±3.83; M:F= 2.33:1) while breathing with three different i/e regulated by a visual metronome on separate days viz., (i) low i/e (28:72), (ii) equal i/e (50:50), (iii) high i/e (72:28) compared to control, without conscious breath modification. Assessments were: (i) brief mood introspection scale (BMIS), (ii) global vigor and affect scale (GVAS), (iii) Spielberger's state trait anxiety inventory-state (STAI-S) and a six letter cancellation test to assess sustained attention. Data were analyzed with repeated measures analysis of variance with Bonferroni adjusted post-hoc tests.

Results

Pleasant feelings increased after low and equal i/e. Low i/e also increased positive feelings whereas equal i/e decreased scores in the cancellation test for sustained attention. All three breathing practices and the control session decreased state anxiety and increased vigor. High i/e breathing alone did not decrease negative feelings. For all the breath ratios the breath frequency cue was set at twelve breaths per minute.

Conclusion

In summary, varying breath phase ratios influenced positive and pleasant feelings but did not influence state anxiety or vigor. Understanding the mechanisms underlying the findings would be improved with concurrent physiological assessments.

Psycho-Religious Therapy improving the Quality of Life of the Elderly in Nursing Homes

Abstract BACKGROUND As people get older, body functions in the elderly will decrease so that it will affect their quality of life. One way to improve the quality of life of the elderly is to meet the basic needs of the elderly through a spiritual approach (Islamic psychotherapy).    AIM: This study aims to determine the effect of Zikr on the quality of life of the elderly in nursing homes.    METHODS: This study used a quasi-experimental nonequivalent control group design. The sampling technique used purposive sampling , a total of 10 respondents from the intervention group and 10 respondents from the control group. Quality of life score using the World Health Organization Quality of Life-BREF questionnaire (WHOQOL-BREF). The research analysis used paired t-test and Wilcoxon test for differences in quality-of-life scores of each group and for differences in quality of life between the intervention group and control group using unpaired t-test and Mann-Whitney test.    RESULTS: The effect of psycho-religious therapy (Zikr) on the quality of life of the elderly in the intervention group before and after doing Zikr (p = 0.000), there were differences in 3 domains of quality of life, namely the psychological domain ( p = 0.000), the domain of social relations (p = 0.027), and the environmental domain.  p = 0.010).    CONCLUSION: Psycho-religious therapy (Zikr) affects the quality of life of the elderly in the nursing home and suggests Nursing homes to provide guidance with a religious approach, especially Zikr to improve the quality of life of the elderly.  

MEDEX 2015: Prophylactic Effects of Positive Expiratory Pressure in Trekkers at Very High Altitude

Purpose: Positive expiratory pressure (PEP) breathing has been shown to increase arterial oxygenation during acute hypoxic exposure but the underlying mechanisms and consequences on symptoms during prolonged high-altitude exposure remain to be elucidated. Methods: Twenty-four males (41 ± 16 years) were investigated, at sea level and at 5,085 m after 18 days of trekking from 570 m. Participants breathed through a face-mask with PEP = 0 cmH₂O (PEP₀, 0-45^th min) and with PEP = 10 cmH₂O (PEP₁₀, 46-90^th min). Arterial (SpO₂), quadriceps and prefrontal (near infrared spectroscopy) oxygenation was measured continuously. Middle cerebral artery blood velocity (MCAv, transcranial Doppler), cardiac function (2D-echocardiography), extravascular lung water accumulation (UsLC, thoracic ultrasound lung comets) and acute mountain sickness (Lake Louise score, LLS) were assessed during PEP₀ and PEP₁₀. Results: At 5,085 m with PEP₀, SpO₂ was 78 ± 4%, UsLC was 8 ± 5 (a.u.) and the LLS was 2.3 ± 1.7 (all P < 0.05 versus sea level). At 5,085 m, PEP₁₀ increased significantly SpO₂ (+9 ± 5%), quadriceps (+2 ± 2%) and prefrontal cortex (+2 ± 2%) oxygenation (P < 0.05), and decreased significantly MCAv (-16 ± 14 cm.s^-1) and cardiac output (-0.7 ± 1.2 L.min^-1) together with a reduced stroke volume (-9 ± 15 mL, all P < 0.05) and no systemic hypotension. PEP₁₀ decreased slightly the number of UsLC (-1.4 ± 2.7, P = 0.04) while the incidence of acute mountain sickness (LLS ≥ 3) fell from 42% with PEP₀ to 25% after PEP₁₀ (P = 0.043). Conclusion: PEP₁₀ breathing improved arterial and tissue oxygenation and symptoms of acute mountain sickness after trekking to very high altitude, despite reduced cerebral perfusion and cardiac output. Further studies are required to establish whether PEP-breathing prophylactic mechanisms also occur in participants with more severe acute mountain sickness.

