Heart Rate Variability of Various Video-Aided Mindful Deep Breathing Durations and Its Impact on Depression, Anxiety, and Stress Symptom Severity
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Deep breathing (DB) is known to elicit positive changes to the heart rate variability (HRV) measurement and improve the quality of well-being. However, literature reporting on the effects of the mindful DB duration is scant. This study investigated the HRV indices and its correlation with the mental health scores of three different mindful DB durations.
Fifty participants were recruited and assigned to the control (Con, n = 13), mindful DB for 5 min (DB5, n = 14), 7 min (DB7, n = 11), or 9 min (DB9, n = 12) group. The HRV was measured during the baseline, mindful DB intervention, post-intervention, and a follow-up session after 7 days of practicing the DB daily. The mental health state was screened during the baseline and follow-up session.
During the intervention, all three DB groups had a significantly larger standard deviation of the normal-to-normal interval and normalized low frequency power whereas the normalized high frequency power (nHF) was significantly smaller than the control group. The depression score for the DB7 and DB9 participants was significantly smaller than the control group (p = 0.024 and p = 0.021, respectively). A significant negative correlation was obtained for the depression score and nHF of the DB9 group (r = − 0.673, p = 0.016).
The mindful DB duration plays a role in the shifting of the autonomic nervous system such that only the reduction in depression for the DB9 group was associated with the greater activation of the parasympathetic nervous system.
KeywordsHeart rate variability Mindful deep breathing duration Depression High frequency power
Special thanks to ICaterpillar Sdn. Bhd. for sponsoring the HRV device. We also wish to thank all the of the study participants.
KSC assisted in the designing of the study, executed the study, analyzed the data, and wrote the paper. PEC collaborated in the writing and editing of the final manuscript. PFL formulated the research question, designed the study, and provided expert knowledge for the interpretation of the results. All authors approved the final version of the manuscript for submission.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee of University of Tunku Abdul Rahman and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- Agelink, M. W., Boz, C., Ullrich, H., & Andrich, J. (2002). Relationship between major depression and heart rate variability. Clinical consequences and implications for antidepressive treatment. Psychiatry Research, 113(1–2), 139–149.Google Scholar
- Aysin, B., & Aysin, E. (2006). Effect of respiration in heart rate variability (HRV) analysis. Conference proceeding: Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 1, 1776–1779. https://doi.org/10.1109/IEMBS.2006.260773.
- Baer, R. A. (2015). Mindfulness-based treatment approaches: clinician's guide to evidence base and applications. New York, NY: Elsevier.Google Scholar
- Becker, B. J. (1988). Synthesizing standardized mean-change measures. British Journal of Mathematical and Statistical Psychology, 41(2), 257–278.Google Scholar
- Buccelletti, E., Gilardi, E., Scaini, E., Galiuto, L., Persiani, R., Biondi, A., et al. (2009). Heart rate variability and myocardial infarction: systematic literature review and metanalysis. European Review for Medical and Pharmacological Sciences, 13(4), 299–307.Google Scholar
- Busch, V., Magerl, W., Kern, U., Haas, J., Hajak, G., & Eichhammer, P. (2012). The effect of deep and slow breathing on pain perception, autonomic activity, and mood processing—an experimental study. Pain Medicine (Malden, Mass), 13(2), 215–228.Google Scholar
- Carney, R. M., Blumenthal, J. A., Stein, P. K., Watkins, L., Catellier, D., Berkman, L. F., et al. (2001). Depression, heart rate variability, and acute myocardial infarction. Circulation, 104(17), 2024–2028.Google Scholar
- Cheng, K. S., Chang, Y. F., Han, R. P. S., & Lee, P. F. (2017). Enhanced conflict monitoring via a short-duration, video-assisted deep breathing in healthy young adults: an event-related potential approach through the Go/NoGo paradigm. PeerJ, 5, e3857. https://doi.org/10.7717/peerj.3857.Google Scholar
