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Treatments

WHAT IS IT?

Paced breathing is a relaxation technique used to slow breathing. It prolongs the time spent breathing in (for example, to the count of 4) and breathing out (for example to the count of 6). It can be done once or twice a day to help you relax, or when you have symptoms.

There are apps that can help with paced breathing. There are also books, CDs, and YouTube videos to help people learn you control your breathing rate. Some clinicians may offer biofeedback training to help you learn to control your breath. You may see new devices on the market, too.

Paced breathing can also be done as part of mediation, mindfulness, yoga, tai chi, or Qigong practice.

Paced breathing has been shown to have positive effects on heart rate variability (HRV). HRV, in turn, is related to overall mortality and heart health. This is an active area of research, so we should learn more in the coming years.

OUR BOTTOM LINE:  DOES IT HELP?

MAYBE. It may help with anxiety and it’s easy to try. It won’t hurt you.

NO. Paced breathing does not help with hot flashes.

MAY HELP FOR THESE SYMPTOMS

common-depression

MOOD, ANXIETY & DEPRESSION

While not studied specifically in menopausal women, slow paced breathing techniques at approximately 6 breaths per minute help against stress and anxiety.

DOES NOT HELP THESE SYMPTOMS

common-hot-flashes

HOT FLASHES AND NIGHT SWEATS

Studies of paced breathing find no impact on hot flashes and night sweats frequency, severity or interference.

POTENTIAL RISKS & SIDE EFFECTS

Some people may get lightheaded when trying to control their rate of breathing. Its normal to sit down when you practice paced respiration, but lay down if you feel light headed.

QUALITY OF LIFE EXPECTATIONS

NONE

IF I WANT TO TRY THIS TREATMENT WHAT ARE MY NEXT STEPS?

You can try it on your own for a few weeks to see if it makes a difference. We recommend using a diary to track your level of anxiety. Note your anxiety level daily and how many times you practiced paced respiration during the day.  You can use our assessment tool to measure how anxious you were.

There are apps that can help you time your breaths. But you can also count on your own.

Sit comfortably. The goal is 10 breaths a minute. Breath slowly, counting in for 4 and out for 6. To breathe out longer than you breathe in, it can help to exhale through your mouth. Keep this up for 2 minutes at first, but gradually increase to about 10 minutes each time. Do it at least once a day. It’s relaxing, so you may want to do it more!

NOT USED FOR THESE SYMPTOMS

  • Heavy, irregular periods
  • Sleep problems / insomnia
  • Pain with sex
  • Vaginal pain or dryness, not during sex
  • Low sex drive
  • Brain fog, cognitive issues
  • Bladder control problems
  • Physical symptoms/aches & pains
  • Palpitations
  • Weight gain
REFERENCES

Carpenter JS, Burns DS, Wu J, Otte JL, Schneider B, Ryker K, Tallman E, Yu MJ. Paced respiration for vasomotor and other menopausal symptoms: a randomized, controlled trial. Gen Intern Med. 2013 Feb;28(2):193-200. doi: 10.1007/s11606-012-2202-6. PMID: 22936289 Free PMC Article

Gibson CJ, Mendes WB, Schembri M, Grady D, Huang AJ. Cardiac autonomic function and hot flashes among perimenopausal and postmenopausal women. Menopause. 2017 Jul;24(7):756-761. doi: 10.1097/GME.0000000000000843. PMID: 28169914 Free PMC Article

Goldstein KM, Coeytaux RR, Williams JW Jr, Shepherd-Banigan M, Goode AP, McDuffie JR, Befus D, Adam S, Masilamani V, Van Noord M, Nagi A, Wing L. Nonpharmacologic Treatments for Menopause-Associated Vasomotor Symptoms [Internet]. Washington (DC): Department of Veterans Affairs (US); 2016 Jul. PMID:28825782 Free Books & Documents

Huang AJ, Phillips S, Schembri M, Vittinghoff E, Grady D. Device-guided slow-paced respiration for menopausal hot flushes: a randomized controlled trial. Obstet Gynecol. 2015 May;125(5):1130-8. doi: 10.1097/AOG.0000000000000821. PMID: 25932840 Free PMC Article

Kennedy L., Parker S. H. (2018). Biofeedback as a stress management tool: a systematic review. Cogn. Tech. Work 21, 161–190. 10.1007/s10111-018-0487-x

Leyro TM, Versella MV, Yang M-J, Brinkman HR, Hoyt DL, Lehrer P, Respiratory therapy for the treatment of anxiety: Meta-analytic review and regression, Clinical Psychology Review, 84, 2021, https://doi.org/10.1016/j.cpr.2021.101980.

Stefanopoulou E, Hunter MS. Telephone-guided Self-Help Cognitive Behavioural Therapy for menopausal symptoms. Maturitas. 2014;77(1):73-77. doi:10.1016/j.maturitas.2013.09.013. PMID: 24144959

Sood R, Sood A, Wolf SL, Linquist BM, Liu H, Sloan JA, Satele DV, Loprinzi CL, Barton DL. Paced breathing compared with usual breathing for hot flashes. Menopause. 2013;20(2):179-184. doi: 10.1097/gme.0b013e31826934b6. PMID: 22990758

Yu B., Funk M., Hu J., Wang Q., Feijs L. (2018). Biofeedback for everyday stress management: a systematic review. Front. ICT 5:23. 10.3389/fict.2018.00023

Zaccaro A, Piarulli A, Laurino M, Garbella E, Menicucci D, Neri B, Gemignani A. How Breath-Control Can Change Your Life: A Systematic Review on Psycho-Physiological Correlates of Slow Breathing. Front Hum Neurosci. 2018;12:353. Published 2018 Sep 7. doi:10.3389/fnhum.2018.00353. PMID: 30245619 PMC free article

Authors: Dr. Janet Carpenter, Dr. Katherine Newton, & Dr. Leslie Snyder.  Last reviewed April 29, 2021

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