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Breathing exercise combined with cognitive behavioural intervention improves sleep quality and heart rate variability in major depression

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  • Hui‐Ching Chien
  • Yu‐Chu Chung
  • Mei‐Ling Yeh
  • Jia‐Fu Lee

Abstract

Aims and objectives The aim of this study was to investigate the effects of a cognitive behavioural intervention combined with a breathing relaxation exercise on sleep quality and heart rate variability in patients with major depression. Background Depression is a long‐lasting illness with significant effects not only in individuals themselves, but on their family, work and social relationships as well. Cognitive behavioural therapy is considered to be an effective treatment for major depression. Breathing relaxation may improve heart rate variability, but few studies have comprehensively examined the effect of a cognitive behavioural intervention combined with relaxing breathing on patients with major depression. Design An experimental research design with a repeated measure was used. Methods Eighty‐nine participants completed this study and entered data analysed. The experimental group (n = 43) received the cognitive behavioural intervention combined with a breathing relaxation exercise for four weeks, whereas the control group (n = 46) did not. Sleep quality and heart rate variability were measured at baseline, posttest1, posttest2 and follow‐up. Data were examined by chi‐square tests, t‐tests and generalised estimating equations. Results After adjusting for age, socioeconomic status, severity of disease and psychiatric history, the quality of sleep of the experimental group improved, with the results at posttest achieving significance. Heart rate variability parameters were also significantly improved. Conclusions This study supported the hypothesis that the cognitive behavioural intervention combined with a breathing relaxation exercise could improve sleep quality and heart rate variability in patients with major depression, and the effectiveness was lasting. Relevance to clinical practice The cognitive behavioural intervention combined with a breathing relaxation exercise that included muscle relaxation, deep breathing and sleep hygiene could be provided with major depression during hospitalisation. Through group practice and experience sharing, participants could modulate their heart rate variability and share feeling about good sleep as well relaxation.

Suggested Citation

  • Hui‐Ching Chien & Yu‐Chu Chung & Mei‐Ling Yeh & Jia‐Fu Lee, 2015. "Breathing exercise combined with cognitive behavioural intervention improves sleep quality and heart rate variability in major depression," Journal of Clinical Nursing, John Wiley & Sons, vol. 24(21-22), pages 3206-3214, November.
    • Handle: RePEc:wly:jocnur:v:24:y:2015:i:21-22:p:3206-3214
    DOI: 10.1111/jocn.12972
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    References listed on IDEAS

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    1. Nores, Maria Laura & Diaz, Maria del Pilar, 2008. "Some properties of regression estimators in GEE models for clustered ordinal data," Computational Statistics & Data Analysis, Elsevier, vol. 52(7), pages 3877-3888, March.
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    Cited by:

    1. Cristina J. González-Flores & Guillermo Garcia-Garcia & Claudia Lerma & Rebeca María Elena Guzmán-Saldaña & Abel Lerma, 2023. "Effect of Cognitive Behavioral Intervention Combined with the Resilience Model to Decrease Depression and Anxiety Symptoms and Increase the Quality of Life in ESRD Patients Treated with Hemodialysis," IJERPH, MDPI, vol. 20(11), pages 1-15, May.

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