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Cited by 264Asthma and respiratory diseasesHeart Rate Variability and Autonomic ControlChronic Obstructive Pulmonary Disease (COPD) Research

Biofeedback treatment for asthma.

Lehrer, Paul M., Vaschillo, Evgeny, Vaschillo, Bronya, Lu, Shou-En, Scardella, Anthony, Siddique, Mahmood, Habib, Robert H.·2004·Chest
DOI 10.1378/chest.126.2.352
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Abstract

Study objectives We evaluated the effectiveness of heart rate variability (HRV) biofeedback as a complementary treatment for asthma. Patients Ninety-four adult outpatient paid volunteers with asthma. Setting The psychophysiology laboratory at The University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, and the private outpatient offices of participating asthma physicians. Interventions The interventions were as follows: (1) a full protocol (ie, HRV biofeedback and abdominal breathing through pursed lips and prolonged exhalation); (2) HRV biofeedback alone; (3) placebo EEG biofeedback; and (4) a waiting list control. Design Subjects were first prestabilized using controller medication and then were randomly assigned to experimental groups. Medication was titrated biweekly by blinded asthma specialists according to a protocol based on National Heart, Lung, and Blood Institute guidelines, according to symptoms, spirometry, and home peak flows. Measurements Subjects recorded daily asthma symptoms and twice-daily peak expiratory flows. Spirometry was performed before and after each weekly treatment session under the HRV and placebo biofeedback conditions, and at triweekly assessment sessions under the waiting list condition. Oscillation resistance was measured approximately triweekly. Results Compared with the two control groups, subjects in both of the two HRV biofeedback groups were prescribed less medication, with minimal differences between the two active treatments. Improvements averaged one full level of asthma severity. Measures from forced oscillation pneumography similarly showed improvement in pulmonary function. A placebo effect influenced an improvement in asthma symptoms, but not in pulmonary function. Groups did not differ in the occurrence of severe asthma flares. Conclusions The results suggest that HRV biofeedback may prove to be a useful adjunct to asthma treatment and may help to reduce dependence on steroid medications. Further evaluation of this method is warranted.

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  • Biofeedback approaches aiming to mimic heightened cardiorespiratory synchronization achieved during 0.1 Hz breathing have proven effective in disorders as diverse as asthma, PTSD, and depression.

    “These approaches, aiming to mimic the heightened cardiorespiratory synchronization achieved during 0.1 Hz breathing and ranging from wearable sensors and patches to mobile phone applications, have proven effective in disorders as diverse as asthma, PTSD, and depression (Lehrer et al., 2004; Karavidas et al., 2007; Zucker et al., 2009).”

    From Hypothesis: Pulmonary Afferent Activity Patterns During Slow, Deep Breathing Contribute to the Neural Induction of Physiological Relaxation (2019) · cites this paper as Lehrer et al., 2004

  • Learning to voluntarily increase HF-HRV through biofeedback has beneficial effects for diverse medical and psychopathological conditions such as asthma, cardiovascular disease, depression, and PTSD.

    “Learning to voluntarily increase HF-HRV through biofeedback also has beneficial effects for diverse medical and psychopathological conditions such as asthma31,32, cardiovascular disease33, depression34, and PTSD35.”

    From Voluntary upregulation of heart rate variability through biofeedback is improved by mental contemplative training (2019) · cites this paper as [31]

  • The ability to increase HF-HRV through slower breathing has been linked to symptom reduction in a variety of bodily and mental disorders, such as cardiovascular and pulmonary disease, as well as depression and PTSD, making these findings clinically relevant.

    “The ability to increase HF-HRV through slower breathing has been linked to symptom reduction in a variety of bodily and mental disorders, such as cardiovascular33 and pulmonary disease31,32, as well as depression34 and PTSD35, making these findings clinically relevant.”

    From Voluntary upregulation of heart rate variability through biofeedback is improved by mental contemplative training (2019) · cites this paper as [31]

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Authors
Lehrer, P. M., Vaschillo, E., Vaschillo, B., Lu, S.-E., Scardella, A., Siddique, M., & Habib, R. H.
Affiliations
  • University of Medicine and Dentistry of New Jersey (US)
  • Rutgers New Jersey Medical School (US)
  • Mercy Children's Hospital (US)
Corresponding author
Lehrer, Paul M.
ORCID
Venue
Chest
Publisher
Elsevier BV
Published
2004-08
Volume
126
Issue
2
Pages
352-361
ISSN
0012-3692 (ISSN-L)
DOI
10.1378/chest.126.2.352
OpenAlex
W2149624545
Cited by
264
References
40
Citations by year
2026: 3 · 2025: 6 · 2024: 11 · 2023: 14 · 2022: 11 · 2021: 16 · 2020: 11 · 2019: 10 · 2018: 12 · 2017: 11 · 2016: 6 · 2015: 14 · 2014: 22 · 2013: 26 · 2012: 19
FWCI
4.88
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • CHEST Journal (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Heart, Lung, and Blood Institute (R01HL58805, R01HL058805)
Topics
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
Keywords
asthma, heart rate variability biofeedback, complementary therapy, pursed-lip breathing, steroid dependence, lung function, peak expiratory flow
MeSH terms
Adult, Asthma, Biofeedback, Psychology, Electroencephalography, Female, Heart Rate, Humans, Male, Spirometry, Models, Statistical, Baroreflex

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