{"paper_id":"4e44c059-9cf4-4618-89f7-d494afd9afc4","body_text":"Interplay between cognitive conditions and individual traits in voluntary apnea | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Interplay between cognitive conditions and individual traits in voluntary apnea Eleonora Malloggi, Enrica Laura Santarcangelo, Ursula Debarnot This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7978493/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 17 Feb, 2026 Read the published version in Experimental Brain Research → Version 1 posted You are reading this latest preprint version Abstract Apnea is employed to enhance performance in diving and other sports due to its specific physiological correlates. Its duration can be enhanced through training and the use of specific cognitive strategies and can be influenced by individual traits. Hypnotizability could be one of them, being associated with interoceptive sensibility and imagery abilities. The study investigates whether these traits affect apnea duration during imagery of normal breathing (motor imagery, a cognitively incongruent condition) and while focusing attention on apnea sensations (internally focused attention, a cognitively congruent condition) in participants with different hypnotizability scores. Hypnotizability was assessed in healthy participants -as low-medium (med-lows, N = 16) and medium-to-high hypnotizables (med-highs, N = 17)-, according to the Stanford Hypnotic Susceptibility Scale: Form A. They completed the Multidimensional Assessment of Interoceptive Awareness and the Movement Imagery Questionnaire-3 to assess interoceptive sensibility and trait imagery abilities and performed three apnea trials of internally focused attention and motor imagery in counterbalanced order. Heart rate and skin conductance were monitored. The vividness and ease of motor imagery and internally focused attention tasks were reported. Apnea duration increased across trials independently of the cognitive condition and hypnotizability. Heart rate increased during motor imagery more than during internally focused attention, skin conductance decreased quasi-significantly during both tasks in both groups. Imagery abilities and interoceptive sensibility masked hypnotizability-related differences in the tasks' subjective experience, heart rate, and increase in apnea duration across trials. Thus, hypnotizability, imagery abilities, and interoceptive sensibility jointly contribute to increase apnea duration across trials and to the associated experience and autonomic responses. breath-holding motor imagery interoceptive sensibility hypnotizability absorption Figures Figure 1 Figure 2 1. Introduction Voluntary apnea, also known as breath-hold, represents a specific physiological state characterized by coordinated autonomic responses, including bradycardia, increased mean arterial blood pressure, peripheral vasoconstriction (Ferrigno & Lundgren, 2003 ), and reduced hemoglobin saturation (Ichinose et al., 2017). These changes reflect the diving reflex, an oxygen-conserving response that aims to maintain cerebral and cardiac perfusion under hypoxic stress. Breath-holding time is determined by the increase in CO 2 and lung volume (Godfrey et al., 1969 ; Godfrey and Campbell, 1969 ; Kelman and Wann, 1971) and by the preceding oxygenation rate (Bruce et al., 2021 ). The reported urge to breathe is positively correlated with the magnitude of the thoracic and abdominal expansion (Decavèle et al., 2025 ). Apnea elicits a maximal autonomic response, as the change in blood pressure is not sensitive to additional cold stimulation (Matsutake et al., 2025 ). Adenosine is likely involved in its adaptive cardiovascular response because of its vasodilating and bradycardic properties (Marlinge et al., 2021 ). Apnea performance can be trained, as observed in swimmers and divers who can hold their breath for over 10 minutes and exhibit marked increases in cerebral blood flow (Arce-Álvarez et al., 2021 ; Bain et al., 2018 ). Cognitive factors also modulate apnea duration, including time perception and mental tasks such as imagery of normal breathing and deep absorption in the apnea-related sensation (Vigran et al., 2019 ; Kanthack et al., 2019 ). 1.1 Motor imagery, hypnotizability and interoception Motor imagery (MI) refers to the mental simulation of a movement without overt motor output (Decety, 1996 ) and is used in sports to enhance performance (McNeil et al., 2025). It can be experienced either through internal visual imagery from a first-person perspective or through kinesthetic imagery, which involves vivid sensations of movement (Munzert et al., 2009 ). MI is characterized by subjective, behavioral and physiological variables that are influenced by imagery abilities (Guillot et al., 2009 ), motor conditions (Di Rienzo et al., 2022 ) and interoceptive sensibility (Malloggi et al., 2024). The latter represents the experience and interpretation of internal bodily signals (Critchley & Garfinkel, 2017 ) and is measured by questionnaires (Mehling et al., 2018 ; Porges, 1994). MI is also influenced by hypnotizability, a psychophysiological trait measured by scales that evaluate the ability to experience cognitive and physical states different from the actual ones (Santarcangelo, 2024). High hypnotizability is associated with greater functional equivalence between actual and imagined perception/action, that is, more similar cortical activations and connections during the two conditions (Ibanez-Marcelo et al., 2019 a,b), and the greater excitability of their motor cortex during imagery (Spina et al., 2020; Cesari et al., 2020). Also, hypnotizability levels display different “adaptive” interoceptive sensibility (Diolaiuti et al., 2020 ) and interoceptive accuracy (Giusti et al., 2024), that is the ability to accurately detect interoceptive information, likely due to hypnotizability-related variations in the insula grey matter volume (Landry et al., 2017; Picerni et al., 2019). 1.2 Aim of the study In the general population, apnea duration is influenced by the concomitant cognitive context, with longer durations observed during MI of normal breathing compared to IFA (Kanthack et al., 2019 ). Since imagery abilities, interoceptive sensibility, and hypnotizability are interrelated (Zelič et al., 2023), the present study aimed to expand the findings of Kanthack et al. ( 2019 ) about apnea duration in cognitively congruent (IFA) and incongruent conditions (MI) by examining the role of these individual traits in modulating apnea duration. 2. Methods 2.1 Participants Thirty-three healthy, sedentary volunteers (age mean ± SD): 27.2 ± 8.5; 15 females) were recruited among students at the University of Pisa. After signing an informed consent approved by the Pisa University Bioethics Committee (n.29/2022), a semi-structured interview ascertained the absence of cardiovascular, respiratory, neurological, psychiatric conditions, sleep and attention disorders, and any current pharmacological therapies. Participants were administered with the Italian version of the Hypnotic Susceptibility Scale: Form A (SHSS: A, range 0–12) (Weitzenhoffer & Hilgard, 1959 ), classifying them in highs (score ≥ 8 out of 12), mediums (score 5–7) and lows (score ≤ 4). In the general population, mediums represent 70%, while highs and lows represent 15% each (De Pascalis et al., 2000). Owing to the small number of recruited mediums, a group of medium-to-highs (med-highs including 2 mediums, 8 females, SHSS score (mean ± SD): 8.88 ± 1.32) and a group of medium-to-lows (med-lows, including 3 mediums, 7 females, SHSS score: 2.88 ± 1.82, 3 mediums) were studied. For a preliminary assessment of the participants’ psychophysiological traits, they completed the Multidimensional Assessment of Interoceptive Awareness (MAIA; Mehling et al., 2018 ) and the Motor Imagery Questionnaire-3 (MIQ-3; Williams et al., 2012 ). The MAIA questionnaire includes 8 scales ( noticing, not distracting, not worrying, attention regulation, emotional awareness, self-regulation, body listening, trusting ; range 0–5), while the MIQ includes three modalities (external visual, MIQEVI; internal visual, MIQIVI; kinesthetic imagery, MIQKI; total range 0–28). For experiential and behavioral variables, which were studied during tasks, G*power (Faul et al., 2007 ) indicated a minimum number of 20 subjects to obtain significant main effects and interactions for experiential and behavioral variables, and a minimum number of 14 subjects for physiological variables with f = .25, p = .05, and 1-β = .80. 2.2 Experimental procedure The experiment was performed at least one week after the hypnotic assessment. The participants were asked to refrain from caffeine and alcohol for the three hours preceding the session, which was conducted in a sound and light-attenuated room. Before starting the experimental procedure, participants completed the State Anxiety Questionnaire (STAI-Y1; cut off for clinical anxiety = 52; Spielberger, 1983 ). Before undergoing the experimental conditions, participants performed a familiarization trial of apnea until their breaking point, without cognitive instructions. The experimental closed-eye session included 2-minute baseline intervals (spontaneous, non-controlled breaths), following every trial of IFA (B1) and MI (B2) to let physiological signals return to baseline. Three maximal breath-hold trials were performed for IFA and MI in a seated position, with knees at 90° and with hands and forearms placed on the thighs. Before the breath-hold tasks (apnea), participants were instructed to take a deep breath. The inspiratory act was considered acceptable if its depth was at least one and a half times the normal breath, as controlled online by a Compumedics Summit IP® Inductive Respiratory Effort System (Compumedics, Newton, PA, USA). The duration of the breath hold was measured with a chronometer and controlled online by visualizing the respiratory signal. Participants were blinded to their maximal breath-hold duration. In the IFA condition, participants were instructed to focus on the bodily sensations that emerge during breath-holding. The experimenter provided guidance using instructions such as: “Focus on the sensations associated with the effort of voluntary breath-holding. Feel the muscle contractions pressing against your lungs and the tension in your chest as it remains still. Notice the absence of movement in your respiratory tract and the growing urge to breathe.”. In the MI condition, performed while imagining normal breathing, participants were instructed to engage in both visual and kinesthetic imagery of natural respiration. They were guided with instructions such as: “Imagine the sensations associated with breathing. Feel the air entering your nose and the pressure changes in your lungs and chest. Sense the muscular contractions and stretches accompanying inhalation and exhalation, as if you were breathing.” After each apnea trial, the participants were invited to rate the vividness and easiness of their IFA and MI experience. IFA and MI were randomly administered to the participants. After each apnea trial, the participants were invited to rate the vividness and easiness of their IFA and MI experience. 