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NCT Number: NCT07594873

The Acute Effects of Controlled Breathing Exercises and Music Therapy on the Autonomic Nervous System in Anxious Individuals

This project aims to investigate the acute effects of controlled breathing exercises and music therapy on parasympathetic nervous system activation and increased heart rate variability in anxious individuals.

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Key information

Conditions

Age range

18 year–40 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Istanbul Health and Technology University

Istanbul, Beyoğlu, 34421, Turkey (Türkiye)

Location status: Recruiting

Location contact

Gülce Esentürk, DMD, PhD

CONTACT

[email protected]

444 3 788

About this study

The main objective of our project is to reduce the suppressive effect of stress on the parasympathetic nervous system and, accordingly, to increase heart rate variability in individuals with anxiety through controlled breathing exercises and music therapy applications. For this purpose, individuals aged between 18 and 40 years who have moderate anxiety levels according to the State-Trait Anxiety Inventory, who have not previously been diagnosed with any cardiovascular, respiratory, neurological, or psychiatric diseases, and who have not smoked for at least the past 6 months will be included in the study.

The individuals included in the study will be randomly assigned into three groups: a control group, a controlled breathing exercise group, and a music-supported breathing exercise group. At the baseline assessment, the State-Trait Anxiety Inventory will be used to determine the anxiety levels of all participants and to ensure group homogenization. In addition to determining anxiety levels at baseline, heart rate variability, blood pressure, heart rate, and oxygen saturation will be assessed in all groups.

No intervention will be applied to the control group; only assessments will be conducted. A single-session exercise protocol lasting 20 minutes will be applied to the breathing exercise group and the music-supported breathing exercise group. Heart rate variability will be measured using the Polar H9 device and Elite HRV software. Blood pressure and heart rate measurements will be performed using a digital blood pressure monitor. Oxygen saturation will be determined using a fingertip pulse oximeter.

The heart rate variability, blood pressure, heart rate, and oxygen saturation assessments performed at baseline will be repeated at the 0th, 10th, and 20th minutes after the completion of the exercise in the intervention groups. In the control group, participants will be asked to remain seated for 20 minutes, and following the completion of this period, the measurements performed at baseline will be repeated at the 0th, 10th, and 20th minutes. Thus, the final evaluation will be completed, and the obtained data will be analyzed.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Volunteer to participate in the study
  • Not having a prior diagnosis of cardiovascular, respiratory, or neurological/psychiatric disease
  • Not having a history of regular arrhythmias, pacemakers, or severe hypertension
  • Not having smoked for at least 6 months
  • Not having engaged in strenuous exercise in the last 24 hours
  • Not having consumed caffeine/energy drinks within 6-8 hours prior to the intervention
  • Being between 18 and 40 years of age
  • Having a moderate level of anxiety according to the State-Trait Anxiety Scale
  • Participants must be literate and have at least a high school diploma.

Exclusion criteria

  • Having an active or chronic illness
  • Experiencing cooperation problems
  • Regular use of psychiatric medication (antidepressants, anxiolytics, etc.)
  • Use of medications that affect heart rate, such as beta-blockers
  • Auditory dysfunction (to the point of being unable to hear music)
  • Individuals who are highly trained (very experienced) in breathing exercises or meditation

Treatment and study plan

Controlled Breathing Exercises Group

Other

Controlled breathing exercises include Resonance Breathing Exercises, Nadi Shodhana Pranayama, Bhramari Pranayama, and physiological sighing exercises. The controlled breathing exercise group will receive these exercises in a single 20-minute session. Resonance breathing will be practiced for 5 minutes at a rate of 6 breaths per minute. During the intervention, patients will receive 2 sets of Nadi Shodhana Pranayama consisting of 8 breathing cycles, with a 2-minute rest period between sets. The session will also include 2 sets of Bhramari Pranayama consisting of 8 breathing cycles at a low breathing rate, with a 1-minute rest period between sets. The physiological sighing exercise involves an initial inhalation phase lasting 1 second, a second inhalation phase lasting 0.25 seconds, and an exhalation phase lasting 2 seconds, and is repeated for 5 minutes.

Music-Assisted Breathing Group

Other

The music-assisted breathing exercise will perform the same breathing exercises (resonant breathing, nadi shodhana, bhramari pranayama, and physiological sighing) along with music. Music-assisted breathing exercise will be performed in a single session lasting a total of 20 minutes. Music 1 (250-1000 Hz) and Music 2 (1000-16000 Hz) will be used at specific frequencies. A slow, rhythmically consistent, vocalless basic melody will be selected within these frequency ranges. The volume levels of all tracks will be kept constant. The music will be played through stereo headphones. Participants will listen to Music 1 (250-1000 Hz) for 10 minutes and Music 2 (1000-16000 Hz) for another 10 minutes. Individuals will be provided with an environment where disturbing factors (sound, light) are prevented.

Primary outcomes

  1. Autonomic Nervous System Assessment

    Time frame: Baseline, and at 0, 10, and 20 minutes after the 20-minute exercise session.

    To assess the autonomic nervous system, heart rate variability will be evaluated. A Polar H9 heart rate sensor chest strap and Elite HRV software will be used to measure analytical heart rate variability. During the assessment, the participant will be in a seated position in a chair, the Polar system chest strap will be placed directly over the sternum, and ultrasound gel will be used to increase the conductivity of the sensor. This method has validity with electrocardiogram. Heart rate variability parameters such as RMSSD, PNN50, and LF/HF will be measured.

  2. Pulse Measurement

    Time frame: Baseline, and at 0, 10, and 20 minutes after the 20-minute exercise session.

    Pulse measurements will be performed using an Omron brand digital blood pressure monitor. Individuals will be rested for at least 5 minutes before the measurement to ensure relaxation for an accurate reading.

  3. Blood Pressure Measurement

    Time frame: Baseline, and at 0, 10, and 20 minutes after the 20-minute exercise session.

    Blood pressure measurements will be performed using an Omron brand digital blood pressure monitor. Individuals will be rested for at least 5 minutes before the measurement to ensure relaxation for an accurate reading.

Secondary outcomes

  1. Oxygen Saturation

    Time frame: Baseline, and at 0, 10, and 20 minutes after the 20-minute exercise session.

    Pulse oximetry is a non-invasive, painless, and reliable method used to measure oxygen saturation (SpO2) in arterial blood. Oxygen saturation measurement will be performed with a finger-type pulse oximeter device.

Other outcomes

  1. State-Trait Anxiety Scale

    Time frame: Baseline

    To determine the anxiety level of all participants and to ensure group homogeneity, the State-Trait Anxiety Scale will be used. Individuals with moderate anxiety according to the State-Trait Anxiety Scale will be included in the study. This scale aims to assess the intensity of the emotions or behaviors expressed in the items on the scale. Theoretically, scores on this scale can range from 20 to 80. A higher score indicates a high level of anxiety, while a lower score indicates a low level of anxiety.

Study contacts

Contact information is provided by the study sponsor or research team.

Gülce Esentürk, PhD, DMD

CONTACT

[email protected]

444 3 788

Sponsors and collaborators

Lead sponsor

Istanbul Health and Technology University

Other

Registry information

Official study title

The Acute Effects of Controlled Breathing Exercises and Music Therapy on the Autonomic Nervous System in Anxious Individuals: A Randomized Controlled Study

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
May 19, 2026
Registry last updated
May 19, 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.