The Effect of Deep Breathing Exercise and 4–7-8 Breathing Techniques Applied to Patients After Bariatric Surgery on Anxiety and Quality of Life

Existing literature confirms widespread benefits of slow breathing practices for stress/anxiety reduction, but null or negative results are reported in some studies.

“Although existing literature confirms the widespread benefits of slow breathing practices for stress/anxiety reduction [23,24,25,35,36,37,38], null or negative results are reported in some studies [39,40,41,42,43,44,45,46,47,48,49,50].”

Of the four effective interventions lacking human-guided training, three included multiple sessions [39,80,106], and the other [79] may have incorporated unreported and unintentional human guidance due to investigator presence.

“Of the four effective interventions that lacked such training, three included multiple sessions [39,80,106], and the other [79] may have incorporated some unreported and unintentional human guidance due to the investigator’s presence during the practice.”

Stress reduction may have been hindered by fast-only breathing in Watson et al. and by discomfort of deep diaphragmatic breathing after abdominal surgery in Aktas et al.

“Regarding the latter, stress reduction may have also been hindered by fast-only breathing in Watson and colleague’s intervention and by the discomfort of doing deep diaphragmatic breathing after abdominal surgery in Aktas and colleagues’ intervention [39,105].”

The presence of core components in the three effective <5 min interventions suggests that short sessions may be particularly sensitive to practice implementation, requiring human guidance, multiple sessions, or long-term practice for effective stress reduction.

“The presence of core components in the three effective interventions [39,105,106] suggests that such short sessions may be particularly sensitive to practice implementation, such that human guidance, multiple sessions, or long-term practice are required for effective stress reduction.”

Significant associations between effectiveness, intervention duration, and number of sessions suggest that breathing practices are more beneficial when performed repeatedly.

“Three of the four effective unguided interventions included multiple sessions [39,80,106]; and significant associations between effectiveness, intervention duration, and number of sessions suggest that breathing practices are more beneficial when performed repeatedly.”

Three ineffective interventions with at-home practice [39,50] reported either inconsistent or unknown practice compliance.

“Nonetheless, interventions incorporating at-home practices should motivate and assess practice compliance, as our three ineffective interventions with at-home practice [39,50] reported either inconsistent or unknown practice compliance.”

Three of four effective unguided interventions included multiple sessions [39,80,106].

“Three of the four effective unguided interventions included multiple sessions [39,80,106]; and significant associations between effectiveness, intervention duration, and number of sessions suggest that breathing practices are more beneficial when performed repeatedly.”