2.3 Signal acquisition and analysis Electrocardiogram (EKG) and skin conductance level (SCL) were monitored by a Psylab device (Contact Precision Instrument) and stored for offline analysis. For EKG acquisition, disposable electrodes ( https://www.fiab.it/it/index.php ) were placed according to the standard DI configuration. SCL was recorded using two similar electrodes placed on the middle phalanges of the index and middle fingers of the dominant hand. A common reference electrode was used for both EKG and SCL signals. A band-pass filter (0.5 Hz − 20 Hz) was applied to the EKG signal, and HR was computed as 60/mean RR interval for each condition (B1, B2, IFA, MI). Heart rate variability (HRV) was estimated using the root mean square of successive differences (RMSSD), a time-domain index reflecting short-term parasympathetic modulation. RMSSD values were interpreted in consideration of normative data for short-term resting conditions (Nunan et al., 2010 ). Notably, total HRV (SDNN) could not be studied due to the short duration of the studied conditions (Shaffer et al., 2017). For SCL, the signal was detrended, and its mean value was subtracted from the entire signal as baseline removal. A fourth-order low-pass butter filter was applied with a cut-off frequency set at 0.5 Hz. Then, a Savitzky-Golay smoothing filter was applied (Savitzky & Golay, 1964 ). Breath-hold trials were averaged during IFA and MI, respectively, as well as baseline intervals. The mean value of HRV and SCL was computed for each condition. 2.4 Variables For the assessment of interoceptive sensibility and motor imagery abilities, we studied the MAIA and MIQ-3 scales. The variables studied during the experimental session were experiential (state anxiety, STAI-Y1, Spielberger, 1983 , vividness and easiness of IFA and MI, range 1 min − 7 max), behavioral (apnea duration, s), and autonomic (heart rate (HR, bpm), HR fast variability (RMSSD, ms), and skin conductance level (SCL, µS)). A reduced number of participants (N = 21, 10 med-highs and 11 med-lows) agreed to undergo the assessment of HR and SCL. 2.5 Statistical analysis The statistical Package SPSS 15 was used for all analyses. For the preliminary assessment, separate multivariate analyses of variance (MANOVAs) were conducted on the MAIA and MIQ-3 scales. For the experimental session, univariate ANOVA was applied to STAI-Y1 scores. Repeated measures ANOVAs were applied to apnea duration, vividness, and easiness of the cognitive task, according to a 2 groups (med-highs, med-lows) x 2 Tasks (IFA, IM) x 3 Trials (T1, T2, T3) design. Repeated measures ANOVAs were applied to HR, RMSSD, and SCL following a 2 Group (med-highs, med-lows) x 3 Trial (T1, T2, T3) x 2 Task (IFA, MI) x 2 Level (baseline, task). The Greenhouse-Geisser ε correction was used for non-sphericity. Contrast analysis between levels was performed. ANCOVAs were applied to apnea duration, vividness, easiness, HR, RMSSD, and SCL, controlling MIQ-3 and MAIA dimensions. In addition, linear backward regression analysis was performed to detail the magnitude of the effects of hypnotizability, MAIA and MIQ scores, HR and SCL on the apnea duration. 3. Results 3.1 Questionnaires MIQ-3 scores (Cronbach's alpha = .63) were not significantly different between groups (Fig. 1 A). MAIA scales (Cronbach's alpha = .89) did not exhibit a significant group effect. Nonetheless, not worrying ( F (1,30) = 4.42, p = .044), self-regulation ( F (1,30) = 7.81, p = .009) and body listening ( F (1,30) = 4.63, p = .040) differed between med-highs and med-lows (Fig. 1 B). STAI-Y1 scores did not differ between groups (mean ± SD; med-highs, 31.59 ± 8.96; med-lows, 33.18 ± 8.41) and were in the normality range (< 52). 3.2 Apnea duration Repeated measures ANOVA revealed only a significant Trial effect ( F (2,38) = 3.79, p = .032, η 2 = .166, 1 – ß = .656) indicating increasing apnea duration across consecutive trials (T1 < T3, (F (1,19) = 8.21, p = .010; T2 < T3 ( F (1,19) = 4.13, p = .056) independently from tasks and hypnotizability (Fig. 2 A). Both imagery abilities and interoceptive sensibility accounted for these learning effects, as controlling for MAIA and MIQ-3 dimensions separately abolished the Trial effect. A B 3.3 Self-reported easiness and vividness of IFA and MI The reported easiness (IFA (mean ± SD): 5.29 ± 1.09; MI: 4.41 ± 1.47) of the tasks exhibited a significant Task effect ( F (1,31) = 7.17, p = .012, η 2 = .188, 1 – ß = .737), indicating greater easiness to perform IFA than MI. Controlling ANOVA for MIQIVI disclosed a Trial effect ( F (2,60) = 3.49, p = .037, η 2 = .104, 1 – ß = .631), with T2 < T3 ( F (1,30) = 7.85, p = .009). Controlling it for MIQKI disclosed a Task x Group interaction ( F (1,30) = 4.14, p = .051, η 2 = .121, 1 – ß = .504). Its decomposition revealed that med-highs report greater easiness than med-lows for MI ( F (1,31) = 6.56, p = .015). Controlling ANOVA for all MAIA dimensions, except for not worrying , abolished the Task effect. The reported vividness (IFA, mean ± SD: 5.20 ± 1.21; MI: 4.45 ± 1.48) differed between Trials ( F (2,62) = 5.10, p = .009, η 2 = .141, 1 – ß = .804) and increased from T1 to T3 (T1 = T2, T2 < T3 ( F (1,31) = 11.04, p = .002; T1 < T3 ( F (1,31) = 5.70, p = .023 ), and indicated greater vividness for IFA than MI (Task effect, F (1,31) = 8.67, p = .006, η 2 = .219, 1 – ß = .813). Controlling for MAIA noticing, not distracting, attention regulation, trusting, MIQEVI, and MIQIVI abolished both effects. Controlling for not worrying, emotional awareness , and self-regulation abolished only the Trial effect. Controlling for MIQKI abolished both effects and disclosed a Task x Group interaction ( F (1,30) = 4.88, p = .035, η 2 = .140, 1 – ß = .571). Its decomposition revealed a difference between tasks only in med-lows who exhibited higher vividness for IFA than MI ( F (1,15) = 8.21, p = .012). 3.4 Physiological variables HR did not exhibit any significant differences between groups and tasks (mean ± SD; baseline: 72.74 ± 11.21; task: 71.88 ± 11.41). Controlling for MAIA not distracting disclosed a Task x Level interaction ( F (1,18) = 7.58, p = .013, η 2 = .296, 1 – ß = .739) whose decomposition revealed lower HR during IFA than MI ( F (1,19) = 13.29, p = .002) in the presence of a non-different baseline. RMSSD (ms) did not exhibit significant effects and interactions (mean ± SD; B: 92.78 ± 70.13; task: 146.72 ± 162.98). Mean SCL exhibited a significant Trial effect ( F (2,38) = 3.16, p = .054, η 2 = .143, 1 – ß = .571), with T1 = T2, T1 < T3 ( F (1,19) = 4.52, p = .047), and T2 = T3. The Level effect ( F (1,19) = 6.11, p = .023, η 2 = .243, 1 – ß = .650) consisted only of higher SCL in B than in tasks independently of the cognitive condition (Fig. 2 B). Controlling for all MAIA dimensions abolished all effects. Controlling for MIQIVI and MIQEVI abolished all effects. MIQKI abolished all effects and disclosed a Trial x Task x Level x Group interaction ( F (2,36) = 3.90, p = .029, η 2 = .178, 1 – ß = .667). Its decomposition revealed a Level effect in med-highs ( F (1,8) = 7.12, p = .028), with B > Task. In med-lows it revealed a Level x Task interaction ( F (1,9) = 12.03, p = .007), with B > IFA in T1 ( F (1,9) = 15.60, p = .003), and no significant effects in T2 and T3. 3.5 Regression analysis of SHSS and MAIA scores, and physiological variables on apnea duration After controlling collinearities, linear backward regression of MAIA and MIQ dimensions, HR, and SCL on apnea duration is reported in Table 1 . It indicates the role of a few MAIA dimensions in apnea duration in the first trial of both IFA and MI, and an increasing role of MAIA dimensions and autonomic variables in the successive trials during IFA, but not during MI. Table 1 Linear backward regression. Apnea duration IFA MI R 2 B p R 2 B p T1 .198 noticing − .468 .045 .241 noticing − .604 .014 trusting .484 .039 attention regulation .486 .043 T2 .526 SHSS − .797 .003 noticing -1.09 .0001 emotional awareness .710 .009 body listening .984 .001 SCL − .886 .002 T3 .362 noticing − .587 .013 attention regulation .743 .004 RMSSD − .453 . 052 HR − .539 .026 B, standardized beta; HR, heart rate; IFA, internal focus apnea; MI, motor imagery apnea; R 2 , adjusted R 2 ; RMSSD, heart rate fast variability; SCL, skin conductance level; SHSS, hypnotizability score; T1, T2, T3, first, second, and third trial. 4. Discussion The present study was designed to explore how hypnotizability, imagery abilities, and interoceptive sensibility influence breath-hold performance in different cognitive conditions. Our findings indicate that apnea duration did not differ significantly between the cognitively congruent and incongruent conditions. Additionally, attention to apnea sensations (congruent with the physical state) and motor imagery of normal breathing (incongruent with it) are differentially associated with experiential and physiological variables. The findings reveal a dissociation between subjective experience and apnea duration, as interoceptive sensibility and autonomic markers are more strongly associated with apnea duration in the congruent cognitive condition than in the incongruent condition. Interoceptive sensibility and motor imagery abilities account for most of the differences between the two conditions, and masked hypnotizability-related differences. 4.1 Subjective Experience The study did not demonstrate significant hypnotizability-related differences in the self-reported scores of trait imagery abilities (measured by the Betts’ questionnaire), in line with the observation that questionnaire scores do not always correlate with hypnotizability (Srzich et al., 2016 ) and functional equivalence between actual and imagined perception/action (Ibanez-Marcelo et al., 2019). Med-highs and med-lows reported different experiences in cognitively congruent and incongruent apnea conditions. The higher vividness of the congruent than the incongruent experience observed in both groups suggests that the former was easier than the latter. In contrast, the greater easiness of the cognitively incongruent task in med-highs was masked by the trait kinesthetic ability of imagery, which compensated for the med-lows' lower imagery ability and weaker functional equivalence (Ibanez-Marcelo et al., 2019). Two non-alternative hypotheses can account for the groups’ different experiences. One can be based on the highs’ flexible functional connections between the salience and executive systems (Hoeft et al., 2012), the other can be sustained by the highs' lower ability to represent bodily signals accurately (Giusti et al., 2024). Interoceptive sensibility contributed to the difference in task easiness. The ability to allocate attention ( attention regulation ) and adaptively modulate internal bodily sensations of discomfort (self-regulation ), together with emotional awareness , likely induced a more vivid experience during the cognitively congruent apnea condition. Enhanced vividness also depends on the association between respiratory sensations and emotional processes (Harrison et al., 2021), making them more easily accessible or meaningful during imagery in emotionally resonant contexts such as apnea. 