Breathing Exercises + Meditation for Glaucoma

Overseen By Monali Malvankar, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: London Health Sciences Centre Research Institute and Lawson Research Institute of St. Joseph's

Disqualifiers: Bipolar, Schizophrenia, Substance abuse, others

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

Compensation: Varies

Number of Visits: 4

Duration: 12 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether breathing exercises and meditation can reduce stress and improve life quality for people with glaucoma, a condition affecting eye health. Participants will learn these techniques online and compare their results to those receiving usual care. The trial also aims to determine if these practices alter how glaucoma patients perceive their future. Individuals with glaucoma who can sit comfortably for meditation and have computer access may be suitable for this study. As an unphased trial, this study offers a unique opportunity to explore innovative stress-reduction techniques that could enhance quality of life.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on breathing and meditation techniques, so it's likely you can continue your usual medications, but you should confirm with the study team.

What prior data suggests that these breathing and meditation techniques are safe for glaucoma patients?

Research has shown that meditation and breathing exercises are generally safe and easy to handle. Studies have found that these practices can lower intraocular pressure without causing harm. Specific breathing methods, such as breathing through one nostril at a time, do not increase eye pressure in healthy individuals. Additionally, mindfulness meditation might reduce stress hormones, potentially benefiting those with glaucoma. Overall, these exercises appear to be a safe way to manage stress and possibly improve eye health. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Unlike the standard treatment for glaucoma, which mainly involves medications to lower eye pressure, this new approach combines breathing exercises with meditation. Researchers are excited about this because it offers a holistic way to potentially manage glaucoma by addressing stress, which may impact eye health. The treatment involves guided online sessions that teach specific breathing techniques followed by meditation, aiming to create mental balance and reduce stress levels. This innovative method could complement existing treatments by providing a non-invasive option that promotes overall well-being.

What evidence suggests that breathing exercises and meditation could be effective for stress in glaucoma patients?

Research has shown that breathing exercises and meditation can help lower eye pressure in people with glaucoma. Studies have found that these practices reduce stress and cortisol, which are linked to high eye pressure and worsening glaucoma. For instance, one study found that adding specific breathing techniques to glaucoma treatment lowered eye pressure and cortisol after six weeks. Another study showed that relaxation exercises effectively reduced eye pressure. In this trial, participants in the "Breathing Exercises followed by Meditation" arm will receive these practices in addition to standard care, suggesting that including breathing and meditation could be helpful for managing glaucoma. ^{1 5 6 7 8}

Are You a Good Fit for This Trial?

This trial is for glaucoma patients aged 40-65 who can consent, read English, and have no major mental health issues. They must be able to sit comfortably for half an hour, hear well with closed eyes, and access a computer for virtual sessions.

Inclusion Criteria

Being able to read and understand English

I have been diagnosed with glaucoma.

I am in good overall health.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive online instructions for breathing exercises and meditation, with weekly follow-ups

12 weeks

3 weekly online sessions (90 minutes each), weekly 60-minute follow-ups

Follow-up

Participants are monitored for changes in quality of life, consideration of future consequences, and perceived stress

4 weeks

Online questionnaires at Week 1, Week 3, Week 6, Week 12

What Are the Treatments Tested in This Trial?

Interventions

• Breathing Exercises and Meditation

Trial Overview The study tests if breathing exercises followed by meditation can reduce stress and improve life quality in glaucoma patients. Participants will learn these techniques online and practice independently while their results are compared to those receiving usual care.

How Is the Trial Designed?

Group I: Breathing Exercises followed by Meditation Experimental Treatment 1 Intervention

Breathing exercises and Meditation taught by Prasanna Wellness, a non-profit organization, helps dissolve stress and create a proper system in the mind. These breathing exercises include slow deep breaths and rapid breaths and are followed by meditation. Participants will receive three weekly online instructions (90 minutes each) by trained instructors in addition to standard care. Weekly 60 minutes follow-ups will include 10 minutes of breathing exercises followed by 33 minutes of guided meditation practice, and then focus on participants' experiences with breathing exercise followed by meditation during the week, additional observations, and a review of relevant knowledge to support their home practice.

