Changes in Autonomic Function and serum levels of inflammatory markers following guided deep breathing for a period of 6 weeks in the patients of rheumatoid arthritis.

Rheumatoid arthritis (RA) is a chronic autoimmune disease marked by joint inflammation, systemic complications, and increased morbidity and mortality. Growing evidence shows that RA patients often have autonomic nervous system imbalance, especially reduced parasympathetic activity and low heart rate variability (HRV), both linked to higher cardiovascular risk. Inflammation and autonomic dysfunction appear to interact through elevated cytokines and impaired vagal regulation. The vagus nerve plays a key anti-inflammatory role via the cholinergic anti-inflammatory pathway. Because of this, non-invasive methods that enhance vagal activity—such as deep breathing, yoga, and meditation—are being explored as adjunct therapies. Guided deep breathing, in particular, improves vagal tone and HRV through baroreflex activation and may help modulate inflammation and disease activity in RA.