Effect of Heart Rate Variability Biofeedback Sessions With Resonant Frequency Breathing on Sleep: A Pilot Study Among Family Caregivers of Patients With Cancer

Abstract

Heart rate variability biofeedback (HRV-BF) is used as a skill in psychosomatic medicine, but is not yet established in the field of sleep. The present study aimed to evaluate the effect of HRV-BF with resonant frequency breathing (RFB) on sleep performed once every 2 weeks and the usefulness of practice of RFB using a portable device at home before bedtime. Participants were 69 family caregivers of patients with cancer that felt burdened by nursing care. We conducted a randomized controlled trial with an HRV-BF+Home practice group and an HRV-BF group. HRV-BF with RFB was administered to both groups at our medical institution for up to 30 min on the experiment days. Home practice involved RFB using a portable device, which was performed at home each day within 20 min before bedtime. Evaluation items were: change ratio of total score of the Pittsburgh Sleep Quality Index (PSQI) at 28 days after the trial started. In total, 52.2% of participants had insomnia. The two HRV-BF groups had decreased PSQI total scores, which indicated an improvement in PSQI total score near 5.5 on Day 28. The two HRV-BF groups had significantly increased HRV scores on Day 28, and there was correlation between the variation of PSQI total score and the variation of HRV score. The quality of sleep assessed by PSQI scores in the HRV-BF+Home practice group was significantly improved compared with the HRV-BF group on Day 28 (p = 0.001). This suggests HRV-BF may be a useful skill for enhancing sleep among family caregivers of patients with cancer, as well as supporting their autonomic nervous function. Additional actual regular practice of RFB (using a portable device at home before bedtime) may further enhance the effect.

Substance Use and Addiction Affect More Than the Brain: the Promise of Neurocardiac Interventions

“…The benefits of HRV biofeedback are not limited to those with mental and physical health conditions. Evidence has shown that in the wider population, practicing resonance breathing, in some cases only for 5 or 10 min, can improve cognitive performance [50•], decrease performance anxiety [51], reduce stress, and improve sleep quality [52,53]. This suggests that resonance breathing not only confers benefit in persons with disorders, but more broadly it enhances baroreflex signaling and the integration of cardiovascular signals with neural processes responsible for cognitive and emotional regulation for all people.…”

Interventions that Improve Sleep in Caregivers of Adult Care-Recipients: A Systematic Review

“…Nine articles used other types of interventions not included in any of the previous groups. These studies had various objectives, including reducing stress (Cheung et al, 2020;Korn et al, 2009), depression (Korn et al, 2009;Lai Rose et al, 2009) and anxiety state (Lai et al, 2011;Pinar & Afsar, 2015;Toygar et al, 2020), and improving sleep quality (Friedman et al, 2012;Hasuo et al, 2020;Lai et al, 2011;Pinar & Afsar, 2015;Rose et al, 2009;Rowe et al, 2010;Toygar et al, 2020).…”

“…Lai et al (2011) used a psychophysiological theory for their music intervention. Other theorical foundations included the psychoneuroimmunology of a negative appraisal of caregiving in the development of sleep disturbances (Rose et al, 2009), the amplitude of the circadian system oscillations for improving sleep (Friedman et al, 2012), the combination of factors (such as awakenings) that perpetuate sleep problems as a therapy target (Rowe et al, 2010), and biofeedback as a behavioral therapy that regulates the mind and body (Hasuo et al, 2020).…”

“…The trial conducted by Rowe et al (2010) used an alert device for awakening the caregiver when the patient left the bed at night. The last trial included the use of a behavioral intervention based on heart rate variability biofeedback (HRV-BF) with resonant frequency breathing to improve sleep (Hasuo et al, 2020).…”

Impact of COVID-19 Pandemic Burnout on Cardiovascular Risk in Healthcare Professionals Study Protocol: A Multicenter Exploratory Longitudinal Study

“…Smartphone-Delivered Biofeedback Training was effective in increasing resilience while reducing stress and depressive symptoms ( 32 ). Heart rate variability biofeedback with resonant frequency breathing on sleep significantly improved the quality of sleep assessed by the Pittsburgh Sleep Quality Index (PSQI) scores ( 33 ). Wearable smart device heart rate variability biofeedback shows promise for individualized real-life stress reduction interventions and further and further well-designed trials are warranted ( 34 ).…”