Training Strategies to Maintain Performance

Summary

• Statement of the Problem and Justification Cognitive performance under physiologically stressful conditions is critical in high-demand environments such as military operations, diving, and firefighting. One such stressor is restricted breathing, which can occur due to equipment (e.g., masks, regulators) or environmental pressures (e.g., underwater). Restricted breathing has been shown to increase physiological strain, which may in turn impact attention, reaction time, and task execution. Despite this, there is limited research examining how different breathing strategies can mitigate the cognitive effects of restricted respiration.

Understanding whether specific breathing techniques can preserve cognitive function under stress has practical implications for operational readiness, safety, and task performance in extreme or demanding environments.

• Synopsis of Relevant Research Previous human studies have shown that controlled breathing techniques, such as tactical or box breathing (inhale-hold-exhale-hold patterns), can reduce anxiety and improve focus in stressful situations. For example, tactical breathing has been adopted in military and law enforcement settings to enhance performance under pressure. Other research in sports psychology and respiratory therapy suggests that altering breathing frequency or depth can modulate autonomic nervous system activity, potentially affecting cognitive control and reaction time.

Additionally, psychomotor vigilance tasks (PVTs) have been widely used to assess the impact of physiological stressors - such as sleep deprivation, hypoxia, and fatigue - on sustained attention and reaction time. However, few studies have directly examined the interaction between structured breathing patterns and PVT performance during restrictive breathing loads.

• Importance and Next Step This study represents a logical next step in understanding how breathing techniques can buffer against cognitive decline under conditions that simulate real-world respiratory restriction (e.g., underwater diving). By directly comparing the effects of two distinct breathing strategies during a controlled, restrictive breathing task, this research will help determine whether certain techniques are more effective in preserving attention and reaction time. The findings could inform training and operational protocols for individuals working in challenging environments, as well as guide future studies into breathing-cognition interactions under physical stress.

Conditions

• Shortness of Breath
• Shortness of Breath/Dyspnea
• Respiratory Distress

Interventions

BEHAVIORAL

Multiple Inhalation Breathing Pattern

This behavioral intervention involves a breathing pattern characterized by brief, rapid successive inhalations within each breath cycle. The timing of each short inhalation is coordinated with fast, cyclical auditory tones, providing a consistent rhythm for participants to follow. Visual cues are also displayed to reinforce the timing and sequence of breaths. During training, participants first practice the breathing pattern without any cognitive task, followed by practice while performing the psychomotor vigilance task (PVT). The technique is then applied during the main experimental condition, where participants wear a chest wall force antagonistic device set at 25 cmH₂O to simulate the added work of breathing experienced underwater. The PVT lasts for 10 minutes, requiring participants to respond as quickly as possible to visual stimuli, allowing researchers to measure sustained attention and reaction time.

BEHAVIORAL

Tactical Breathing Technique

This behavioral intervention uses a slow, paced breathing cycle incorporating four distinct phases: inhale, hold, exhale, and hold. Each phase is precisely timed and synchronized with distinct auditory tones for inhalation, hold phase, and exhalation. Participants also receive visual cues to reinforce correct timing and ensure consistency throughout the exercise. Training begins with participants practicing the breathing pattern without any cognitive task, followed by practice while completing the psychomotor vigilance task (PVT). The full experimental condition involves performing the 10-minute PVT while wearing a chest wall force antagonistic device set at 25 cmH₂O to simulate the restrictive breathing load experienced in underwater environments. The PVT requires quick responses to visual stimuli, allowing measurement of sustained attention and reaction time under load.

Sponsors & Collaborators

• University of Florida

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

BASIC_SCIENCE

Masking

NONE

Model

CROSSOVER

Eligibility

Min Age

18 Years

Max Age

45 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2025-08-31

Primary Completion

2025-11-30

Completion

2025-12-31

Countries

• United States

Study Locations