Regulation of the autonomic nervous system in older adults with accelerated respiratory system aging: effectiveness of breathing training with positive end-expiratory pressure

Authors

DOI:

https://doi.org/10.14739/2310-1210.2025.4.331846

Keywords:

accelerated aging of the respiratory system, breathing exercises with PEEP, autonomic nervous system

Abstract

Aim. To evaluate the effectiveness of breathing training with positive end-expiratory pressure (PEEP) on the autonomic nervous system in older adults with accelerated respiratory system aging.

Materials and methods. Ninety-four older adults aged 60–74 years were examined, including 45 with physiological aging and 49 with accelerated aging of the respiratory system. Participants with accelerated respiratory aging were divided into three groups: 16 underwent breathing training without PEEP (0 cm H2O), 17 with PEEP of 5 cm H2O, and 16 with PEEP of 10 cm H2O. The autonomic nervous system was assessed at baseline and after completing the breathing training program.

Results. Older adults with accelerated respiratory system aging showed reduced high-frequency (HF) power and an increased low-frequency / high-frequency (LF/HF) ratio. In this group, HF power was inversely correlated with the functional age of the respiratory system (r = -0.33, p < 0.05) and oxygen saturation (SpO2; r = -0.29, p < 0.05). Breathing training with PEEP increased SpO2 and HF power while reducing the LF/HF ratio. However, increasing PEEP from 5 cm H2O to 10 cm H2O did not improve the effectiveness of the training.

Conclusions. In older adults with accelerated respiratory aging, parasympathetic activity decreases, and sympathetic activity increases. Changes in parasympathetic activity of the autonomic nervous system in this group are associated with the functional age of the respiratory system and pulmonary gas exchange. Breathing training with PEEP increases vagal activity and reduces sympathetic dominance. However, the magnitude of this effect is independent of the PEEP level.

Author Biographies

E. O. Asanov, D. F. Chebotarev Institute of Gerontology of the NAMS of Ukraine, Kyiv

MD, PhD, DSc, Professor, Chief Scientific Researcher of the Department of Clinical Physiology and Pathology of Internal Organs

I. A. Dyba, D. F. Chebotarev Institute of Gerontology of the NAMS of Ukraine, Kyiv

MD, PhD, Senior Researcher, Senior Scientific Researcher of the Department of Clinical Physiology and Pathology of Internal Organs

S. S. Naskalova, D. F. Chebotarev Institute of Gerontology of the NAMS of Ukraine, Kyiv

MD, PhD, Senior Researcher, Senior Scientific Researcher of the Department of Clinical Physiology and Pathology of Internal Organs

O. V. Bondarenko, D. F. Chebotarev Institute of Gerontology of the NAMS of Ukraine, Kyiv

MD, PhD, Senior Scientific Researcher of the Department of Clinical Physiology and Pathology of Internal Organs

