Effect of suboccipital release versus diaphragmatic release technique combined with relaxation technique on blood pressure stress level and sleep quality in pre hypertention A randomized clinicl trial

Prehypertension is a highly prevalent condition, affecting nearly 31–41% of adults, particularly younger populations, and is commonly associated with obesity, dyslipidaemia, stress, and poor sleep quality, with nearly 19% progressing to hypertension within four years. It is a major risk factor for cardiovascular and cerebrovascular diseases due to autonomic imbalance, vascular remodelling, and increased cardiac workload. Exercise and relaxation-based interventions have shown promise in blood pressure control, with Jacobson relaxation exercises, diaphragmatic release technique (DRT), and suboccipital release technique (SRT) demonstrating beneficial effects on autonomic regulation, stress reduction, and sleep quality through vagal modulation and central autonomic pathways. However, comparative evidence between DRT and SRT in prehypertensive individuals remains limited. Therefore, this randomized clinical trial aims to compare the effectiveness of diaphragmatic release and suboccipital release techniques combined with relaxation exercises in reducing blood pressure, perceived stress, and improving sleep quality among prehypertensive adults aged 18–40 years. Thirty participants will be randomly allocated into two groups: Group A receiving diaphragmatic release with relaxation techniques and Group B receiving suboccipital release with relaxation techniques, administered for 20–30 minutes, three sessions per week over four weeks. Outcome measures include blood pressure assessed using a mercury sphygmomanometer, sleep quality measured by the Pittsburgh Sleep Quality Index, and stress levels evaluated using the Perceived Stress Scale. Pre- and post-intervention assessments will be conducted, and the collected data will be statistically analyzed to determine the more effective intervention for improving cardiovascular health, stress, and sleep outcomes in prehypertensive individuals