Ancient Wisdom. New Technology

The cardiovascular and neurological benefits of slow breathing with prolonged exhalation have been known for centuries

RESPeRATE patented technology delivers these known benefits via a smart portable device with unprecedented efficacy to significantly lower blood pressure and induce sleep.

RESPeRATE was clinically demonstrated to lower neural sympathetic activity [3,4,20], treat hypertension [2,5-21], heart-failure [22-24],  COPD [25], PSTD [26], reduce, chronic stress [27] and anxiety [28] and more.

RESPeRATE is now recommended by the American Heart Association Scientific statement on non-pharmacological treatments for hypertension. [1]

The award-winning 2breathe Sleep Inducer was developed after finding that 90% of RESPeRATE users surveyed reported they also slept better

The overall evidence from clinical trials and meta-analyses suggests that device-guided slow breathing [RESPeRATE] can significantly lower blood pressure. There are no known contraindications to the use of the device, and no adverse effects have been noted.”

American Heart Association Scientific Statement 2013. [1]

Proven Efficacy in Hypertension


RESPeRATE safety and efficacy was demonstrated in 17 separate clinical studies published in peer reviewed medical journals. It has been used by over 250,000 patients and doctors in the past 15 years with great success and no reports of adverse reactions.

The clinical studies demonstrated that using RESPeRATE as directed resulted in:

• Significant and sustained reduction in blood pressure (BP) within 8 weeks demonstrated when measured at the office [2-18], at home [3-7, 9, 12-13, 17] and with  24-hour ABPM [4 ,10, 19]. 

• 10/5  mmHg (weighted average) sustained office BP reduction  in adults both with controlled and uncontrolled BP (weighted average  from the 16 studies  (chart 1)  [2-18]. Patients population ranged from controlled patients to refractory hypertensives [5],  included comorbidities as diabetes [9, 11, 17, 19,] and obstructive sleep apnea [14],  in the US, Europe, Middle East and Far East.

• Data available from 10 studies [2-8,10-11] show greater BP reductions for:
  • Older patients: 16/7 mmHg for >age 65
  • Higher initial BP:  17/7 for systolic BP>160 mmHg
  • More time spent in slow breathing (<10 breaths/min) [chart 3]. 
  • BP reductions were  independent of gender and medications


How Does RESPeRATE Work

RESPeRATE’s patented “Device Guided Breathing” taps the body’s natural tendency to follow musical rhythms. RESPeRATE analyses the breathing pattern and composes, in real time, a personalized melody with two distinct inhale and exhale guiding tones. By gradually prolonging the exhalation tone RESPeRATE leads the patient to the therapeutic zone of 5-6 breaths per minutes with prolonged exhalation guiding tones.

After each session of device guided breathing, respiration returns to normal, but the beneficial impact on blood pressure accumulates and maintained with routine use.



RESPeRATE BP lowering effect is rationalized by an acute reduction of the sympathetic neural activity [18, 20, 21] and a sustained decrease in peripheral resistance and arterial stiffness  [15] (see scheme above [22]).


Why 2breathe Induces Sleep

The fact that 90% RESPeRATE of users reported they also slept better is not surprising.

Poor sleep typically reflects heightened pre-sleep tension: A ‘vicious cycle’ that includes daily stress, intrusive thoughts resulting in elevated sympathetic neural activity.

To quiet our racing thoughts, the American Academy of Sleep Medicine recommends deep breathing exercises [29, 30]. The problem is that sleep-inducing breathing exercises are highly specific, difficult to master, and require concentration to do correctly.

2breathe enables anyone to perform highly effective breathing exercises without prior training or conscious effort using patented real-time coaching technology. It captivates the racing mind, keeping it focused on breathing via its guiding tones. The whole breathing synchronization and prolonging the exhalation process happens subliminally in a way you can’t do on your own. The tones guide the breathing via the emotional part of the brains and not the “decision-making” cognitive part of the brain, as other methods such as counting or “thinking about it” tend to do.



Furthermore, 2breathe’s core patented technology composes the guiding tones in real-time, in a way that continuously adapts to the user’s ability to be guided. Such adaptive guidance creates an optimal and personalized breathing exercise shown to play a prominent role in the beneficial effect beyond pre-recorded relaxing tones used by most breathing apps [5,23].

