{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:55:49Z","timestamp":1790787349244,"version":"4.1.0"},"reference-count":15,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ARM"],"abstract":"<jats:p>Background: Dysfunctional breathing patterns may impair autonomic regulation and increase perceived stress. Breathing-based interventions, particularly those involving guided exercises and supportive tools, have the potential to provide non-pharmacological benefits. Methods: In this parallel two-arm randomized controlled trial, 14 women aged 35\u201345 years with signs of dysfunctional breathing and no comorbidities were recruited from a fitness club. Participants were randomly assigned (1:1) using a computer-generated sequence to an intervention group (n = 7) or a control group (n = 7). Blinding was not applied. Both groups completed a 6-week program of guided breathing exercises using the iBreathe app, while the intervention group additionally used mouth tape during sleep. The primary outcomes were heart rate variability (HRV) indices\u2014root mean square of successive differences (RMSSD) and the high-frequency (HF) component. Secondary outcomes included respiratory rate, Hencho test performance, and perceived stress measured using the Perceived Stress Scale-10 (PSS-10) and a Visual Analogue Scale (VAS). All participants were included in the final analysis (no loss to follow-up). Results: The intervention group showed a significant increase in the HF component of HRV (p = 0.018) and improved Hencho test performance (p = 0.018). Both groups demonstrated significant reductions in respiratory rate (p &lt; 0.05) and PSS scores (p &lt; 0.05). Between-group differences were not significant for RMSSD or perceived stress. No adverse events were reported. Conclusions: A 6-week breathing intervention improved respiratory efficiency and reduced perceived stress among women with dysfunctional breathing. The additional of night-time mouth taping provided further benefits for HRV and respiratory control. Larger and longer trials are needed to confirm these findings.<\/jats:p>","DOI":"10.3390\/arm93060056","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T15:32:17Z","timestamp":1765380737000},"page":"56","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Breathing Interventions Improve Autonomic Function, Respiratory Efficiency and Stress in Dysfunctional Breathing: A Randomised Controlled Trial"],"prefix":"10.3390","volume":"93","author":[{"given":"Laura","family":"Zaliene","sequence":"first","affiliation":[{"name":"Department of Rehabilitation and Aesthetic Therapy, Faculty of Health Sciences, Klaipedos valstybine kolegija\/Higher Education Institution, LT-92255 Klaip\u0117da, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvina","family":"Mockute","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation and Aesthetic Therapy, Faculty of Health Sciences, Klaipedos valstybine kolegija\/Higher Education Institution, LT-92255 Klaip\u0117da, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Levickiene","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation and Aesthetic Therapy, Faculty of Health Sciences, Klaipedos valstybine kolegija\/Higher Education Institution, LT-92255 Klaip\u0117da, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,10]]},"reference":[{"key":"ref_1","first-page":"2578","article-title":"The effect of heart rate variability biofeedback training on stress and anxiety: A meta-analysis","volume":"47","author":"Goessl","year":"2017","journal-title":"Psychophysiol. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/s10484-011-9147-0","article-title":"Effects of heart rate variability biofeedback in subjects with stress-related chronic neck pain: A pilot study","volume":"36","author":"Hallman","year":"2011","journal-title":"Appl. Psychophysiol. Biofeedback"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1016\/j.mehy.2006.02.042","article-title":"Physiology of long pranayamic breathing: Neural respiratory elements may provide a mechanism that explains how slow deep breathing shifts the autonomic nervous system","volume":"67","author":"Jerath","year":"2006","journal-title":"Med. Hypotheses"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Lehrer, P.M., and Gevirtz, R. (2014). Heart rate variability biofeedback: How and why does it work? Front. Psychol., 5.","DOI":"10.3389\/fpsyg.2014.00756"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Shaffer, F., and Ginsberg, J.P. (2017). An overview of heart rate variability metrics and norms. Front. Public Health, 5.","DOI":"10.3389\/fpubh.2017.00258"},{"key":"ref_6","first-page":"471","article-title":"Anxiety and Respiratory variability","volume":"38","author":"Thayer","year":"2006","journal-title":"Psychophysiol."},{"key":"ref_7","first-page":"4431","article-title":"Mouth Breathing in Paediatric Population: A Literature Review","volume":"25","author":"Achmad","year":"2021","journal-title":"Ann. Rom. Soc. Cell Biol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.ijosm.2008.10.002","article-title":"Comparison of the Manual Assessment of respiratory Motion (MARM) and Hi Lo Breathing Assessment in determining a simulated breathing pattern","volume":"12","author":"Courtney","year":"2009","journal-title":"Int. J. Osteopath. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"385","DOI":"10.2307\/2136404","article-title":"A global measure of perceived stress","volume":"24","author":"Cohen","year":"1983","journal-title":"J. Health Soc. Behav."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1123\/jsr.2018-0027","article-title":"Clinical Breathing Mechanics Differ Based on Test and Position","volume":"28","author":"Horris","year":"2019","journal-title":"J. Sport Rehabil."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Yeung, A.W.K., and Wong, N.S.M. (2019). The historical roots of visual analog scale in psychology as revealed by reference publication year spectroscopy. Front. Hum. Neurosci., 13.","DOI":"10.3389\/fnhum.2019.00086"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Liu, S., Cui, Y., and Chen, M. (2025). Heart rate variability: A multidimensional perspective from physiological marker to brain-heart axis disorders prediction. Front. Cardiovasc. Med., 12.","DOI":"10.3389\/fcvm.2025.1630668"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"McKeown, P., O\u2019Connor-Reina, C., and Plaza, G. (2021). Breathing Re-Education and Phenotypes of Sleep Apnea: A Review. J. Clin. Med., 10.","DOI":"10.3390\/jcm10030471"},{"key":"ref_14","unstructured":"Sipavi\u010dien\u0117, S., Vadopalas, K., and Juod\u017ebalien\u0117, V. (2017). Assessment of Functional Status. First Aid, Lithuanian Sports University. Available online: https:\/\/eshop.lsmu.lt\/knygynas\/funkcines-bukles-vertinimas-pirmoji-pagalba-903145572."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"4","DOI":"10.15561\/26649837.2021.0101","article-title":"The effect of six-week slow breathing exercises on hear rate variability in physically active, healthy individuals","volume":"25","author":"Guner","year":"2021","journal-title":"Pedagog. Phys. Cult. Sports"}],"container-title":["Advances in Respiratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2543-6031\/93\/6\/56\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T15:59:46Z","timestamp":1765382386000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2543-6031\/93\/6\/56"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,10]]},"references-count":15,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["arm93060056"],"URL":"https:\/\/doi.org\/10.3390\/arm93060056","relation":{},"ISSN":["2543-6031"],"issn-type":[{"value":"2543-6031","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,10]]}}}