Breathing exercises to improve stress and sleep in pregnancy (ASTRA):

Abstract Background and aim Pregnant women are especially vulnerable to poor sleep patterns, which have been linked to health risks such as gestational diabetes and preterm birth. Since breathing exercises have been shown to reduce sympathetic activity and promote relaxation, this study aims to examine their effects on stress levels and sleep quality in pregnant women. Methods This single-center, randomized, parallel two-arm trial at the Department of Obstetrics and Feto-Maternal Medicine, Bern University Hospital (Switzerland) evaluates the effects of structured breathing exercises using the commercially available Oxa System (Myant Europe AG, Rumlang, CH) performed during gestational weeks 20–24 and 28–32, compared with no intervention. The primary endpoint is the change in perceived stress level and sleep quality during pregnancy, assessed using patient-reported outcomes and physiological parameters (including heart rate and heart rate variability) measured via a bra wearable (Myant Europe AG). Secondary endpoints include additional health data collection and sleep monitoring. The monitoring starts at gestational week 10 and continues until delivery. Discussion This study could offer insights in the physiology and effects of breathing exercises on vital parameters, perceived stress levels and sleep quality during pregnancy. If proven effective, this low-cost intervention could be readily integrated into existing perinatal care structures.