Breathing Awareness Meditation Research Articles

Design and rationale of a pilot randomized clinical trial investigating the use of a mHealth app for sarcoidosis-associated fatigue

Fatigue is the most reported symptom in patients with sarcoidosis (SPs) and is a significant predictor of decreased quality of life that is strongly associated with stress and negative mood states. Few medications exist for treating fatigue in SPs, and outpatient physical rehabilitation programs are limited by availability and cost. Sarcoidosis in the US predominantly impacts minorities and underserved populations who are of working age and often have limited resources (e.g., financial, transportation, time off work) that may prevent them from attending in-person programs. The use of mobile health (mHealth) is emerging as a viable alternative to provide access to self-management resources to improve quality of life. The Sarcoidosis Patient Assessment and Resource Companion (SPARC) App is a sarcoidosis-specific mHealth App intended to improve fatigue and stress in SPs. It prompts SPs to conduct breathing awareness meditation (BAM) and contains educational modules aimed at improving self-efficacy.Herein we describe the design and methods of a 3-month randomized control trial comparing use of the SPARC App (10-min BAM twice daily) to standard care in 50 SPs with significant fatigue (FAS ≥22). A Fitbit® watch will provide immediate heartrate feedback after BAM sessions to objectively monitor adherence. The primary outcomes are feasibility and usability of the SPARC App (collected monthly). Secondary endpoints include preliminary efficacy at improving fatigue, stress, and quality of life. We expect the SPARC App to be a useable and feasible intervention that has potential to overcome barriers of more traditional in-person programs.

Perceptions of the fatigue experience and a breathing awareness meditation-integrated mHealth App for fatigue and stress in patients with sarcoidosis

ABSTRACT Objective Fatigue is a debilitating consequence of sarcoidosis, a multi-system inflammatory disease, potentially related to increased stress associated with the disease. Breathing awareness meditation has potential as an intervention for managing stress and fatigue for patients with sarcoidosis (PS). The project aim was to obtain feedback from key informants to design and tailor a patient-centered Sarcoidosis Patient Resource and Companion (SPARC) mHealth App developed for PS to manage fatigue/stress at home using meditation. Methods A mixed-method patient/user-centered design was used with triangulation to understand patient experiences of sarcoidosis-associated fatigue and stress (n = 13), and to obtain feedback on the SPARC App prototype integrating meditation from patients and health care team members (HCTMs; n = 5). Using deductive content analysis, transcribed interviews were coded for themes/subthemes. Results Themes indicated that sarcoidosis patients find fatigue to be a profoundly difficult and stressful experience affecting multiple domains of functioning with few effective strategies to cope with these challenges. Patients and HCTMs shared feedback on the SPARC App prototype after a test session and found it user friendly with potential to improve fatigue/stress. Key points for tailoring the App to patients were shared. Conclusion Sarcoidosis-associated fatigue poses a significant burden for patients. The SPARC App prototype with breathing awareness meditation was acceptable, feasible and well-received by patients and HCTMs. Future iterations of the SPARC App to test the effect of meditation on fatigue will need to incorporate study recommendations for individual tailoring for these patients.

Does an acute bout of breathing awareness meditation improve breathing stability correlated with regulatory prefrontal cortex neural activity in obstructive sleep apnea?

Does an acute bout of breathing awareness meditation improve breathing stability correlated with regulatory prefrontal cortex neural activity in obstructive sleep apnea?

Ethnicity Differences in Sleep Changes Among Prehypertensive Adults Using a Smartphone Meditation App: Dose-Response Trial.