4.2 Apnea Duration Hypnotizability did not influence apnea duration in both cognitive conditions and in both groups, despite the highs’ lower interoceptive accuracy (Giusti et al., 2024), which was expected to positively influence apnea duration when attention was focused on the apnea -related sensations, and their stronger functional equivalence between actual and imagined normal breathing, which was expected to increase apnea duration during imagination of normal breathing. The absence of behavioral hypnotizability-related differences between groups contrasts with their subjective experiences, as observed earlier for other functions, such as postural control, which was quite different between highs and lows but was similarly reported (Santarcangelo et al., 2008). In contrast to the study by Kanthack et al. ( 2019 ), we did not find a significant difference in apnea duration between the cognitively congruent (IFA) and incongruent (MI) conditions. A possible explanation for this discrepancy lies in the composition of the two samples. While Kanthack et al.'s participants were recruited from the general population through a sports science department and were all physically active individuals engaged in regular sporting practices, our sample consisted of non-athletes with no systematic physical training. It is plausible that athletes are more familiar with motor imagery, either through formal practice or embodied experience, which may enhance the effectiveness of MI in extending apnea duration. This hypothesis aligns with the well-established role of motor imagery in sports performance and motor learning (Desai et al., 2024). In contrast, our sample's limited familiarity with MI, and its composition comprising many med-lows, which differs from the general population (De Pascalis et al., 2000), may have reduced the efficacy of MI (Ibanez-Marcelo et al., 2019). In line with earlier reports (Kanthack et al., 2019 ), the duration of apnea increased across trials. In our study, both interoceptive sensibility and imagery abilities contributed to this effect, which can be attributed to the observed cooperation of interoceptive sensibility in the cortical representation of both actual and imagined movements (Malloggi et al., 2024). Interestingly, no correlation emerged between apnea duration and the subjective experience of the two tasks, suggesting that performance improvements may have been more strongly influenced by arousal or emotional regulation than by cognitive engagement (Maric et al., 2020 ; Harrison et al., 2021). 4.3 Physiological variables In the general population, heart rate decreases during 30–60 seconds of normoxic apnea (O’Croinin et al., 2024 ). In this condition, earlier findings do not reveal significant differences in heart rate between apnea with instructions and with attention focused on bodily sensations (Kanthack et al., 2019 ), which could be attributed to the low cognitive effort required by the congruent condition. In the more demanding, cognitively incongruent condition, in contrast to earlier reports (Kanthack et al., 2019 ), we observed an increase in heart rate compared to baseline, consistent with the increase in the sympathetic/parasympathetic ratio observed during demanding cognitive tasks (Chang & Huang, 2012 ). The MAIA not distracting dimension, not measured in the earlier study (Kanthack et al., 2019 ), may have masked the difference. The parasympathetic, fast heart rate variability (RMSSD) did not differ between tasks and hypnotizability groups, likely due to the different contributions to its regulation by multiple components, such as apnea, cognitive effort, emotion, and arousal, which may balance each other. Indeed, apnea is associated with both sympathetic and parasympathetic activation (Bain et al., 2018 ). Our results also showed a reduction in skin conductance during apnea compared to baseline. While both physical and cognitive load are typically associated with increased skin conductance due to elevated sympathetic nervous system activity (Critchley, 2002 ; Boucsein, 2012; Chang & Huang, 2012 ), voluntary breath-holding constitutes a unique autonomic condition. It triggers the diving reflex, a physiological response characterized by bradycardia, peripheral vasoconstriction, and reduced blood flow to the extremities of the limbs (Ferrigno & Lundgren, 2003 ), which potentially leads to reduced skin conductance despite an elevated central sympathetic drive (Heusser et al., 2009 ). It is noteworthy that interoceptive sensibility sustained the observed SCL differences, supporting the idea that it modulates autonomic activity during challenging bodily states such as apnea. 4.4 Limitations and conclusions Limitations of the study are the sample's scarce representativeness of the general population (De Pascalis et al., 2000) and the classification of highs, mediums, and lows based on their total hypnotizability scores rather than on a more accurate categorization based on motor inhibition, hallucination, and dissociation (Terhune et al., 2011 ). Another limitation is not having acquired, but only monitored online, the respirogram. Its acquisition could have allowed for the correlation of the amplitudes of maximal inspiration with the experiential, behavioral, and autonomic results, as different thorax enlargements correspond to different interoceptive conditions. However, the sample was substantially composed of females of comparable age who did not practice sports; thus, large differences between groups were not expected. Furthermore, the addition of a neutral apnea condition without employing cognitive strategies could have represented a control condition. In conclusion, the results support the view that, in healthy participants, interoceptive sensibility and trait imagery abilities are relevant to apnea duration and that hypnotizability contributes to its subjective and physiological correlates. The complexity of the interaction between these variables in regulating the effects of cognitive conditions on the physiological state of apnea suggests that assessing interoceptive and imagery abilities could be beneficial for sports performers, who may benefit from training in voluntary apnea (Bouten et al., 2024 ). Declarations Author Contribution Statement E.L.S., E.M. and U.D. conceived and designed the research. E.M. conducted experiments. E.L.S. and E.M. analyzed data. E.L.S., E.M. and U.D. wrote the manuscript. All authors read and approved the manuscript. Conflict of interest The authors declare that they have no conflict of interest. Funding This study was carried out within the Space It Up project and received funding from the ASI and the MUR – Contract n. 2024-5-E.0 - CUP n. I53D24000060005 (Prof. D. Manzoni). It was produced by Eleonora Malloggi while attending the Ph.D. program in Space Science and Technology at the University of Trento, Cycle XXXVIII, with the support of a scholarship financed by the Ministerial Decree no. 352 of 9 April 2022, based on the NRRP—funded by the European Union—NextGenerationEU—Mission 4 “Education and Research”, Component 1 “Enhancement of the offer of educational services: from nurseries to universities”—Investment 4.1 “Extension of the number of research doctorates and innovative doctorates for public administration and cultural heritage”. Author Contribution E.L.S., E.M. and U.D. conceived and designed the research. E.M. conducted experiments. E.L.S. and E.M. analyzed data. E.L.S., E.M. and U.D. wrote the manuscript. All authors read and approved the manuscript. Acknowledgement We acknowledge the contribution of Prof. D. Manzoni, who is the recipient of funds from the Space It Up project supporting this research. Data Availability Data are available at https://osf.io/knxt8/overview. References Arce-Álvarez A, Veliz C, Vazquez-Muñoz M et al (2021) Hypoxic respiratory chemoreflex control in young, trained swimmers. Front Physiol 12:632603. https://doi.org/10.3389/fphys.2021.632603 Bain AR, Drvis., Dujic Z et al (2018) Physiology of static breath holding in elite apneists. Exp Physiol 103(5):635–651. https://doi.org/10.1113/EP086269 Bouten J, Declercq L, Boone J et al (2024) Apnoea as a novel method to improve exercise performance: A current state of the literature. 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Exp Brain Res 238(9):1937–1943. https://doi.org/10.1007/s00221-020-05853-4 Faul F, Erdfelder E, Lang AG et al (2007) G*Power 3: A flexible statistical power analysis program for social, behavioral, and biomedical sciences. Behav Res Met 39:175–191. https://doi.org/10.3758/bf03193146 Ferrigno M, Lundgren CEG (2003) Breath-hold diving. In: Brubakk AO, Neuman T (eds) Bennett and Elliott’s physiology and medicine of diving. Saunders, pp 153–180 Godfrey S, Campbell E (1969) Mechanical and chemical control of breath holding. Q J Experimental Physiol Cognate Med Sci 54:117–128 Godfrey S, Edwards RH, Warrell DA (1969) The influence of lung shrinkage on breath holding time. Q J Exp Physiol Cogn Med Sci 54:129–140 Guillot A, Collet C, Nguyen VA et al (2009) Brain activity during visual versus kinesthetc imagery: An fMRI study. Hum Brain Mapp 30(7):2157–2172. https://doi.org/10.1002/hbm.20658 Harrison OK, Köchl K, Marino S et al Interoception of breathing and its relationship with anxiety. Neuron, 109 (24): 4080–4093e8. https://doi.org/10.1016/j.neuron.2021.09.045 Hétu S, Grégoire M, Saimpont A et al (2013) The neural network of motor imagery: An ALE meta-analysis. 2021; Neurosci and Biobehavl Rev, 37(5): 930–949. https://doi.org/10.1016/j.neubiorev.2013.03.017 Heusser K, Dzamonja G, Tank J et al (2009) Cardiovascular regulation during apnea in elite divers. Hypertension 53(4):719–724 Hoeft F, Gabrieli JD, Whitfield-Gabrieli S et al Functional brain basis of hypnotizability. Arch Gen Psychiat, 69(10): 1064–1072. https://doi.org/10.1001/archgenpsychiatry.2011.2190 Ibáñez-Marcelo E, Campioni L, Phinyomark A et al (2019) Topology highlights mesoscopic functional equivalence between imagery and perception: The case of hypnotizability. NeuroImage. 