Key result
Slow deep breathing increases thermal pain threshold and tolerance vs baseline alongside increased vagal cardiac activity.
Why the study?
Slow deep breathing has been proposed as an effective method to decrease pain, but experimental studies validating this claim have not been conducted.
Do slow deep breathing, rapid breathing, distraction, and HR biofeedback improve thermal pain threshold and tolerance in healthy adults?
Do slow deep breathing, rapid breathing, distraction, and HR biofeedback improve thermal pain threshold and tolerance in healthy adults?
p-value: p=0.002
Slow deep breathing and HR biofeedback produce analgesic effects and increase vagal cardiac activity, suggesting distinct neurobiological mechanisms from distraction-induced analgesia.
Hypothesis-generating for slow deep breathing in acute pain; prospective trials needed before clinical adoption.
OBJECTIVE: Slow deep breathing has been proposed as an effective method to decrease pain. However, experimental studies conducted to validate this claim have not been carried out. DESIGN: We measured thermal pain threshold and tolerance scores from 20 healthy adults during five different conditions, namely, during natural breathing (baseline), slow deep breathing (6 breaths/minute), rapid breathing (16 breaths/minute), distraction (video game), and heart rate (HR) biofeedback. We measured respiration (rate and depth) and HR variability from the electrocardiogram (ECG) output and analyzed the effects of respiration on pain and HR variability using time and frequency domain measures of the ECG. RESULTS: Compared with baseline, thermal pain threshold was significantly higher during slow deep breathing (P = 0.002), HR biofeedback (P < 0.001), and distraction (P = 0.006), whereas thermal pain tolerance was significantly higher during slow deep breathing (P = 0.003) and HR biofeedback (P < 0.001). Compared with baseline, only slow deep breathing and HR biofeedback conditions had an effect on cardiac activity. These conditions increased the amplitude of vagal cardiac markers (peak-to-valley, P < 0.001) as well as low frequency power (P < 0.001). CONCLUSION: Slow deep breathing and HR biofeedback had analgesic effects and increased vagal cardiac activity. Distraction also produced analgesia; however, these effects were not accompanied by concomitant changes in cardiac activity. This suggests that the neurobiology underlying respiratory-induced analgesia and distraction are different. Clinical implications are discussed, as are the possible cardiorespiratory processes responsible for mediating breathing-induced analgesia.
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Chalaye et al. (2009) studied Healthy adults (experimental heat pain) (n=20). Slow deep breathing, rapid breathing, distraction, and heart rate biofeedback vs. Natural breathing (baseline) was evaluated on Thermal pain threshold (p=0.002). Slow deep breathing significantly increased thermal pain threshold (P=0.002) and tolerance (P=0.003) compared with baseline natural breathing, accompanied by increased vagal cardiac activity.
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