Relaxation Effects of Personalized Breathing Exercises for Healthy College Students
Study Details
Study Description
Brief Summary
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.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Breathing Exercise with 40 Percent of the Spontaneous Breathing Frequency (A) Participants are instructed (via visual pacer) to reduce their breathing frequency to 40 percent of their spontaneous breathing frequency for a period of five minutes. In advance, participants are instructed (via pre-recorded video) to breathe nasally (if possible) and abdominally, with a prolonged exhalation (inspiration-to-expiration ratio is 1-to-2 - also instructed via visual pacer) during the breathing exercise. |
Behavioral: Breathing Exercise
A breathing exercise is a relaxation technique (or therapy) to increase relaxation (induces a relaxation response) and decrease stress (reduces a stress response).
|
| Experimental: Breathing Exercise with 60 Percent of the Spontaneous Breathing Frequency (B) Participants are instructed (via visual pacer) to reduce their breathing frequency to 60 percent of their spontaneous breathing frequency for a period of five minutes. In advance, participants are instructed (via pre-recorded video) to breathe nasally (if possible) and abdominally, with a prolonged exhalation (inspiration-to-expiration ratio is 1-to-2 - also instructed via visual pacer) during the breathing exercise. |
Behavioral: Breathing Exercise
A breathing exercise is a relaxation technique (or therapy) to increase relaxation (induces a relaxation response) and decrease stress (reduces a stress response).
|
| Experimental: Breathing Exercise with 80 Percent of the Spontaneous Breathing Frequency (C) Participants are instructed (via visual pacer) to reduce their breathing frequency to 80 percent of their spontaneous breathing frequency for a period of five minutes. In advance, participants are instructed (via pre-recorded video) to breathe nasally (if possible) and abdominally, with a prolonged exhalation (inspiration-to-expiration ratio is 1-to-2 - also instructed via visual pacer) during the breathing exercise. |
Behavioral: Breathing Exercise
A breathing exercise is a relaxation technique (or therapy) to increase relaxation (induces a relaxation response) and decrease stress (reduces a stress response).
|
Outcome Measures
Primary Outcome Measures
- General Relaxation Score [Immediately after the 5-minute baseline measurement and immediately after each 5-minute breathing exercise]
Measured with the German Version of the Relaxation State Questionnaire
Secondary Outcome Measures
- Current Perceived Stress Level [Immediately after the 5-minute baseline measurement and immediately after each 5-minute breathing exercise]
Measured on a visual analog scale ranging from 0 to 100, where zero is absolutely no stress and 100 is extreme stress.
- Heart Rate Variability [During the 5-minute baseline measurement and during each 5-minute breathing exercise]
Measured via blood volume pulse with a finger clip on the middle finger
- Peripheral Temperature [During the 5-minute baseline measurement and during each 5-minute breathing exercise]
Measured via temperature sensor on the small finger
- Skin Conductance [During the 5-minute baseline measurement and during each 5-minute breathing exercise]
Measured via skin conductance sensor on the index and ring finger
- Power in Frequency Bands [During the 5-minute baseline measurement and during each 5-minute breathing exercise]
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
Other Outcome Measures
- Breathing Frequency [During the first questionnaire and video-based instructions before the baseline measurement, the 5-minute baseline measurement and during each 5-minute breathing exercise]
Measured via chest strap sensor. This is not an outcome, it measures the participant's spontaneous breathing frequency and the compliance to the breathing protocols.
- Number of Participants with Treatment-Related Adverse Events as Assessed by CTCAE v5.0 [Immidiately after the last breathing exercise]
Assessed with a questionnaire. This is not an outcome measure, this is a measure to build a prediction model for expected efficacy of breathing exercises.
- Difficulty with any of the Breathing Exercises [Immidiately after the last breathing exercise]
Assessed with a questionnaire. This is not an outcome measure, this is a measure to build a prediction model for expected efficacy of breathing exercises.
- Transferability of Breathing Exercises into Daily Life [Immidiately after the last breathing exercise]
Assessed with a questionnaire. This is not an outcome measure, this is a measure to build a prediction model for expected efficacy of breathing exercises.
- One Word Description for Breathing Exercises [Immidiately after the last breathing exercise]
Assessed with an open question. This is not an outcome measure, this is a measure to build a prediction model for expected efficacy of breathing exercises.
- Previous Training in Relaxation Techniques (such as Breathing Exercises, Autogenic Training, Progressive Relaxation, etc.) [Immidiately after the last breathing exercise]
Assessed with a closed (Yes/No) question. This is not an outcome measure, this is a measure to build a prediction model for expected efficacy of breathing exercises.
- Duration of Training in Relaxation Techniques (such as Breathing Exercises, Autogenic Training, Progressive Relaxation, etc.) [Immidiately after the last breathing exercise]
Assessed with a questionnaire. This is not an outcome measure, this is a measure to build a prediction model for expected efficacy of breathing exercises.
- Average Volume of Training in Relaxation Techniques (such as Breathing Exercises, Autogenic Training, Progressive Relaxation, etc.) [Immidiately after the last breathing exercise]
Assessed with a questionnaire. This is not an outcome measure, this is a measure to build a prediction model for expected efficacy of breathing exercises.
- Stress, Anxiety and Depression Score of the Past Two Weeks [Immidiately after the last breathing exercise]
Measured with the Depression-Anxiety-Stress-Scale Questionnaire. This is not an outcome measure, this is a measure to build a prediction model for expected efficacy of breathing exercises.
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Above 18 years old
-
University student
-
Native German speaker
Exclusion Criteria:
- Any psychiatric (e.g., anxiety), neurologic (e.g., epilepsy) or cardio-pulmonary (e.g., asthma) diagnosis
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Technical University of Munich | Munich | Bavaria | Germany | 80992 |
Sponsors and Collaborators
- Technical University of Munich
Investigators
- Principal Investigator: Lukas Moebus, M.Sc., Technical University of Munich
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- P-BP-40-60-80-RCT