Changes in Humans' Autonomic Nervous System under Dynamic Lighting Environment During A Short Rest

Overloaded work and life stress often result in excessive fatigue and stresses in people, further leading to psychological burden and physiological disease. In this case, good rest is important in busy life. Good rest could result in good quality of life and work efficiency. In order to assist people in getting into deep rest to obtain a restorative state after fatigue, a dynamic lighting system with low-frequency change for assisting users in effective relaxation is proposed in this study. Heart rate variability analysis is used for discussing the change in the autonomic nervous system of the subjects under dynamic lighting environment, and a self-report questionnaire is applied to understand the subjects' psychological feeling. The research results indicate that the subjects significantly showed enhancement in the activities of parasympathetic nervous system within 25 minutes in the dynamic lighting process, in comparison with the steady lighting system. The questionnaire survey results also reveal that the subjects receive higher quality of rest, after the dynamic and low-illuminance lighting stimuli, with good feeling.

A Proposal for a Data-Driven Approach to the Influence of Music on Heart Dynamics

Electrocardiographic signals (ECG) and heart rate viability measurements (HRV) provide information in a range of specialist fields, extending to musical perception. The ECG signal records heart electrical activity, while HRV reflects the state or condition of the autonomic nervous system. HRV has been studied as a marker of diverse psychological and physical diseases including coronary heart disease, myocardial infarction, and stroke. HRV has also been used to observe the effects of medicines, the impact of exercise and the analysis of emotional responses and evaluation of effects of various quantifiable elements of sound and music on the human body. Variations in blood pressure, levels of stress or anxiety, subjective sensations and even changes in emotions constitute multiple aspects that may well-react or respond to musical stimuli. Although both ECG and HRV continue to feature extensively in research in health and perception, methodologies vary substantially. This makes it difficult to compare studies, with researchers making recommendations to improve experiment planning and the analysis and reporting of data. The present work provides a methodological framework to examine the effect of sound on ECG and HRV with the aim of associating musical structures and noise to the signals by means of artificial intelligence (AI); it first presents a way to select experimental study subjects in light of the research aims and then offers possibilities for selecting and producing suitable sound stimuli; once sounds have been selected, a guide is proposed for optimal experimental design. Finally, a framework is introduced for analysis of data and signals, based on both conventional as well as data-driven AI tools. AI is able to study big data at a single stroke, can be applied to different types of data, and is capable of generalisation and so is considered the main tool in the analysis.

Multimodal prediction of trait emotional intelligence-Through affective changes measured using non-contact based physiological measures

Inability to efficiently deal with emotionally laden situations, often leads to poor interpersonal interactions. This adversely affects the individual's psychological functioning. A higher trait emotional intelligence (EI) is not only associated with psychological wellbeing, educational attainment, and job-related success, but also with willingness to seek professional and non-professional help for personal-emotional problems, depression and suicidal ideation. Thus, it is important to identify low (EI) individuals who are more prone to mental health problems than their high EI counterparts, and give them the appropriate EI training, which will aid in preventing the onset of various mood related disorders. Since people may be unaware of their level of EI/emotional skills or may tend to fake responses in self-report questionnaires in high stake situations, a system that assesses EI using physiological measures can prove affective. We present a multimodal method for detecting the level of trait Emotional intelligence using non-contact based autonomic sensors. To our knowledge, this is the first work to predict emotional intelligence level from physiological/autonomic (cardiac and respiratory) response patterns to emotions. Trait EI of 50 users was measured using Schutte Self Report Emotional Intelligence Test (SSEIT) along with their cardiovascular and respiratory data, which was recorded using FMCW radar sensor both at baseline and while viewing affective movie clips. We first examine relationships between users' Trait EI scores and autonomic response and reactivity to the clips. Our analysis suggests a significant relationship between EI and autonomic response and reactivity. We finally attempt binary EI level detection using linear SVM. We also attempt to classify each sub factor of EI, namely-perception of emotion, managing own emotions, managing other's emotions, and utilization of emotions. The proposed method achieves an EI classification accuracy of 84%, while accuracies ranging from 58 to 76% is achieved for recognition of the sub factors. This is the first step towards identifying EI of an individual purely through physiological responses. Limitation and future directions are discussed.

Extreme prolongation of expiration breathing: Effects on electroencephalogram and autonomic nervous function

To clarify the physiological and psychological effects of deep breathing, the effects of extreme prolongation of expiration breathing (Okinaga) were investigated using electroencephalogram (EEG) and electrocardiogram (ECG). Participants were five male Okinaga practitioners in their 50s and 60s. Participants performed Okinaga for 31 minutes while continuous EEG and ECG measurements were taken. After 16 minutes of Okinaga, and until the end of the session, the percentages of theta and alpha 2 waves were significantly higher than at baseline. After 20 minutes, and until the end of the session, the percentage of beta waves was significantly lower than at baseline. The high frequency component of heart rate variability was significantly lower after 12 minutes of Okinaga and lasted until 23 minutes. The low frequency/high frequency ratio was significantly lower after 18 minutes of Okinaga and until the end of the session. Okinaga produced relaxation, suggesting that deep breathing may relieve anxiety. However, study limitations include potential ambiguity in the interpretation of the low frequency/high frequency ratio, the small sample, and the fact that EEG was measured only on the forehead.