200:437–449. https://doi.org/10.1016/j.neuroimage.2019.06.044 Ichinose M, Matsumoto M, Fujii N et al (2018) Voluntary apnea during dynamic exercise activates the muscle metaboreflex in humans. Am J Physiol 314(3):H434–H442. https://doi.org/10.1152/ajpheart.00367.2017 Kanthack TFD, Guillot A, Sabou D et al (2019) Breathing with the mind: Effects of motor imagery on breath-hold performance. Physiol Behav 208:112583. https://doi.org/10.1016/j.physbeh.2019.112583 Maric V, Ramanathan D, Mishra J (2020) Respiratory regulation & interactions with neuro-cognitive circuitry. Neurosci Biobehav Rev 112:95–106. https://doi.org/10.1016/j.neubiorev.2020.02.001 Marlinge M, Chefrour M, Billaut F et al (2021) Blood adenosine increase during apnea in spearfishermen reinforces the efficiency of the cardiovascular component of the diving reflex. Front Physiol 12:743154. https://doi.org/10.3389/fphys.2021.743154 Matsutake R, Fujimoto T, Ichinose M et al (2025) The blood flow and vascular responses in dynamically exercising skeletal muscles evoked by combination of cold stimulation and voluntary apnea in humans. Eur J Appl Physiol 125(4):1179–1190. https://doi.org/10.1007/s00421-024-05643-8 Mehling WE, Acree M, Stewart A et al (2018) The Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2). PLoS ONE 13(12):e0208034. https://doi.org/10.1371/journal.pone.0208034 Munzert J, Lorey B, Zentgraf K (2009) Cognitive motor processes: The role of motor imagery in the study of motor representations. Brain Res Rev 60:306–326. https://doi.org/10.1016/j.brainresrev.2008.12.024 Nunan D, Sandercock GR, Brodie DA (2010) A quantitative systematic review of normal values for short-term heart rate variability in healthy adults. Pacing and Clinical Electrophysiology, 33(11): 1407–1417. https://doi.org/10.1111/j.1540-8159.2010.02841.x 2010 O’Croinin BR, Young DA, Maier LE et al (2024) Influence of hypercapnia and hypercapnic hypoxia on the heart rate response to apnea. Physioll Rep 12(11):e16054. https://doi.org/10.14814/phy2.16054 Santarcangelo EL, Zelic Z (2025) Updating the physiology of hypnotizability: Cerebellum and insula, Int Rev of Neurobiol, Academic Press, accepted. https://doi.org/10.1016/bs.irn.2025.06.002 Savitzky A, Golay MJE (1964) Smoothing and differentiation of data by simplified least squares procedures. Anal Chem 36(8):1627–1639. https://doi.org/10.1021/ac60214a047 Spielberger CD (1983) Manual for the State-Trait Anxiety Inventory. Consulting Psychologists Srzich AJ, Byblow WD, Stinear JW et al (2016) Can motor imagery and hypnotic susceptibility explain conversion disorder with motor symptoms? Neuropsychologia. 89:287–298. https://doi.org/10.1016/j.neuropsychologia.2016.06.030 Terhune DB, Cardeña E, Lindgren M (2011) Dissociative tendencies and individual differences in high hypnotic suggestibility. Cogn Neuropsychiatry 16(2):113–135. https://doi.org/10.1080/13546805.2010.503048 Vigran HJ, Kapral AG, Tytell ED et al (2019) Manipulating the perception of time affects voluntary breath-holding duration. Physiol Rep 7(23):e14309. https://doi.org/10.14814/phy2.14309 Weitzenhoffer AM, Hilgard E (1959) Stanford hypnotic susceptibility scale: forms A and B. Palo Alto. Consulting Psychologists, Calif. Williams S, Cumming J, Ntoumanis N et al (2012) Further validation and development of the movement imagery questionnaire. J Sport Exerc Psychol 34:621–646. https://doi.org/10.1123/jsep.34.5.621 Additional Declarations No competing interests reported. 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Malloggi\",\"email\":\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABE0lEQVRIiWNgGAWjYDACdgST8cADIMnG3sDAkABi4NLCjMQ+AFbJcwCoBchiw6UHQwuDBIjEYw0/M/PBxwUV9+QZxA4/OJBQUWvXJ/nG7MHDH3cY+OQbsGqRbGZLNp5xptiwQTrN4EDCmePJbdI55gYJCc9wOszgMI+ZNG9bAmODdILBgcS2Y8ls0jlmEgkJh3FqsT/M/w2kxb5BOv0DRIvkGfxaDJh52EBaEhukc0C21NixSfDg1yJxmM3YmOdMAsgLBUC/HEhg40krk0hIO8zDxpaAPcTamx8+5qlIsO2XTt/44ENFnb18++Ftkj9sDsvJNx/Abg0MQF1xOLEBKsCDXz0C1NkTq3IUjIJRMApGDgAAtDdV8/U4pMoAAAAASUVORK5CYII=\",\"orcid\":\"\",\"institution\":\"University of Trento\",\"correspondingAuthor\":true,\"prefix\":\"\",\"firstName\":\"Eleonora\",\"middleName\":\"\",\"lastName\":\"Malloggi\",\"suffix\":\"\"},{\"id\":542273075,\"identity\":\"8d75f43f-41f5-4de4-bf9b-8261818a9f8d\",\"order_by\":1,\"name\":\"Enrica Laura Santarcangelo\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"University of 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02:19:29\",\"extension\":\"png\",\"order_by\":1,\"title\":\"Figure 1\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":55288,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eImagery abilities and interoceptive scores (mean, SD). A) MIQ; MIQIVI, internal visual imagery, MIQ EVI, external visual imagery; MIQKI, Kinesthetic imagery. B) MAIA scales. b) Lines indicate significant differences between groups (* p \\u0026lt; .05).\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"floatimage1.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-7978493/v1/4a161f26734a3cd1417cbad6.png\"},{\"id\":95691386,\"identity\":\"2e9f188f-172c-439a-bbbd-99964e8618ba\",\"added_by\":\"auto\",\"created_at\":\"2025-11-12 02:19:29\",\"extension\":\"jpeg\",\"order_by\":2,\"title\":\"Figure 2\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":101768,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eImagery abilities and interoceptive scores (mean, SD). A) MIQ; MIQIVI, internal visual imagery, MIQ EVI, external visual imagery; MIQKI, Kinesthetic imagery. B) MAIA scales. b) Lines indicate significant differences between groups (* p \\u0026lt; .05).\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"floatimage2.jpeg\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-7978493/v1/2141351a9bd05a542df93436.jpeg\"},{\"id\":103251503,\"identity\":\"c7511a33-0ce2-4de9-84eb-9739be3ae13e\",\"added_by\":\"auto\",\"created_at\":\"2026-02-23 16:09:48\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":877606,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-7978493/v1/eab3ae6c-ff9e-4a8e-8f39-9cb584ad2b36.pdf\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"Interplay between cognitive conditions and individual traits in voluntary apnea\",\"fulltext\":[{\"header\":\"1. Introduction\",\"content\":\"\\u003cp\\u003eVoluntary apnea, also known as breath-hold, represents a specific physiological state characterized by coordinated autonomic responses, including bradycardia, increased mean arterial blood pressure, peripheral vasoconstriction (Ferrigno \\u0026amp; Lundgren, \\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e2003\\u003c/span\\u003e), and reduced hemoglobin saturation (Ichinose et al., 2017). These changes reflect the diving reflex, an oxygen-conserving response that aims to maintain cerebral and cardiac perfusion under hypoxic stress. Breath-holding time is determined by the increase in CO\\u003csub\\u003e2\\u003c/sub\\u003e and lung volume (Godfrey et al., \\u003cspan citationid=\\\"CR17\\\" class=\\\"CitationRef\\\"\\u003e1969\\u003c/span\\u003e; Godfrey and Campbell, \\u003cspan citationid=\\\"CR16\\\" class=\\\"CitationRef\\\"\\u003e1969\\u003c/span\\u003e; Kelman and Wann, 1971) and by the preceding oxygenation rate (Bruce et al., \\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e2021\\u003c/span\\u003e). The reported urge to breathe is positively correlated with the magnitude of the thoracic and abdominal expansion (Decav\\u0026egrave;le et al., \\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e2025\\u003c/span\\u003e).\\u003c/p\\u003e\\u003cp\\u003eApnea elicits a maximal autonomic response, as the change in blood pressure is not sensitive to additional cold stimulation (Matsutake et al., \\u003cspan citationid=\\\"CR28\\\" class=\\\"CitationRef\\\"\\u003e2025\\u003c/span\\u003e). Adenosine is likely involved in its adaptive cardiovascular response because of its vasodilating and bradycardic properties (Marlinge et al., \\u003cspan citationid=\\\"CR27\\\" class=\\\"CitationRef\\\"\\u003e2021\\u003c/span\\u003e). Apnea performance can be trained, as observed in swimmers and divers who can hold their breath for over 10 minutes and exhibit marked increases in cerebral blood flow (Arce-\\u0026Aacute;lvarez et al., \\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e2021\\u003c/span\\u003e; Bain et al., \\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2018\\u003c/span\\u003e). Cognitive factors also modulate apnea duration, including time perception and mental tasks such as imagery of normal breathing and deep absorption in the apnea-related sensation (Vigran et al., \\u003cspan citationid=\\\"CR38\\\" class=\\\"CitationRef\\\"\\u003e2019\\u003c/span\\u003e; Kanthack et al., \\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e2019\\u003c/span\\u003e).\\u003c/p\\u003e\\u003cdiv id=\\\"Sec2\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003e1.1 Motor imagery, hypnotizability and interoception\\u003c/h2\\u003e\\u003cp\\u003eMotor imagery (MI) refers to the mental simulation of a movement without overt motor output (Decety, \\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e1996\\u003c/span\\u003e) and is used in sports to enhance performance (McNeil et al., 2025). It can be experienced either through internal visual imagery from a first-person perspective or through kinesthetic imagery, which involves vivid sensations of movement (Munzert et al., \\u003cspan citationid=\\\"CR30\\\" class=\\\"CitationRef\\\"\\u003e2009\\u003c/span\\u003e). MI is characterized by subjective, behavioral and physiological variables that are influenced by imagery abilities (Guillot et al., \\u003cspan citationid=\\\"CR18\\\" class=\\\"CitationRef\\\"\\u003e2009\\u003c/span\\u003e), motor conditions (Di Rienzo et al., \\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e2022\\u003c/span\\u003e) and interoceptive sensibility (Malloggi et al., 2024). The latter represents the experience and interpretation of internal bodily signals (Critchley \\u0026amp; Garfinkel, \\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e2017\\u003c/span\\u003e) and is measured by questionnaires (Mehling et al., \\u003cspan citationid=\\\"CR29\\\" class=\\\"CitationRef\\\"\\u003e2018\\u003c/span\\u003e; Porges, 1994). MI is also influenced by hypnotizability, a psychophysiological trait measured by scales that evaluate the ability to experience cognitive and physical states different from the actual ones (Santarcangelo, 2024). High hypnotizability is associated with greater functional equivalence between actual and imagined perception/action, that is, more similar cortical activations and connections during the two conditions (Ibanez-Marcelo et al., 2019 a,b), and the greater excitability of their motor cortex during imagery (Spina et al., 2020; Cesari et al., 2020). Also, hypnotizability levels display different \\u0026ldquo;adaptive\\u0026rdquo; interoceptive sensibility (Diolaiuti et al., \\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e2020\\u003c/span\\u003e) and interoceptive accuracy (Giusti et al., 2024), that is the ability to accurately detect interoceptive information, likely due to hypnotizability-related variations in the insula grey matter volume (Landry et al., 2017; Picerni et al., 2019).\\u003c/p\\u003e\\u003c/div\\u003e\\u003cdiv id=\\\"Sec3\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003e1.2 Aim of the study\\u003c/h2\\u003e\\u003cp\\u003eIn the general population, apnea duration is influenced by the concomitant cognitive context, with longer durations observed during MI of normal breathing compared to IFA (Kanthack et al., \\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e2019\\u003c/span\\u003e).\\u003c/p\\u003e\\u003cp\\u003eSince imagery abilities, interoceptive sensibility, and hypnotizability are interrelated (Zelič et al., 2023), the present study aimed to expand the findings of Kanthack et al. (\\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e2019\\u003c/span\\u003e) about apnea duration in cognitively congruent (IFA) and incongruent conditions (MI) by examining the role of these individual traits in modulating apnea duration.