This project aims to investigate the acute effects of controlled breathing exercises and music therapy on parasympathetic nervous system activation and increased heart rate variability in anxious individuals.

The main objective of our project is to reduce the suppressive effect of stress on the parasympathetic nervous system and, accordingly, to increase heart rate variability in individuals with anxiety through controlled breathing exercises and music therapy applications. For this purpose, individuals aged between 18 and 40 years who have moderate anxiety levels according to the State-Trait Anxiety Inventory, who have not previously been diagnosed with any cardiovascular, respiratory, neurological, or psychiatric diseases, and who have not smoked for at least the past 6 months will be included in the study.

The individuals included in the study will be randomly assigned into three groups: a control group, a controlled breathing exercise group, and a music-supported breathing exercise group. At the baseline assessment, the State-Trait Anxiety Inventory will be used to determine the anxiety levels of all participants and to ensure group homogenization. In addition to determining anxiety levels at baseline, heart rate variability, blood pressure, heart rate, and oxygen saturation will be assessed in all groups.

No intervention will be applied to the control group; only assessments will be conducted. A single-session exercise protocol lasting 20 minutes will be applied to the breathing exercise group and the music-supported breathing exercise group. Heart rate variability will be measured using the Polar H9 device and Elite HRV software. Blood pressure and heart rate measurements will be performed using a digital blood pressure monitor. Oxygen saturation will be determined using a fingertip pulse oximeter.

The heart rate variability, blood pressure, heart rate, and oxygen saturation assessments performed at baseline will be repeated at the 0th, 10th, and 20th minutes after the completion of the exercise in the intervention groups. In the control group, participants will be asked to remain seated for 20 minutes, and following the completion of this period, the measurements performed at baseline will be repeated at the 0th, 10th, and 20th minutes. Thus, the final evaluation will be completed, and the obtained data will be analyzed.

Inclusion Criteria:

• Volunteer to participate in the study
• Not having a prior diagnosis of cardiovascular, respiratory, or neurological/psychiatric disease
• Not having a history of regular arrhythmias, pacemakers, or severe hypertension
• Not having smoked for at least 6 months
• Not having engaged in strenuous exercise in the last 24 hours
• Not having consumed caffeine/energy drinks within 6-8 hours prior to the intervention
• Being between 18 and 40 years of age
• Having a moderate level of anxiety according to the State-Trait Anxiety Scale
• Participants must be literate and have at least a high school diploma.

Exclusion Criteria:

• Having an active or chronic illness
• Experiencing cooperation problems
• Regular use of psychiatric medication (antidepressants, anxiolytics, etc.)
• Use of medications that affect heart rate, such as beta-blockers
• Auditory dysfunction (to the point of being unable to hear music)
• Individuals who are highly trained (very experienced) in breathing exercises or meditation

The individuals to be included in the study will be randomized into three groups as Control Group (CG), Controlled Breathing Exercises Group (CBE), or Music-Assisted Breathing Group (MAB) after the first evaluations are completed. Randomization will be done with the www.randomizer.com site. The groups of individuals determined according to the order of participation will be placed in opaque envelopes and the envelopes will be closed. On the same day, the physiotherapist, who will apply the intervention will do the application according to the group that comes out of the envelope. Post-intervention assessments for all participants will be conducted by the first physiotherapist, who will remain blinded to group assignments throughout the study.