The Effect of Heart Rate Variability Biofeedback Training on Mental Health of Pregnant and Non-Pregnant Women: A Randomized Controlled Trial

Abstract

In this study, we examined the efficacy of heart rate variability (HRV)-biofeedback on stress and stress-related mental health problems in women. Furthermore, we examined whether the efficacy differed between pregnant and non-pregnant women. Fifty women (20 pregnant, 30 non-pregnant; mean age 31.6, SD = 5.9) were randomized into an intervention (n = 29) or a waitlist condition (n = 21). All participants completed questionnaires on stress, anxiety, depressive symptoms, sleep, and psychological well-being on three occasions with 6-week intervals. Women in the intervention condition received HRV-biofeedback training between assessment 1 and 2, and women in the waitlist condition received the intervention between assessment 2 and 3. The intervention consisted of a 5-week HRV-biofeedback training program with weekly 60–90 min. sessions and daily exercises at home. Results indicated a statistically significant beneficial effect of HRV-biofeedback on psychological well-being for all women, and an additional statistically significant beneficial effect on anxiety complaints for pregnant women. No significant effect was found for the other stress-related complaints. These findings support the use of HRV-biofeedback as a stress-reducing technique among women reporting stress and related complaints in clinical practice to improve their well-being. Furthermore, it supports the use of this technique for reducing anxiety during pregnancy.

Effects of interventions for women and their partners to reduce or prevent stress and anxiety: A systematic review

“…Only one study was rated as low risk of bias [49], six studies were rated as moderate risk of bias [40][41][42][43][44]50]; nine studies were rated as high risk of bias [38,39,41,42,47,48,[51][52][53]. The most common sources of bias related to blinding; selective reporting bias in most studies was unclear as few studies were pre-registered or had published protocols.…”

“…Characteristics of the included studies are summarised in Table 1. Seven studies [40,42,[44][45][46][47][48] examined effects of prenatal interventions for women at risk of developing stress, anxiety and/or depression [45,48], or who already experienced elevated levels [40,42,44,46,47]. One study examined effects of an intervention for low-income pregnant women who were, for the most part, unmarried [41].…”

“…Two interventions focused solely on information provision and relaxation techniques [50,53]. One study involved nurse community health visits [41]; one intervention involved peer-mentoring [54]; one involved heart rate variability (HRV) biofeedback [44]. Thirteen of these interventions included some delivery in a medical setting, mostly hospitals providing maternity Please cite this article in press as: K. Matvienko-Sikar, et al, Effects of interventions for women and their partners to reduce or prevent stress and anxiety: A systematic review, Women Birth (2020), https://doi.org/10.1016/j.wombi.2020.02.010 (p = .019), no effect if both low resources and high stress (p = .131) Depression (p = .036) Significant differences if high baseline stress (p = .019), low psychosocial resources (p = .016), or both (p = .022) Mastery (p = .057) Self Esteem (p = .79) Social Support (p = .…”

“…Please cite this article in press as: K. Matvienko-Sikar, et al, Effects of interventions for women and their partners to reduce or prevent stress and anxiety: A systematic review, Women Birth (2020), https://doi.org/10.1016/j.wombi.2020.02.010 and/or neonatal care [41,42,45,[48][49][50][51][52]54,55]. Four interventions took in place in both medical settings and participants' homes [41,49,51,53]; one intervention took place at-home only [44].…”

Feasibility and efficacy of the addition of heart rate variability biofeedback to a remote digital health intervention for depression

“…Several preliminary studies have reported a therapeutic benefit of HRV-B for patients with high levels of anxiety, stress, and depression 27,[30][31][32][33] . Thus, clinicians have begun integrating HRV-B into existing depressive treatments 34 .…”