Inclusion of a rest period in diaphragmatic breathing increases high frequency heart rate variability: Implications for behavioral therapy
Corresponding Author
Matthew E. B. Russell
Psychology Department, University of Kentucky, Lexington, Kentucky, USA
Address correspondence to: Matthew Russell, M.S., University of Kentucky, Kastle Hall, Rm. 111E, Lexington, KY 40506, USA. E-mail: [email protected]Search for more papers by this authorApril B. Scott
Psychology Department, University of Kentucky, Lexington, Kentucky, USA
Search for more papers by this authorIan A. Boggero
Psychology Department, University of Kentucky, Lexington, Kentucky, USA
Search for more papers by this authorCharles R. Carlson
Psychology Department, University of Kentucky, Lexington, Kentucky, USA
College of Dentistry, Division of Orofacial Pain, University of Kentucky, Lexington, Kentucky, USA
Search for more papers by this authorCorresponding Author
Matthew E. B. Russell
Psychology Department, University of Kentucky, Lexington, Kentucky, USA
Address correspondence to: Matthew Russell, M.S., University of Kentucky, Kastle Hall, Rm. 111E, Lexington, KY 40506, USA. E-mail: [email protected]Search for more papers by this authorApril B. Scott
Psychology Department, University of Kentucky, Lexington, Kentucky, USA
Search for more papers by this authorIan A. Boggero
Psychology Department, University of Kentucky, Lexington, Kentucky, USA
Search for more papers by this authorCharles R. Carlson
Psychology Department, University of Kentucky, Lexington, Kentucky, USA
College of Dentistry, Division of Orofacial Pain, University of Kentucky, Lexington, Kentucky, USA
Search for more papers by this authorWork reported in this publication was supported in part by the National Institute on Aging of the National Institutes of Health under Award Number F31AG048692. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Abstract
Heart rate variability (HRV) is associated with positive physiological and psychological effects. HRV is affected by breathing parameters, yet debate remains regarding the best breathing interventions for strengthening HRV. The objective of the current study was to test whether the inclusion of a postexhalation rest period was effective at increasing HRV, while controlling for breathing rate. A within-subject crossover design was used with 40 participants who were assigned randomly to a breathing pattern including a postexhalation rest period or a breathing pattern that omitted the postexhalation rest period. Participants completed training on each breathing pattern, practiced for 6 min, and sat quietly during a 5-min washout period between practices. Participants were given instructions for diaphragmatic breathing at a pace of six breaths/minute with or without a postexhalation rest period. Recordings of heart rate, breathing rate, HF-HRV, RMSSD, LF-HRV, and SDNN were collected before and during each of the breathing trials. HRV indices were derived from Lead 1 ECG recordings. Pairwise contrasts showed that inclusion of a postexhalation rest period significantly decreased heart rate (p < .001) and increased HF-HRV (p < .05). No differences were found for breathing rates (p > .05), RMSSD (p > .05), and SDNN (p > .05). Results indicated that omission of the postexhalation rest period resulted in higher LF-HRV (p < .05). A postexhalation rest period improves HF-HRV, commonly associated with self-regulatory control, yet the importance of a postexhalation rest period requires further exploration.
References
- Aickin M., & Gensler H. (1996). Adjusting for multiple testing when reporting research results: The Bonferroni vs Holm methods. American Journal of Public Health. 86(5), 726–728. doi: 10.2105/AJPH.86.5.726
- Appelhans, B. M., & Luecken, L. J. (2006). Heart rate variability as an index of regulated emotional responding. Review of General Psychology, 10(3), 229–240. doi: 10.1037/1089-2680.10.3.229
- Berntson, G. G., Bigger, J. T. Eckberg, D. L., Grossman, P., Kaufmann, P. G., Malik, M., … van der Molen, M. W. (1997). Heart rate variability: Origins, methods, and interpretive caveats. Psychophysiology, 34(6), 623–648. doi: 10.1111/j.1469-8986.1997.tb02140.x
- Berntson, G. G., Lozano, D. L., & Chen, Y. J. (2005). Filter properties of root mean square successive difference (RMSSD) for heart rate. Psychophysiology, 42(2), 246–252. doi: 10.1111/j.1469-8986.2005.00277.x
- Brown, R. P., Gerbarg, P. L., & Muench, F. (2013). Breathing practices for treatment of psychiatric and stress-related medical conditions. Psychiatric Clinics of North America, 36(1), 121–140. doi: 10.1016/j.psc.2013.01.001
- Courtney, R., Cohen, M., & van Dixhoorn, J. (2010). Relationship between dysfunctional breathing patterns and ability to achieve target heart rate variability with features of “coherence” during biofeedback. Alternative Therapies in Health and Medicine, 17(3), 38–44.
- Denver, J. W., Reed, S. F., & Porges, S. W. (2007). Methodological issues in the quantification of respiratory sinus arrhythmia. Biological Psychology, 74(2), 286–294. doi: 10.1016/j.biopsycho.2005.09.005
- Faul, F., Erdfelder, E., Buchner, A., & Lang, A. G. (2009). Statistical power analyses usingG*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41(4), 1149–1160.
