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Randomized Controlled Trial
. 2013 Feb;28(2):193-200.
doi: 10.1007/s11606-012-2202-6.

Paced respiration for vasomotor and other menopausal symptoms: a randomized, controlled trial

Janet S Carpenter  1 , Debra S Burns, Jingwei Wu, Julie L Otte, Bryan Schneider, Kristin Ryker, Eileen Tallman, Menggang Yu
Affiliations
Randomized Controlled Trial

Paced respiration for vasomotor and other menopausal symptoms: a randomized, controlled trial

Janet S Carpenter et al. J Gen Intern Med. 2013 Feb.

Abstract

Background: Paced respiration has been internationally recommended for vasomotor symptom management, despite limited empirical evidence.

Objective: To evaluate efficacy of a paced respiration intervention against breathing control and usual care control for vasomotor and other menopausal symptoms.

Design: A 16-week, 3-group, partially blinded, controlled trial with 2:2:1 randomization and stratification by group (breast cancer, no cancer), in a Midwestern city and surrounding area.

Participants: Two hundred and eighteen randomized women (96 breast cancer survivors, 122 menopausal women without cancer), recruited through community mailings and registries (29 % minority).

Interventions: Training, home practice support, and instructions to use the breathing at the time of each hot flash were delivered via compact disc with printed booklet (paced respiration intervention) or digital videodisc with printed booklet (fast shallow breathing control). Usual care control received a letter regarding group assignment.

Main measures: Hot flash frequency, severity, and bother (primary); hot flash interference in daily life, perceived control over hot flashes, and mood and sleep disturbances (secondary). Intervention performance, adherence, and adverse events were assessed.

Key results: There were no significant group differences for primary outcomes at 8-weeks or 16-weeks post-randomization. Most intervention participants did not achieve 50 % reduction in vasomotor symptoms, despite demonstrated ability to correctly do paced respiration and daily practice. Statistically significant differences in secondary outcomes at 8 and 16 weeks were small, not likely to be clinically relevant, and as likely to favor intervention as breathing control.

Conclusions: Paced respiration is unlikely to provide clinical benefit for vasomotor or other menopausal symptoms in breast cancer survivors or menopausal women without cancer.

Trial registration: ClinicalTrials.gov NCT00819182.

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Figures

Figure 1.
Figure 1.
Participant flow diagram for primary and secondary outcomes. Legend: Accrual diagram showing attrition. HF hot flash, HFRDIS Hot Flash Related Daily Interference, PCI Perceived Control Index, PANAS Positive and Negative Affect Scale, POMS Profile of Mood Disturbance Scale, PSQI Pittsburgh Sleep Quality Index.
Figure 2.
Figure 2.
24-hour average hot flash frequency by group over time. Legend: Data points are unadjusted means and standard errors with 95 % confidence interval error bars. Frequency was 24-hour average. No significant differences at 8 or 16 weeks.
See this image and copyright information in PMC

References

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