Slow breathing as a means to improve orthostatic tolerance: a randomized sham-controlled trial

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  • Sam Lucas
  • Nia C S Lewis
  • Elisabeth L G Sikken
  • Kate N Thomas
  • Philip N Ainslie

Colleges, School and Institutes


Endogenous oscillations in blood pressure and cerebral blood flow have been associated with improved orthostatic tolerance. Although slow breathing induces such responses, it has not been tested as a therapeutic strategy to improve orthostatic tolerance. Utilising a randomized crossover, sham-controlled design, we tested the hypothesis that breathing at 6 breaths⋅min(-1) (vs. spontaneous breathing) would improve orthostatic tolerance via inducing oscillations in mean arterial blood pressure (MAP) and cerebral blood flow. Sixteen healthy participants (aged 25±4 y; mean±SD) had continuous beat-to-beat measurements of middle cerebral artery blood velocity (MCAv), blood pressure (finometer), heart rate (ECG) and end-tidal PCO2 during an incremental orthostatic stress test to pre-syncope by combining head-up tilt with incremental lower-body negative pressure. Tolerance time to pre-syncope was improved (+15%) with slow breathing compared with spontaneous breathing (29.2±5.4 vs. 33.7±6.0 min; P


Original languageEnglish
JournalJournal of Applied Physiology
Publication statusPublished - 16 May 2013