BackgroundAfrican Americans (AAs) experience greater sleep quality problems than non-Hispanic Whites (NHWs). Meditation may aid in addressing this disparity, although the dosage levels needed to achieve such benefits have not been adequately studied. Smartphone apps present a novel modality for delivering, monitoring, and measuring adherence to meditation protocols.ObjectiveThis 6-month dose-response feasibility trial investigated the effects of a breathing awareness meditation (BAM) app, Tension Tamer, on the secondary outcomes of self-reported and actigraphy measures of sleep quality and the modulating effects of ethnicity of AAs and NHWs.MethodsA total of 64 prehypertensive adults (systolic blood pressure <139 mm Hg; 31 AAs and 33 NHWs) were randomized into 3 different Tension Tamer dosage conditions (5,10, or 15 min twice daily). Sleep quality was assessed at baseline and at 1, 3, and 6 months using the Pittsburgh Sleep Quality Index (PSQI) and 1-week bouts of continuous wrist actigraphy monitoring. The study was conducted between August 2014 and October 2016 (IRB #Pro00020894).ResultsAt baseline, PSQI and actigraphy data indicated that AAs had shorter sleep duration, greater sleep disturbance, poorer efficiency, and worse quality of sleep (range P=.03 to P<.001). Longitudinal generalized linear mixed modeling revealed a dose effect modulated by ethnicity (P=.01). Multimethod assessment showed a consistent pattern of NHWs exhibiting the most favorable responses to the 5-min dose; they reported greater improvements in sleep efficiency and quality as well as the PSQI global value than with the 10-min and 15-min doses (range P=.04 to P<.001). Actigraphy findings revealed a consistent, but not statistically significant, pattern in the 5-min group, showing lower fragmentation, longer sleep duration, and higher efficiency than the other 2 dosage conditions. Among AAs, actigraphy indicated lower sleep fragmentation with the 5-min dose compared with the 10-min and 15-min doses (P=.03 and P<.001, respectively). The 10-min dose showed longer sleep duration than the 5-min and 15-min doses (P=.02 and P<.001, respectively). The 5-min dose also exhibited significantly longer average sleep than the 15-min dose (P=.03).ConclusionsThese findings indicate the need for further study of the potential modulating influence of ethnicity on the impact of BAM on sleep indices and user-centered exploration to ascertain the potential merits of refining the Tension Tamer app with attention to cultural tailoring among AAs and NHWs with pre-existing sleep complaints.

Acceptability and Impact of a Breathing Awareness Meditation Application on Stress, Strain, Sleep Quality Among Caregivers of Kidney Transplant Recipients

Acceptability and Impact of a Breathing Awareness Meditation Application on Stress, Strain, Sleep Quality Among Caregivers of Kidney Transplant Recipients

A single case design to examine short-term intracranial EEG patterns during focused meditation

PurposeThis study used a multiple crossover ABAB single case design to examine intracranial EEG data during a breath awareness meditation and an active control task. ResultsVisual analyses suggest that a brief breath awareness mediation was consistently associated with increased alpha power when compared to the active control. Less consistent effects were found with theta, beta, and high gamma activity. Nonparametric tests provided additional support for this finding. ConclusionsAcquiring intracranial EEG patterns during a meditative state may provide more insight into the physiology of meditation with less contamination of high-frequency muscle activity. While access to intracranial EEG during meditation is rarely available, single case design studies are considered adaptations of interrupted time-series designs and can provide an experimental evaluation of intervention effects

Short-term mindful breath awareness training improves inhibitory control and response monitoring.

Mindfulness meditation is thought to lead to positive changes in cognitive and affective functioning. However, the mechanisms underlying these changes are not well understood. One reason for this is that so far only very few studies considered the effects of specific meditation practices. We thus investigated the effects of engaging in one specific form of mindfulness meditation for a brief time period on behavioral and neural indicators of inhibitory control and metacognition. Performance on the Go/No-Go task and concurrent neural activity (EEG) was assessed before and after participants engaged in 3 weeks of mindful breath awareness meditation. Compared to a waitlist control group, meditation training enhanced the N2 event-related potential in No-Go trials and the error-related negativity (ERN) after error responses. As these two components reflect conflict and response monitoring, respectively, our results support the notion that mindfulness meditation improves metacognitive processes. The changes in the ERN were correlated with the accumulated amount of meditation time, highlighting the importance of meditation practice. Furthermore, meditation improved a behavioral marker of impulsive responding, indicating the relevance of mindfulness-based approaches for supporting health-related behaviors that are associated with deficits in impulsive control, such as substance abuse or over-eating. This study demonstrated that investigating one particular meditation practice rather than complex mindfulness-based interventions can contribute to a deeper understanding of mindfulness meditation mechanisms.

