Three Breathing Techniques for Heart Rate Variability, Attention, Reaction Time, and Anxiety

NCT07810595 | Completed

• 1 other identifier: E 22686390 050.99 62685
• Study Type: interventional
• Target: 48
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial compared the effects of Mindfulness Breathing, Box Breathing, and Nadi Shodhana Pranayama on heart rate variability, attention performance, reaction time, and anxiety in healthy adults aged 18-40 years. Participants were randomly assigned to one of three breathing intervention groups and practiced their assigned technique daily for six weeks. Primary outcomes included resting heart rate, RMSSD, and respiratory rate derived from 5-minute heart rate variability recordings. Secondary outcomes included attention performance assessed by the Digit Cancellation Test, reaction time assessed using the BlazePod system, and state and trait anxiety assessed using the State-Trait Anxiety Inventory. Participants received standardized face-to-face instruction, home practice videos, and daily WhatsApp reminders throughout the intervention.

Conditions

Breathing Exercises; Healthy Volunteers

Keywords

Mindfulness Breathing; Box Breathing; Nadi Shodhana; Heart Rate Variability; Attention; Reaction Time; Anxiety

Outcome Measures

Primary Outcomes (3)

• Resting Heart Rate

  Resting heart rate (beats per minute) measured from a 5-minute seated recording using the Polar H10 heart rate monitor (Polar Electro, Kempele, Finland).

  Baseline and Week 6

• Root Mean Square of Successive Differences (RMSSD)

  RMSSD (milliseconds), a vagally mediated heart rate variability parameter, derived from 5-minute RR interval recordings analyzed using Kubios HRV software.

  Baseline and Week 6

• Respiratory Rate

  Respiratory rate (breaths per minute) obtained from the 5-minute Polar H10 recording.

  Baseline and Week 6

Secondary Outcomes (3)

• Digit Cancellation Test Score

  Baseline and Week 6

• BlazePod Reaction Time

  Baseline and Week 6

• Anxiety

  Baseline and Week 6

Study Arms (3)

Mindfulness Breathing

ACTIVE COMPARATOR

Participants practiced mindful awareness of their natural breathing without intentionally altering breathing rhythm during daily home sessions for six weeks.

Behavioral: Mindfulness Breathing

Box Breathing

EXPERIMENTAL

Participants performed a structured 4-4-4-4 breathing cycle consisting of 4 seconds of inhalation, 4 seconds of breath holding, 4 seconds of exhalation, and a 4-second post-exhalation pause during daily home practice for six weeks.

Behavioral: Box Breathing

Nadi Shodhana Pranayama

EXPERIMENTAL

Participants performed alternate nostril breathing with controlled inhalation and exhalation while maintaining a slow and rhythmic breathing pattern during daily home practice for six weeks.

Behavioral: Nadi Shodhana Pranayama

Interventions

Mindfulness Breathing BEHAVIORAL

Participants received an individual face-to-face training session from the same physiotherapist, practiced under supervision until correct performance was confirmed, and subsequently performed daily home-based mindfulness breathing for six weeks using standardized instructional videos and daily WhatsApp reminders.

Mindfulness Breathing

Box Breathing BEHAVIORAL

Participants received standardized face-to-face instruction and performed daily home-based Box Breathing using a 4-second inhalation, 4-second breath hold, 4-second exhalation, and 4-second pause for six weeks, supported by instructional videos and daily WhatsApp reminders.

Box Breathing

Nadi Shodhana Pranayama BEHAVIORAL

Participants received standardized face-to-face instruction and performed daily home-based alternate nostril breathing for six weeks using instructional videos and daily WhatsApp reminders.

Nadi Shodhana Pranayama

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Healthy adults aged 18 to 40 years.
• Ability to provide written informed consent.
• Ownership of a smartphone with internet access.
• Willingness to participate in daily breathing practice for six weeks.

You may not qualify if:

• Respiratory disease.
• History of lung transplantation.
• Pregnancy or suspected pregnancy.
• Previous experience with yoga, Qigong, breath therapy, or other structured breathing practices.

Sponsors & Collaborators

• Atlas University: lead

Study Sites (1)

Istanbul Atlas University

Istanbul, Kagıthane, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Anxiety Disorders

Condition Hierarchy (Ancestors)

Mental Disorders

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: BASIC SCIENCE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 3, 2026
• First Posted: September 9, 2026
• Study Start: September 1, 2025
• Primary Completion: June 20, 2026
• Study Completion: June 20, 2026
• Last Updated: September 11, 2026

Record last verified: 2026-09

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)