The Effect of Breathing on Cognitive Performance and Stress

NCT06986135 | Completed

• 1 other identifier: IRB #9665
• Study Type: interventional
• Target: 66
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to determine the effectiveness of different breathing techniques on biomarkers of stress and cognitive performance following the Trier Social Stress Test.

Conditions

Stress; Acute Stress Reaction; Breathing Techniques; Cognitive Performance

Keywords

Stress; Trier Social Stress Test; Acute Stress; Breathing Technique; Box Breathing; Cognitive Performance; Biomarkers

Outcome Measures

Primary Outcomes (6)

• Cognitive Challenge

  Subjects participated in a 1 minute familiarization for the Stroop Color Word Challenge, followed by a full 2 minute Stroop Color Word challenge. Immediately following the Stroop, subjects then participated in a 2 minute mental arithmetic. The Stroop consisted of conflicting color-word fonts, and the subject had to choose the correct font color: subjects had .5 seconds to respond to each answer utilizing a color coordinated keypad. The mental arithmetic consisted of a series of mathematical problems (i.e., one, two, or three digit addition and subtraction). If subjects got an answer wrong for the mental math, a buzzer would sound.

  20 minutes prior to TSST start and immediately post TSST.

• Heart Rate

  Heart rate was recorded immediately prior to each saliva sample using the same tools to record the HRV measure. The Polar H10 and HRVTrace app was utilized to record a Heart rate measure 4 times throughout the study.

  HR was recorded 4 times, during each saliva sample collection period

• State Anxiety Inventory (SAI)

  The SAI is a 6 question survey on a 24 point scale, asking the subject to record how they feel. Questions asked were "I am calm", "I am tense", "I am worried", "I am relaxed", etc. Subjects were asked to fill this out 4 times throughout the study, alongside the HR and saliva samples.

  Timepoint 1-4, 40 minutes pre, 10 minutes pre, immediately post, 25 minutes post.

• Heart rate variability

  Heart Rate Variability (HRV) was measured three times over the course of the study in order to measure responses to stress. A Polar H10 monitor was used, alongside the HRVTrace app to record the three measures. Each HRV measurement was 7 minutes, and required the subjects to sit quietly and watch a standardized nature video.

  HRV was recorded immediately following the 2nd, 3rd, and 4th saliva samples.

• Secretory Immunoglobin-A

  SIgA is a marker of immune function and salivary SIgA concentrations tend to increase when exposed to stress

  40 minutes prior to modified TSST start, 10 minutes prior to modified TSST start, immediately post modified TSST, and 25 minutes post TSST

• Salivary Alpha Amylase

  salivary alpha amylase is an enzyme involved in digestive processes. Amylase concentration in saliva have been shown to reflect sympathetic stress. Thus, as sympathetic stress increases, salivary amylase concentrations tend to increase.

  40 minutes prior to modified TSST start, 10 minutes prior to modified TSST start, immediately post modified TSST, and 25 minutes post TSST

Study Arms (3)

Box Breathing group

EXPERIMENTAL

Group to be assigned box breathing.

Other: Box Breathing

Prolonged Exhalation Breathing assignment group

EXPERIMENTAL

Breathing group to be assigned the prolonged exhalation intervention.

Other: Prolonged Exhalation

Placebo (normal breathing) group

PLACEBO COMPARATOR

This group is not assigned a breathing technique, and acts as a placebo.

Other: Normal Breathing

Interventions

Box Breathing OTHER

Box breathing consisted of a 4 second inhale, 4 second hold, 4 second exhale, 4 second hold; for 4 minutes.

Box Breathing group

Prolonged Exhalation OTHER

Prolonged Exhalation consisted of a deep, 3 second inhale, followed by a slow 6 second exhale through pursed lips, once every 30 seconds for 4 minutes.

Prolonged Exhalation Breathing assignment group

Normal Breathing OTHER

This was the placebo, normal breathing group was instructed to breath as they normally would for the entirety of the 4 minute period.