- Chung, L. J., Tsai, P. S., Liu, B. Y., Chou, K. R., Lin, W. H., Shyu, Y. K., et al. (2010). Home-based deep breathing for depression in patients with coronary heart disease: a randomised controlled trial. International Journal of Nursing Studies, 47(11), 1346–1353. https://doi.org/10.1016/j.ijnurstu.2010.03.007.Google Scholar
- Cohen, J. (1992). A power primer. Psychological Bulletin, 112(1), 155–159.Google Scholar
- Farnia, V., Gharehbaghi, H., Alikhani, M., Almasi, A., Golshani, S., Tatari, F., et al. (2018). Efficacy and tolerability of adjunctive gabapentin and memantine in obsessive compulsive disorder: double-blind, randomized, placebo-controlled trial. Journal of Psychiatric Research, 104, 137–143. https://doi.org/10.1016/j.jpsychires.2018.07.008.Google Scholar
- Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175–191.Google Scholar
- Guzik, P., Piskorski, J., Krauze, T., Schneider, R., Wesseling, K. H., Wykretowicz, A., et al. (2007). Correlations between the Poincare plot and conventional heart rate variability parameters assessed during paced breathing. The Journal of Physiological Sciences, 57(1), 63–71. https://doi.org/10.2170/physiolsci.RP005506.Google Scholar
- Jacobsen, P. B., Meade, C. D., Stein, K. D., Chirikos, T. N., Small, B. J., & Ruckdeschel, J. C. (2002). Efficacy and costs of two forms of stress management training for cancer patients undergoing chemotherapy. Journal of Clinical Oncology, 20(12), 2851–2862. https://doi.org/10.1200/JCO.2002.08.301.Google Scholar
- Katz, A., Liberty, I. F., Porath, A., Ovsyshcher, I., & Prystowsky, E. N. (1999). A simple bedside test of 1-minute heart rate variability during deep breathing as a prognostic index after myocardial infarction. American Heart Journal, 138(1 Pt 1), 32–38.Google Scholar
- Kim, K. S., Lee, S. W., Choe, M. A., Yi, M. S., Choi, S., & Kwon, S.-H. (2005). Effects of abdominal breathing training using biofeedback on stress, immune response and quality of life in patients with a mastectomy for breast cancer. Taehan Kanho Hakhoe Chi, 35(7), 1295–1303.Google Scholar
- Kim, S. H., Schneider, S. M., Bevans, M., Kravitz, L., Mermier, C., Qualls, C., et al. (2013). PTSD symptom reduction with mindfulness-based stretching and deep breathing exercise: randomized controlled clinical trial of efficacy. The Journal of Clinical Endocrinology & Metabolism, 98(7), 2984–2992. https://doi.org/10.1210/jc.2012-3742.Google Scholar
- Kim, J.-H., Bae, H.-S., & Park, S.-S. (2016). The effects of breath-counting meditation and deep breathing on heart rate variability. Journal of Korean Medicine, 37(2), 36–44.Google Scholar
- 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.Google Scholar
- McCorry, L. K. (2007). Physiology of the autonomic nervous system. American Journal of Pharmaceutical Education, 71(4), 78.Google Scholar
- Milicevic, G. (2005). Low to high frequency ratio of heart rate variability spectra fails to describe sympatho-vagal balance in cardiac patients. Collegium Antropologicum, 29(1), 295–300.Google Scholar
- Offen, W., Chuang-Stein, C., Dmitrienko, A., Littman, G., Maca, J., Meyerson, L., et al. (2007). Multiple co-primary endpoints: medical and statistical solutions: a report from the multiple endpoints expert team of the Pharmaceutical Research and Manufacturers of America. Drug Information Journal, 41(1), 31–46. https://doi.org/10.1177/009286150704100105.Google Scholar
- Patel, V. N., Pierce, B. R., Bodapati, R. K., Brown, D. L., Ives, D. G., & Stein, P. K. (2017). Association of holter-derived heart rate variability parameters with the development of congestive heart failure in the Cardiovascular Health Study. JACC: Heart Failure, 5(6), 423–431. https://doi.org/10.1016/j.jchf.2016.12.015.Google Scholar
- Ponikowski, P., Anker, S. D., Chua, T. P., Szelemej, R., Piepoli, M., Adamopoulos, S., et al. (1997). Depressed heart rate variability as an independent predictor of death in chronic congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy. The American Journal of Cardiology, 79(12), 1645–1650.Google Scholar
- Prinsloo, G. E., Rauch, H. G. L., Lambert, M. I., Muench, F., Noakes, T. D., & Derman, W. E. (2011). The effect of short duration heart rate variability (HRV) biofeedback on cognitive performance during laboratory induced cognitive stress. Applied Cognitive Psychology, 25(5), 792–801. https://doi.org/10.1002/acp.1750.Google Scholar