- Ferreira, J. B., Plentz, R. D. M., Stein, C., Casali, K. R., Arena, R., & Lago, P. D. (2013). Inspiratory muscle training reduces blood pressure and sympathetic activity in hypertensive patients: A randomized controlled trial. International Journal of Cardiology, 166(1), 61–67. doi: 10.1016/j.ijcard.2011.09.069
-
Fried, R., &
Grimaldi, J. (1993). The psychology and physiology of breathing: In behavioral medicine, clinical psychology and psychiatry. New York, NY: Plenum Press.
10.1007/978-1-4899-1239-8 Google Scholar
-
Gevirtz, R. (2013). The promise of heart rate variability biofeedback: Evidence based applications. Biofeedback, 41, 110–120. doi: 10.5298/1081-5937-41.3.01
10.5298/1081-5937-41.3.01 Google Scholar
- Hall, J. E., & Guyton, A. C. (2011). Textbook of medical physiology. Philadelphia, PA: Saunders.
- Hallman, D. M., & Lyskov, E. (2012). Autonomic regulation, physical activity and perceived stress in subjects with musculoskeletal pain: 24-hour ambulatory monitoring. International Journal of Psychophysiology, 86(3), 276–282. doi: 10.1016/j.ijpsycho.2012.09.017
- Henriques, G., Keffer, S., Abrahamson, C., & Horst, S. J. (2011). Exploring the effectiveness of a computer-based heart rate variability biofeedback program in reducing anxiety in college students. Applied Psychophysiology and Biofeedback, 36(2), 101–112. doi: 10.1007/s10484-011-9151-4
- Kang, J. H., Chen, H. S., Chen, S. C., & Jaw, F. S. (2012). Disability in patients with chronic neck pain: Heart rate variability analysis and cluster analysis. Clinical Journal of Pain, 28(9), 797–803. doi: 10.1097/AJP.0b013e3182442afd
- Kniffin, T. C., Carlson, C. R., Ellzey, A., Eisenlohr-Moul, T., Beck, K. B., McDonald, R., & Jouriles, E. N. (2014). Using virtual reality to explore self-regulation in high-risk settings. Trauma, Violence, & Abuse. 15(4), 310–321. doi: 10.1177/1524838014521501
- Lehrer, P. M., & Gevirtz, R. (2014). Heart rate variability biofeedback: How and why does it work? Frontiers in Psychology, 5. doi: 10.3389/fpsyg.2014.00756
- Lehrer, P., Karavidas, M., Lu, S. E., Vaschillo, E., Vaschillo, B., & Cheng, A. (2010). Cardiac data increase association between self-report and both expert ratings of task load and task performance in flight simulator tasks: An exploratory study. International Journal of Psychophysiology, 76(2), 80–87.
- Lehrer, P. M., Vaschillo, E., & Vaschillo, B. (2000). Resonant frequency biofeedback training to increase cardiac variability: Rationale and manual for training. Applied Psychophysiology and Biofeedback, 25(3), 177–191. doi: 10.1023/A:1009554825745
- Lin, I. M., Tai, L. Y., & Fan, S. Y. (2014). Breathing at a rate of 5.5 breaths per minute with equal inhalation-to-exhalation ratio increases heart rate variability. International Journal of Psychophysiology, 91(3), 206–211. doi: 10.1016/j.ijpsycho.2013.12.006
- Litchfield, P. M. (2003). A brief overview of the chemistry of respiration and the breathing heart wave. California Biofeedback, 19(1), 1–11.
- Moak, J. P., Goldstein, D. S., Eldadah, B. A., Saleem, A., Holmes, C., Pechnik, S., & Sharabi, Y. (2007). Supine low-frequency power of heart rate variability reflects baroreflex function, not cardiac sympathetic innervation. Heart Rhythm, 4(12), 1523–1529. doi: 10.1016/j.hrthm.2007.07.019
- Nazarewicz, J., Verdejo-Garcia, A., & Giummarra, M. J. (2015). Sympathetic pain? A role of poor parasympathetic nervous system engagement in vicarious pain states. Psychophysiology, 52(11), 1529–1537. doi: 10.1111/psyp.12516
- Patron, E., Benvenuti, S. M., Favretto, G., Valfrè, C., Bonfa, C., Gasparotto, R., & Palomba, D. (2013). Biofeedback assisted control of respiratory sinus arrhythmia as a biobehavioral intervention for depressive symptoms in patients after cardiac surgery: A preliminary study. Applied Psychophysiology and Biofeedback, 38(1), 1–9. doi: 10.1007/s10484-012-9202-5
- Porges, S. W. (2007). The polyvagal perspective. Biological Psychology, 74(2), 116–143. doi: 10.1016/j.biopsycho.2006.06.009
- Prinsloo, G. E., Derman, W. E., Lambert, M. I., & Rauch, H. L. (2013). The effect of a single session of short duration biofeedback-induced deep breathing on measures of heart rate variability during laboratory-induced cognitive stress: A pilot study. Applied Psychophysiology and Biofeedback, 38(2), 81–90. doi: 10.1007/s10484-013-9210-0
- Russell, M. E. B., Hoffman, B., Stromberg, S., & Carlson, C. R. (2014). Use of controlled diaphragmatic breathing for the management of motion sickness in a virtual reality environment. Applied Psychophysiology and Biofeedback, 39(4), 1–9. doi: 10.1007/s10484-014-9265-6
- Sargunaraj, D., Lehrer, P. M., Hochron, S. M., Rausch, L., Edelberg, R., & Porges, S. W. (1996). Cardiac rhythm effects of 125-Hz paced breathing through a resistive load: Implications for paced breathing therapy and the polyvagal theory. Biofeedback and Self-Regulation, 21(2), 131–147. doi: 10.1007/BF02284692
- Sauer, S. E., Burris, J. L., & Carlson, C. R. (2010). New directions in the management of chronic pain: Self-regulation theory as a model for integrative clinical psychology practice. Clinical Psychology Review, 30(6), 805–814. doi: 10.1016/j.cpr.2010.06.008
- Schmidt, J. E., & Carlson, C. R. (2009). A controlled comparison of emotional reactivity and physiological response in masticatory muscle pain patients. Journal of Orofacial Pain, 23(3), 230–242.
