Effect of '365 Breathing Technique' on Intraocular Pressure and Autonomic Functions in Glaucoma Patients: A Randomised Controlled Trial

Author: Tanuj Dada1, Rajat S Gwal1, Karthikeyan Mahalingam1, Dinu Santha Chandran2, Dewang Angmo1, Shikha Gupta1, Thirumurthy Velpandian3, Kishore Kumar Deepak2
1 Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
2 Department of Physiology, All India Institute of Medical Sciences, New Delhi, India.
3 Department of Ocular Pharmacology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Conference/Journal: J Glaucoma
Date published: 2024 Jan 9
Other: Special Notes: doi: 10.1097/IJG.0000000000002356. , Word Count: 297

Primary open angle glaucoma patients were advised to follow '365 breathing technique' for 6 weeks in addition to their pharmacological glaucoma treatment. It helped to reduce IOP, stress biomarker- cortisol and improve autonomic dysfunction.

To study the effect of '365 breathing technique' on intraocular pressure(IOP), autonomic functions and stress biomarkers in patients with primary open angle glaucoma(POAG).

In this randomised, controlled, interventional trial: after randomisation, forty subjects in intervention group followed "365 breathing" ( 3times a day, breathing rate: 6cycles/min for 5 min) in addition to their pharmacological glaucoma treatment and forty subjects in control group continued only with their pharmacological glaucoma treatment. IOP, serum cortisol, heart rate variability(HRV) and heart rate response to deep breathing test(DBT) were recorded at pre-intervention and 6weeks post-intervention.

The mean IOP, serum cortisol, parameters of HRV test and DBT were comparable between two groups at baseline. At 6weeks follow-up, in the intervention group: mean IOP was significantly lower(16.09±2.24 mmHg vs. 18.38±1.58 mmHg, P-value=0.03) and serum cortisol was significantly lower(13.20±3.11 mcg/dl vs. 14.95±2.60 mcg/dl, P=0.038) compared to control group. In the HRV test Time domain analysis showed a significant difference in root mean square of successive difference between RR interval value between both groups at 6weeks(P=0.015) pointing towards higher post-intervention parasympathetic activation in intervention group. In frequency domain analysis(HRV-test), ratio of low-frequency component to high-frequency component was significantly lower in intervention group at 6weeks(1.65 vs. 1.79, P-value=0.019) indicating a shift in sympatho-vagal balance towards greater vagal modulation.There was a significant increase in delta heart rate(P-value=0.019) and Expiratory:Inspiratory ratio(P-value=0.011) in intervention group at 6weeks when compared to baseline values, indicating improved parasympathetic reactivity to DBT.

365 breathing technique can reduce IOP, serum cortisol and improve autonomic dysfunction in glaucoma patients.

PMID: 38194285 DOI: 10.1097/IJG.0000000000002356