\\u003c/p\\u003e\\u003c/div\\u003e\"},{\"header\":\"2. Methods\",\"content\":\"\\u003cdiv id=\\\"Sec5\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003e2.1 Participants\\u003c/h2\\u003e\\u003cp\\u003eThirty-three healthy, sedentary volunteers (age mean\\u0026thinsp;\\u003cspan type=\\\"Underline\\\" class=\\\"Underline\\\" name=\\\"Emphasis\\\"\\u003e\\u0026plusmn;\\u003c/span\\u003e\\u0026thinsp;SD): 27.2\\u0026thinsp;\\u003cspan type=\\\"Underline\\\" class=\\\"Underline\\\" name=\\\"Emphasis\\\"\\u003e\\u0026plusmn;\\u003c/span\\u003e\\u0026thinsp;8.5; 15 females) were recruited among students at the University of Pisa. After signing an informed consent approved by the Pisa University Bioethics Committee (n.29/2022), a semi-structured interview ascertained the absence of cardiovascular, respiratory, neurological, psychiatric conditions, sleep and attention disorders, and any current pharmacological therapies. Participants were administered with the Italian version of the Hypnotic Susceptibility Scale: Form A (SHSS: A, range 0\\u0026ndash;12) (Weitzenhoffer \\u0026amp; Hilgard, \\u003cspan citationid=\\\"CR39\\\" class=\\\"CitationRef\\\"\\u003e1959\\u003c/span\\u003e), classifying them in highs (score\\u0026thinsp;\\u003cspan type=\\\"Underline\\\" class=\\\"Underline\\\" name=\\\"Emphasis\\\"\\u003e\\u0026ge;\\u003c/span\\u003e\\u0026thinsp;8 out of 12), mediums (score 5\\u0026ndash;7) and lows (score\\u0026thinsp;\\u003cspan type=\\\"Underline\\\" class=\\\"Underline\\\" name=\\\"Emphasis\\\"\\u003e\\u0026le;\\u003c/span\\u003e\\u0026thinsp;4). In the general population, mediums represent 70%, while highs and lows represent 15% each (De Pascalis et al., 2000). Owing to the small number of recruited mediums, a group of medium-to-highs (med-highs including 2 mediums, 8 females, SHSS score (mean\\u0026thinsp;\\u003cspan type=\\\"Underline\\\" class=\\\"Underline\\\" name=\\\"Emphasis\\\"\\u003e\\u0026plusmn;\\u003c/span\\u003e\\u0026thinsp;SD): 8.88\\u0026thinsp;\\u003cspan type=\\\"Underline\\\" class=\\\"Underline\\\" name=\\\"Emphasis\\\"\\u003e\\u0026plusmn;\\u003c/span\\u003e\\u0026thinsp;1.32) and a group of medium-to-lows (med-lows, including 3 mediums, 7 females, SHSS score: 2.88\\u0026thinsp;\\u003cspan type=\\\"Underline\\\" class=\\\"Underline\\\" name=\\\"Emphasis\\\"\\u003e\\u0026plusmn;\\u003c/span\\u003e\\u0026thinsp;1.82, 3 mediums) were studied.\\u003c/p\\u003e\\u003cp\\u003eFor a preliminary assessment of the participants\\u0026rsquo; psychophysiological traits, they completed the Multidimensional Assessment of Interoceptive Awareness (MAIA; Mehling et al., \\u003cspan citationid=\\\"CR29\\\" class=\\\"CitationRef\\\"\\u003e2018\\u003c/span\\u003e) and the Motor Imagery Questionnaire-3 (MIQ-3; Williams et al., \\u003cspan citationid=\\\"CR40\\\" class=\\\"CitationRef\\\"\\u003e2012\\u003c/span\\u003e). The MAIA questionnaire includes 8 scales (\\u003cem\\u003enoticing, not distracting, not worrying, attention regulation, emotional awareness, self-regulation, body listening, trusting\\u003c/em\\u003e; range 0\\u0026ndash;5), while the MIQ includes three modalities (external visual, MIQEVI; internal visual, MIQIVI; kinesthetic imagery, MIQKI; total range 0\\u0026ndash;28). For experiential and behavioral variables, which were studied during tasks, G*power (Faul et al., \\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e2007\\u003c/span\\u003e) indicated a minimum number of 20 subjects to obtain significant main effects and interactions for experiential and behavioral variables, and a minimum number of 14 subjects for physiological variables with f\\u0026thinsp;=\\u0026thinsp;.25, p\\u0026thinsp;=\\u0026thinsp;.05, and 1-β\\u0026thinsp;=\\u0026thinsp;.80.\\u003c/p\\u003e\\u003c/div\\u003e\\u003cdiv id=\\\"Sec6\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003e2.2 Experimental procedure\\u003c/h2\\u003e\\u003cp\\u003eThe experiment was performed at least one week after the hypnotic assessment. The participants were asked to refrain from caffeine and alcohol for the three hours preceding the session, which was conducted in a sound and light-attenuated room. Before starting the experimental procedure, participants completed the State Anxiety Questionnaire (STAI-Y1; cut off for clinical anxiety\\u0026thinsp;=\\u0026thinsp;52; Spielberger, \\u003cspan citationid=\\\"CR35\\\" class=\\\"CitationRef\\\"\\u003e1983\\u003c/span\\u003e). Before undergoing the experimental conditions, participants performed a familiarization trial of apnea until their breaking point, without cognitive instructions.\\u003c/p\\u003e\\u003cp\\u003eThe experimental closed-eye session included 2-minute baseline intervals (spontaneous, non-controlled breaths), following every trial of IFA (B1) and MI (B2) to let physiological signals return to baseline. Three maximal breath-hold trials were performed for IFA and MI in a seated position, with knees at 90\\u0026deg; and with hands and forearms placed on the thighs. Before the breath-hold tasks (apnea), participants were instructed to take a deep breath. The inspiratory act was considered acceptable if its depth was at least one and a half times the normal breath, as controlled online by a Compumedics Summit IP\\u0026reg; Inductive Respiratory Effort System (Compumedics, Newton, PA, USA). The duration of the breath hold was measured with a chronometer and controlled online by visualizing the respiratory signal. Participants were blinded to their maximal breath-hold duration.\\u003c/p\\u003e\\u003cp\\u003e In the IFA condition, participants were instructed to focus on the bodily sensations that emerge during breath-holding. The experimenter provided guidance using instructions such as: \\u003cem\\u003e\\u0026ldquo;Focus on the sensations associated with the effort of voluntary breath-holding. Feel the muscle contractions pressing against your lungs and the tension in your chest as it remains still. Notice the absence of movement in your respiratory tract and the growing urge to breathe.\\u0026rdquo;.\\u003c/em\\u003e In the MI condition, performed while imagining normal breathing, participants were instructed to engage in both visual and kinesthetic imagery of natural respiration. They were guided with instructions such as: \\u003cem\\u003e\\u0026ldquo;Imagine the sensations associated with breathing. Feel the air entering your nose and the pressure changes in your lungs and chest. Sense the muscular contractions and stretches accompanying inhalation and exhalation, as if you were breathing.\\u0026rdquo;\\u003c/em\\u003e After each apnea trial, the participants were invited to rate the vividness and easiness of their IFA and MI experience.\\u003c/p\\u003e\\u003cp\\u003eIFA and MI were randomly administered to the participants. After each apnea trial, the participants were invited to rate the vividness and easiness of their IFA and MI experience.\\u003c/p\\u003e\\u003c/div\\u003e\\u003cdiv id=\\\"Sec7\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003e2.3 Signal acquisition and analysis\\u003c/h2\\u003e\\u003cp\\u003eElectrocardiogram (EKG) and skin conductance level (SCL) were monitored by a Psylab device (Contact Precision Instrument) and stored for offline analysis. For EKG acquisition, disposable electrodes (\\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://www.fiab.it/it/index.php\\u003c/span\\u003e\\u003cspan address=\\\"https://www.fiab.it/it/index.php\\\" targettype=\\\"URL\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e) were placed according to the standard DI configuration. SCL was recorded using two similar electrodes placed on the middle phalanges of the index and middle fingers of the dominant hand. A common reference electrode was used for both EKG and SCL signals. A band-pass filter (0.5 Hz \\u0026minus;\\u0026thinsp;20 Hz) was applied to the EKG signal, and HR was computed as 60/mean RR interval for each condition (B1, B2, IFA, MI). Heart rate variability (HRV) was estimated using the root mean square of successive differences (RMSSD), a time-domain index reflecting short-term parasympathetic modulation. RMSSD values were interpreted in consideration of normative data for short-term resting conditions (Nunan et al., \\u003cspan citationid=\\\"CR31\\\" class=\\\"CitationRef\\\"\\u003e2010\\u003c/span\\u003e). Notably, total HRV (SDNN) could not be studied due to the short duration of the studied conditions (Shaffer et al., 2017). For SCL, the signal was detrended, and its mean value was subtracted from the entire signal as baseline removal. A fourth-order low-pass butter filter was applied with a cut-off frequency set at 0.5 Hz. Then, a Savitzky-Golay smoothing filter was applied (Savitzky \\u0026amp; Golay, \\u003cspan citationid=\\\"CR34\\\" class=\\\"CitationRef\\\"\\u003e1964\\u003c/span\\u003e). Breath-hold trials were averaged during IFA and MI, respectively, as well as baseline intervals. The mean value of HRV and SCL was computed for each condition.\\u003c/p\\u003e\\u003c/div\\u003e\\u003cdiv id=\\\"Sec8\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003e2.4 Variables\\u003c/h2\\u003e\\u003cp\\u003eFor the assessment of interoceptive sensibility and motor imagery abilities, we studied the MAIA and MIQ-3 scales. The variables studied during the experimental session were experiential (state anxiety, STAI-Y1, Spielberger, \\u003cspan citationid=\\\"CR35\\\" class=\\\"CitationRef\\\"\\u003e1983\\u003c/span\\u003e, vividness and easiness of IFA and MI, range 1 min \\u0026minus;\\u0026thinsp;7 max), behavioral (apnea duration, s), and autonomic (heart rate (HR, bpm), HR fast variability (RMSSD, ms), and skin conductance level (SCL, \\u0026micro;S)). A reduced number of participants (N\\u0026thinsp;=\\u0026thinsp;21, 10 med-highs and 11 med-lows) agreed to undergo the assessment of HR and SCL.\\u003c/p\\u003e\\u003c/div\\u003e\\u003cdiv id=\\\"Sec9\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003e2.5 Statistical analysis\\u003c/h2\\u003e\\u003cp\\u003eThe statistical Package SPSS 15 was used for all analyses. For the preliminary assessment, separate multivariate analyses of variance (MANOVAs) were conducted on the MAIA and MIQ-3 scales. For the experimental session, univariate ANOVA was applied to STAI-Y1 scores. Repeated measures ANOVAs were applied to apnea duration, vividness, and easiness of the cognitive task, according to a 2 groups (med-highs, med-lows) x 2 Tasks (IFA, IM) x 3 Trials (T1, T2, T3) design.\\u003c/p\\u003e\\u003cp\\u003eRepeated measures ANOVAs were applied to HR, RMSSD, and SCL following a 2 Group (med-highs, med-lows) x 3 Trial (T1, T2, T3) x 2 Task (IFA, MI) x 2 Level (baseline, task). The Greenhouse-Geisser ε correction was used for non-sphericity. Contrast analysis between levels was performed. ANCOVAs were applied to apnea duration, vividness, easiness, HR, RMSSD, and SCL, controlling MIQ-3 and MAIA dimensions.\\u003c/p\\u003e\\u003cp\\u003eIn addition, linear backward regression analysis was performed to detail the magnitude of the effects of hypnotizability, MAIA and MIQ scores, HR and SCL on the apnea duration.\\u003c/p\\u003e\\u003c/div\\u003e\"},{\"header\":\"3. Results\",\"content\":\"\\u003cdiv id=\\\"Sec11\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003e3.1 Questionnaires\\u003c/h2\\u003e\\u003cp\\u003eMIQ-3 scores (Cronbach's alpha\\u0026thinsp;=\\u0026thinsp;.63) were not significantly different between groups (Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003eA). MAIA scales (Cronbach's alpha\\u0026thinsp;=\\u0026thinsp;.89) did not exhibit a significant group effect. Nonetheless, \\u003cem\\u003enot worrying\\u003c/em\\u003e (\\u003cem\\u003eF\\u003c/em\\u003e(1,30)\\u0026thinsp;=\\u0026thinsp;4.42, p\\u0026thinsp;=\\u0026thinsp;.044), \\u003cem\\u003eself-regulation\\u003c/em\\u003e (\\u003cem\\u003eF\\u003c/em\\u003e(1,30)\\u0026thinsp;=\\u0026thinsp;7.81, p\\u0026thinsp;=\\u0026thinsp;.009) and \\u003cem\\u003ebody listening\\u003c/em\\u003e (\\u003cem\\u003eF\\u003c/em\\u003e(1,30)\\u0026thinsp;=\\u0026thinsp;4.63, p\\u0026thinsp;=\\u0026thinsp;.040) differed between med-highs and med-lows (Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003eB).