Eight weeks of device-guided slow breathing decreases sympathetic nervous reactivity to stress in posttraumatic stress disorder

Ida T. Fonkoue, Yingtian Hu, Toure Jones, Monica Vemulapalli, Justin D. Sprick, X. Barbara Rothbaum, X. Jeanie Park

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Posttraumatic stress disorder (PTSD) is characterized by increased risk for developing hypertension and cardiovascular disease. We recently showed that device-guided slow breathing (DGB) acutely lowers blood pressure (BP) and muscle sympathetic activity (MSNA) and improves baroreflex sensitivity (BRS) in PTSD. The aim of this study was to assess the long-term benefits of DGB on autonomic function at rest and during stress. We hypothesized that long-term DGB improves arterial BRS and lowers BP and MSNA in PTSD. Twenty-five veterans with PTSD were studied and randomized to either 8 wk of daily DGB (n = 12) or 8 wk of sham device (Sham; n = 13). BP, heart rate (HR), and MSNA were measured at rest and during mental math. Arterial BRS was assessed using the modified Oxford technique. Resting MSNA, BP, and heart rate (HR) remained comparable before and after 8 wk in both groups (DGB and Sham). Likewise, the change in sympathetic and cardiovagal BRS was not different between the groups. Interestingly, DGB significantly decreased MSNA reactivity to mental math when expressed as burst frequency (P = 0.012) or burst incidence (P = 0.008) compared with Sham, suggesting a sustained effect of DGB on sympathetic reactivity to stress in PTSD. Contrary to our hypothesis, long-term DGB did not lower systolic BP, diastolic BP, or HR responses to stress compared with Sham. Likewise, pulse pressure reactivity after 8 wk (P = 0.121) was also comparable. In summary, these data suggest that long-term use of DGB may lead to a sustained dampening of sympathetic reactivity to mental stress in PTSD.

Original languageEnglish (US)
Pages (from-to)R466-R475
JournalAmerican Journal of Physiology - Regulatory Integrative and Comparative Physiology
Issue number4
StatePublished - Oct 2020
Externally publishedYes

Bibliographical note

Funding Information:
This work was supported by United States Department of Veterans Affairs Clinical Sciences Research and Development Program Merit Review Award I01CX001065; American Heart Association National Affiliate, Collaborative Sciences Award 15CSA24340001; National Heart Lung Blood Institute Grant R01 HL135183; National Center for Complementary and Integrative Health Grant R61 AT010457; National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH) under Award Numbers UL1TR002378 and KL2TR002381; NIH Training Grant T32 DK-00756; Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development and the Clinical Studies Center of the Atlanta Veterans Affairs Health Care System, Decatur, Georgia; and Foundation for Atlanta Veterans Education and Research (FAVER).

Publisher Copyright:
Copyright © 2020 the American Physiological Society.


  • Autonomic function
  • Mental stress
  • PTSD
  • Slow breathing


Dive into the research topics of 'Eight weeks of device-guided slow breathing decreases sympathetic nervous reactivity to stress in posttraumatic stress disorder'. Together they form a unique fingerprint.

Cite this