A four-week combined respiratory muscle training and breathing exercise program improves sleep quality and reduces perceived stress in healthy university students.
A 4-week intervention combining diaphragmatic breathing, pursed-lip breathing, and threshold-loaded inspiratory/expiratory muscle training (40-60% maximal inspiratory pressure, 5 days/week) was associated with a 26% improvement in sleep quality (PSQI) and a 19% reduction in perceived stress (PSS) in 40 healthy university students (median age 22, BMI 23.14 ± 4.05 kg/m²). Breath-holding time increased by 132% (p < 0.001, r = 0.87), and functional performance improved significantly (TUG decreased 9%, d_z = 1.01; STS improved 12%, d_z = 1.12).
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A four-week combined respiratory muscle training and breathing exercise program improves sleep quality and reduces perceived stress in healthy university students. The current body of evidence comprises 1 study. EvidenceHub rates the overall confidence at 38/100 (low).
The Claim
A four-week combined respiratory muscle training and breathing exercise program improves sleep quality and reduces perceived stress in healthy university students.
This conclusion is most relevant to: Healthy university students aged 18-25 years with BMI < 29.9 kg/m² in Saudi Arabia..
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Effects of a Four-Week Combined Respiratory Muscle Training and Breathing Exercise Program on Breath-Holding Time, Functional Performance, Sleep Quality, and Perceived Stress in Healthy University Students. (Journal of clinical medicine, 2026) —
How It Works
The proposed biological pathway:
- ▸Respiratory muscle training strengthens inspiratory and expiratory muscles, improving respiratory efficiency.
- ▸Breathing exercises (diaphragmatic, pursed-lip) enhance vagal tone and reduce sympathetic activity.
- ▸Improved autonomic regulation leads to better sleep quality and lower perceived stress.
- ▸Result: 26% improvement in sleep quality and 19% reduction in perceived stress.
Who Might Benefit
Evidence fit by population:
- ▸Healthy university students aged 18-25 years with BMI < 29.9 kg/m² in Saudi Arabia.
Recommended Dose
N/A
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Single-arm pre-post design without a control group, limiting causal inference.
- ▸Pilot study with small sample size (n=40) and short duration (4 weeks), reducing generalizability.
Frequently Asked Questions
What specific breathing exercises were used in this study?▼
The intervention included diaphragmatic breathing, pursed-lip breathing, and threshold-loaded inspiratory and expiratory muscle training at 40-60% of maximal inspiratory pressure.
How much did sleep quality improve after the program?▼
Sleep quality, measured by the Pittsburgh Sleep Quality Index (PSQI), improved by 26% after the 4-week intervention.
Was the study a randomized controlled trial?▼
No, it was a pilot pre-post experimental study without a control group, so results are preliminary and hypothesis-generating.
Who participated in this study?▼
Forty healthy university students aged 18-25 years with a BMI less than 29.9 kg/m², 50% female, from Saudi Arabia.
References
- 1.Alonazi A, Almasoudi L, Almzini N, Alzakari N, Almutairi R, Alhassan S, Albosager A, Alsaeed Q, Alojayan A, Alismail A. “Effects of a Four-Week Combined Respiratory Muscle Training and Breathing Exercise Program on Breath-Holding Time, Functional Performance, Sleep Quality, and Perceived Stress in Healthy University Students..” Journal of clinical medicine, 2026. PMID: 42452611 DOI: 10.3390/jcm15135151