\\u003c/p\\u003e\\u003cp\\u003eSTAI-Y1 scores did not differ between groups (mean\\u0026thinsp;\\u003cspan type=\\\"Underline\\\" class=\\\"Underline\\\" name=\\\"Emphasis\\\"\\u003e\\u0026plusmn;\\u003c/span\\u003e\\u0026thinsp;SD; med-highs, 31.59\\u0026thinsp;\\u003cspan type=\\\"Underline\\\" class=\\\"Underline\\\" name=\\\"Emphasis\\\"\\u003e\\u0026plusmn;\\u003c/span\\u003e\\u0026thinsp;8.96; med-lows, 33.18\\u0026thinsp;\\u003cspan type=\\\"Underline\\\" class=\\\"Underline\\\" name=\\\"Emphasis\\\"\\u003e\\u0026plusmn;\\u003c/span\\u003e\\u0026thinsp;8.41) and were in the normality range (\\u0026lt;\\u0026thinsp;52).\\u003c/p\\u003e\\u003cp\\u003e\\u003c/p\\u003e\\u003c/div\\u003e\\u003cdiv id=\\\"Sec12\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003e3.2 Apnea duration\\u003c/h2\\u003e\\u003cp\\u003eRepeated measures ANOVA revealed only a significant Trial effect (\\u003cem\\u003eF\\u003c/em\\u003e(2,38)\\u0026thinsp;=\\u0026thinsp;3.79, p\\u0026thinsp;=\\u0026thinsp;.032, η\\u003csup\\u003e2\\u003c/sup\\u003e\\u0026thinsp;=\\u0026thinsp;.166, 1 \\u0026ndash; \\u0026szlig; = .656) indicating increasing apnea duration across consecutive trials (T1\\u0026thinsp;\\u0026lt;\\u0026thinsp;T3, \\u003cem\\u003e(F\\u003c/em\\u003e(1,19)\\u0026thinsp;=\\u0026thinsp;8.21, p\\u0026thinsp;=\\u0026thinsp;.010; T2\\u0026thinsp;\\u0026lt;\\u0026thinsp;T3 (\\u003cem\\u003eF\\u003c/em\\u003e(1,19)\\u0026thinsp;=\\u0026thinsp;4.13, p\\u0026thinsp;=\\u0026thinsp;.056) independently from tasks and hypnotizability (Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig2\\\" class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003eA). Both imagery abilities and interoceptive sensibility accounted for these learning effects, as controlling for MAIA and MIQ-3 dimensions separately abolished the Trial effect.\\u003c/p\\u003e\\u003cp\\u003e\\u003cb\\u003eA B\\u003c/b\\u003e\\u003c/p\\u003e\\u003cp\\u003e\\u003c/p\\u003e\\u003c/div\\u003e\\u003cdiv id=\\\"Sec13\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003e3.3 Self-reported easiness and vividness of IFA and MI\\u003c/h2\\u003e\\u003cp\\u003eThe reported easiness (IFA (mean\\u0026thinsp;\\u003cspan type=\\\"Underline\\\" class=\\\"Underline\\\" name=\\\"Emphasis\\\"\\u003e\\u0026plusmn;\\u003c/span\\u003e\\u0026thinsp;SD): 5.29\\u0026thinsp;\\u003cspan type=\\\"Underline\\\" class=\\\"Underline\\\" name=\\\"Emphasis\\\"\\u003e\\u0026plusmn;\\u003c/span\\u003e\\u0026thinsp;1.09; MI: 4.41\\u0026thinsp;\\u003cspan type=\\\"Underline\\\" class=\\\"Underline\\\" name=\\\"Emphasis\\\"\\u003e\\u0026plusmn;\\u003c/span\\u003e\\u0026thinsp;1.47) of the tasks exhibited a significant Task effect (\\u003cem\\u003eF\\u003c/em\\u003e(1,31)\\u0026thinsp;=\\u0026thinsp;7.17, p\\u0026thinsp;=\\u0026thinsp;.012, η\\u003csup\\u003e2\\u003c/sup\\u003e\\u0026thinsp;=\\u0026thinsp;.188, 1 \\u0026ndash; \\u0026szlig; = .737), indicating greater easiness to perform IFA than MI. Controlling ANOVA for MIQIVI disclosed a Trial effect (\\u003cem\\u003eF\\u003c/em\\u003e(2,60)\\u0026thinsp;=\\u0026thinsp;3.49, p\\u0026thinsp;=\\u0026thinsp;.037, η\\u003csup\\u003e2\\u003c/sup\\u003e\\u0026thinsp;=\\u0026thinsp;.104, 1 \\u0026ndash; \\u0026szlig; = .631), with T2\\u0026thinsp;\\u0026lt;\\u0026thinsp;T3 (\\u003cem\\u003eF\\u003c/em\\u003e(1,30)\\u0026thinsp;=\\u0026thinsp;7.85, p\\u0026thinsp;=\\u0026thinsp;.009). Controlling it for MIQKI disclosed a Task x Group interaction (\\u003cem\\u003eF\\u003c/em\\u003e(1,30)\\u0026thinsp;=\\u0026thinsp;4.14, p\\u0026thinsp;=\\u0026thinsp;.051, η\\u003csup\\u003e2\\u003c/sup\\u003e\\u0026thinsp;=\\u0026thinsp;.121, 1 \\u0026ndash; \\u0026szlig; = .504). Its decomposition revealed that med-highs report greater easiness than med-lows for MI (\\u003cem\\u003eF\\u003c/em\\u003e(1,31)\\u0026thinsp;=\\u0026thinsp;6.56, p\\u0026thinsp;=\\u0026thinsp;.015). Controlling ANOVA for all MAIA dimensions, except for \\u003cem\\u003enot worrying\\u003c/em\\u003e, abolished the Task effect.\\u003c/p\\u003e\\u003cp\\u003eThe reported vividness (IFA, mean\\u0026thinsp;\\u003cspan type=\\\"Underline\\\" class=\\\"Underline\\\" name=\\\"Emphasis\\\"\\u003e\\u0026plusmn;\\u003c/span\\u003e\\u0026thinsp;SD: 5.20\\u0026thinsp;\\u003cspan type=\\\"Underline\\\" class=\\\"Underline\\\" name=\\\"Emphasis\\\"\\u003e\\u0026plusmn;\\u003c/span\\u003e\\u0026thinsp;1.21; MI: 4.45\\u0026thinsp;\\u003cspan type=\\\"Underline\\\" class=\\\"Underline\\\" name=\\\"Emphasis\\\"\\u003e\\u0026plusmn;\\u003c/span\\u003e\\u0026thinsp;1.48) differed between Trials (\\u003cem\\u003eF\\u003c/em\\u003e(2,62)\\u0026thinsp;=\\u0026thinsp;5.10, p\\u0026thinsp;=\\u0026thinsp;.009, η\\u003csup\\u003e2\\u003c/sup\\u003e\\u0026thinsp;=\\u0026thinsp;.141, 1 \\u0026ndash; \\u0026szlig; = .804) and increased from T1 to T3 (T1\\u0026thinsp;=\\u0026thinsp;T2, T2\\u0026thinsp;\\u0026lt;\\u0026thinsp;T3 (\\u003cem\\u003eF\\u003c/em\\u003e(1,31)\\u0026thinsp;=\\u0026thinsp;11.04, p\\u0026thinsp;=\\u0026thinsp;.002; T1\\u0026thinsp;\\u0026lt;\\u0026thinsp;T3 (\\u003cem\\u003eF\\u003c/em\\u003e(1,31)\\u0026thinsp;=\\u0026thinsp;5.70, p\\u0026thinsp;=\\u0026thinsp;.023 ), and indicated greater vividness for IFA than MI (Task effect, \\u003cem\\u003eF\\u003c/em\\u003e(1,31)\\u0026thinsp;=\\u0026thinsp;8.67, p\\u0026thinsp;=\\u0026thinsp;.006, η\\u003csup\\u003e2\\u003c/sup\\u003e\\u0026thinsp;=\\u0026thinsp;.219, 1 \\u0026ndash; \\u0026szlig; = .813).\\u003c/p\\u003e\\u003cp\\u003eControlling for MAIA noticing, not distracting, attention regulation, trusting, MIQEVI, and MIQIVI abolished both effects. Controlling for \\u003cem\\u003enot worrying, emotional awareness\\u003c/em\\u003e, and \\u003cem\\u003eself-regulation\\u003c/em\\u003e abolished only the Trial effect. Controlling for MIQKI abolished both effects and disclosed a Task x Group interaction (\\u003cem\\u003eF\\u003c/em\\u003e(1,30)\\u0026thinsp;=\\u0026thinsp;4.88, p\\u0026thinsp;=\\u0026thinsp;.035, η\\u003csup\\u003e2\\u003c/sup\\u003e\\u0026thinsp;=\\u0026thinsp;.140, 1 \\u0026ndash; \\u0026szlig; = .571). Its decomposition revealed a difference between tasks only in med-lows who exhibited higher vividness for IFA than MI (\\u003cem\\u003eF\\u003c/em\\u003e(1,15)\\u0026thinsp;=\\u0026thinsp;8.21, p\\u0026thinsp;=\\u0026thinsp;.012).\\u003c/p\\u003e\\u003c/div\\u003e\\u003cdiv id=\\\"Sec14\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003e3.4 Physiological variables\\u003c/h2\\u003e\\u003cp\\u003eHR did not exhibit any significant differences between groups and tasks (mean\\u0026thinsp;\\u003cspan type=\\\"Underline\\\" class=\\\"Underline\\\" name=\\\"Emphasis\\\"\\u003e\\u0026plusmn;\\u003c/span\\u003e\\u0026thinsp;SD; baseline: 72.74\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;11.21; task: 71.88\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;11.41). Controlling for MAIA \\u003cem\\u003enot distracting\\u003c/em\\u003e disclosed a Task x Level interaction (\\u003cem\\u003eF\\u003c/em\\u003e(1,18)\\u0026thinsp;=\\u0026thinsp;7.58, p\\u0026thinsp;=\\u0026thinsp;.013, η\\u003csup\\u003e2\\u003c/sup\\u003e\\u0026thinsp;=\\u0026thinsp;.296, 1 \\u0026ndash; \\u0026szlig; = .739) whose decomposition revealed lower HR during IFA than MI (\\u003cem\\u003eF\\u003c/em\\u003e(1,19)\\u0026thinsp;=\\u0026thinsp;13.29, p\\u0026thinsp;=\\u0026thinsp;.002) in the presence of a non-different baseline.\\u003c/p\\u003e\\u003cp\\u003eRMSSD (ms) did not exhibit significant effects and interactions (mean\\u0026thinsp;\\u003cspan type=\\\"Underline\\\" class=\\\"Underline\\\" name=\\\"Emphasis\\\"\\u003e\\u0026plusmn;\\u003c/span\\u003e\\u0026thinsp;SD; B: 92.78\\u0026thinsp;\\u003cspan type=\\\"Underline\\\" class=\\\"Underline\\\" name=\\\"Emphasis\\\"\\u003e\\u0026plusmn;\\u003c/span\\u003e\\u0026thinsp;70.13; task: 146.72\\u0026thinsp;\\u003cspan type=\\\"Underline\\\" class=\\\"Underline\\\" name=\\\"Emphasis\\\"\\u003e\\u0026plusmn;\\u003c/span\\u003e\\u0026thinsp;162.98).\\u003c/p\\u003e\\u003cp\\u003eMean SCL exhibited a significant Trial effect (\\u003cem\\u003eF\\u003c/em\\u003e(2,38)\\u0026thinsp;=\\u0026thinsp;3.16, p\\u0026thinsp;=\\u0026thinsp;.054, η\\u003csup\\u003e2\\u003c/sup\\u003e\\u0026thinsp;=\\u0026thinsp;.143, 1 \\u0026ndash; \\u0026szlig; = .571), with T1\\u0026thinsp;=\\u0026thinsp;T2, T1\\u0026thinsp;\\u0026lt;\\u0026thinsp;T3 (\\u003cem\\u003eF\\u003c/em\\u003e(1,19)\\u0026thinsp;=\\u0026thinsp;4.52, p\\u0026thinsp;=\\u0026thinsp;.047), and T2\\u0026thinsp;=\\u0026thinsp;T3. The Level effect (\\u003cem\\u003eF\\u003c/em\\u003e(1,19)\\u0026thinsp;=\\u0026thinsp;6.11, p\\u0026thinsp;=\\u0026thinsp;.023, η\\u003csup\\u003e2\\u003c/sup\\u003e\\u0026thinsp;=\\u0026thinsp;.243, 1 \\u0026ndash; \\u0026szlig; = .650) consisted only of higher SCL in B than in tasks independently of the cognitive condition (Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig2\\\" class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003eB). Controlling for all MAIA dimensions abolished all effects. Controlling for MIQIVI and MIQEVI abolished all effects. MIQKI abolished all effects and disclosed a Trial x Task x Level x Group interaction (\\u003cem\\u003eF\\u003c/em\\u003e(2,36)\\u0026thinsp;=\\u0026thinsp;3.90, p\\u0026thinsp;=\\u0026thinsp;.029, η\\u003csup\\u003e2\\u003c/sup\\u003e\\u0026thinsp;=\\u0026thinsp;.178, 1 \\u0026ndash; \\u0026szlig; = .667). Its decomposition revealed a Level effect in med-highs (\\u003cem\\u003eF\\u003c/em\\u003e(1,8)\\u0026thinsp;=\\u0026thinsp;7.12, p\\u0026thinsp;=\\u0026thinsp;.028), with B\\u0026thinsp;\\u0026gt;\\u0026thinsp;Task. In med-lows it revealed a Level x Task interaction (\\u003cem\\u003eF\\u003c/em\\u003e(1,9)\\u0026thinsp;=\\u0026thinsp;12.03, p\\u0026thinsp;=\\u0026thinsp;.007), with B\\u0026thinsp;\\u0026gt;\\u0026thinsp;IFA in T1 (\\u003cem\\u003eF\\u003c/em\\u003e(1,9)\\u0026thinsp;=\\u0026thinsp;15.60, p\\u0026thinsp;=\\u0026thinsp;.003), and no significant effects in T2 and T3.\\u003c/p\\u003e\\u003c/div\\u003e\\u003cdiv id=\\\"Sec15\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003e3.5 Regression analysis of SHSS and MAIA scores, and physiological variables on apnea duration\\u003c/h2\\u003e\\u003cp\\u003eAfter controlling collinearities, linear backward regression of MAIA and MIQ dimensions, HR, and SCL on apnea duration is reported in Table\\u0026nbsp;\\u003cspan refid=\\\"Tab1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e. It indicates the role of a few MAIA dimensions in apnea duration in the first trial of both IFA and MI, and an increasing role of MAIA dimensions and autonomic variables in the successive trials during IFA, but not during MI.