- Solberg Nes, L., Carlson, C. R., Crofford, L. J., de Leeuw, R. D., & Segerstrom, S. C. (2010). Self-regulatory deficits in fibromyalgia and temporomandibular disorders. Pain, 151(1), 37–44. doi: 10.1016/j.pain.2010.05.009
- Song, H. S., & Lehrer, P. M. (2003). The effects of specific respiratory rates on heart rate and heart rate variability. Applied Psychophysiology and Biofeedback, 28(1), 13–23. doi: 10.1023/A:1022312815649
- Strauss-Blasche, G., Moser, M., Voica, M., McLeod, D. R., Klammer, N., & Marktl, W. (2000). Relative timing of inspiration and expiration affects respiratory sinus arrhythmia. Clinical and Experimental Pharmacology and Physiology, 27(8), 601–606. doi: 10.1046/j.1440-1681.2000.03306.x
- Stromberg, S., Russell, M. E. B., & Carlson, C. R. (2014). Diaphragmatic breathing and its effectiveness for the management of motion sickness. Aerospace Medicine and Human Performance, 86(5), 452–457. doi: 10.3357/AMHP.4152.2015
- Task Force of the European Society of Cardiology. (1996). Heart rate variability standards of measurement, physiological interpretation, and clinical use. European Heart Journal, 17, 354–381. doi: 10.1093/oxfordjournals.eurheartj.a014868
- Thayer, J. F., Hansen, A. L., Saus-Rose, E., & Johnsen, B. H. (2009). Heart rate variability, prefrontal neural function, and cognitive performance: The neurovisceral integration perspective on self-regulation, adaptation, and health. Annals of Behavioral Medicine, 37(2), 141–153. doi: 10.1007/s12160-009-9101-z
- Thayer, J. F., & Lane, R. D. (2009). Claude Bernard and the heart–brain connection: Further elaboration of a model of neurovisceral integration. Neuroscience & Biobehavioral Reviews, 33(2), 81–88.
- Van Diest, I., Verstappen, K., Aubert, A. E., Widjaja, D., Vansteenwegen, D., & Vlemincx, E. (2014). Inhalation/exhalation ratio modulates the effect of slow breathing on heart rate variability and relaxation. Applied Psychophysiology and Biofeedback, 39(3–4), 171–180. doi: 10.1007/s10484-014-9253-x
- Vaschillo, E., Lehrer, P., Rishe, N., & Konstantinov, M. (2002). Heart rate variability biofeedback as a method for assessing baroreflex function: A preliminary study of resonance in the cardiovascular system. Applied Psychophysiology and Biofeedback, 27(1), 1–27. doi: 10.1023/A:1014587304314
- Wang, S. Z., Li, S., Xu, X. Y., Lin, G. P., Shao, L., Zhao, Y., & Wang, T. H. (2010). Effect of slow abdominal breathing combined with biofeedback on blood pressure and heart rate variability in prehypertension. Journal of Alternative and Complementary Medicine, 16(10), 1039–1045. doi: 10.1089/acm.2009.0577
- Whited, A., Larkin, K. T., & Whited, M. (2014). Effectiveness of emWave biofeedback in improving heart rate variability reactivity to and recovery from stress. Applied Psychophysiology and Biofeedback, 39(2), 75–88. doi: 10.1007/s10484-014-9243-z
- Zucker, T. L., Samuelson, K. W., Muench, F., Greenberg, M. A., & Gevirtz, R. N. (2009). The effects of respiratory sinus arrhythmia biofeedback on heart rate variability and posttraumatic stress disorder symptoms: A pilot study. Applied Psychophysiology and Biofeedback, 34(2), 135–143. doi: 10.1007/s10484-009-9085-2