ClinicalTrials.gg
Status unknownNCT03345381Updated Jun 18, 2019

Impact of Breathing Exercises and Meditation on Quality of Life in Dry Eye Disease Patients: A Pilot Study

An interventional study of SKY + ASTM + usual care and Usual care in Depression, Quality of Life and Dry Eye, sponsored by London Health Sciences Centre Research Institute and Lawson Research Institute of St. Joseph's. Status unknown at 1 site in Canada. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2019-06-18.

Sponsored by London Health Sciences Centre Research Institute and Lawson Research Institute of St. Joseph's · Not applicable, Interventional, and Supportive care

The sponsor has not verified this record recently (last verified Jun 2019), so the status shown — last known as Not yet recruiting — may be out of date.

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Phase
Not applicable
Study type
Interventional
Enrollment
70
Allocation
Randomized
Ages
18 Years to 80 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-13

Among 532 studies in Depression with a site in Canada — 107 open to participants now, 124 under way, 7 of them phase 3. Depression · Canada.

Planned enrollment
257th of 487
70 · median 76
Started
2019
with 32 others
No phase
334 of 532
79 open now
Registered
234th of 532
by date

Among the 532 studies in Depression with a site in Canada, this one is the 257th largest by planned enrollment of the 487 interventional ones that give a count, is one of 33 that started in 2019, is one of 334 with no phase, and was the 234th registered.

Depression

8,582 studies on the registry are indexed under Depression; 1,723 are open to participants now.

Browse Depression studies →

Open to participants now

107 of the 532 studies in Depression with a site in Canada are open now. Recruiting first, the newest first:

102 more — sign in →

All 107 open studies →

A study can be open while its sites in Canada have not opened yet or have stopped. Only those recruiting at a site in Canada →

Who these studies take

Of the 1,089 Depression studies recruiting now, 470 (43%) set no upper age limit and 519 (48%) stop at 75 or younger; 203 take children under 18; 311 take healthy volunteers.

This study: 18 Years to 80 Years · all sexes · no healthy volunteers.

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02

Study summary

People staring at computer screens for long hours, blinking less frequently, or having long-term contact lens wear are prone to dry eye disease (DED). DED is a multifactorial disease accompanied by inflammation of the ocular surface. Further, DED may degrade vision and is associated with depression and have an adverse impact on patient's quality of life. Sudarshan Kriya Yoga (SKY) incorporates standardized collection of breathing techniques followed by Automatic Self Transcending Meditation (ASTM) may help reduce stress, depression, and anxiety, enhance quality of life in patients diagnosed with DED. Thus, the investigators will be studying the effect of SKY plus ASTM on quality of life of DED patients. The investigators plan to conduct a single-center pilot RCT. Patients with DED will be randomized to SKY followed by ASTM plus Usual care (UC) or UC alone to assess changes in health-related quality of life (HRQOL). HRQOL is a vital construct focusing on impact of health on quality of life. Along with HRQOL the investigators will measure changes in extent of depression and anxiety. Additionally, majority of current ophthalmic literature describes changes in clinical variables whilst lacking information on HRQOL. Thus, there is a high necessity to assess if there is an association between HRQOL and routinely measured clinical data. Through this study the investigators shall attempt to correlate HRQOL with clinical data.

Read the detailed description

Background: Prevalence of dry eye disease (DED) ranges from 3.5% to 33.7% and increase with age. Further, DED is associated with decreased productivity, absenteeism from work, depression, and has an adverse impact on patient's quality of life. Odds of a DED patient suffering from depression is 2.9 and anxiety is 2.8. Yoga - a practice to help improve health and well-being - has also been the subject of clinical studies globally. Two central aspects of yoga practice are physical postures and breathing exercises. These breathing exercises aim to focus the mind, facilitate relaxation and enhance wellness.

