Mobile Heart Rate Variability Biofeedback Improves Autonomic Activation and Subjective Sleep Quality of Healthy Adults – A Pilot Study
Open accessAbstract
Objective: Restorative sleep is associated with increased autonomous parasympathetic nervous system activity that might be improved by heart rate variability-biofeedback (HRV-BF) training. Hence the aim of this study was to investigate the effect of a four-week mobile HRV-BF intervention on the sleep quality and HRV of healthy adults. Methods: In a prospective study, 26 healthy participants (11 females; mean age: 26.04 ± 4.52 years; mean body mass index: 23.76 ± 3.91 kg/m 2) performed mobile HRV-BF training with 0.1 Hz breathing over four weeks, while sleep quality, actigraphy and HRV were measured before and after the intervention. Results: Mobile HRV-BF training with 0.1 Hz breathing improved the subjective sleep quality in healthy adults [t(24) = 4.9127, p ≤ 0.001, d = 0.99] as measured by the Pittsburgh Sleep Quality Index. In addition, mobile HRV-BF training with 0.1 Hz breathing was associated with an increase in the time and frequency domain parameters SDNN, Total Power and LF after four weeks of intervention. No effect was found on actigraphy metrics. Conclusions: Mobile HRV-BF intervention with 0.1 Hz breathing increased the reported subjective sleep quality and may enhance the vagal activity in healthy young adults. HRV-BF training emerges as a promising tool for improving sleep quality and sleep-related symptom severity by means of normalizing an impaired autonomic imbalance during sleep.
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Mindfulness-based interventions typically yield small-to-moderate improvements in insomnia severity and sleep quality, particularly among individuals with depression or anxiety disorders.
“Recent systematic reviews and meta-analyses have shown that mindfulness-based interventions typically yield smallto-moderate improvements in insomnia severity and sleep quality, particularly among individuals with depression or anxiety disorders [75].”
From Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice. (2026) · cites this paper as [75]
The Discussion reports improved subjective sleep quality after heart-rate-variability biofeedback in healthy adults, not mindfulness-based interventions. The Introduction and additional searches for mindfulness, effect size, insomnia severity, and depression or anxiety found no passage reporting the claimed review findings. (LLM, conf=0.76)
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- Authors
- Herhaus, B., Kalin, A., Gouveris, H., & Petrowski, K.
- Affiliations
- University Medical Center of the Johannes Gutenberg University Mainz (DE)
- Corresponding author
- Petrowski, Katja
- Venue
- Frontiers in Physiology
- Publisher
- Frontiers Media SA
- Published
- 2022-02-17
- Volume
- 13
- Pages
- 821741-821741
- ISSN
- 1664-042X (ISSN-L)
- PMC
- PMC8892186
- OpenAlex
- W4212821655
- Cited by
- 16
- References
- 38
- Citations by year
- 2026: 7 · 2025: 4 · 2024: 2 · 2023: 1 · 2022: 2
- FWCI
- 1.57
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Physiology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Qucosa (Saxon State and University Library Dresden) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
- Keywords
- heart rate variability biofeedback, mobile health, sleep quality, parasympathetic nervous system, parasympathetic activity, autonomic nervous system, actigraphy, healthy young adults, autonomic imbalance
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