Breathing Techniques for Chronic Stress

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: University of Northern Colorado

Disqualifiers: Asthma, Cardiovascular disease, Musculoskeletal disease, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 6

36 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. However, it does require participants to refrain from regular high-intensity interval training and structured breathing practices for a month before participation.

What data supports the effectiveness of the treatment Cyclic Hyperventilation with Retention, High intensity interval training for chronic stress?

Research shows that controlled breathing exercises, including cyclic hyperventilation with retention, can improve mood and reduce anxiety. Additionally, exercise is known to lower anxiety levels, suggesting that combining these techniques may help manage chronic stress. ^{1 2 3 4 5}

Is breathing retraining safe for humans?

Breathing retraining, including techniques like cyclic hyperventilation with retention, has been studied for various conditions and is generally considered safe for humans. Studies have shown lasting positive effects on respiratory health and a reduction in stress-related symptoms without significant adverse effects. ^{1 2 3 6 7}

How does the treatment Cyclic Hyperventilation with Retention differ from other treatments for chronic stress?

Cyclic Hyperventilation with Retention is unique because it involves specific breathing patterns with longer inhalations and shorter exhalations, which can improve mood and reduce anxiety by lowering physiological arousal. This approach is different from traditional stress treatments as it focuses on controlled breathwork rather than medication or standard therapy. ^{1 3 8 9 10}

What is the purpose of this trial?

The purpose of this clinical trial is to explore the effects of either a 2-week high-intensity interval training (HIIT) or breath training intervention on measures of overall health, circulating biomarkers of stress, and immune function. Specific aims include: - Does a 2-week HIIT or breath training intervention improve measurements of overall health, including heart rate variability, physical activity, sleep quality, and severity of depression, anxiety, and stress? -Does a 2-week HIIT or breath training intervention improve circulating concentrations of stress-related biomarkers? Does a 2-week HIIT or breath training intervention improve immune function? Researchers will compare HIIT and breath training to see if equivalent immune improvements are observed. Participants will: -Undergo 2 weeks of HIIT or breath training interventions at a frequency of 3 times per week for 30 minutes or 5 times per week for 5 minutes if placed into an intervention group. -Undergo testing measures at the two pre- and post-intervention time points, if placed in the intervention groups or the healthy control group.

Eligibility Criteria

This trial is for individuals with autonomic dysfunction, dysautonomia, cancer, chronic stress, or disorders of the autonomic nervous system. It aims to explore how high-intensity interval training (HIIT) and a breathing technique called cyclic hyperventilation with retention (CHR) can impact health.

Inclusion Criteria

I can complete a fitness readiness survey without needing a doctor's approval.

Participants must score in the mild or greater category for Depression, Anxiety, and Stress on the Depression Anxiety and Stress Scale (DASS-21). Depression score ≥ 10, Anxiety score ≥ 8, and Stress score ≥ 14

I am either male or female.

Exclusion Criteria

I have a serious lung condition like asthma or COPD.

I have a serious heart or blood vessel condition.

I do not have untreated mental health issues like anxiety, depression, or PTSD.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1 week

1 visit (in-person)

Intervention

Participants undergo either a 2-week high-intensity interval training (HIIT) or breath training intervention

2 weeks

3 visits per week (HIIT group), 5 virtual sessions per week (Breath training group)

Follow-up

Participants are monitored for safety and effectiveness after the intervention

2 weeks

2 visits (in-person)

Treatment Details

Interventions

• Cyclic Hyperventilation with Retention
• High intensity interval training

Trial Overview The study tests whether HIIT or CHR can improve immune function and overall health in participants. It measures changes in natural killer cell activity and circulating biomarkers after a 2-week intervention period using these techniques.

Participant Groups

Group I: CON, control Active Control 1 Intervention

The control group will undergo the same testing procedures outlined above, but they will be asked to maintain their current level of activity and normal daily habits for the duration of the intervention.

Group II: HIG, High intensity group Active Control 1 Intervention

During the exercise session, HR will be measured via a Polar heart rate strap (Kempele, Finland). The training sessions will consist of six 90-second high-intensity cycling (HIC) sprints performed on a cycle ergometer (Monark Ergomedic 895E, Monark, Varberg, Sweden) at 80-90% VO2max, followed by 180 seconds of low-intensity cycling (LIC) at 50-60% of VO2max. During both HIC and LIC intensities, participants will be asked rate of perceived exertion, which will be compared to the participants' heart rate throughout the exercise sessions. This supervised training protocol will require 9 minutes of HIC at 80-90% VO2max and 18 minutes of LIC at 50-60% VO2max. The cycling session will begin with a brief warm-up and end with a cool-down down totaling the entire supervised exercise session for 30 minutes. Training sessions will be performed 48 hours after the previous training session for a total of 3 times per week on Mondays, Wednesdays, and Fridays.

Group III: CHG, Cyclic hyperventilation group Active Control 1 Intervention

The breathing intervention will consist of a daily breathing practice lasting 5 to 10 minutes for 5 days per week. Breathing practice is a form of cyclic hyperventilation consisting of 30 breath (inhalation and exhalation) repetitions followed by an exhaled breath retention for 15 seconds during the first week and up to 30 seconds during the second week. A total of 3 rounds will be performed by the participants. Participants will be instructed to perform breathing repetitions in a controlled and consistent manner while either seated or lying down. Participants will receive guided instruction via a video on breath cycle queues, informing the participants when to inhale, exhale, and when to retain their breath while being supervised by the research team via Zoom call. Upon completion of the breath training sessions, the research team will conduct a guided cooldown and check in with all participants to ensure they are feeling no adverse side effects from the breathing exercise.

Who Is Running the Clinical Trial?

University of Northern Colorado

Lead Sponsor

Trials

8

Recruited

550+

Findings from Research

Aerobic exercise is associated with significant reductions in both state and trait anxiety, with effects comparable to other anxiety-reducing treatments like relaxation techniques.

To achieve meaningful reductions in anxiety, exercise programs should last at least 10 weeks and include sessions of at least 21 minutes, although the exact minimum duration for effective anxiety reduction is still unclear.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A meta-analysis on the anxiety-reducing effects of acute and chronic exercise. Outcomes and mechanisms. Petruzzello, SJ., Landers, DM., Hatfield, BD., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Brief structured respiration practices enhance mood and reduce physiological arousal. [2023]

2. England pubmed.ncbi.nlm.nih.gov

Respiratory control: its contribution to the treatment of panic attacks. A controlled study. [2019]

3. United States pubmed.ncbi.nlm.nih.gov

Breathing retraining: a three-year follow-up study of treatment for hyperventilation syndrome and associated functional cardiac symptoms. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Breathing and feeling: capnography and the individually meaningful psychological stressor. [2019]

5. New Zealand pubmed.ncbi.nlm.nih.gov

A meta-analysis on the anxiety-reducing effects of acute and chronic exercise. Outcomes and mechanisms. [2022]

6. England pubmed.ncbi.nlm.nih.gov

The active cycle of breathing technique: a systematic review and meta-analysis. [2022]

7. England pubmed.ncbi.nlm.nih.gov

Walking versus biofeedback: a comparison of acute interventions for stressed students. [2018]

8. England pubmed.ncbi.nlm.nih.gov

Exercise training in patients with chronic airways obstruction. [2005]

9. Switzerland pubmed.ncbi.nlm.nih.gov

Influence of Slow-Paced Breathing on Inhibition After Physical Exertion. [2020]

10. Germany pubmed.ncbi.nlm.nih.gov

Hyperventilation-induced respiratory alkalosis falls short of countering fatigue during repeated maximal isokinetic contractions. [2018]