Device-guided breathing in the home setting: technology, performance and clinical outcomes.

Routine practice of slow breathing is a major component of a variety of behavioral treatments of chronic conditions. The present paper addresses the challenge of using device-guided breathing (DGB) as a self-treatment tool in the home setting. The breathing patterns of hypertensive patients treated using DGB over 8 weeks in 15-min daily sessions were analyzed using minute-by-minute stored data. The relationship of breathing pattern with office blood pressure changes over the treatment period was evaluated. The treatment device operated to reduce breathing rate effortlessly while prolonging exhalation: patients were requested to synchronize breathing with the guiding tones, generated in response to the monitored breathing pattern. Breathing modification was highly individualized, repeatable over sessions, and unrelated to clinical or demographic characteristics; it also seemed to reflect behavioral aspects of device-patient interaction. Quality of breathing synchronization with the guiding tones and time spent in slow breathing displayed a relationship with the clinical outcomes. Different DGB methods are believed to share similar features. A possible physiological mechanism underlying the beneficial effect of slow and effortless breathing in chronic conditions is discussed in relation to restoring autonomic balance via lung reflexes.