\\u003c/p\\u003e\\u003cp\\u003e\\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab1\\\" border=\\\"1\\\"\\u003e\\u003ccaption language=\\\"En\\\"\\u003e\\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 1\\u003c/div\\u003e\\u003cdiv class=\\\"CaptionContent\\\"\\u003e\\u003cp\\u003eLinear backward regression.\\u003c/p\\u003e\\u003c/div\\u003e\\u003c/caption\\u003e\\u003ccolgroup cols=\\\"10\\\"\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c5\\\" colnum=\\\"5\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c6\\\" colnum=\\\"6\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c7\\\" colnum=\\\"7\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c8\\\" colnum=\\\"8\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c9\\\" colnum=\\\"9\\\"\\u003e\\u003c/div\\u003e\\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c10\\\" colnum=\\\"10\\\"\\u003e\\u003c/div\\u003e\\u003cthead\\u003e\\u003ctr\\u003e\\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eApnea duration\\u003c/p\\u003e\\u003c/th\\u003e\\u003cth 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colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u003cp\\u003eR\\u003csup\\u003e2\\u003c/sup\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u003cp\\u003eB\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u003cp\\u003ep\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eT1\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e.198\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003enoticing\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e\\u0026minus;\\u0026thinsp;.468\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" 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colname=\\\"c4\\\"\\u003e\\u003cp\\u003e.484\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e.039\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u003cp\\u003eattention regulation\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u003cp\\u003e.486\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u003cp\\u003e.043\\u003c/p\\u003e\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eT2\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e.526\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eSHSS\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e\\u0026minus;\\u0026thinsp;.797\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e.003\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003enoticing\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e-1.09\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e.0001\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eemotional awareness\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e.710\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e.009\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003ebody listening\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e.984\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e.001\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eSCL\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e\\u0026minus;\\u0026thinsp;.886\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e.002\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u003cp\\u003eT3\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u003cp\\u003e.362\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003enoticing\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e\\u0026minus;\\u0026thinsp;.587\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e.013\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eattention regulation\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e.743\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e.004\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eRMSSD\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e\\u0026minus;\\u0026thinsp;.453\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e.\\u003cem\\u003e052\\u003c/em\\u003e\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003c/tr\\u003e\\u003ctr\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u003cp\\u003eHR\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u003cp\\u003e\\u0026minus;\\u0026thinsp;.539\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u003cp\\u003e.026\\u003c/p\\u003e\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\u003c/tr\\u003e\\u003c/tbody\\u003e\\u003c/colgroup\\u003e\\u003c/table\\u003e\\u003c/div\\u003e\\u003c/p\\u003e\\u003cp\\u003eB, standardized beta; HR, heart rate; IFA, internal focus apnea; MI, motor imagery apnea; R\\u003csup\\u003e2\\u003c/sup\\u003e, adjusted R\\u003csup\\u003e2\\u003c/sup\\u003e; RMSSD, heart rate fast variability; SCL, skin conductance level; SHSS, hypnotizability score; T1, T2, T3, first, second, and third trial.\\u003c/p\\u003e\\u003c/div\\u003e\"},{\"header\":\"4. Discussion\",\"content\":\"\\u003cp\\u003eThe present study was designed to explore how hypnotizability, imagery abilities, and interoceptive sensibility influence breath-hold performance in different cognitive conditions. Our findings indicate that apnea duration did not differ significantly between the cognitively congruent and incongruent conditions. Additionally, attention to apnea sensations (congruent with the physical state) and motor imagery of normal breathing (incongruent with it) are differentially associated with experiential and physiological variables.\\u003c/p\\u003e\\u003cp\\u003eThe findings reveal a dissociation between subjective experience and apnea duration, as interoceptive sensibility and autonomic markers are more strongly associated with apnea duration in the congruent cognitive condition than in the incongruent condition. Interoceptive sensibility and motor imagery abilities account for most of the differences between the two conditions, and masked hypnotizability-related differences.\\u003c/p\\u003e\\u003cdiv id=\\\"Sec17\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003e\\u003cem\\u003e4.1 Subjective Experience\\u003c/em\\u003e\\u003c/h2\\u003e\\u003cp\\u003eThe study did not demonstrate significant hypnotizability-related differences in the self-reported scores of trait imagery abilities (measured by the Betts\\u0026rsquo; questionnaire), in line with the observation that questionnaire scores do not always correlate with hypnotizability (Srzich et al., \\u003cspan citationid=\\\"CR36\\\" class=\\\"CitationRef\\\"\\u003e2016\\u003c/span\\u003e) and functional equivalence between actual and imagined perception/action (Ibanez-Marcelo et al., 2019).\\u003c/p\\u003e\\u003cp\\u003eMed-highs and med-lows reported different experiences in cognitively congruent and incongruent apnea conditions. The higher vividness of the congruent than the incongruent experience observed in both groups suggests that the former was easier than the latter. In contrast, the greater easiness of the cognitively incongruent task in med-highs was masked by the trait kinesthetic ability of imagery, which compensated for the med-lows' lower imagery ability and weaker functional equivalence (Ibanez-Marcelo et al., 2019). Two non-alternative hypotheses can account for the groups\\u0026rsquo; different experiences. One can be based on the highs\\u0026rsquo; flexible functional connections between the salience and executive systems (Hoeft et al., 2012), the other can be sustained by the highs' lower ability to represent bodily signals accurately (Giusti et al., 2024).\\u003c/p\\u003e\\u003cp\\u003eInteroceptive sensibility contributed to the difference in task easiness. The ability to allocate attention (\\u003cem\\u003eattention regulation\\u003c/em\\u003e) and adaptively modulate internal bodily sensations of discomfort \\u003cem\\u003e(self-regulation\\u003c/em\\u003e), together with \\u003cem\\u003eemotional awareness\\u003c/em\\u003e, likely induced a more vivid experience during the cognitively congruent apnea condition. Enhanced vividness also depends on the association between respiratory sensations and emotional processes (Harrison et al., 2021), making them more easily accessible or meaningful during imagery in emotionally resonant contexts such as apnea.\\u003c/p\\u003e\\u003c/div\\u003e\\u003cdiv id=\\\"Sec18\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003e4.2 Apnea Duration\\u003c/h2\\u003e\\u003cp\\u003eHypnotizability did not influence apnea duration in both cognitive conditions and in both groups, despite the highs\\u0026rsquo; lower interoceptive accuracy (Giusti et al., 2024), which was expected to positively influence apnea duration when attention was focused on the apnea -related sensations, and their stronger functional equivalence between actual and imagined normal breathing, which was expected to increase apnea duration during imagination of normal breathing. The absence of behavioral hypnotizability-related differences between groups contrasts with their subjective experiences, as observed earlier for other functions, such as postural control, which was quite different between highs and lows but was similarly reported (Santarcangelo et al., 2008).\\u003c/p\\u003e\\u003cp\\u003eIn contrast to the study by Kanthack et al. (\\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e2019\\u003c/span\\u003e), we did not find a significant difference in apnea duration between the cognitively congruent (IFA) and incongruent (MI) conditions. A possible explanation for this discrepancy lies in the composition of the two samples. While Kanthack et al.'s participants were recruited from the general population through a sports science department and were all physically active individuals engaged in regular sporting practices, our sample consisted of non-athletes with no systematic physical training. It is plausible that athletes are more familiar with motor imagery, either through formal practice or embodied experience, which may enhance the effectiveness of MI in extending apnea duration. This hypothesis aligns with the well-established role of motor imagery in sports performance and motor learning (Desai et al., 2024). In contrast, our sample's limited familiarity with MI, and its composition comprising many med-lows, which differs from the general population (De Pascalis et al., 2000), may have reduced the efficacy of MI (Ibanez-Marcelo et al., 2019).\\u003c/p\\u003e\\u003cp\\u003eIn line with earlier reports (Kanthack et al., \\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e2019\\u003c/span\\u003e), the duration of apnea increased across trials. In our study, both interoceptive sensibility and imagery abilities contributed to this effect, which can be attributed to the observed cooperation of interoceptive sensibility in the cortical representation of both actual and imagined movements (Malloggi et al., 2024). Interestingly, no correlation emerged between apnea duration and the subjective experience of the two tasks, suggesting that performance improvements may have been more strongly influenced by arousal or emotional regulation than by cognitive engagement (Maric et al., \\u003cspan citationid=\\\"CR26\\\" class=\\\"CitationRef\\\"\\u003e2020\\u003c/span\\u003e; Harrison et al., 2021).