RESPeRATE clinical studies supported these reports by demonstrating positive effects on factors that play prominent role in sleeplessness, including lowering neural sympathetic activity [3,4,20]. More specifically, two separate randomized controlled studies reported that RESPeRATE used during the day improved sleep in different populations: Reduction in insomnia severity index in menopausal women [31], and in the severity of sleep disordered breathing in heart failure patients [24].


[1] Brook RC et al. A Scientific Statement From the American Heart Association Beyond Medications and Diet: Alternative Approaches to Lowering Blood Pressure. Hypertension. 2013;61(6):1360-1383

[2] Cernes R, Zimlichman R. RESPeRATE: the role of paced breathing in hypertension treatment. J Am Soc Hypertens. 2015;9:38-47.

[3] Oneda B, Ortega KC, Gusmão JL, Araújo TG, Mion D Jr. Sympathetic nerve activity is decreased during device-guided slow breathing. Hypertens Res. 2010 Jul;33(7):708-712.

[4] Harada D, Asanoi H, Takagawa J, Ishise H, Ueno H, Oda Y et al. Slow and deep respiration suppresses steady-state sympathetic nerve activity in patients with chronic heart failure: from modeling to clinical application. American Journal of Physiology-Heart and Circulatory Physiology. 2014;307(8):H1159-H68

[5] Schein MH, Gavish B, Herz M, Rosner-Kahana D, Naveh P, Knishkowy B, Zlotnikov E, Ben-Zvi N, Melmed RN. Treating hypertension with a device that slows and regularises breathing: a randomised, double-blind controlled study. J Hum Hypertens. 2001;15:271-278.

[6] Grossman E, Grossman A, Schein MH, Zimlichman R, Gavish B. Breathing-control lowers blood pressure. J Hum Hypertens 2001;15:263–9.

[7] Rosenthal T, Alter A, Peleg E, Gavish B. Device guided breathing exercises reduce blood pressure: ambulatory and home measurements. Am J Hypertens 2001;14:74–76.

[8] Viskoper R, Shapira I, Priluck R, Mindlin R, Chornia L, Laszt A, et al. Nonpharmacologic treatment of resistant hypertensives by device-guided slow breathing exercises. Am J Hypertens 2003;16:484–487.

[9] Elliott WJ, Izzo JL Jr, White WB, Rosing DR, Snyder CS, Alter A, et al. Graded blood pressure reduction in hypertensive outpatients associated with use of a device to assist with slow breathing. J Clin Hypertens (Greenwich) 2004;6:553–559.

[10] Meles E, Giannattasio C, Failla M, Gentile G, Capra A, Mancia G. Nonpharmacologic treatment of hypertension by respiratory exercise in the home setting. Am J Hypertens 2004;17:370–4.

[11] Bae JH, Kim JH, Choe KH, Hong SP, Kim KS, Kim CH, Ko JK, Kim CH, Kim KS. Blood pressure change following 8-week, 15-minute daily treatment with paced breathing guided by a device: a Korean multi-center study. J Clin Hypertens 2006;8:79 [Korean with abstract in English in Korean Hyperten J 2006;1:19-23]

[12] Logtenberg SJ, Kleefstra N, Houweling ST, Groenier KH, Bilo HJ. Effect of device-guided breathing exercises on blood pressure in hypertensive patients with type 2 diabetes mellitus: a randomized controlled trial. J Hypertens 2007;25:241–6.

[13] Aydin L  et al, J Hyperten 2008; 26 (suppl 2): S371-S372.

[14] Schein MH, Gavish B, Baevsky T, Kaufman M, Levine S, Nessing A, et al. Treating hypertension in type II diabetic patients with device-guided breathing: a randomized controlled trial. J Hum Hypertens 2009; 23:325–331.

[15] Altena MR, Kleefstra N, Logtenberg SJ, Groenier KH, Houweling ST, Bilo HJ. Effect of device-guided breathing exercises on blood pressure in patients with hypertension: a randomized controlled trial. Blood Press 2009;18:273–9.

[16] Anderson DE, McNeely JD, Windham BG. Regular slow-breathing exercise effects on blood pressure and breathing patterns at rest. J Hum Hypertens 2010;24:807–813.

