Slow breathing techniques before bedtime and the effects on sleep: A systematic review

Area of Science:

• Sleep Science
• Respiratory Physiology
• Health and Well-being

Background:

• Sleep insufficiency is a prevalent global concern with significant health and economic impacts.
• Effective interventions to improve sleep are in high demand.

Purpose of the Study:

• To systematically review the evidence on the effectiveness of slow breathing for improving sleep.
• To synthesize findings from studies examining slow breathing protocols (≤10 breaths/min) before bedtime.

Main Methods:

• Systematic literature search conducted in Web of Science, MEDLINE, and PsycINFO.
• Included nine studies (457 participants) adhering to PRISMA guidelines.
• Assessed study quality using the GRADE approach and extracted data on sleep, heart rate variability, and intervention protocols.

Main Results:

• Self-reported sleep duration and quality significantly improved with slow breathing interventions.
• Objective sleep measures (actigraphy, polysomnography) yielded inconclusive results.
• Slow breathing influenced both parasympathetic and sympathetic activity, as indicated by heart rate variability.

Conclusions:

• Slow breathing shows promise for enhancing self-perceived sleep quality and duration.
• Further high-quality research with extended intervention periods is necessary to confirm efficacy using objective sleep measures.
• The impact of slow breathing on autonomic nervous system activity warrants further investigation in relation to sleep improvement.