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V. TipsBreathe effortlessly. In order to effectively lower blood pressure,it is essential to breathe effortlessly during the entire RESPeRATEsession. Normal breathing is usually 12–18 breaths per minute.In the first few sessions, your slowest comfortable breathing rateachieved might be higher than 10 breaths per minute. Don’t pushyourself. Within a few RESPeRATE sessions, your breathing ratewill likely drop to below 10 breaths per minute.Breathe gradually. While following the guiding tones avoidholding your breath after inhaling or exhaling. Breathing excessivelydeep is counterproductive. Effortless breathing is best achieved bya gradual inhalation through the nose, then a gradual exhalationthrough the mouth. One easy way to prolong exhalation is topurse your lips as if you were blowing out a candle. If at any timeduring the session you feel that following the guiding tones isuncomfortable, use the Refresh function by pressing and holdingthe INFO button .It’s not a competition. The slowest breathing rate and patternthat is comfortable for each individual varies from person to personand from day to day. Only you can decide when breathing becomesuncomfortable. The goal is to reach the Therapeutic Zone of slower22

than 10 breaths per minute, not to reach as slow a breathing rate aspossible. Making an effort to achieve an excessively slow breathingrate may not be as beneficial in lowering blood pressure levels.The more therapeutic breathing minutes, the better!Be sure to accumulate no less than 40 therapeutic breathingminutes per week. Remember that the more time spent inthe Therapeutic Breathing Zone, the better your chances ofachieving greater blood pressure reduction.Avoid other breathing techniques. During the RESPeRATEsession, don’t try other breathing techniques such as breathholding or Buteyko. These types of breathing require effortwhich is counter-productive to lowering blood pressure.Stay awake to lower blood pressure. RESPeRATE is veryrelaxing. Some users have been known to fall asleep. Whensleeping, your breathing rate may become faster and you willnot accumulate therapeutic minutes. You may use RESPeRATEto fall asleep as a secondary purpose.Be patient. As with any physical exercise program, longterm results are not immediate. Each session can provide animmediate sense of calm and relaxation. However, an all-dayblood pressure reduction starts to be seen within - 3-4 weeks.23

FunctionsYour RESPeRATE can be adjusted based on your preferences.The following section will explain how to set the functions toyour likings. The functions are listed according to the order theyis pressed.appear when the MENU buttonTo select a function, press the MENU buttonand thenpress the UP/DOWN button to reach your preferred setting.RESPeRATE will return to the previous screen after the change ismade and it will save the change for the next session.I. Melody SelectionTo select a different melody, press theone (1) time. ThenMENU buttonpress the UP/DOWN button to reachyour preferred melody. The melodyand the selected melodyiconnumber will appear on the screen.24Melody Display

II. Guiding ArrowsThe guiding arrows depict when to breathe in and when tobreathe out. By default they will turn off one minute into a sessionas some people tend to constantly focus on them. However, ifyou are having problems following the tones or prefer to havethe visual aid, you can activate them.Guiding Arrows OnGuiding Arrows OffTo turn the guiding arrows on/off, press the MENU button two(2) times. Then press the UP button to turn it on and the Downbutton to turn it off. Your display will change accordingly.25

III. MuteDuring the session voice instructions and warnings will be spoken.However, if they become a distraction they can be muted.Voice Instructions OnVoice Instructions OffTo turn the voice instructions on/off, press the MENU buttonthree (3) times. Then press the UP button to turn it on or theDown button to mute. Your display will change accordingly.IV. Default Session DurationTo change the default session durationfour (4)press the MENU buttontimes. Then press the UP/DOWNbutton to increase/decrease the time.The time changes in increments of 5minutes. Sessions can range between10 and 60 minutes.26Session Duration

