Author: Jafari H1, Gholamrezaei A2, Franssen M3, Van Oudenhove L4, Aziz Q5, Van den Bergh O6, Vlaeyen JWS7, Van Diest I6
Affiliation:
1KU Leuven - University of Leuven, Health Psychology Unit, Leuven, Belgium; Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. Electronic address: Hassan.Jafari@kuleuven.be.
2KU Leuven - University of Leuven, Health Psychology Unit, Leuven, Belgium; KU Leuven - University of Leuven, Department Chronic Diseases, Metabolism & Ageing (CHROMETA), Translational Research Center for Gastrointestinal Disorders (TARGID), Leuven, Belgium.
3KU Leuven - University of Leuven, Health Psychology Unit, Leuven, Belgium; Center for the Psychology of Learning and Experimental Psychopathology, University of Leuven, Leuven, Belgium.
4KU Leuven - University of Leuven, Department Chronic Diseases, Metabolism & Ageing (CHROMETA), Translational Research Center for Gastrointestinal Disorders (TARGID), Leuven, Belgium.
5Wingate Institute of Neurogastroenterology, Centre for Neuroscience and Trauma, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London UK.
6KU Leuven - University of Leuven, Health Psychology Unit, Leuven, Belgium.
7KU Leuven - University of Leuven, Health Psychology Unit, Leuven, Belgium; Experimental Health Psychology, Maastricht University, Maastricht, The Netherlands.
Conference/Journal: J Pain.
Date published: 2020 Jan 21
Other:
Pages: S1526-5900(20)30002-X , Special Notes: doi: 10.1016/j.jpain.2019.12.010. [Epub ahead of print] , Word Count: 244
Slow deep breathing (SDB) is commonly employed in the management of pain, but the underlying mechanisms remain equivocal. This study sought to investigate effects of instructed breathing patterns on experimental heat pain and to explore possible mechanisms of action. In a within-subject experimental design, healthy volunteers (n = 48) performed four breathing patterns: 1) unpaced breathing (UB), 2) paced breathing at the participant's spontaneous breathing frequency (PB), 3) SDB at six breaths per minute with a high inspiration/expiration ratio (SDB-H), and 4) SDB at six breaths per minute with a low inspiration/expiration ratio (SDB-L). During presentation of each breathing pattern, participants received painful heat stimuli of three different temperatures and rated each stimulus on pain intensity. Respiration, heart rate, and blood pressure were recorded. Compared to UB, participants reported less intense pain during each of the three instructed breathing patterns. Among the instructed breathing patterns, pain did not differ between PB and SDB-H, and SDB-L attenuated pain more than the PB and SDB-H patterns. The latter effect was paralleled by greater blood pressure variability and baroreflex effectiveness index during SDB-L. Cardiovascular changes did not mediate the observed effects of breathing patterns on pain. Perspective: SDB is more efficacious to attenuate pain when breathing is paced at a slow rhythm with an expiration that is long relative to inspiration, but the underlying mechanisms remain to be elucidated.
Copyright © 2020. Published by Elsevier Inc.
KEYWORDS: baroreflex; blood pressure; cardiac vagal tone; paced breathing; pain; slow deep breathing
PMID: 31978501 DOI: 10.1016/j.jpain.2019.12.010