[17] Bertisch SM, Schomer A, Kelly EE, Baloa LA, Hueser LE, Pittman SD, et al. Device-guided paced respiration as an adjunctive therapy for hypertension in obstructive sleep apnea: a pilot feasibility study. Appl Psychophysiol Biofeedback 2011;36:173–179.

[18] Kim JH, Yoo BS, Lee SH, Yoon J, Choe KH, The Changes of Noninvasive Hemodynamic Parameters after Device-Guided Slow Breathing Exercise in Hypertensive Patients.  J Korean Soc Hypertens 2013;19:55-62

[19] KLandman GW, Drion I, van Hateren KJ, van Dijk PR, Logtenberg SJ, Lambert J, et al. Device-guided breathing as treatment for hypertension in type 2 diabetes mellitus: a randomized, double-blind, sham-controlled trial. JAMA Intern Med 2013;173:1346–1350.

[20] Hering D, Kucharska W, Kara T, Somers VK, Parati G, Narkiewicz K. Effects of acute and long-term slow breathing exercise on muscle sympathetic nerve activity in untreated male patients with hypertension. J Hypertens. 2013;31:739-746.

[21] Howorka K, Pumprla J, Tamm J, Schabmann A, Klomfar S, Kostineak E, et al. Effects of guided breathing on blood pressure and heart rate variability in hypertensive diabetic patients. Auton Neurosci 2013;179:131–137.

[22] Parati G, Malfatto G, Boarin S, Branzi G, Caldara G, Giglio A, Bilo G, Ongaro G, Alter A, Gavish B, Mancia G. Device-Guided Paced Breathing in the Home Setting. on Exercise Capacity, Pulmonary and Ventricular Function in Patients With Chronic Heart Failure: A Pilot Study. Circulation: Heart Failure. 2008;1:178-183

[23] Ekman I, Kjellström B, Falk K, Norman J, Swedberg K. Impact of device-guided slow breathing on symptoms of chronic heart failure: a randomized, controlled feasibility study. Eur J Heart Fail. 2011;13:1000-1005.

[24] Debicka-Dabrowska D, Lisi E, Drozdz T, Styczkiewicz K, Malfatto G, Salerno S, Bednarek A, Olszanecka A, Kielbasa G, Bilo G, Czarnecka, D, Kawecka-Jaszcz K, Parati G. Usefulness of slow breathing training in chronic heart failure. Study design and intermediate results. Journal of Hypertens 2015:33 e-Supplement1; e 462

[25] Borge CR, Mengshoel AM, Omenaas E, Mourn E,  Ekman I, Lein MP,  Mack U, Wahl AK,: Effects of guided deep breathing on breathlessness and the breathing pattern in chronic obstructive pulmonary disease: A double-blind randomized control study; Patient Education and Counseling 2015 ;98:182-190.

[26] de Jong MC, Boersma CH. Device-guided breathing as a possible tool to improve the outcome of exposure therapy.Mental Illness 2010;2:e6 [pp.25-27]

[27] Ouseph R, Calvin Croy C,Natvig C, Simoneau T, Laudenslager ML. Decreased mental health care utilization following a psychosocial intervention in caregivers of hematopoietic stem cell transplant patients. Mental Illness 2014; 6:5120 [pp. 9-13]

[28] Morarend QA, Spector ML, Dawson DV, Clark SH, Holmes DC. The use of a respiratory rate biofeedback device to reduce dental anxiety: an exploratory investigation. Appl Psychophysiol Biofeedback. 2011 Jun;36(2):63-70

[29] Morgenthaler T, Practice parameters for the psychological and behavioral treatment of insomnia: an update. An american academy of sleep medicine report. Sleep 2006;29:1415-9

[30] Bertisch SM, Use of relaxation techniques and complementary and alternative medicine by American adults with insomnia symptoms: results from a national survey. Journal of Clinical Sleep Medicine, Vol. 8, No. 6, 2012

[31] Huang AJ1, Phillips S, Schembri M, Vittinghoff E, Grady D. Device-guided slow-paced respiration for menopausal hot flushes: a randomized controlled trial. Obstet Gynecol. 2015;125:1130-1138