- Prinsloo, G. E., Derman, W. E., Lambert, M. I., & Laurie Rauch, H. G. (2013a). 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.Google Scholar
- Prinsloo, G. E., Rauch, H. G. L., Karpul, D., & Derman, W. E. (2013b). The effect of a single session of short duration heart rate variability biofeedback on EEG: a pilot study. Applied Psychophysiology and Biofeedback, 38(1), 45–56.Google Scholar
- Ramshur, J. (2010). Design, evaluation, and application of heart rate variability analysis software (HRVAS). Memphis, TN: University of Memphis.Google Scholar
- Sanderson, J. E., Yeung, L. Y., Yeung, D. T., Kay, R. L., Tomlinson, B., Critchley, J. A., et al. (1996). Impact of changes in respiratory frequency and posture on power spectral analysis of heart rate and systolic blood pressure variability in normal subjects and patients with heart failure. Clinical Science (London), 91(1), 35–43.Google Scholar
- 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.Google Scholar
- Sridhar, B., Haleagrahara, N., Bhat, R., Kulur, A. B., Avabratha, S., & Adhikary, P. (2010). Increase in the heart rate variability with deep breathing in diabetic patients after 12-month exercise training. The Tohoku Journal of Experimental Medicine, 220(2), 107–113. https://doi.org/10.1620/tjem.220.107.Google Scholar
- Stein, P. K., Bosner, M. S., Kleiger, R. E., & Conger, B. M. (1994). Heart rate variability: a measure of cardiac autonomic tone. American Heart Journal, 127(5), 1376–1381.Google Scholar
- Task Force of The European Society of Cardiology and The North American Society of Pacing and Electrophysiology. (1996). Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. European Heart Journal, 17(3), 354–381. https://doi.org/10.1161/01.CIR.93.5.1043.Google Scholar
- Tharion, E., Samuel, P., Rajalakshmi, R., Gnanasenthil, G., & Subramanian, R. K. (2012). Influence of deep breathing exercise on spontaneous respiratory rate and heart rate variability: a randomised controlled trial in healthy subjects. Indian Journal of Physiology and Pharmacology, 56(1), 80–87.Google Scholar
- Tsai, S. H., Wang, M. Y., Miao, N. F., Chian, P. C., Chen, T. H., & Tsai, P. S. (2015). The efficacy of a nurse-led breathing training program in reducing depressive symptoms in patients on hemodialysis: a randomized controlled trial. American Journal of Nursing, 115(4), 24–32; quiz 33, 42. https://doi.org/10.1097/01.NAJ.0000463023.48226.16.Google Scholar
- Udupa, K., Sathyaprabha, T. N., Thirthalli, J., Kishore, K. R., Lavekar, G. S., Raju, T. R., et al. (2007). Alteration of cardiac autonomic functions in patients with major depression: a study using heart rate variability measures. Journal of Affective Disorders, 100(1–3), 137–141. https://doi.org/10.1016/j.jad.2006.10.007.Google Scholar
- Umetani, K., Singer, D. H., McCraty, R., & Atkinson, M. (1998). Twenty-four hour time domain heart rate variability and heart rate: relations to age and gender over nine decades. Journal of the American College of Cardiology, 31(3), 593–601. https://doi.org/10.1016/s0735-1097(97)00554-8.Google Scholar
- Van Dongen, H. P., Olofsen, E., Van Hartevelt, J. H., & Kruyt, E. W. (1999). Searching for biological rhythms: peak detection in the periodogram of unqueally spaced data. Biological Rhythm Research, 30(2), 149–177.Google Scholar
- van Schaik, D. J., Klijn, A. F., van Hout, H. P., van Marwijk, H. W., Beekman, A. T., de Haan, M., et al. (2004). Patients’ preferences in the treatment of depressive disorder in primary care. General Hospital Psychiatry, 26(3), 184–189. https://doi.org/10.1016/j.genhosppsych.2003.12.001.Google Scholar
- Veith, R. C., Lewis, N., Linares, O. A., Barnes, R. F., Raskind, M. A., Villacres, E. C., et al. (1994). Sympathetic nervous system activity in major depression. Basal and desipramine-induced alterations in plasma norepinephrine kinetics. Archives of General Psychiatry, 51(5), 411–422.Google Scholar
- Wang, S. Z., Li, S., Xu, X. Y., Lin, G. P., Shao, L., Zhao, Y., et al. (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. https://doi.org/10.1089/acm.2009.0577.Google Scholar
- Whooley, M. A., & Wong, J. M. (2013). Depression and cardiovascular disorders. Annual Review of Clinical Psychology, 9, 327–354. https://doi.org/10.1146/annurev-clinpsy-050212-185526.Google Scholar