Mindful breath awareness meditation facilitates efficiency gains in brain networks: A steady-state visually evoked potentials study

The beneficial effects of mindfulness-based therapeutic interventions have stimulated a rapidly growing body of scientific research into underlying psychological processes. Resulting evidence indicates that engaging with mindfulness meditation is associated with increased performance on a range of cognitive tasks. However, the mechanisms promoting these improvements require further investigation. We studied changes in behavioural performance of 34 participants during a multiple object tracking (MOT) task that taps core cognitive processes, namely sustained selective visual attention and spatial working memory. Concurrently, we recorded the steady-state visually evoked potential (SSVEP), an EEG signal elicited by the continuously flickering moving objects, and indicator of attentional engagement. Participants were tested before and after practicing eight weeks of mindful breath awareness meditation or progressive muscle relaxation as active control condition. The meditation group improved their MOT-performance and exhibited a reduction of SSVEP amplitudes, whereas no such changes were observed in the relaxation group. Neither group changed in self-reported positive affect and mindfulness, while a marginal increase in negative affect was observed in the mindfulness group. This novel way of combining MOT and SSVEP provides the important insight that mindful breath awareness meditation may lead to refinements of attention networks, enabling more efficient use of attentional resources.

Meditation smartphone application effects on prehypertensive adults' blood pressure: Dose-response feasibility trial.

Essential hypertension (EH) is the most common chronic disease in the United States and a major cause of morbidity and mortality. Lifestyle interventions (e.g., diet, exercise, stress management) to reduce blood pressure (BP) are often complex with varying effectiveness. Breathing awareness meditation (BAM) is a stress management strategy with encouraging effects on BP, though widespread dissemination is hampered by the lack of an easy-to-use methodology to train and monitor BAM practices. A smartphone application (Tension Tamer [TT]) that implements BAM and tracks adherence has shown promise in addressing these gaps. This 6-month dose-response feasibility trial evaluated effects of the app on BP to further optimize BAM user guidelines. Sixty-four adults with prehypertension were randomized to complete TT-guided BAM sessions for 5-, 10-, or 15-min intervals twice daily over 6 months. Continuous heart rate readings derived from the phone's video camera via reflective photoplethysmography were used as feedback and as an index of time-stamped adherence. Outcomes (resting BP, HR) were collected at baseline, 1-, 3-, and 6-months. Mixed modeling results showed a significant time effect for systolic BP (SBP) with a dose-response effect at Months 3 and 6. Adherence declined over time and was lowest in the 15-min dose condition, though SBP reductions were maintained. Generally, adherence was negatively associated with dose as the study progressed. Smartphone-implemented BAM appears to reduce SBP and can be a low-cost method to reach large populations. (PsycINFO Database Record

Mindfulness‐based SEL programming to increase preservice teachers’ mindfulness and emotional competence

AbstractEighty‐seven preservice teachers, some of whom had preschool teaching experience, were randomly assigned to an intervention that included training in breathing awareness meditation infused with social‐emotional learning (n = 43) or a control group that received training in (n = 44) in breathing awareness meditation only. Both groups showed an increase in mindfulness from pre‐ to posttest. However, as expected, dimensions of emotional competence improved more significantly for preservice teachers in the intervention group. Increases were also greater for participants with teaching experience. Both groups also increased in the belief that classroom misbehavior would result in negative cognitive and social costs to children, but a larger increase was observed for the intervention group. Implications for teacher preparation are discussed.

Formative evaluation on cultural tailoring breathing awareness meditation smartphone apps to reduce stress and blood pressure.