I. A. Antoniuk-Shchehlova, D. F. Chebotarev Institute of Gerontology of the NAMS of Ukraine, Kyiv

MD, PhD, DSc, Senior Researcher, Scientific Secretary

References

  1. Tian YE, Cropley V, Maier AB, Lautenschlager NT, Breakspear M, Zalesky A. Heterogeneous aging across multiple organ systems and prediction of chronic disease and mortality. Nat Med. 2023;29(5):1221-31. doi: https://doi.org/10.1038/s41591-023-02296-6
  2. Pyo IS, Yun S, Yoon YE, Choi JW, Lee SJ. Mechanisms of aging and the preventive effects of resveratrol on age-related diseases. Molecules. 2020;25(20):4649. doi: https://doi.org/10.3390/molecules25204649
  3. Lissek T. Aging, adaptation and maladaptation. Front Aging. 2023;4:1256844. doi: https://doi.org/10.3389/fragi.2023.1256844
  4. Cho SJ, Stout-Delgado HW. Aging and Lung Disease. Annu Rev Physiol. 2020;82:433-59. doi: https://doi.org/10.1146/annurev-physiol-021119-034610
  5. Olivieri F, Biscetti L, Pimpini L, Pelliccioni G, Sabbatinelli J, Giunta S. Heart rate variability and autonomic nervous system imbalance: Potential biomarkers and detectable hallmarks of aging and inflammaging. Ageing Res Rev. 2024;101:102521. doi: https://doi.org/10.1016/j.arr.2024.102521
  6. Benarroch EE. Physiology and Pathophysiology of the Autonomic Nervous System. Continuum (Minneap Minn). 2020;26(1):12-24. doi: https://doi.org/10.1212/CON.0000000000000817
  7. Hamrefors V. The Autonomous Nervous System: A Novel and Potentially Modifiable Risk Factor for Chronic Obstructive Pulmonary Disease in the Population? Ann Am Thorac Soc. 2023;20(10):1402-3. doi: https://doi.org/10.1513/AnnalsATS.202307-618ED
  8. Jubran A. Setting positive end-expiratory pressure in the severely obstructive patient. Curr Opin Crit Care. 2024;30(1):89-96. doi: https://doi.org/10.1097/MCC.0000000000001131
  9. Lin Q, Zhuo L, Wu Z, Li C, Zhou M, Cai C. Effects of breathing exercises using home-based positive pressure in the expiratory phase in patients with COPD. Postgrad Med J. 2019;95(1127):476-81. doi: https://doi.org/10.1136/postgradmedj-2019-136580
  10. Pantoni CB, Thommazo-Luporini LD, Mendes RG, Caruso FC, Castello-Simões V, Mezzalira D, et al. Effect of continuous positive airway pressure associated to exercise on the breathing pattern and heart rate variability of patients undergoing coronary artery bypass grafting surgery: a randomized controlled trial. Braz J Med Biol Res. 2021;54(11):e10974. doi: https://doi.org/10.1590/1414-431X2021e10974
  11. Fincham GW, Strauss C, Montero-Marin J, Cavanagh K. Effect of breath work on stress and mental health: A meta-analysis of randomised-controlled trials. Sci Rep. 2023;13(1):432. doi: https://doi.org/10.1038/s41598-022-27247-y
  12. Chu AA, Yu HM, Yang H, Tian LM, Hu ZY, Jiang N, et al. Evaluation of right ventricular performance and impact of continuous positive airway pressure therapy in patients with obstructive sleep apnea living at high altitude. Sci Rep. 2020;10(1):20186. doi: https://doi.org/10.1038/s41598-020-71584-
  13. Pysaruk AV, Asanov EO, inventor. [Method for determination of functional age of respiratory human system]. Ukrainian patent UA 54304, 2010 Nov 10. Available from: https://sis.nipo.gov.ua/uk/search/detail/255385/
  14. Asanov EO, Dyba IA, Osmak ED. Pulmonary gas exchange in elderly people with physiological and accelerated aging of the respiratory system: effect of respiratory training with positive end expiratory pressure. Ukrainian Pulmonology Journal. 2014;(3):64-7. Available from: http://www.ifp.kiev.ua/doc/journals/upj/14/pdf14-3/64.pdf
  15. Pincus AB, Fryer AD, Jacoby DB. Mini review: Neural mechanisms underlying airway hyper responsiveness. Neurosci Lett. 2021;751:135795. doi: https://doi.org/10.1016/j.neulet.2021.135795
  16. Mehra R, Tjurmina OA, Ajijola OA, Arora R, Bolser DC, Chapleau MW, et al. Research Opportunities in Autonomic Neural Mechanisms of Cardiopulmonary Regulation: A Report From the National Heart, Lung, and Blood Institute and the National Institutes of Health Office of the Director Workshop. JACC Basic Transl Sci. 2022;7(3):265-293. doi: https://doi.org/10.1016/j.jacbts.2021.11.003
  17. Liao YS, Collins EN, Guevara MV, Schurmann V, Atanasova KR, Bravo L, et al. Airway cholinergic history modifies mucus secretion properties to subsequent cholinergic challenge in diminished chloride and bicarbonate conditions. Exp Physiol. 2020;105(10):1673-83. doi: https://doi.org/10.1113/EP088900
  18. Pang C, An F, Yang S, Yu N, Chen D, Chen L. In vivo and in vitro observation of nasal ciliary motion in a guinea pig model. Exp Biol Med (Maywood). 2020;245(12):1039-48. doi: https://doi.org/10.1177/1535370220926443
  19. Porges SW. The vagal paradox: A polyvagal solution. Compr Psychoneuroendocrinol. 2023;16:100200. doi: https://doi.org/10.1016/j.cpnec.2023.100200. Erratum in: Compr Psychoneuroendocrinol. 2024;18:100233. doi: https://doi.org/10.1016/j.cpnec.2024.100233
  20. Zaccaro A, Piarulli A, Laurino M, Garbella E, Menicucci D, Neri B, et al. How Breath-Control Can Change Your Life: A Systematic Review on Psycho-Physiological Correlates of Slow Breathing. Front Hum Neurosci. 2018;12:353. doi: https://doi.org/10.3389/fnhum.2018.00353

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Published

2025-08-31

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1.
Asanov EO, Dyba IA, Naskalova SS, Bondarenko OV, Antoniuk-Shchehlova IA. Regulation of the autonomic nervous system in older adults with accelerated respiratory system aging: effectiveness of breathing training with positive end-expiratory pressure. Zaporozhye Medical Journal [Internet]. 2025Aug.31 [cited 2026May16];27(4):290-5. Available from: https://zmj.zsmu.edu.ua/article/view/331846

Issue

Vol. 27 No. 4 (2025)

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Original research

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Copyright (c) 2025 E. O. Asanov, I. A. Dyba, S. S. Naskalova, O. V. Bondarenko, I. A. Antoniuk-Shchehlova

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