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Effect of slow, deep breathing on visceral pain perception and its underlying psychophysiological mechanisms
Author(s) -
Gholamrezaei Ali,
Van Diest Ilse,
Aziz Qasim,
Pauwels Ans,
Tack Jan,
Vlaeyen Johan W. S.,
Van Oudenhove Lukas
Publication year - 2022
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.14242
Subject(s) - diaphragmatic breathing , breathing , medicine , respiratory rate , anesthesia , heart rate , heart rate variability , arousal , psychology , blood pressure , neuroscience , alternative medicine , pathology
Abstract Background Studies using somatic pain models have shown the hypoalgesic effects of slow, deep breathing. We evaluated the effect of slow, deep breathing on visceral pain and explored putative mediating mechanisms including autonomic and emotional responses. Methods Fifty‐seven healthy volunteers (36 females, mean age = 22.0 years) performed controlled, deep breathing at a slow frequency (6 breaths per minute), controlled breathing at a normal frequency (14 breaths per minute; active control), and uncontrolled breathing (no‐treatment control) in randomized order. Moderate painful stimuli were given during each condition by delivering electrical stimulation in the distal esophagus. Participants rated pain intensity after each stimulation. Heart rate variability and self‐reported arousal were measured during each condition. Key Results Compared to uncontrolled breathing, pain intensity was lower during slow, deep breathing (Cohen’s d = 0.40) and normal controlled breathing ( d = 0.47), but not different between slow, deep breathing and normal controlled breathing. Arousal was lower ( d = 0.53, 0.55) and heart rate variability was higher ( d = 0.70, 0.86) during slow, deep breathing compared to the two control conditions. The effect of slow, deep breathing on pain was not mediated by alterations in heart rate variability or arousal but was moderated by pain catastrophizing. Conclusions and Inferences Slow, deep breathing can reduce visceral pain intensity. However, the effect is not specific to the slow breathing frequency and is not mediated by autonomic or emotional responses, suggesting other underlying mechanisms (notably distraction). Whether a long‐term practice of slow, deep breathing can influence (clinical) visceral pain warrants to be investigated.