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NYT Well blog post overstates the proven benefits of controlled breathing

Rating

2 Star

Categories

Breathe. Exhale. Repeat: The benefits of controlled breathing

Our Review Summary

One woman with her eyes closedThis election-week story attempts to give readers news you can use: how to calm yourself with deep breathing exercises. However, it overstates the proven benefits of controlled breathing and doesn’t compare it with other stress-busting strategies, such as exercise or talking to a friend. And while some readers may have welcomed some timely stress management advice, there’s really not much news here.

Additionally the story includes specific instructions for three breathing techniques, which may be helpful to readers who are curious to try them out immediately.  This is not so much a critical appraisal of the techniques as an informational “hey try this” piece.

 

Why This Matters

Some stress can be good, motivating us to overcome challenges such as work deadlines. But severe amounts can have health consequences, according to the American Psychological Association, which says untreated chronic stress can result in serious health conditions including anxiety, insomnia, muscle pain, high blood pressure and a weakened immune system as well as contributing to the development of heart disease, depression and obesity.

While controlled breathing is an age-old practice, research on the impact of such relaxation techniques is limited, and some studies on have been of poor quality, according to the NIH’s National Center for Complimentary and Integrative Health. Still, it’s not news that relaxation techniques may be helpful in managing a variety of health conditions. If this story had critically compared breathing with other strategies (eg, walking outdoors, imagery, etc) it may have been more impactful for readers.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Applicable

Since deep breathing is free, no discussion of costs is warranted.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story asserts that controlled breathing “has been shown to reduce stress, increase alertness and boost your immune system.” It also states that studies have found breathing practices “can help reduce symptoms associated with anxiety, insomnia, post-traumatic stress disorder, depression and attention deficit disorder.”

But none of these purported benefits are quantified in any measurable way–i.e., by how much does it reduce symptoms? And for how long?  And the story’s opening line that you will have “calmed your nervous system” by taking just five deep breaths isn’t backed up by evidence.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

No harms are mentioned. The National Center for Complementary and Integrative Health says relaxation techniques such as deep breathing exercises “are generally considered safe for healthy people, although there have been a few reports of negative experiences such as increased anxiety. People with serious physical or mental health problems should discuss relaxation techniques with their health care providers.”

It’s also possible that some people with serious disorders may not seek other proven treatments in the belief that deep breathing will help them.

Does the story seem to grasp the quality of the evidence?

Satisfactory

This was a tough call. The story rightly alludes to the need for more research. “How controlled breathing may promote healing remains a source of scientific study,” it says, describing a “theory” that controlled breathing can change the response of the body’s autonomic nervous system, which controls unconscious processes such as heart rate and digestion as well as the body’s stress response.

But more skepticism is warranted. For example, when it comes to the description of a “small study” at Boston University of patients with major depressive disorder, who experienced fewer depressive symptoms and increased levels of a brain chemical with calming and anti-anxiety effects after they did 12 weeks of daily yoga and breathing exercises. The story mentions the lack of a control group and plans for a randomized control trial “to further test the intervention,” but nevertheless quotes the researcher’s assertion that the findings “show that a behavioral intervention can have effects of similar magnitude as an antidepressant.” That’s quite a leap.

And the story doesn’t challenge an statement by a psychiatry professor who wrote a book about breathing and has a private practice teaching breathing workshops, that he has “seen patients transformed by adopting regular breathing practices.” It should have cautioned on the limitations of such anecdotes and noted that the professor clearly has a strong vested interest in this approach.

Does the story commit disease-mongering?

Satisfactory

No disease-mongering here. Stress is ubiquitous as are insomnia, anxiety, and depression.

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

This is the biggest shortcoming of the article: All of those quoted have research and/or books to promote. The story could have used some sources who have a broader view of therapeutic approaches to stress.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

No mention is made of other approaches to manage stress. Exercise, laughter, social support, meditation and mindful prayer, and stepping away from the problem have all been shown through research to reduce stress, according to the American Psychological Association, which notes that not every strategy works for every person.

Does the story establish the availability of the treatment/test/product/procedure?

Not Applicable

Availability is not an issue with breathing exercises. As one psychologist and book author quoted in the story says, “Breathing is massively practical.”

However, the story misleads readers a bit by implying that the benefits of breathing exercises can be achieved in just a couple of minutes. In fact, proponents espouse at least 20 minutes of controlled breathing on a daily basis, often over several months, to achieve benefits.

Does the story establish the true novelty of the approach?

Not Satisfactory

Deep breathing has been a fixture in the West since the 1970s, when cardiologist Dr. Herbert Benson of Harvard Medical School published the book, “The Relaxation Response.” It seems like a stretch to say that “science is just beginning to provide evidence that the benefits of this ancient practice are real.

Does the story appear to rely solely or largely on a news release?

Satisfactory

The story does not appear to rely on a news release.

Total Score: 3 of 8 Satisfactory

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