Biofeedback Therapy for Asthma

  • Paul M. LehrerEmail author
Part of the Respiratory Medicine book series (RM)


Many asthma sufferers refuse to take prescribed levels of asthma medication, because of their concerns about its costs and possible side effects, and turn instead to various herbal and mind-body treatments. Biofeedback is one of the better documented of these approaches. Biofeedback involves using information from various electrophysiological measures as a means of exercising voluntary control over the measured functions. This chapter reviews several biofeedback approaches, including biofeedback training to reduce respiratory resistance, surface electromyographic biofeedback to achieve relaxation of the skeletal muscles of the face, neurofeedback to control electroencephalographic activity, and heart rate variability biofeedback to increase respiratory sinus arrhythmia. The best documented effects are for heart rate variability biofeedback, wherein people learn to breathe at a particular slow frequency for each individual that is the resonance frequency of the cardiovascular system. This technique has large autonomic and psychological effects, which produce increases in baroreflex gain, modulation of blood pressure, and decreases in anxiety and depression. There is evidence that it also produces both acute and chronic decreases in airway resistance in asthma patients, and in one well-controlled single blind study, it appeared to have 100% effectiveness in preventing asthma exacerbations requiring increased doses of controller medications. Symptoms, medication consumption, and airway resistance all decreased, with fewer exacerbations. However, the mechanism of action is still poorly understood.


Resonance frequency Forced oscillation Psychological stress Baroreflex Vagal trigeminal reflex loop Alternative and complementary medicine Applied psychophysiology 



Preparation of this chapter was partially supported by Grant # 1R01HL089495-01A2 from the National Heart, Lung, and Blood Institute, of the National Institutes of Health.

Supplementary material

Video 10.1: An example of how to teach a patient about heart rate variability biofeedback.mp4 (MP4 55.2 MB)


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of PsychiatryUniversity of Medicine & Dentistry of New Jersey, Robert Wood Johnson Medical SchoolPiscatawayUSA

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