Purpose: Sleep disturbance, dyspnea, fatigue, depression are common in patients with pulmonary arterial hypertension (PAH). The purpose of this study was to test the feasibility of using slow-paced respiration therapy to treat symptoms in PAH. Methods: We enrolled 10 women in this single-arm, open-label clinical trial (NCT02080533) who underwent baseline and follow up assessments after 8 weeks of slow-paced respiration therapy using the RESPeRATETM device. The device has a sensor belt worn around the chest which relays the person's respiratory patterns. A melody comprising two tones (rising tone for inhalation; lower tone for exhalation) assists patients to lower their respiratory rate. Assessments included sleep quality [Pittsburgh Sleep Quality Index (PSQI)], dyspnea [Multidimensional Dyspnea Profile (MDP)], fatigue [Multidimensional Fatigue Inventory (MFI)], depression [Patient Health Questionnaire-8 (PHQ-8)], health-related quality of life (HRQOL- emPHasis-10), echocardiography, 6 minute walk and interleukin-6 (IL-6) levels. Subjects also completed 7 days of actigraphy and a sleep diary. Results: The mean age was 50.1 + 13.5 and 50% had idiopathic/heritable PAH. All subjects completed the study and there was 92% adherence to the study intervention. There were decreases in wake after sleep onset (WASO) (ES= 0.63, p= 0.17) measured by actigraphy and an increase in sleep efficiency (ES= 0.43, p= 0.24) which were not statistically significant. There was a significant decrease in median IL-6 levels pg/mL (pre 1.3 (1.1-1.7); post 1.2 (0.8-1.4), p= 0.037) and possible improvements in self-reported dyspnea (ES= 0.23, p= 0.17), depressive symptoms (ES= 0.26, p= 0.07) and HRQOL (ES= 0.40, p= 0.13) post intervention. Conclusion: Eight weeks of slow-paced respiration therapy was feasible and associated with a significant decrease in IL-6 levels and possible improvements in sleep disturbance, dyspnea, depressive symptoms and HRQOL. A larger randomized clinical trial is needed to determine if slow-paced respiration therapy is effective in PAH.
Matura, L., Fargo, J., Fritz, J. S., Smith, K. A., Vaidya, A., Pinder, D., … Kawut, S. M. (2016). Slow-Paced Respiration Therapy to Treat Sleep Disturbance and Symptoms in Pulmonary Arterial Hypertension. The Journal of Heart and Lung Transplantation, 35(4), S348. https://doi.org/10.1016/j.healun.2016.01.998