The Effects of Respiratory Sinus Arrhythmia Biofeedback on Heart Rate Variability and Posttraumatic Stress Disorder Symptoms: A Pilot Study

  title={The Effects of Respiratory Sinus Arrhythmia Biofeedback on Heart Rate Variability and Posttraumatic Stress Disorder Symptoms: A Pilot Study},
  author={Terri L. Zucker and Kristin W. Samuelson and Frederick J Muench and Melanie A. Greenberg and Richard Gevirtz},
  journal={Applied Psychophysiology and Biofeedback},
Recent studies have found a significant association between PTSD and low heart rate variability (HRV), a biomarker of autonomic dysregulation. Research indicates that respiratory sinus arrhythmia (RSA) biofeedback increases HRV while reducing related pathological symptoms. This controlled pilot study compared RSA biofeedback to progressive muscle relaxation (PMR) as adjunctive interventions for 38 persons with PTSD symptoms in a residential treatment facility for a substance use disorder. Both… 

Heart Rate Variability (HRV) and Posttraumatic Stress Disorder (PTSD): A Pilot Study

The results indicated that HRV biofeedback significantly increased the HRV while reducing symptoms of PTSD, however, the TAU had no significant effect on either HRV or symptom reduction.

Respiratory sinus arrhythmia biofeedback therapy may increase heart rate variability activity and decrease reactivity in male patients with major depressive disorder: A pilot study

The study results highlight the potential rôle of RSA-BT on the increased HRV activity with a shift sympathetic predominance at rest and decreased HRV reactivity toward parasympathetic dominance during mental stress in patients with depression, which is not related to the effects of antidepressant or benzodiazepine medication.

Heart Rate Variability and Posttraumatic Stress Disorder

Review of existing published research suggests that HRV biofeedback seems promising as a treatment for PTSD, both in significantly alleviating the symptoms and in improving cognition for those suffering from PTSD.

Pilot Study of a Single Session Heart Rate Variability Biofeedback Intervention on Veterans’ Posttraumatic Stress Symptoms

HRVB significantly reduced global posttraumatic stress symptoms, whereas diaphragmatic breathing alone did not, and veterans found the approach acceptable, as demonstrated by a high degree of adherence with prescribed practice, low study attrition, and continued use over time.

Peak High-Frequency HRV and Peak Alpha Frequency Higher in PTSD

  • H. WahbehB. Oken
  • Psychology, Biology
    Applied psychophysiology and biofeedback
  • 2013
Respiration, electroencephalography and heart rate variability and peak alpha frequency are sensitive to PTSD status and may be potential biofeedback parameters for future PTSD clinical trials.

Effects of Heart Rate Variability Biofeedback in Subjects with Stress-Related Chronic Neck Pain: A Pilot Study

Improvement in perceived health over a 10 week intervention with HRV-biofeedback in subjects with chronic neck-pain is indicated, and it is suggested that this intervention protocol is suitable for a larger controlled trial.

Relaxation training assisted by heart rate variability biofeedback: Implication for a military predeployment stress inoculation protocol.

Examination of PRESTINT protocol found it to be appropriate for efficiently teaching self-help skills to reduce the psychological harm following trauma exposure by increasing the capacity for parasympathetically modulated reactions to stress and providing a coping tool for use following a stressful situation.

Alcohol Use Disorder Moderates the Effect of Age on Heart Rate Variability in Veterans With Posttraumatic Stress Disorder

Findings support HRV as a biomarker of PTSD and extend research by demonstrating the complex relationship between PTSD and HRV in the context of co-occurring AUD.

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

Outcome studies on HRVB offers promising therapeutic benefit for any medical or mental health disorder known to be accompanied by autonomic nervous system dysregulation, and the authors review outcome studies on a sampling of common disorders.



Normalization of heart rate variability in post-traumatic stress disorder patients following fluoxetine treatment: preliminary results.

The preliminary results show that the HRV parameters indicating autonomic dysregulation, which characterize PTSD patients at rest, are normalized in responding patients by use of SSRIs.

Preliminary Results of an Open Label Study of Heart Rate Variability Biofeedback for the Treatment of Major Depression

HRV biofeedback appears to be a useful adjunctive treatment for the treatment of MDD, associated with large acute increases in HRV and some chronic increases, suggesting increased cardiovagal activity.

Vagal modulation of responses to mental challenge in posttraumatic stress disorder

Analysis of heart rate variability in posttraumatic stress disorder patients in response to a trauma-related reminder

A Meta-Analytic Examination of Basal Cardiovascular Activity in Posttraumatic Stress Disorder

A positive association between PTSD and basal cardiovascular activity is found and the results suggest that PTSD is associated with elevations in blood pressure; however, the effect sizes were smaller in magnitude than those obtained for heart rate.

Effect of Cognitive Behavioral Therapy on Heart Rate Variability During REM Sleep in Female Rape Victims with PTSD

A remission in PTSD symptoms following CBT accompanied a reduction in the HRV indicator of sympathetic predominance in REM sleep, which led to a remission in symptoms following cognitive–behavioral therapy.

A multisite study of initial respiration rate and heart rate as predictors of posttraumatic stress disorder.

Elevated heart rate and respiration rate are predictors of subsequent PTSD and the need for future research into secondary prevention strategies that reduce acute arousal immediately after trauma and may limit PTSD development in some individuals is underscore.

Increases in heart rate variability with successful treatment in patients with major depressive disorder.

Findings indicate that pharmacologic treatment leading to improvement in MDD is associated with increased HRV, and brief measures of HRV could be developed as a useful adjunctive, physiologic measure of treatment response to pharmacotherapy in clinical trials and other settings.