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HRV biofeedback: what heart rate variability training is and whether it works

Updated Well Day Media Editorial Team
The short answerHeart rate variability (HRV) biofeedback is slow-breathing training while watching your heart rhythm on a screen. A meta-analysis of 58 studies found it may reduce anxiety and depression and improve well-being, but the quality of many studies is limited. The core technique, breathing about 6 times a minute, can be practiced without a device.

Key points

What the research shows

A meta-analysis of 58 studies found that HRV biofeedback was linked to improvements in anxiety, depression, anger and athletic and cognitive performance, with small to moderate effects. The authors noted that many studies were small and of limited quality (Lehrer et al., 2020).

Slow breathing at about 6 breaths a minute is linked to increased HRV and relaxation (Zaccaro et al., 2018), and breathwork in general reduces self-reported stress (Fincham et al., 2023).

Exercise: resonance breathing

  1. Sit upright and relax your shoulders.
  2. Inhale through your nose for about 4 to 5 seconds.
  3. Exhale slowly for about 5 to 6 seconds.
  4. Continue for 5 to 10 minutes.
  5. Practice once or twice a day.

Frequently asked questions

What is a good HRV?

HRV varies widely with age, fitness and the device used. Compare your own trends over time rather than with others.

Do I need a device?

No. Breathing slowly at about 6 breaths a minute is the active ingredient; a device just shows feedback.

Sources

  1. Lehrer et al. (2020). Heart Rate Variability Biofeedback Improves Emotional and Physical Health and Performance: A Systematic Review and Meta Analysis. Applied Psychophysiology and Biofeedback 45(3):109-129. doi:10.1007/s10484-020-09466-z
  2. Zaccaro et al. (2018). How Breath-Control Can Change Your Life: A Systematic Review on Psycho-Physiological Correlates of Slow Breathing. Frontiers in Human Neuroscience 12. doi:10.3389/fnhum.2018.00353
  3. Fincham et al. (2023). Effect of breathwork on stress and mental health: A meta-analysis of randomised-controlled trials. Scientific Reports 13(1). doi:10.1038/s41598-022-27247-y

Prepared according to our evidence methodology and the principles of lifestyle medicine. For education only; it does not replace advice from your doctor.

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