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Completed

NCT Number: NCT07810595

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

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.

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Key information

Conditions

Breathing Exercises Anxiety Disorders Healthy Volunteers Mental Disorders

Age range

18 year–40 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Istanbul Atlas University

Istanbul, Kagıthane, Turkey (Türkiye)

About this study

Healthy adults aged 18-40 years were recruited using convenience sampling and randomly assigned in a 1:1:1 ratio to Mindfulness Breathing, Box Breathing, or Nadi Shodhana Pranayama. Participants received an individual face-to-face training session delivered by the same physiotherapist, practiced their assigned breathing technique under supervision until correct performance was confirmed, and subsequently performed daily home-based practice for six weeks using standardized instructional videos. Daily WhatsApp reminders containing the appropriate video link were sent to support adherence.

Heart rate variability was assessed using a Polar H10 heart rate monitor with 5-minute resting recordings analyzed using Kubios HRV software. Attention performance was measured using the Digit Cancellation Test, reaction time was assessed using the BlazePod wireless reaction system, and anxiety outcomes were evaluated using the State-Trait Anxiety Inventory. Assessments were performed at baseline and after six weeks.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 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.

Exclusion criteria

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

Treatment and study plan

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.

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.

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.

Primary outcomes

  1. Resting Heart Rate

    Time frame: Baseline and Week 6

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

  2. Root Mean Square of Successive Differences (RMSSD)

    Time frame: Baseline and Week 6

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

  3. Respiratory Rate

    Time frame: Baseline and Week 6

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

Secondary outcomes

  1. Digit Cancellation Test Score

    Time frame: Baseline and Week 6

    Attention performance assessed using the Digit Cancellation Test by recording the number of correctly identified targets within 30 seconds.

  2. BlazePod Reaction Time

    Time frame: Baseline and Week 6

    Reaction time assessed using a single BlazePod wireless light-based reaction system with the dominant hand. The system recorded average reaction time, number of successful responses, and number of errors.

  3. Anxiety

    Time frame: Baseline and Week 6

    Anxiety assessed using the Staterait Anxiety Inventory

Sponsors and collaborators

Lead sponsor

Atlas University

Other

Registry information

Official study title

Comparative Effects of Three Breathing Techniques on Heart Rate Variability, Attention, Reaction Time, and Anxiety in Healthy Adults: A Randomized Controlled Trial

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Sep 9, 2026
Registry last updated
Sep 9, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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