RESPeRATE®: Lowering Blood Pressure By Synchronizing Breathing With Melody

RESPeRATE is a portable biofeedback device that guides users through specialized breathing exercises designed to slow breathing, which, in turn, lowers blood pressure.

How It Works

The battery-operated device resembles a personal CD player and consists of a breathing sensor, a computerized panel, and headphones. The belt-like sensor wraps around the chest to analyze breathing patterns, which are then converted into a personalized two-tone melody: one tone for inhaling and another for exhaling. As breathing synchronizes with the tones, the device gradually prolongs the exhalation tone and guides the user to a slower respiratory rate with prolonged exhalation. The goal is to reach a “therapeutic zone” of 10 breaths per minute.

Focused slow breathing, with an emphasis on prolonged exhalation, is believed to calm the autonomic nervous system, allowing small blood vessels to dilate so that blood flows more freely.[1] Fifteen-minute sessions of “therapeutic zone” breathing are recommended three or four times weekly.[1]

Hypertension in Canada

Approximately one-fifth of Canadians have hypertension.[2] Elevated blood pressure increases the risk of developing heart disease, heart failure, stroke, and kidney disease.[1,3 ]

Regulatory Status

RESPeRATE (InterCure Ltd.) was licensed by Health Canada in March 2004. It is indicated for use only as an adjunctive treatment for high blood pressure, together with other pharmacological or non-pharmacological interventions.

Evidence

The California Technology Assessment Forum reviewed the evidence on RESPeRATE reported in seven published studies involving 357 individuals.[4] All studies, including two randomized controlled trials (RCTs), showed moderate reductions in systolic and diastolic blood pressure. In one RCT with 65 patients, systolic blood pressure was reduced by an average of 15.2 mm Hg and diastolic blood pressure by 10.0 mm Hg in those using RESPeRATE for 10 minutes per day for eight weeks.[5] This compared to reductions of 11.3 mm Hg (p=0.14) and 5.6 mm Hg (p=0.008) in those listening to quiet music on a Walkman. Another RCT with 149 patients found that for those who used RESPeRATE for more than 180 minutes over eight weeks, systolic blood pressure decreased by a mean of 15 mm Hg (p<0.001) versus a 7.3 mm Hg reduction (p=0.005) for those using the device for less than 180 minutes.[3] There was a 9.2 mm Hg reduction (p=0.012) in the control patients who simply measured their blood pressure. The California assessment concluded that daily use of RESPeRATE met their technology assessment criteria for safety, effectiveness, and improvement in health outcomes for otherwise healthy, non-pregnant individuals.[4]

Cost

According to the Canadian distributor’s web site, the RESPeRATE device costs approximately $300.

References

[1] Elliott WJ, et al. MedGenMed 2006;8(3):23.
[2] McAlister FA, et al. CMAJ 2005;173(5):508-9. http://www.cmaj.ca/cgi/reprint/173/5/508?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=508&searchid=1&FIRSTINDEX=0&volume=173&issue=5&resourcetype=HWCI T T
[3] Elliott WJ, et al. J Clin Hypertens (Greenwich) 2004;6(10):553-9.
[4] Device-guided controlled breathing as a treatment for hypertension. San Francisco: California Technology Assessment Forum; 2004. Available: http://www.ctaf.org/content/general/detail/625
[5] Schein MH, et al. J Hum Hypertens 2001;15:271-8.