Resonance breathing is associated with improvements in depression and anxiety symptoms during heart rate variability biofeedback sessions

2021 ◽  
Author(s):  
Adam Khan Pettitt ◽  
Benjamin W Nelson ◽  
Richard Gevirtz ◽  
Paul Lehrer ◽  
Kristian Ranta ◽  
...  
Keyword(s):  
Mental Health ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Resonance Frequency ◽  
Treatment Protocol ◽  
Anxiety Symptoms ◽  
Adjunctive Treatment ◽  
Depression And Anxiety ◽  
Heart Rate Variability Biofeedback ◽  
Item Scale

Heart rate variability (HRV) appears to be a transdiagnostic biomarker for health and disease. Although initial studies using HRV biofeedback (HRVB) to regulate HRV as a potential adjunctive treatment to gold-standard interventions seem promising, more research is needed to determine which aspects of HRVB training provide the most clinical benefits to those suffering from mental health symptoms. In the current study, we sought to investigate whether time spent in resonance, between-person differences in resonance frequency, and/or within-person resonance frequency trajectory across repeated HRVB sessions were related to changes in depression and/or anxiety symptoms during a 12-week digital mental health intervention that contains HRVB as part of the treatment protocol. We used a retrospective cohort study to examine these associations among 387 participants in the Meru Health Program. For depression, we found that average resonance time per HRVB session, but not total time in resonance, was significantly associated with decreased depression as measured by the Patient Health Questionnaire 9-item scale (PHQ-9) across treatment (b=-0.38, 95% CI [-0.76,-0.01], t(377)=-1.99, p=.047). For anxiety symptoms as measured by the Generalized Anxiety Disorder 7-item scale (GAD-7), we found neither association significant. Within-person effects were significant for both depression and anxiety, with steeper slopes of time spent in resonance significantly related to reductions in PHQ-9 and GAD-7 symptoms, respectively. Between-person effects were not significant for either depression or anxiety. Our results demonstrate that improvements in resonance efficiency over time in treatment, independent of how each participant starts, are related to reductions in depression and anxiety symptoms.

scholarly journals A Practical Guide to Resonance Frequency Assessment for Heart Rate Variability Biofeedback

2020 ◽  
Vol 14 ◽  
Author(s):  
Fred Shaffer ◽  
Zachary M. Meehan
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Resonance Frequency ◽  
Muscle Tension ◽  
Initial Assessment ◽  
Cardiorespiratory System ◽  
Frequency Model ◽  
Heart Rate Variability Biofeedback ◽  
Resonance Frequencies ◽  
Non Linear

Heart rate variability (HRV) represents fluctuations in the time intervals between successive heartbeats, which are termed interbeat intervals. HRV is an emergent property of complex cardiac-brain interactions and non-linear autonomic nervous system (ANS) processes. A healthy heart is not a metronome because it exhibits complex non-linear oscillations characterized by mathematical chaos. HRV biofeedback displays both heart rate and frequently, respiration, to individuals who can then adjust their physiology to improve affective, cognitive, and cardiovascular functioning. The central premise of the HRV biofeedback resonance frequency model is that the adult cardiorespiratory system has a fixed resonance frequency. Stimulation at rates near the resonance frequency produces large-amplitude blood pressure oscillations that can increase baroreflex sensitivity over time. The authors explain the rationale for the resonance frequency model and provide detailed instructions on how to monitor and assess the resonance frequency. They caution that patterns of physiological change must be compared across several breathing rates to evaluate candidate resonance frequencies. They describe how to fine-tune the resonance frequency following an initial assessment. Furthermore, the authors critically assess the minimum epochs required to measure key HRV indices, resonance frequency test-retest reliability, and whether rhythmic skeletal muscle tension can replace slow paced breathing in resonance frequency assessment.

Are Trait Emotional Competencies and Heart Rate Variability Linked to Mental Health of Coronary Heart Disease Patients?

2020 ◽  
pp. 003329411989811
Author(s):  
Batselé Elise ◽  
Sophie Vanden Eynde ◽  
Nathalie Egée ◽  
Michel Lamotte ◽  
Philippe Van de Borne ◽  
...  
Keyword(s):  
Heart Rate ◽  
Coronary Heart Disease ◽  
Heart Rate Variability ◽  
Heart Disease ◽  
Cardiac Rehabilitation ◽  
Depression Scale ◽  
Anxiety Symptoms ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Emotional Competencies

Purpose Depression and anxiety have been extensively associated with adverse outcomes in coronary heart disease patients. However, psychological and physiological processes underlying the persistence of these troubles in coronary heart disease patients attending cardiac rehabilitation are poorly investigated. Trait emotional competencies and heart rate variability could be some of these processes. Thus, the aim of this study was to assess the predictive value of trait emotional competencies and heart rate variability on depression and anxiety symptoms persistence in coronary heart disease patients. Methods Eighty-four patients who recently presented a myocardial infarction were evaluated at the beginning of cardiac rehabilitation. Forty-two patients continued their rehabilitation program and were then assessed three months later. They completed the Profile of Emotional Competence as well as the Hospital Anxiety and Depression Scale and underwent a 5-minute resting heart rate variability measure. Results Low trait emotional competencies score predicted depression symptoms persistence, but unexpectedly, high trait emotional competencies score was also associated with withdrawal from cardiac rehabilitation. Contrary to our expectations, heart rate variability did not predict depression or anxiety symptoms persistence and was not associated with trait emotional competencies. Conclusions This study is the first to report an association between trait emotional competencies and depression symptoms persistence in coronary heart disease patients. However, heart rate variability was not associated with either depression or anxiety supporting the idea of mixed literature and highlighting the need of future research.

