Device-guided slow breathing reduces stress, urinary symptoms in women with overactive bladder
A device-guided, slow-paced respiration leads to modest improvements in perceived stress at 12 weeks among women with an overactive bladder, but it is not superior to a music-listening control for reducing urinary symptoms or changing autonomic function, results of a new study have shown.
This randomized, parallel group trial of slow-paced respiration to improve perceived stress and autonomic dysfunction as potential contributors to overactive bladder included a total of 161 ambulatory women who reported at least three voiding or incontinence episodes per day associated with moderate to severe urgency.
Participants were randomly assigned to use a portable biofeedback device to practice daily slow, guided breathing exercises (n=79) or a control device that appeared identical and was reprogrammed to play music without guided breathing (n=82).
The researchers evaluated changes in urinary symptoms by voiding diaries, perceived stress and anxiety by validated questionnaires, and autonomic function by heart rate variability and impedance cardiography for 12 weeks.
The average baseline frequency of voiding or incontinence related to moderate to severe urgency was 6.9±3.4 episodes per day. Women in the paced respiration group vs control group showed greater improvement in perceived stress (average Perceived Stress Scale score decrease, 2.8 vs 1.1; p=0.03) but not in autonomic function markers. [J Urol 2019;202:787-794]
A decrease was noted in the average frequency of voiding or incontinence associated with moderate to severe urgency after 12 weeks (mean, 0.9±3.2 episodes per day). However, there was no significant difference seen between the two groups.
In another study, the device-guided, slow-paced respiration was also shown to fairly improve the frequency and severity of hot flushes in peri- or postmenopausal women. However, this strategy was not as effective as a music-listening intervention in reducing the frequency and severity of these symptoms. [Obstet Gynecol 2015;125:1130-1138]
This analysis included 123 women (mean age, 53.4 years) with average of 8.5 hot flushes per day at baseline. Those randomized to paced respiration (n=61) had an average decrease of 1.8 (0.9–2.6) hot flushes per day (–21 percent) compared with 3.0 (2.1–3.8; –35 percent) in the music-listening group (n=62; p=0.048). Paced respiration led to a much lower decrease in frequency of moderate to severe hot flushes compared with music listening (19 percent vs 44 percent; p=0.02).
A study by Sand and Appell reported that an overactive bladder in women could increase the risk of depression, sexual dysfunction, sleep disruption and productivity loss in the workplace. However, instead of seeking treatment, many patients would rather adopt coping strategies. As a result, available treatments remain underused in this population. [Am J Med 2006;119(3 Suppl 1):16-23]