• Imke Courtois, Ali Gholamrezaei, Hassan Jafari, Stefan Lautenbacher, Ilse Van Diest, Lukas Van Oudenhove, and VlaeyenJohan W SJWSHealth Psychology, KU Leuven, Leuven, Belgium; Experimental Health Psychology, Maastricht University, The Netherlands..
• Health Psychology, KU Leuven, Leuven, Belgium. Electronic address: imke.courtois@kuleuven.be.
• J Pain. 2020 May 1; 21 (5-6): 616-632.

AbstractThe aim of the study reported in this paper is to investigate the effect of slow-deep breathing (SDB) on self-reported pain, heart rate variability, and baroreflex sensitivity (BRS). These effects are examined in 3 separate experiments, each using a different phasic pain modality. For each experiment, different subjects were recruited. Eighty-three healthy female participants were instructed to breathe guided by a visual cue at a slow frequency (SDB: .1 Hz), and at a frequency close to the spontaneous breathing frequency (normal paced breathing, .2 Hz). Pain was induced during instructed breathing using electrocutaneous (experiment 1, n = 31), thermal (experiment 2, n = 28), or mechanical stimuli (experiment 3, n = 24). Participants were requested to rate the intensity of each painful stimulus (Numerical Rating Scale) and subjective level of pleasantness, arousal, and dominance (self-assessment manikin). During the experiment, R-R interval, blood pressure, tidal volume, and end-tidal CO2 were continuously measured. Results for self-reported pain, self-assessment manikin, and physiological measurements were consistent across the 3 experiments. Although SDB significantly increased baroreflex sensitivity and heart rate variability, self-reported pain did not differ between breathing conditions, regardless of pain modality. Other potential mechanisms or components should be considered such as behavioral modulators including relaxation and treatment expectation. PERSPECTIVE: Merely slowing down the breathing frequency to .1 Hz is not sufficient to induce hypoalgesia, despite the significant physiological effects associated with SDB compared to spontaneous breathing.Copyright © 2019 United States Association for the Study of Pain, Inc. Published by Elsevier Inc. All rights reserved.

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