Breath Modulation Tools

Secrets Of The Ocean Breath

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Secrets Of The Ocean Breath Overview


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Methods Of Assessment

Heart rate variability to deep breathing (usually at six breaths per minute) Assessments include standard deviation, coefficient of variation, expiratory inspiratory difference and ratio, mean circular resultant of vector analysis, spectral analysis (mid 0.05-0.15 Hz and high 0.15-0.5 Hz frequency fluctuations) Heart rate response on standing Assessments include maximum minimum 30 15 ratio (i.e., longest and shortest R-R intervals at about beat 30 and 15, respectively), or the longest and shortest R-R intervals between beats 20-40 and 5-25, respectively Tests of predominantly sympathetic integrity the blood pressure response to sustained handgrip (predominantly tests of sympathetic function), and the Valsalva ratio (tests both parasympathetic as well as sympathetic integrity) (40). These tests can be utilized to stage the severity of CAN, with the mildest degree consisting isolated deficits in heart rate response to deep breathing, and the most severe when postural hypotension is also...

Autonomic Function Tests In Diabetics With Enteropathy

(B) R-R interval response to deep breathing This is a test of cardiovagal reflexes. However, Buyschaert et al. (64) showed that this is a good surrogate for the testing of abdominal vagal function, consistent with the concept that vagal denervation, as with most forms of diabetic neuropathy commences caudally and progresses in a cranial direction.


Peripheral neuropathy during pregnancy was studied by Lapolla et al. during which 14 pregnant nondiabetic women were monitored and compared with 16 pregnant women with DM1 and 12 non-pregnant women with DM1 (109). Peripheral neuropathy endpoints including motor conduction velocities were not significantly different for pregnant women with DM1 compared with pregnant women without DM in the third trimester (109). At the start of the study, none of the pregnant women with DM1 had signs of autonomic neuropathy. At the end of pregnancy, all of the pregnant women (both nondiabetic and DM1) had a reduced cardiovascular autonomic test of deep breathing that was considered to be a result of the decreased ventilatory excursion due to the pregnancy. Overall, pregnancy did not worsen autonomic neuropathy in this small study.

Composite Scores

The reproducibility of the different measures of neuropathy and interobserver agreement varies markedly between tests. This leads to the situation where the analysis for a clinical trial produces some results which are found to be significant whereas others are not, yet they might be assessing the same modality. To overcome this, Dyck and coworkers (43) pioneered composite scores such as the NDS and later the neuropathy impairment score (NIS). This allows an assessment of an alteration in function of several classes of nerve fibres, all of which are likely to be affected by diabetes. In the Rochester longitudinal study the NIS LL + 7 (vibration perception threshold VPT great toe, R-R variation to deep breathing, peroneal motor nerve conduction velocity, CMAP, and motor nerve distal latency, tibial motor nerve distal latency, and sural SNAP) have been shown to be 100 sensitive and specific in comparison with an abnormal VPT, which had a sensitivity of 27.8 (Table 4). Based on the...

Diabetic Neuropathy

Damage to the autonomic nervous system, or auto-nomic neuropathy, is seen in diabetic patients, although the exact prevalence is unknown. Tests of autonomic nerve function often reveal abnormalities in patients with no symptoms of autonomic dysfunction. These tests include the heart rate response to the Valsalva maneuver, to deep breathing and to moving from the supine to the erect posture, and the blood pressure response to sustained handgrip and standing up. Cardiovascular tests are relatively simple to perform, but evaluating the autonomic control of other systems, such as the gastrointestinal tract and micturition, is much more complex.

Breath Modulation Tools

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