Chronic stress is an independent risk factor for essential hypertension (EH), cardiovascular disease (CVD), and is sometimes confronted by mal-adaptive coping behaviors (e.g., stress eating, excessive alcohol consumption, etc.). Pre-essential hypertension (preEH) is the leading predictor of future EH status. Breathing awareness meditation (BAM) can result in clinically beneficial blood pressure (BP) reductions, though face-to-face sessions presents barriers to reach those in need. The purpose of this study was to identify if a culturally tailored approach is needed in the design and preferences between groups of preEH African American and White adults toward using a smartphone BAM app, the Tension Tamer (TT) app. TT includes audio delivered BAM instructions, real-time heart rate, feedback graphs and motivational reinforcement text messaging. Questionnaires and two focus groups each of African American and White adults, [n=34, mean age =43.1 years, (SD 13.8 years), 44.1% African American] were conducted to understand stress, EH knowledge, app usage along with feedback from a hands-on demonstration of TT. Grounded theory using NVivo 10 was used to develop themes and combined with the questionnaires in the analysis. No racial differences were found in the analysis including app use scenarios, preferences, knowledge, technology use or the attitudes and acceptance toward mobile health (mHealth) programs. Reported stress was high for African Americans [PSS-4: mean 6.87 (SD 3.3) versus mean 4.56 (SD 2.6); P=0.03]. Four main themes were found: (I) stress was pervasive; (II) coping strategies were both positive and negative; (III) BAM training was easy to incorporated; and (IV) tracking stress responses was useful. Responses suggest that additional personalization of app interfaces may drive ownership and adherence to protocols. Measures and reports of heart rate monitoring while in session were favorably viewed with low issues with confidentiality or trust issues on collected session data. Results suggest that a culturally tailored approach may be unnecessary in the design of BAM apps. Further investigation is warranted for other racial groups, age ranges, and disease conditions.

Meditation Breath Attention Scores (MBAS): Test–Retest Reliability and Sensitivity to Repeated Practice

The sensitivity of an experience-sampling measure of meditators’ ability to maintain attention to their breathing during 15-min practices of mindful breath awareness meditation, referred to as “Meditation Breath Attention Scores” (MBAS), was previously shown to vary with other meditative experiences and mindfulness-related traits. The objectives of the present study were to assess: (1) the test–retest reliability of MBAS and (2) the sensitivity to practice-related effects of MBAS. Participants completed as many as four meditation sessions held on average 8–10 days apart. Ninety-five participants took part in session 1, with 77 (81 %) completing all four sessions. Test–retest reliability of MBAS was established (mean r between sessions = 0.50) and MBAS were sensitive to practice effects (η2 = 0.20) consistent with their interpretation as a performance measure. Individual differences in MBAS thus appear to be reliable over time but improve with the repeated practice of meditation. Future research directions are discussed.

Tension Tamer: Delivering Meditation With Objective Heart Rate Acquisition for Adherence Monitoring Using a Smart Phone Platform

This brief report demonstrates the proof of concept of the Tension Tamer (TT) smartphone application, which integrates photoplethysmograph capabilities with breathing awareness meditation (BAM), to reduce stress and measure heart rate and adherence. Methods for objectively measuring heart rate and adherence to BAM were developed as part of a future randomized controlled trial. The study was conducted at Jerry Zucker Middle School of Science and the Medical University of South Carolina, Charleston. The subjects were three prehypertensive male teachers. The method used was smartphone delivered BAM. Objective measures included heart rate, adherence, and ambulatory blood pressure (BP). Adherence data was successfully collected by the TT application. Increased adherence to TT coincided with increased improvements in ambulatory BP over a 3-month period. TT shows promise as a simple inexpensive program for administering BAM and capturing adherence data in future clinical trials.

Differential Impact of Stress Reduction Programs upon Ambulatory Blood Pressure among African American Adolescents: Influences of Endothelin-1 Gene and Chronic Stress Exposure

Stress-activated gene × environment interactions may contribute to individual variability in blood pressure reductions from behavioral interventions. We investigated effects of endothelin-1 (ET-1) LYS198ASN SNP and discriminatory stress exposure upon impact of 12-week behavioral interventions upon ambulatory BP (ABP) among 162 prehypertensive African American adolescents. Following genotyping, completion of questionnaire battery, and 24-hour ABP monitoring, participants were randomized to health education control (HEC), life skills training (LST), or breathing awareness meditation (BAM). Postintervention ABP was obtained. Significant three-way interactions on ABP changes indicated that among ET-1 SNP carriers, the only group to show reductions was BAM from low chronic stress environments. Among ET-1 SNP noncarriers, under low chronic stress exposure, all approaches worked, especially BAM. Among high stress exposure noncarriers, only BAM resulted in reductions. If these preliminary findings are replicated via ancillary analyses of archival databases and then via efficacy trials, selection of behavioral prescriptions for prehypertensives will be edging closer to being guided by individual's underlying genetic and environmental factors incorporating the healthcare model of personalized preventive medicine.