Performance StatisticsPerformance statistics track and provide feedback on yourperformance using RESPeRATE. This feature is optional and isnot necessary to lower blood pressure.The two simplest ways to assess your performance are thetherapeutic minutes clock icon (during session) and the weeklytherapeutic breathing time (displayed momentarily on the devicedisplay when it is turned on).For a more advanced assessment, RESPeRATE’s built–in memorystores the following six statistics related to your performance:number of sessions, therapeutic minutes, initial breathing rate,final breathing rate, synchronization, and breath detection.Furthermore, each of these performance statistics is providedfor three different time periods: last session, last 7 days, and last30 days.27

To View Performance Statistics1. When RESPeRATE is off, press and hold the INFO buttonuntil the screen displays the statistic. The data that appears isfor your last session.For the Duo and Deluxe models, first select User 1User 2to view the results for the appropriate user.2. Press the UP/DOWN buttonperformance statistics.orto browse between the3. To choose a time period other than your last session pressthe INFO button . Press it once to view data for the last 7days and twice to view data for the past 30 days.28

To Understand Performance Statistics DisplayPerformance statistics are expressed as shown in the example:a letter and a value together with the Report Period.The letter corresponds to the statistic type and range from A to F.The value shows the performance for that particular statistic. Thereport period varies depending on the time frame selected.Statistic typeReport PeriodValuePerformance Display29

Performance StatisticsStatistic A: Number of SessionsThe number of sessions that reached the breathing exercise phase.DescriptionLast session report reads A:01After your first RESPeRATE session,this value will always be “1.”Last 7 days report reads A:05Means that in the past 7 days,5 sessions reached the guidedbreathing exercise period.Last 30 days report reads A:54Means that in the past 30 days, 54sessions reached the guided breathingexercise period.30Example

Statistic B: Therapeutic MinutesAmount of Time (in minutes) spent in the therapeutic breathingzone. The goal is to accumulate at least 10 therapeutic minutesper session and 40 minutes per week.DescriptionExample and GoalLast session report reads b:9.5Means that 9.5 minutes were spent inthe therapeutic zone during the lastSession.Goal 10 MinLast 7 days report reads b:46Means that a total of 46 minutes werespent in the therapeutic zone over thelast 7 days.Goal 40 MinLast 30 days report reads b:46Means that on average, 46 minutesper week of use were spent in thetherapeutic zone.Note: If value is 100 or greater(therapeutic minutes), a blinking“99” appears.Goal 40 Min31

Statistic C: Initial Breathing RateNumber of breaths per minute at the beginning of the breathingexercise phase. The acceptable range is between 6-30 breathsper minute.DescriptionLast session report reads C:17Means that the initial breathing ratewas 17 breaths per minute. Initialbreathing rates are “normal” levelsand typically vary from 12 to18breaths per minute.Last 7 days report reads C:17Means that the average initialbreathing rate was 17 breaths perminute.Last 30 days report reads C:17Means that the average initialbreathing rate was 17 breaths perminute.32Example andAcceptable Range

Statistic D: Final Breathing RateNumber of breaths per minute at the end of the RESPeRATEsession. The recommended range is 5-10 breaths per minute.DescriptionExample andRecommended RangeLast session report reads d:6.2Means that the final breathing ratewas 6.2 breaths per minute. Finalbreathing rates vary and can typicallyreach 6–8 breaths per minute withina few weeks of use.Last 7 days report reads d:6.2Means that the average finalbreathing rate was 6.2 breathsper minute.Last 30 days report reads d:6.2Means that the average finalbreathing rate was 6.2 breathsper minute.33

Statistic E: SynchronizationIndicates how well you are following the guiding tones.Specifically, it is the percentage of time in which breathing wassynchronized with the guiding tones. The acceptable range isfrom 60-99%.DescriptionLast session report reads E:94 meansthat 94% of the time, breathing wassynchronized with the guiding tones.Last 7 days report reads E:94Means that on average, 94% of thetime, breathing was synchronized withthe guiding tones.Last 30 days report reads E:94Means that on average, 94% of thetime, breathing was synchronized withthe guiding tones.34Example andAcceptable Range