Evidence further suggests beneficial effects of a standardized collection of breathing techniques called Sudarshan Kriya Yoga (SKY) on individuals suffering from depression. SKY includes three-stage breathing with Victory breath (slow deep breathing that consists of 4 to 6 breaths per minute), Bellow's breath (forceful rapid deep breathing that consists of 20 to 30 breaths per minute), and a rhythmic breath technique. SKY followed by Automatic Self Transcending Meditation (ASTM) involves breathing exercise followed by meditation. ASTM utilizes a specific sound value mantra to draw attention inward and permit the mind to experience a restful but alert state of consciousness. It helps quiet the mind and induces physiological and mental relaxation whilst the eyes are shut. ASTM may help with depression, anxiety, stress, and may enhance quality of life. Thus, the investigators will be studying the effect of SKY plus ASTM on quality of life of DED patients. Key goal of proposed research is to evaluate HRQOL, depression, anxiety of patients with DED in SKY followed by ASTM and usual care (UC) versus UC alone from baseline to 24 weeks.

Primary Hypothesis: The investigators hypothesize that in patients with dry eye disease in SKY + ASTM + UC may lead to significant improvement in HRQoL compared to UC alone from baseline to 24 weeks.

Secondary Hypotheses: The investigators hypothesize that in patients with DED 1) HRQoL is associated with regularly measured clinical variables 2) SKY + ASTM + UC leads to significant improvement in depression and anxiety symptoms at 24 weeks compared to UC alone.

03

Conditions studied

  • Depression
  • Quality of Life
  • Dry Eye
  • Anxiety
  • Sleep
04

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • dry eye disease suspects or have mild to severe dry eye disease
  • at least between 18 to 80 years of age
  • deemed competent such as no language issues or communication barriers, no self-reported or physician diagnosed mental health disorder besides having depressive and anxiety symptoms
  • have sufficient hearing to be able to follow verbal instructions and able to sit without physical discomfort for 30 minutes
  • willing and able to attend 3 initial SKY and 4 initial ASTM training sessions
  • willing to dedicate 20 minutes per day for SKY and 20 minutes twice per day to ASTM practice at their own home.

Exclusion criteria

Exclusion Criteria:

  • actively suicidal as per self-report (or score on CES-D) or on assessment by the physician
  • they are currently participating in other similar studies
  • currently practicing any type of formal meditation techniques regularly
  • unable or unwilling to answer survey questions.
05

Study design

Phase
Not applicable
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
70 participants (estimated)

Study arms

  • Experimental
    SKY + ASTM + usual care

    Sudarshan Kriya Yoga (SKY) followed by Automatic Self Transcending Meditation (ASTM) plus usual care

    Other: SKY + ASTM + usual care

  • Active comparator
    Usual Care

    Treatment as usual

    Other: Usual care

Interventions

  • OtherSKY + ASTM + usual care

    Sudarshan Kriya Yoga (SKY) followed by Automatic Self Transcending Meditation (ASTM) involves breathing exercise followed by meditation.

  • OtherUsual care

    Treatment as usual

06

What researchers measure

Primary outcomes

  1. Change in Health Related Quality of Life (HRQoL)

    Health Related Quality of LIfe (HRQoL) is an essential measure of quality of life related to health. HRQoL will be measured using time trade-off (TTO) questionnaire. HRQoL varies between 0 and 1 where the score of 1 represents perfect health and 0 represents death.

    Time frame: Up to 24 weeks

Secondary outcomes

  1. Visual Function Score

    Visual related quality of life measured using National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25). The most widely used instrument in vision-related functioning is the NEI VFQ-25. It was designed specifically for a clinical setting and consists of 12 domains: general health, general vision, visual pain, near activities, distance activities, social functioning, mental health, role difficulties, dependency, driving, colour vision and peripheral vision. The shorter 25-item version questionnaire is widely used in different groups of patients and shown to be internally consistent, reproducible and responsive in glaucoma patients. The NEI VFQ-25 scores have a closer relationship to clinical outcomes, in comparison to generic instruments. The scores range from 0 to 100 where higher score represents better vision related quality of life.

    Time frame: Up to 24 weeks

  2. Depression

    Center for Epidemiologic Studies Depression Scale (CES-D) will be used to measure depression. It is one of the most common validated tools used to measure depression in research to identify depressive symptoms. Additionally, it is a brief standardized valid tool for assessing depressive symptoms. Possible range of scores is zero to 60, with the higher scores indicating the presence of more depressive symptoms.