Breathing Awareness Meditation and LifeSkills Training Programs Influence Upon Ambulatory Blood Pressure and Sodium Excretion Among African American Adolescents

To evaluate the effect of breathing awareness meditation (BAM), Botvin LifeSkills Training (LST), and health education control (HEC) on ambulatory blood pressure and sodium excretion in African American adolescents. Following 3 consecutive days of systolic blood pressure (SBP) screenings, 166 eligible participants (i.e., SBP >50th-95th percentile) were randomized by school to either BAM (n = 53), LST (n = 69), or HEC (n = 44). In-school intervention sessions were administered for 3 months by health education teachers. Before and after the intervention, overnight urine samples and 24-hour ambulatory SBP, diastolic blood pressure, and heart rate were obtained. Significant group differences were found for changes in overnight SBP and SBP, diastolic blood pressure, and heart rate over the 24-hour period and during school hours. The BAM treatment exhibited the greatest overall decreases on these measures (Bonferroni adjusted, ps < .05). For example, for school-time SBP, BAM showed a change of -3.7 mmHg compared with no change for LST and a change of -.1 mmHg for HEC. There was a nonsignificant trend for overnight urinary sodium excretion (p = .07), with the BAM group displaying a reduction of -.92 ± 1.1 mEq/hr compared with increases of .89 ± 1.2 mEq/hr for LST and .58 ± .9 mEq/hr for HEC group. BAM appears to improve hemodynamic function and may affect sodium handling among African American adolescents who are at increased risk for development of cardiovascular disease.

Impact of Stress Reduction Interventions on Hostility and Ambulatory Systolic Blood Pressure in African American Adolescents.

This study examined the impact of breathing awareness meditation (BAM), life skills (LS) training, and health education (HE) interventions on self-reported hostility and 24-hour ambulatory blood pressure (ABP) in 121 African American (AA) ninth graders at increased risk for development of essential hypertension. They were randomly assigned to BAM, LS, or HE and engaged in intervention sessions during health class for 3 months. Before, after, and 3 months following intervention cessation, self-reported hostility and 24-hour ABP were measured. Results indicated that between pre- and postintervention, BAM participants displayed significant reductions in self-reported hostility and 24-hour systolic ABP. Reductions in hostility were significantly related to reductions in 24-hour systolic ABP. Between postintervention and follow-up, participants receiving LS showed a significant reduction in hostility but not in 24-hour ABP. Significant changes were not found for the HE group in 24-hour ABP or self-reported hostility, but these change scores were significantly correlated. The implications of the findings are discussed with regard to behavioral stress reduction programs for the physical and emotional health of AAs.

Influences of Family Environment and Meditation Efficacy on Hemodynamic Function among African American Adolescents

This study examined the impact of breathing awareness meditation (BAM) compared to health education (HE) and lifeskills training (LS) upon resting systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) within the context of potential moderating factors of family environment and expectancy of benefit. 186 African American adolescents (mean age: 15.1±0.7 yrs) were randomly assigned by school to three-month BAM, LS, or HE interventions. Laboratory resting blood pressure (BP), Family Relations Index (FRI) and expectancy of benefit evaluations were conducted at pre- and post-intervention. Higher expectancy of benefit from any of the three interventions resulted in greater reductions in SBP. A two-way interaction indicated that BAM group subjects who came from positive family environments exhibited greater decreases in SBP. A two-way interaction indicated that BAM and LS subjects who came from positive family environments exhibited greater DBP decreases. A two-way interaction indicated that BAM subjects who came from positive family environments exhibited a greater HR decrease (all p<.05). Expectancy of intervention benefits beneficially impacted success of behavioral interventions aimed at reducing SBP. Positive family environments in combination with either BAM or LS appear to have a beneficial impact upon hemodynamic function in AA adolescents.