Statistic F: Breath DetectionIndicates how well the sensor is able to recognize inhalation andexhalation as a result of the placement of the sensor. Specifically,it is the percentage of session time that the breathing sensorcould identify the respiration data. This should range from80-99%.DescriptionExample andRecommended RangeLast session report reads F:88Means that 88% of the time, sensorwas able to identify respiration data.Last 7 days report reads F:88Means that on average 88% of thetime the sensor was able to identifythe respiration data.Last 30 days report reads F:88Means that on average 88% of thetime the sensor was able to identifythe respiration data.35

TroubleshootingI. TroubleshootingThe table below describes some situations which may occurand how to best solve them. If your particular problem is notaddressed, contact customer service.ProblemExplanationSolutionThe RecognitionPhase takes longerthan two minutes.The sensor is improperlypositioned.Refer to Tutorial andManual Sensor Positioningsection (page 39)Breathing is too unstableRelax and breathenormally.Breathing is notsynchronized withthe guiding tones.Begin to gently inhalethen, gradually exhalesoon after the start ofthe guiding tones.I repeatedly heara voice message,“Breathe with theguiding tones.”Activate the guidingarrows for assistance.Try followingMelody #4.36

ProblemExplanationSolutionI am unable tocomplete sensorpositioning in thetutorialBreathing is notsynchronized with thevoice instructions.Begin to gently inhalethen, gradually exhalesoon after the voiceinstructions.One or both ofthe guiding tonesare too fast ortoo slow for mycurrent breathingto the point I’muncomfortable orlightheaded.Your breathing rate haschanged abruptly.RESPeRATE will adaptwithin a few breathsto guide you accordingto your naturalbreathing pattern.You are followingthe tones but feeluncomfortable orlightheaded.Use the Refresh functionby pressing and holdingthe INFO button .RESPeRATE will re-calibrateto your comfortablebreathing pattern.Breath per Minutesdisplay is flashing.You are breathing morethan 30 or less than 3breaths per minute.Breathe accordingto the guiding tones.The display doesnot turn on whenthe device isturned on.Batteries need to bereplaced. This iconindicates battery power.Install new batteries.The /– poles of thebatteries are positionedincorrectly.Reinstall the batterieswith the /– polespositioned correctly.37

ProblemExplanationSolutionMusic is not heardthrough the earbuds.The volume is nothigh enough.Press the Up button toincrease the volume level.The Ear buds are notconnected properlyto the device.Reconnect the ear budsto the device. A click willsound when they areproperly inserted.RESPeRATE automaticallyswitched off because thesession is over.Restart to begina new session.Ear buds are not fullyplugged into the earbuds socket.Reconnect the ear budsto the device. A click willsound when they areproperly inserted.Electroniccommunication device(cell phone, beeper, etc)is operating within 5 feetof RESPeRATERemove electroniccommunication devicewhile conducting thesession.Static noise isheard throughthe ear buds.38

II. Manual Sensor PositioningThe Tutorial should determine where you are to position thesensor – abdomen or chest. If you are experiencing difficulty,there is an alternative way to assess the appropriate position.First, any restrictive clothing (tight pants belt or bra) should beloosened. Second, too many layers (heavy sweaters/sweatshirts)may disrupt the signal and should be removed.If the issue persists, try manual sensorpositioning. Sit comfortably on achair. Lean back and place your righthand on the right side of your chest.Place your left hand on the upperabdomen, above the navel.Left handon upperabdomenTake a few breaths. Feel whichhand moves first when you startto inhale and exhale. The sensorposition is determined by whichhand moves first.Place the sensorRight hand onright chestaccordingly.Manual sensor positioning39

Additional Product InformationI. RESPeRATE Limited WarrantyRESPeRATE is warranted to be free from manufacturing defectsfor a period of one year from date of purchase under normaluse. This warranty extends only to the original purchaser.Should repair be needed within the warranty period, please callRESPeRATE Customer Support. We will either repair or replace(at our discretion) free of charge any parts necessary to correctdefects in the materials or workmanship.If it is necessary to replace the entire product, it may be replacedwith a remanufactured product. The above warranty is completeand exclusive. The warrantor expressly disclaims liability forincidental, special, or consequential damages of any nature.Some counties and/or states do not allow the exclusion orlimitation of incidental or consequential damages, so the abovewarranty may not apply to you. Any implied warranties arisingby the operation of law shall be limited in duration to the termof this warranty. This warranty gives you specific legal rights,and you may have other rights which vary from state to state.40

