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.