Before Belief: Embodiment and the “Trying Game”

Last semester I taught a class I called “Mindful Writing.” Together, the students and I practiced simple breath-awareness meditation and read, quite slowly and deliberately, much of Robert Boice’s How Writers Journey to Comfort and Fluency: A Psychological Adventure. Boice, a psychologist, advocates the use of brief, daily writing sessions of 15-60 minutes each and frequent “comfort breaks” to notice and release any tension that arises while writing. As the title of his book suggests, his concern is with the psychology of writing, the ways in which emotional states, habitual patterns, and negative beliefs tend to get in the way of consistent, productive writing. In our class, we used mindful breath awareness, as well as other contemplative practices, as a way to practice comfort in writing and to notice those mind states that interfere with comfort and fluency. Teaching this class was, without a doubt, a highlight of my more than twenty years as a writing instructor. Having practiced yoga even longer than I’ve taught writing, I’ve sensed that paying attention to the breath and coming into the body would be a helpful support to the process of learning and teaching writing. As teachers, and as writers, too, we’ve surely seen how psychologically loaded writing can be. We bring to any writing experience so much baggage, including our own sense of ourselves as writers, things we’ve been told by teachers, and the expectations of the writing situation itself. Bringing a little bodily centering to the process has always seemed like a good idea to me. But it wasn’t until I read Boice’s book that I felt “authorized” to bring mindful practices so overtly into the classroom. And doing so was tremendously rewarding: many students reported a new confidence in their ability to meet the challenges of assigned writing for other classes, a desire to write more often for pleasure rather than using selfsponsored writing only as a means of venting, and a more relaxed pace in their approach to writing. The effects, for many students, spilled over into the rest of their lives so that they became more aware of the effects of stress on their bodies and felt motivated to better care for themselves, to get more sleep, not to push themselves so hard. Given the significant benefits students were reporting, I was surprised that a number of students expressed reluctance to try out Boice’s suggestions for making the writing process more comfortable. When Boice offered evidence against the idea that writers must wait for inspiration and advised instead that writing a little every day was the most effective way to cultivate inspiration and creativity, for example, some students countered that this wasn’t true, or that, if it were true, it was impractical, given the busy lives of students. In addition to this doubting game they played with the text, students indicted the reading as repetitive and overwhelming, even though we were reading only six to ten pages at a time.

Impact of breathing awareness meditation on ambulatory blood pressure and sodium handling in prehypertensive African American adolescents.

This study evaluated the impact of a breathing awareness meditation (BAM) program on ambulatory blood pressure and sodium handling in African American adolescents with high-normal systolic blood pressure (SBP) levels. Following three consecutive days of SBP screenings, 66 eligible ninth graders were randomly assigned by school to either BAM (n = 20) or health education control (n = 46) groups. The BAM group engaged in 10-minute BAM sessions at school and at home each day for three months. Teachers conducted sessions at school during health classes. Before and after the intervention, overnight urine samples were collected, and ambulatory SBP, diastolic blood pressure, and heart rate were recorded periodically for 24 hours. Significant changes before and after the intervention were observed between BAM and control groups for SBP during school hours (-4.7 vs .9 mm Hg, P < .05), SBP at night (-4.8 vs -.6 mm Hg, P < .01), and heart rate during school hours (-6.7 vs -2.3 bpm, P < .02), adjusted for their respective preintervention levels. The overnight urinary sodium excretion rate decreased in the BAM group but increased in the control group (-.3 +/- 4.9 vs 1.1 +/- 4.0 mEq/hour, P < .03). These findings demonstrate the potential beneficial impact of BAM taught by school health teachers on blood pressure control in the natural environment in African American youth at risk for development of hypertension.

Health Effect of Zen Breath Awareness Meditation

Health Effect of Zen Breath Awareness Meditation