Depression and anxiety as predictors of heart rate variability after myocardial infarction

2007 ◽  
Vol 38 (3) ◽  
pp. 375-383 ◽  
Author(s):  
E. J. Martens ◽  
I. Nyklíček ◽  
B. M. Szabó ◽  
N. Kupper
Keyword(s):  
Myocardial Infarction ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Standard Deviation ◽  
Anxiety Disorder ◽  
Depressive Disorder ◽  
Anxiety Symptoms ◽  
Adverse Outcomes ◽  
Depression And Anxiety ◽  
Increased Risk

BackgroundReduced heart rate variability (HRV) is a prognostic factor for cardiac mortality. Both depression and anxiety have been associated with increased risk for mortality in cardiac patients. Low HRV may act as an intermediary in this association. The present study examined to what extent depression and anxiety differently predict 24-h HRV indices recorded post-myocardial infarction (MI).MethodNinety-three patients were recruited during hospitalization for MI and assessed on self-reported symptoms of depression and anxiety. Two months post-MI, patients were assessed on clinical diagnoses of lifetime depressive and anxiety disorder. Adequate 24-h ambulatory electrocardiography data were obtained from 82 patients on average 78 days post-MI.ResultsIn unadjusted analyses, lifetime diagnoses of major depressive disorder was predictive of lower SDNN [standard deviation of all normal-to-normal (NN) intervals; β=−0.26, p=0.022] and SDANN (standard deviation of all 5-min mean NN intervals; β=0.25, p=0.023), and lifetime anxiety disorder of lower RMSSD (root mean square of successive differences; β=−0.23, p=0.039). Depression and anxiety symptoms did not significantly predict HRV. After adjustment for age, sex, cardiac history and multi-vessel disease, lifetime depressive disorder was no longer predictive of HRV. Lifetime anxiety disorder predicted reduced high-frequency spectral power (β=−0.22, p=0.039) and RMSSD (β=−0.25, p=0.019), even after additional adjustment of anxiety symptoms.ConclusionsClinical anxiety, but not depression, negatively influenced parasympathetic modulation of heart rate in post-MI patients. These findings elucidate the physiological mechanisms underlying anxiety as a risk factor for adverse outcomes, but also raise questions about the potential role of HRV as an intermediary between depression and post-MI prognosis.

Effects of Heart Rate Variability Biofeedback on EEG Alpha Asymmetry and Anxiety Symptoms in Male Athletes: A Pilot Study

2015 ◽  
Vol 41 (2) ◽  
pp. 141-150 ◽  
Author(s):  
Inga Dziembowska ◽  
Paweł Izdebski ◽  
Anna Rasmus ◽  
Janina Brudny ◽  
Marta Grzelczak ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Pilot Study ◽  
Anxiety Symptoms ◽  
Male Athletes ◽  
Heart Rate Variability Biofeedback ◽  
Alpha Asymmetry ◽  
Eeg Alpha

The Application of Heart Rate Variability Biofeedback to Medical and Mental Health Disorders

Biofeedback ◽  
2017 ◽  
Vol 45 (1) ◽  
pp. 2-8 ◽  
Author(s):  
Donald Moss ◽  
Fredric Shaffer
Keyword(s):  
Mental Health ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Mental Health Disorders ◽  
Therapeutic Benefit ◽  
Mental Health Disorder ◽  
Outcome Studies ◽  
Heart Rate Variability Biofeedback ◽  
Published Evidence ◽  
Health Disorders

Heart rate variability (HRV) is a medical index for morbidity and wellness. Lower HRV accompanies many illnesses; high HRV accompanies healthy states, resilience, and optimal functioning. Heart rate variability biofeedback (HRVB) uses real-time electronic feedback of the moment-to-moment changes in HRV to train patients to produce increases in HRV. Outcome studies on HRVB have shown therapeutic benefit for a wide variety of medical and mental health disorders. Lehrer and colleagues have published evidence-based protocols for HRV assessment and HRV treatment. Here, the authors review outcome studies on a sampling of common disorders: asthma, chronic muscle pain, depression, heart failure, hypertension, and posttraumatic stress disorder. HRVB offers promising therapeutic benefit for any medical or mental health disorder known to be accompanied by autonomic nervous system dysregulation.

Resonance Frequency Assessment: The Impact and Implications of Inaccurate Assessment in the Clinical Use of Heart Rate Variability Biofeedback

Biofeedback ◽  
2021 ◽  
Vol 49 (2) ◽  
pp. 38-41 ◽  
Author(s):  
Samuel Kohlenberg
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Clinical Practice ◽  
Resonance Frequency ◽  
Clinical Settings ◽  
Clinical Use ◽  
Heart Rate Variability Biofeedback ◽  
The Impact ◽  
As If

While many researchers and clinicians see assessing resonance frequency (RF) as an important step in heart rate variability biofeedback (HRVB), some practitioners providing HRVB acknowledge that they do not pay that much attention to RF. What if RF is not easily measured accurately or is not even particularly relevant to HRVB as it is practiced in the field? There is modest evidence suggesting that intertester reliability for RF may be relatively weak. Further study may be warranted to determine the accuracy and reliability of RF determinations in clinical settings and, perhaps, to what extent RF calculations are necessary at all. If RF is not really being used in the field, then there are a number of questions to be answered concerning the clinical practice of HRVB, such as if reliably determining RF is possible, and even whether HRVB as it is used clinically is biofeedback.

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