Assessing effectiveness of heart rate variability biofeedback to mitigate mental health symptoms: a pilot study

Abstract

Introduction: The increasing burden on mental health has become a worldwide concern especially due to its substantial negative social and economic impact. The implementation of prevention actions and psychological interventions is crucial to mitigate these consequences, and evidence supporting its effectiveness would facilitate a more assertive response. Heart rate variability biofeedback (HRV-BF) has been proposed as a potential intervention to improve mental wellbeing through mechanisms in autonomic functioning. The aim of this study is to propose and evaluate the validity of an objective procedure to assess the effectiveness of a HRV-BF protocol in mitigating mental health symptoms in a sample of frontline HCWs (healthcare workers) who worked in the COVID-19 pandemic.Methods: A prospective experimental study applying a HRV-BF protocol was conducted with 21 frontline healthcare workers in 5 weekly sessions. For PRE–POST intervention comparisons, two different approaches were used to evaluate mental health status: applying (a) gold-standard psychometric questionnaires and (b) electrophysiological multiparametric models for chronic and acute stress assessment.Results: After HRV-BF intervention, psychometric questionnaires showed a reduction in mental health symptoms and stress perception. The electrophysiological multiparametric also showed a reduction in chronic stress levels, while the acute stress levels were similar in PRE and POST conditions. A significant reduction in respiratory rate and an increase in some heart rate variability parameters, such as SDNN, LFn, and LF/HF ratio, were also observed after intervention.Conclusion: Our findings suggest that a 5-session HRV-BF protocol is an effective intervention for reducing stress and other mental health symptoms among frontline HCWs who worked during the COVID-19 pandemic. The electrophysiological multiparametric models provide relevant information about the current mental health state, being useful for objectively evaluating the effectiveness of stress-reducing interventions. Further research could replicate the proposed procedure to confirm its feasibility for different samples and specific interventions.

Effects of heart rate variability biofeedback training on anxiety reduction and brain activity: A randomized active control study using EEG

“…Low-anxiety individuals, based on the trait anxiety scores were excluded, and those with moderate or higher anxiety levels were recruited. Furthermore, participants in our study had similar levels of state and trait anxiety to those in previous studies reporting anxiety reduction and EEG changes in continuous training (Castro Ribeiro et al, 2023;Deschodt-Arsac et al, 2018;Dziembowska et al, 2016) as well as one-time training (Prinsloo et al, 2013;Sherlin et al, 2010). However, in a previous study reporting that attentional bias modification (ABM) reduced attentional bias measured by the emotional Stroop task and its related ERP, the top 20% of individuals with Social Interaction Anxiety Scale (SIAS) scores from a large sample pool were recruited (Pan et al, 2019).…”

The Future of Stress Management: Integration of Smartwatches and HRV Technology

“…Step-by-step instructions, visual cues, and tactile feedback help consumers relax. This guidance emphasizes stress-reduction and stress management [14]. Smartwatches also measure sleep and exercise.…”

“…These interventions may include breathing exercises, guided meditations, mindfulness prompts, or activity recommendations tailored to everyone's needs. Furthermore, comparing HRV patterns before and after implementing stress reduction techniques, individuals can objectively assess the impact of different strategies and make informed decisions about which methods work best for them and help them to enhance their self-awareness, adopt healthier coping mechanisms, and ultimately lead a more balanced and stress-resilient life [13,14].…”