Placebo (normal breathing) group

Eligibility Criteria

• Age: 18 Years - 39 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Generally healthy
• Between the ages of 18-39,
• Student at Texas State.

You may not qualify if:

• Any known cardiovascular or metabolic disease
• Consuming any medication for psychiatric disorders (i.e., anxiety, depression, ADHD)
• Being diagnosed with any psychiatric or physical conditions
• Any major stressors in the last 30 days (i.e., birth of a child, abortion, divorce).

Sponsors & Collaborators

• Texas State University: lead
• Texas State University, San Marcos: collaborator

Study Sites (1)

Texas State University, Metabolic & Applied Physiology Lab

San Marcos, Texas, 78666, United States

Location

Related Publications (7)

• Kotlyar M, Donahue C, Thuras P, Kushner MG, O'Gorman N, Smith EA, Adson DE. Physiological response to a speech stressor presented in a virtual reality environment. Psychophysiology. 2008 Nov;45(6):1034-7. doi: 10.1111/j.1469-8986.2008.00690.x. Epub 2008 Sep 4.

  PMID: 18778321 BACKGROUND

• Allen AP, Kennedy PJ, Dockray S, Cryan JF, Dinan TG, Clarke G. The Trier Social Stress Test: Principles and practice. Neurobiol Stress. 2016 Nov 12;6:113-126. doi: 10.1016/j.ynstr.2016.11.001. eCollection 2017 Feb.

  PMID: 28229114 BACKGROUND

• Matsumoto T, Masuda T, Hotta K, Shimizu R, Ishii A, Kutsuna T, Yamamoto K, Hara M, Takahira N, Matsunaga A. Effects of prolonged expiration breathing on cardiopulmonary responses during incremental exercise. Respir Physiol Neurobiol. 2011 Sep 15;178(2):275-82. doi: 10.1016/j.resp.2011.06.025. Epub 2011 Jul 7.

  PMID: 21763472 BACKGROUND

• Narkiewicz K, van de Borne P, Montano N, Hering D, Kara T, Somers VK. Sympathetic neural outflow and chemoreflex sensitivity are related to spontaneous breathing rate in normal men. Hypertension. 2006 Jan;47(1):51-5. doi: 10.1161/01.HYP.0000197613.47649.02. Epub 2005 Dec 12.

  PMID: 16344363 BACKGROUND

• Ntovas P, Loumprinis N, Maniatakos P, Margaritidi L, Rahiotis C. The Effects of Physical Exercise on Saliva Composition: A Comprehensive Review. Dent J (Basel). 2022 Jan 5;10(1):7. doi: 10.3390/dj10010007.

  PMID: 35049605 BACKGROUND

• Dillard CC, Martaindale H, Hunter SD, McAllister MJ. Slow Breathing Reduces Biomarkers of Stress in Response to a Virtual Reality Active Shooter Training Drill. Healthcare (Basel). 2023 Aug 21;11(16):2351. doi: 10.3390/healthcare11162351.

  PMID: 37628548 BACKGROUND

• Kim HG, Cheon EJ, Bai DS, Lee YH, Koo BH. Stress and Heart Rate Variability: A Meta-Analysis and Review of the Literature. Psychiatry Investig. 2018 Mar;15(3):235-245. doi: 10.30773/pi.2017.08.17. Epub 2018 Feb 28.

  PMID: 29486547 BACKGROUND

MeSH Terms

Conditions

Stress Disorders, Traumatic, Acute

Condition Hierarchy (Ancestors)

Stress Disorders, Traumatic; Trauma and Stressor Related Disorders; Mental Disorders

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: OTHER
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Model Details: Subjects were randomly assigned to one of three groups, between and within subject analysis occurred.

Study Record Dates

• First Submitted: May 7, 2025
• First Posted: May 22, 2025
• Study Start: August 1, 2024
• Primary Completion: May 1, 2025
• Study Completion: May 1, 2025
• Last Updated: May 22, 2025

Record last verified: 2025-05

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)