Slow-Breathing Curriculum for Stress Reduction in High School Students: Lessons Learned From a Feasibility Pilot.
Tanya G K Bentley, Cerena Seeber, Emily Hightower and 6 others
PMID 36189008WHAT IT FOUND
Students found a slow-breathing curriculum easy and tolerable, but compliance dropped from 73% to 47% when done at home.
No significant stress reduction was detected, though trends suggested immediate benefits.
Key findings
01Compliance with the breathing exercises decreased every week, falling from an average of 73% in week 1 to 47% in week 5.
02There were no significant changes in generalized stress or physiological stress tolerance from before to after the 5-week curriculum.
03Students rated the curriculum as somewhat-to-definitely useful and the assessments as definitely-to-very easy and tolerable.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was a small pilot not powered to detect effectiveness, so null findings for stress reduction may reflect sample size rather than lack of benefit. Compliance dropped sharply in the final weeks, which likely limited the ability to see cumulative effects. The intervention was moved to a home-based format due to pandemic restrictions, which the authors hypothesize negatively impacted adherence and support. Students were aware of their assigned group, and the teacher was not blinded, introducing potential bias. The sample was drawn from a single honors-level English class, which may not represent the general high school population.
Declared interests
The study was funded by individual charitable donations to a non-profit foundation. The donors were not involved in the study design, analysis, or writing. The authors declared no commercial or financial conflicts of interest.
The easy way to misread this
Do not interpret the lack of significant stress reduction as proof that slow breathing does not work. The study was explicitly a feasibility pilot with a small sample size and declining compliance, and it was not powered to detect effectiveness. The null results reflect the study's design limitations, not necessarily the intervention's failure.