\\u003c/p\\u003e\\u003c/div\\u003e\\u003cdiv id=\\\"Sec19\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003e4.3 Physiological variables\\u003c/h2\\u003e\\u003cp\\u003eIn the general population, heart rate decreases during 30\\u0026ndash;60 seconds of normoxic apnea (O\\u0026rsquo;Croinin et al., \\u003cspan citationid=\\\"CR32\\\" class=\\\"CitationRef\\\"\\u003e2024\\u003c/span\\u003e). In this condition, earlier findings do not reveal significant differences in heart rate between apnea with instructions and with attention focused on bodily sensations (Kanthack et al., \\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e2019\\u003c/span\\u003e), which could be attributed to the low cognitive effort required by the congruent condition. In the more demanding, cognitively incongruent condition, in contrast to earlier reports (Kanthack et al., \\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e2019\\u003c/span\\u003e), we observed an increase in heart rate compared to baseline, consistent with the increase in the sympathetic/parasympathetic ratio observed during demanding cognitive tasks (Chang \\u0026amp; Huang, \\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e2012\\u003c/span\\u003e). The MAIA \\u003cem\\u003enot distracting\\u003c/em\\u003e dimension, not measured in the earlier study (Kanthack et al., \\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e2019\\u003c/span\\u003e), may have masked the difference. The parasympathetic, fast heart rate variability (RMSSD) did not differ between tasks and hypnotizability groups, likely due to the different contributions to its regulation by multiple components, such as apnea, cognitive effort, emotion, and arousal, which may balance each other. Indeed, apnea is associated with both sympathetic and parasympathetic activation (Bain et al., \\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2018\\u003c/span\\u003e).\\u003c/p\\u003e\\u003cp\\u003eOur results also showed a reduction in skin conductance during apnea compared to baseline. While both physical and cognitive load are typically associated with increased skin conductance due to elevated sympathetic nervous system activity (Critchley, \\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e2002\\u003c/span\\u003e; Boucsein, 2012; Chang \\u0026amp; Huang, \\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e2012\\u003c/span\\u003e), voluntary breath-holding constitutes a unique autonomic condition. It triggers the diving reflex, a physiological response characterized by bradycardia, peripheral vasoconstriction, and reduced blood flow to the extremities of the limbs (Ferrigno \\u0026amp; Lundgren, \\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e2003\\u003c/span\\u003e), which potentially leads to reduced skin conductance despite an elevated central sympathetic drive (Heusser et al., \\u003cspan citationid=\\\"CR21\\\" class=\\\"CitationRef\\\"\\u003e2009\\u003c/span\\u003e). It is noteworthy that interoceptive sensibility sustained the observed SCL differences, supporting the idea that it modulates autonomic activity during challenging bodily states such as apnea.\\u003c/p\\u003e\\u003c/div\\u003e\\u003cdiv id=\\\"Sec20\\\" class=\\\"Section2\\\"\\u003e\\u003ch2\\u003e4.4 Limitations and conclusions\\u003c/h2\\u003e\\u003cp\\u003eLimitations of the study are the sample's scarce representativeness of the general population (De Pascalis et al., 2000) and the classification of highs, mediums, and lows based on their total hypnotizability scores rather than on a more accurate categorization based on motor inhibition, hallucination, and dissociation (Terhune et al., \\u003cspan citationid=\\\"CR37\\\" class=\\\"CitationRef\\\"\\u003e2011\\u003c/span\\u003e). Another limitation is not having acquired, but only monitored online, the respirogram. Its acquisition could have allowed for the correlation of the amplitudes of maximal inspiration with the experiential, behavioral, and autonomic results, as different thorax enlargements correspond to different interoceptive conditions. However, the sample was substantially composed of females of comparable age who did not practice sports; thus, large differences between groups were not expected. Furthermore, the addition of a neutral apnea condition without employing cognitive strategies could have represented a control condition.\\u003c/p\\u003e\\u003cp\\u003eIn conclusion, the results support the view that, in healthy participants, interoceptive sensibility and trait imagery abilities are relevant to apnea duration and that hypnotizability contributes to its subjective and physiological correlates. The complexity of the interaction between these variables in regulating the effects of cognitive conditions on the physiological state of apnea suggests that assessing interoceptive and imagery abilities could be beneficial for sports performers, who may benefit from training in voluntary apnea (Bouten et al., \\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e2024\\u003c/span\\u003e).\\u003c/p\\u003e\\u003c/div\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003e\\u003ch2\\u003eAuthor Contribution Statement\\u003c/h2\\u003e\\u003cp\\u003eE.L.S., E.M. and U.D. conceived and designed the research. E.M. conducted experiments. E.L.S. and E.M. analyzed data. E.L.S., E.M. and U.D. wrote the manuscript. All authors read and approved the manuscript.\\u003c/p\\u003e\\u003c/p\\u003e\\u003cp\\u003e\\u003ch2\\u003eConflict of interest\\u003c/h2\\u003e\\u003cp\\u003eThe authors declare that they have no conflict of interest.\\u003c/p\\u003e\\u003c/p\\u003e\\u003ch2\\u003eFunding\\u003c/h2\\u003e\\u003cp\\u003eThis study was carried out within the Space It Up project and received funding from the ASI and the MUR \\u0026ndash; Contract n. 2024-5-E.0 - CUP n. I53D24000060005 (Prof. D. Manzoni).\\u003c/p\\u003e\\u003cp\\u003eIt was produced by Eleonora Malloggi while attending the Ph.D. program in Space Science and Technology at the University of Trento, Cycle XXXVIII, with the support of a scholarship financed by the Ministerial Decree no. 352 of 9 April 2022, based on the NRRP\\u0026mdash;funded by the European Union\\u0026mdash;NextGenerationEU\\u0026mdash;Mission 4 \\u0026ldquo;Education and Research\\u0026rdquo;, Component 1 \\u0026ldquo;Enhancement of the offer of educational services: from nurseries to universities\\u0026rdquo;\\u0026mdash;Investment 4.1 \\u0026ldquo;Extension of the number of research doctorates and innovative doctorates for public administration and cultural heritage\\u0026rdquo;.\\u003c/p\\u003e\\u003ch2\\u003eAuthor Contribution\\u003c/h2\\u003e\\u003cp\\u003eE.L.S., E.M. and U.D. conceived and designed the research. E.M. conducted experiments. E.L.S. and E.M. analyzed data. E.L.S., E.M. and U.D. wrote the manuscript. All authors read and approved the manuscript.\\u003c/p\\u003e\\u003ch2\\u003eAcknowledgement\\u003c/h2\\u003e\\u003cp\\u003eWe acknowledge the contribution of Prof. D. Manzoni, who is the recipient of funds from the Space It Up project supporting this research.\\u003c/p\\u003e\\u003ch2\\u003eData Availability\\u003c/h2\\u003e\\u003cp\\u003eData are available at https://osf.io/knxt8/overview.\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\u003cli\\u003e\\u003cspan\\u003eArce-\\u0026Aacute;lvarez A, Veliz C, Vazquez-Mu\\u0026ntilde;oz M et al (2021) Hypoxic respiratory chemoreflex control in young, trained swimmers. 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J Sport Exerc Psychol 34:621\\u0026ndash;646. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://doi.org/10.1123/jsep.34.5.621\\u003c/span\\u003e\\u003cspan address=\\\"10.1123/jsep.34.5.621\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e\\u003c/ol\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":true,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":true,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true},\"keywords\":\"breath-holding, motor imagery, interoceptive sensibility, hypnotizability, absorption\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-7978493/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-7978493/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003cp\\u003eApnea is employed to enhance performance in diving and other sports due to its specific physiological correlates. Its duration can be enhanced through training and the use of specific cognitive strategies and can be influenced by individual traits. Hypnotizability could be one of them, being associated with interoceptive sensibility and imagery abilities. The study investigates whether these traits affect apnea duration during imagery of normal breathing (motor imagery, a cognitively incongruent condition) and while focusing attention on apnea sensations (internally focused attention, a cognitively congruent condition) in participants with different hypnotizability scores. Hypnotizability was assessed in healthy participants -as low-medium (med-lows, N\\u0026thinsp;=\\u0026thinsp;16) and medium-to-high hypnotizables (med-highs, N\\u0026thinsp;=\\u0026thinsp;17)-, according to the Stanford Hypnotic Susceptibility Scale: Form A. They completed the Multidimensional Assessment of Interoceptive Awareness and the Movement Imagery Questionnaire-3 to assess interoceptive sensibility and trait imagery abilities and performed three apnea trials of internally focused attention and motor imagery in counterbalanced order. Heart rate and skin conductance were monitored. The vividness and ease of motor imagery and internally focused attention tasks were reported. Apnea duration increased across trials independently of the cognitive condition and hypnotizability. Heart rate increased during motor imagery more than during internally focused attention, skin conductance decreased quasi-significantly during both tasks in both groups. Imagery abilities and interoceptive sensibility masked hypnotizability-related differences in the tasks' subjective experience, heart rate, and increase in apnea duration across trials. Thus, hypnotizability, imagery abilities, and interoceptive sensibility jointly contribute to increase apnea duration across trials and to the associated experience and autonomic responses.\\u003c/p\\u003e\",\"manuscriptTitle\":\"Interplay between cognitive conditions and individual traits in voluntary apnea\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2025-11-12 02:19:24\",\"doi\":\"10.21203/rs.3.rs-7978493/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"cdf30a24-daa6-48f3-873c-e3dd6b16a177\",\"owner\":[],\"postedDate\":\"November 12th, 2025\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"posted\",\"subjectAreas\":[],\"tags\":[],\"updatedAt\":\"2026-02-23T16:05:56+00:00\",\"versionOfRecord\":{\"articleIdentity\":\"rs-7978493\",\"link\":\"https://doi.org/10.1007/s00221-026-07244-7\",\"journal\":{\"identity\":\"experimental-brain-research\",\"isVorOnly\":false,\"title\":\"Experimental Brain Research\"},\"publishedOn\":\"2026-02-17 15:57:55\",\"publishedOnDateReadable\":\"February 17th, 2026\"},\"versionCreatedAt\":\"2025-11-12 02:19:24\",\"video\":\"\",\"vorDoi\":\"10.1007/s00221-026-07244-7\",\"vorDoiUrl\":\"https://doi.org/10.1007/s00221-026-07244-7\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-7978493\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-7978493\",\"identity\":\"rs-7978493\",\"version\":[\"v1\"]},\"buildId\":\"8U1c8b4HqxoKbykW_rLl7\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}