Use of respiratory rates and heart rate variability in the assessment and treatment of children and adolescents with functional somatic symptoms

Abstract

Functional somatic symptoms (FSS) emerge when the stress system is activated in response to physical or emotional stress that is either chronic or especially intense. In such cases, the heightened state of physiological arousal and motor activation can be measured through biological markers. Our team have integrated the use of biological markers of body state – respiratory rate, heart rate (HR) and heart rate variability (HRV) measurements – as a way of helping families to understand how physical symptoms can signal activation of the body’s stress systems. This study measured respiratory rates, HR and HRV in children and adolescents with FSS (and healthy controls) during baseline assessment to determine whether these biological markers were effective at differentiating patients with FSS. The study also implemented a biofeedback intervention during the assessment to determine whether patients with FSS were able to slow their respiratory rates and increase HRV. Patients with FSS had faster respiratory rates, faster HR, and lower HRV, suggesting activation of the autonomic nervous system coupled with activation of the respiratory motor system. Like controls, patients were able to slow their respiratory rates, but in contrast to controls, they were unable to increase their HRV. Our findings suggest that patients with FSS present in a state of physiological activation and struggle to regulate their body state. Patients with FSS are likely to need ongoing training and practice to regulate body state coupled with interventions that target regulatory capacity across multiple systems.

Heart rate variability helps to distinguish the intensity of menopausal symptoms: A prospective, observational and transversal study

“…The limitations of the study consist in a transversal design and can not establish cause and effect relationships with vasomotor symptoms and HRV. The age group is significantly different between two groups and HRV is an age dependent parameter [41]. However, age is a variable related to menopause transition, which does not make possible to provide subjects with similar ages in similar menopause period.…”

Effects of music on behavior and physiological stress response of domestic cats in a veterinary clinic

“…In humans, HR variability was found to be lower in children and adolescents with functional somatic symptoms that occur when the body responds to physical or emotional stress. 25 While there has not been any testing in cats, this could be a potential way to measure stress during veterinary visits, and even prior to the visit, if the stress of wearing a monitor could be controlled for.…”

Evaluating the potential of respiratory-sinus-arrhythmia biofeedback for reducing physiological stress in adolescents with autism: a protocol for a randomized controlled study

“…Prior HRV-RSA biofeedback studies have shown that an increase of HRV was causally related to several positive effects on psychological parameters. These studies were performed in distinct clinical populations of all ages and variable medical and psychological conditions (Chudleigh et al, 2019; Darling et al, 2019; Gevirtz, 2013; Kennedy & Parker, 2019; Knox et al, 2011; Lehrer et al, 2020; Lehrer & Gevirtz, 2014; Thabrew et al, 2018). In this protocol, individuals practice to breath at their resonant frequency, which can be found between 4.5 and 7 breaths per minute.…”