Group II: Treatment as Usual Active Control 1 Intervention

The usual standard of care for patients with glaucoma includes starting them on first line of drugs. Participants will be initiated and maintained on appropriate dosages of such medications as part of standard of care. The usual standard of care also includes an ophthalmic examination measuring best-corrected Snellen VA and pinhole acuities and a follow-up visit once a year.

Who Is Running the Clinical Trial?

London Health Sciences Centre Research Institute and Lawson Research Institute of St. Joseph's

Lead Sponsor

Trials

686

Recruited

427,000+

London Health Sciences Centre OR Lawson Research Institute of St. Joseph's

Lead Sponsor

Trials

668

Recruited

424,000+

London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's

Lead Sponsor

Trials

678

Recruited

421,000+

Lawson Health Research Institute

Lead Sponsor

Trials

684

Recruited

432,000+

Published Research Related to This Trial

The safety profile of glaucoma medications is crucial for treatment adherence, as side effects can lead to patients not following their prescribed therapy.

Long-term use of glaucoma eyedrops, especially those with preservatives, can cause ocular surface changes and systemic effects, highlighting the need for careful selection of medications and patient education on potential side effects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Side effects of glaucoma medications. Detry-Morel, M.[2018]

In a study of 165 patients with glaucoma, 38 experienced adverse effects related to the addition of timolol to their treatment regimen.

Timolol had to be discontinued in 15 patients (9%) due to these side effects, indicating a need for further double-masked studies to better understand the safety profile of timolol in glaucoma therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse effects experienced by patients taking timolol. McMahon, CD., Shaffer, RN., Hoskins, HD., et al.[2019]

Breathing exercises, particularly pursed-lip breathing (PLB) and ventilatory feedback combined with exercise, significantly improve ventilation metrics such as respiratory rate and tidal volume in COPD patients, based on a review of 19 studies involving 745 participants.

While these breathing exercises enhance ventilation and quality of life, they do not significantly reduce dyspnea compared to control groups, indicating that their benefits may be more focused on improving breathing efficiency rather than alleviating breathlessness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Breathing Exercises in Patients With Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-Analysis. Ubolnuar, N., Tantisuwat, A., Thaveeratitham, P., et al.[2020]

Citations

1. openophthalmologyjournal.com openophthalmologyjournal.com/VOLUME/18/ELOCATOR/e18743641340238/

The Role of Stress Reduction and Mindfulness Meditation ... Multiple studies suggest that mental stress and elevated cortisol levels may contribute to IOP elevation and glaucomatous progression.

2. sciencedirect.com sciencedirect.com/org/science/article/pii/S1874364125000025

The Role of Stress Reduction and Mindfulness Meditation ... In numerous randomized-controlled trials, mindfulness meditation and relaxation techniques have been associated with a significant reduction of IOP relative to ...

3. healio.com healio.com/news/optometry/20240327/365-breathing-increases-parasympathetic-activity-reduces-iop-in-patients-with-glaucoma

'365 breathing' increases parasympathetic activity, reduces ... IOP and serum cortisol were significantly lower at 6 weeks in patients who added the “365 breathing” technique to their glaucoma treatment.

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11084912/

The Clinical Efficacy of Different Relaxation Exercises on ... The current meta-analysis indicates that relaxation exercises can significantly reduce IOP levels. Relaxation exercises are a potential class of novel ...

5. journals.sagepub.com journals.sagepub.com/doi/10.1177/02646196231201773

Benefits of meditation and breathing exercises in vision ... Our results indicate that meditation and breathing exercises significantly reduce intraocular pressure (IOP) (ES = −1.76, 95% CI = [−2.69, −0. ...

6. aao.org aao.org/eye-health/news/mindfulness-meditation-may-help-fight-glaucoma

Mindfulness Meditation May Help Fight Glaucoma A new study suggests that mindfulness meditation may help lower eye pressure in glaucoma patients and improve quality of life by lowering stress hormones.

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9748160/

The Effect of Specific Techniques of Nasal Breathing ... Specific breathing techniques like right and left nostril breathing, alternate nostril breathing are safe and do not raise IOP in normal subjects.

8. mdpi.com mdpi.com/2077-0383/13/9/2591

The Clinical Efficacy of Different Relaxation Exercises on ... The current meta-analysis indicates that relaxation exercises can significantly reduce IOP levels. Relaxation exercises are a potential class of novel ...