    Time frame: Up to 24 weeks

  3. State and Trait Anxiety

    State-Trait Anxiety Inventory (STAI)

    Time frame: Up to 24 weeks

  4. Sleep Quality

    Pittsburgh Sleep Quality Index (PSQI)

    Time frame: Up to 24 weeks

  5. Community Integration

    The community integration questionnaire (CIQ) was used to provide a quantitative indicator for the level of social support and ability to perform appropriate roles at home and within the community. The CIQ contains 15-items and uses behavioural items of integration to achieve better reliability. The total CIQ score ranges from 0 to 29, with a higher score representing a higher level of social support and complete community integration.

    Time frame: Up to 24 weeks

  6. Canadian Dry Eye Assessment

    Canadian Dry Eye Assessment

    Time frame: Up to 24 weeks

  7. Dry Eye Assessment

    Standardized Patient Evaluation of Eye Dryness (SPEED) Questionnaire

    Time frame: Up to 24 weeks

07

Study locations

1 site
  • St. Joseph's Hospital, Ivey Eye Institute
    London, Ontario N6G0H8, Canada
08

References and documents

Publications

  • Schein OD, Munoz B, Tielsch JM, Bandeen-Roche K, West S. Prevalence of dry eye among the elderly. Am J Ophthalmol. 1997 Dec;124(6):723-8. doi: 10.1016/s0002-9394(14)71688-5. PubMed 9402817 ↗
  • Schaumberg DA, Dana R, Buring JE, Sullivan DA. Prevalence of dry eye disease among US men: estimates from the Physicians' Health Studies. Arch Ophthalmol. 2009 Jun;127(6):763-8. doi: 10.1001/archophthalmol.2009.103. PubMed 19506195 ↗
  • Schaumberg DA, Sullivan DA, Buring JE, Dana MR. Prevalence of dry eye syndrome among US women. Am J Ophthalmol. 2003 Aug;136(2):318-26. doi: 10.1016/s0002-9394(03)00218-6. PubMed 12888056 ↗
  • Yu J, Asche CV, Fairchild CJ. The economic burden of dry eye disease in the United States: a decision tree analysis. Cornea. 2011 Apr;30(4):379-87. doi: 10.1097/ICO.0b013e3181f7f363. PubMed 21045640 ↗
  • Wan KH, Chen LJ, Young AL. Depression and anxiety in dry eye disease: a systematic review and meta-analysis. Eye (Lond). 2016 Dec;30(12):1558-1567. doi: 10.1038/eye.2016.186. Epub 2016 Aug 12. PubMed 27518547 ↗
  • Elder C, Nidich S, Moriarty F, Nidich R. Effect of transcendental meditation on employee stress, depression, and burnout: a randomized controlled study. Perm J. 2014 Winter;18(1):19-23. doi: 10.7812/TPP/13-102. PubMed 24626068 ↗
  • Burns JL, Lee RM, Brown LJ. The effect of meditation on self-reported measures of stress, anxiety, depression, and perfectionism in a college population. Journal of College Psychotherapy 25(2): 132-144, 2011.

Individual participant data

Plan to share: No — De-identified IPD collected in this study will not be available to other researchers (e.g. outside the primary research group). Because the primary research group has the necessary expertise to conduct analysis and do not need any outside help.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Jul 2019; primary completion for Sep 2020, 14 months later.

Of 3,471 non-industry interventional studies with no phase under Depression, half reached primary completion within 21 months of starting (the median), counting those still running; a quarter within 10 and three quarters within 41. This study's planned 14 months is below that.

Counting every sponsor, half of 3,569 studies reached it within 21 months; a quarter within 9 and three quarters within 41.

How these figures are worked out, and which studies are left out of them.

Registered
Nov 14, 2017
First posted
Nov 17, 2017
StartEst.
Jul 1, 2019
Primary completionEst.
Sep 1, 2020
CompletionEst.
Dec 1, 2020
Last update
Jun 18, 2019
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jun 18, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03345381
Responsible party
Sponsor
First posted
Nov 17, 2017
Start date
Jul 1, 2019 (estimated)
Primary completion
Sep 1, 2020 (estimated)
Completion
Dec 1, 2020 (estimated)
Last update
Jun 18, 2019

Study contacts

Monali Malvankar
Contact
monali.malvankar@sjhc.london.on.ca
5196858500 ext. 61288
Monali Malvankar
principal investigator · University of Western Ontario, Canada

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is status unknown, as verified in Jun 2019. You cannot join it, but the record below documents what was studied.

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