Effect of coherent breathing on mental health and wellbeing: a randomised placebo-controlled trial.

Breathwork may offer simple tools for stress resilience. We conducted the largest parallel randomised-controlled trial on breathwork to date (NCT05676658) wherein 400 participants on the research platform Prolific were randomised, in blocks of 2 via remote software, to coherent breathing at ~ 5.5 breaths/min or a matched attention-placebo at 12 breaths/min, for ~ 10 min/day over 4 weeks. Participants were blinded to their allocated interventions, both of which were paced with equal inhalation:exhalation ratios. There were no differences on credibility and expectancy of benefit between conditions. At the primary timepoint post-intervention for the primary outcome subjective stress, there was no significant group by time interaction (F(1,377) = 0.089, p = 0.765, ηp2 < 0.001) nor main effect of group (F = 0.002, p = 0.961, ηp2 < 0.001), however there was a significant main effect of time (F = 72.1, p < 0.001, ηp2 = 0.161). Similar results were found at 1-month follow-up for stress and for secondary outcomes of anxiety, depression and wellbeing. There were overall improvements on these mental health and wellbeing outcomes from baseline to post-intervention and follow-up across both groups, yet the magnitude of this improvement was not different between arms. Accordingly, we found no measurable effect of coherent breathing over and above a well-designed breathwork placebo at improving mental health and wellbeing. Methodological considerations and recommendations for robust future research are discussed. Funder: Sasakawa Young Leaders Fellowship Fund, Tokyo, Japan.

High ventilation breathwork practices: An overview of their effects, mechanisms, and considerations for clinical applications.

High Ventilation Breathwork (HVB) refers to practices employing specific volitional manipulation of breathing, with a long history of use to relieve various forms of psychological distress. This paper seeks to offer a consolidative insight into potential clinical application of HVB as a treatment of psychiatric disorders. We thus review the characteristic phenomenological and neurophysiological effects of these practices to inform their mechanism of therapeutic action, safety profiles and future clinical applications. Clinical observations and data from neurophysiological studies indicate that HVB is associated with extraordinary changes in subjective experience, as well as with profound effects on central and autonomic nervous systems functions through modulation of neurometabolic parameters and interoceptive sensory systems. This growing evidence base may guide how the phenomenological effects of HVB can be understood, and potentially harnessed in the context of such volitional perturbation of psychophysiological state. Reports of putative beneficial effects for trauma-related, affective, and somatic disorders invite further research to obtain detailed mechanistic knowledge, and rigorous clinical testing of these potential therapeutic uses.

Effects of Mindfulness Meditation Duration and Type on Well-being: an Online Dose-Ranging Randomized Controlled Trial.

Objectives: This multi-arm randomized controlled online trial explored the effects of two key mindfulness characteristics (dose and type) over 2 weeks on mental well-being, along with psychological distress and dispositional mindfulness, in a healthy community sample. Method: Participants were randomly assigned to one of four mindfulness interventions (~ 10 min or ~ 30 min of sitting or movement meditation) to practice daily for 2 weeks; 161 participants fully completed the study and were included in the final sample. We also explored self-reported adherence through how often participants practiced, along with dropout rate via how many participants fully completed the study. Results: Well-being and mindfulness scores increased-and distress scores decreased-within all four conditions. However, most importantly, there were no significant differences between the conditions as a function of meditation dose or type. There were also no differences between the conditions on how regularly the meditations were practiced irrespective of type or dose. Additionally, there was no difference on dropout rate regarding meditation dose. However, meditation type had an effect, with a significantly higher dropout rate for participants allocated to a movement meditation irrespective of the dose. Conclusions: Brief mindfulness meditation may offer some benefit to well-being regardless of the meditation type and dose but, fundamentally, no differences in effects were detected between short/long sitting meditations and short/long movement meditations. Moreover, the results indicate that movement meditations may possibly be harder to adhere to, potentially informing the tailoring of mindfulness-based self-help programs. Limitations and future directions are also discussed. Preregistration: This study was retrospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619000422123). Supplementary Information: The online version contains supplementary material available at 10.1007/s12671-023-02119-2.