II. Cleaning and MaintenanceTo clean RESPeRATE, use a soft, slightly damp cloth. Do notwash the sensor or the RESPeRATE device. Do not use petroleumproducts, thinners, or cleaning solvents!Protect your RESPeRATE against excessive vibrations.Do not leave your RESPeRATE in a place where temperatures arebelow -14 F (-10 C) or above 158 F (70 C), or in conditions ofvery high humidity ( 85%).Do not attempt to make repairs of any kind on RESPeRATE.Contact Customer Care if repairs are necessary.Please use only Alkaline batteries.If you do not plan to use RESPeRATE for a period of more thantwo months, remove batteries from the battery compartment toavoid damaging the device.41

III. Technical InformationModel Name: RESPeRATE , RESPeRATE Duo and RESPeRATEDeluxe (RESPeRATE Ultra is a marketing name of RESPeRATE );Model #: RR152, RR152D, RR152-1M, RR152-1DM, RR152-1,RR152-1DDisplay type: LCD; The Deluxe edition includes a back lightthat makes it easier to read the screen in the dark or in poor light;Power source: four alkaline batteries, 1.5V (type AA);Battery life: two months, with regular use of 15 minutes per day;Maximum audio output: 10mW with 16 Ohm Ear buds;Device display respiration rate: range of 2-42 BPM butguides between 5-20 BPM;Operating temperature: 10 C - 40 C (50 F - 104 F);Operation humidity: 30 - 75%;Storage temperature: -10 C - 70 C (14 F - 158 F);Storage humidity: 30 - 85%;Weight: 360 grams;Outer product dimensions: 12.4 L x 11.7 W x 6.6 H cm,4.9” L x 4.6” W x 2”.6 HExpected Service Life: 5 years42

Guidance and manufacturer’s declaration –electromagnetic immunityThe RESPeRATE is intended for use in the electromagnetic environmentspecified below. The customer or the user of the RESPeRATE shouldassure that it is used in such an environment.Immunity testIEC 60601test levelCompliancelevelElectromagneticenvironment guidanceElectrostaticdischarge (ESD)IEC 61000-4-2 6 kV contact 8 kV air 6 kV contact 8 kV airFloors should bewood, concreteor ceramic tile. Iffloors are coveredwith syntheticmaterial, therelative humidityshould be at least30 %.Electrical fasttransient/burstIEC 61000-4-4 2 kV forpowersupply linesNot applicableNot applicable.SurgeIEC 61000-4-5 1 kV line(s)and neutralNot applicableNot applicable.43

Immunity testIEC 60601test levelCompliancelevelElectromagneticenvironment guidanceVoltagedips, shortinterruptionsand voltagevariationson powersupplyinput linesIEC 61000-4-11 5 % UT( 95 % dip inUT)for 0,5 cycle40 % UT(60 % dip in UT)for 5 cycles70 % UT(30 % dip in UT)for 25 cycles 5 % UT( 95 % dip inUT)for 5sNot applicableNot applicablePowerfrequency(50/60 Hz)magnetic fieldIEC 61000-4-83 A/mNot applicableNot applicableNOTE44UT is the a.c. mains voltage prior to application of the test level

ImmunitytestIEC 60601test levelCompliancelevelElectromagnetic environment - guidanceConductedRFIEC 610004-63 Vrms150 kHz to80 MHz3 VrmsRadiated RFIEC 610004-33 V/m80 MHz to2.5 GHz3 V/mPortable and mobile RF communicationsequipment should be used no closer to any partof the RES

Blood Pressure Introduction Congratulations on the purchase of your RESPeRATE, the first medical device clinically proven to lower blood pressure in an effective and pleasant way. Please note: RESPeRATE should only be used as part of your overall health program for achieving goal