Heart Rate Variability Biofeedback Research Articles

Adding Core Muscle Contraction to Wrist-Ankle Rhythmical Skeletal Muscle Tension Increases Respiratory Sinus Arrhythmia and Low-Frequency Power.

Paced breathing and rhythmical skeletal muscle tension (RSMT) at an individual's resonance frequency [~ 6 breaths or contractions per min (cpm)] can stimulate the arterial and vascular tone baroreflexes. Lehrer (Appl Psychophysiol Biofeedback 1-10, 2022, https://doi.org/10.1007/s10484-022-09535-5 ) has explained that the stimulation rate is important, not the modality. Early RSMT protocols differed in the muscles recruited and whether legs were crossed or uncrossed (in France et al. Clin Physiol Funct Imaging 26: 21-25, 2006, https://doi.org/10.1111/j.1475-097X.2005.00642.x ; Leher et al. Biol Psychol 81: 24-30, 2009, https://doi.org/10.1016/j.biopsycho.2009.01.003 ; Vaschillo et al. Psychophysiology, 48: 927-936, 2011, https://doi.org/10.1111/j.1469-8986.2010.01156.x ). Whereas core muscle RSMT with crossed legs and wrist-ankle RSMT with uncrossed legs produced resonance effects, researchers have not directly compared the effect of these exercises on respiratory sinus arrhythmia (RSA) and low-frequency (LF) power. The current within-subjects experiment investigated whether crossing the legs and recruiting core muscles enhances wrist-ankle RSMT effects on RSA and LF power. We trained 35 participants to complete 6-cpm wrist-ankle RSMT (ankles uncrossed), 6-cpm wrist-core-ankle RSMT (ankles crossed), and a control condition in which participants sat quietly (ankles uncrossed) without performing RSMT. We predicted that 6-cpm wrist-core-ankle RSMT would produce greater heart rate (HR), HR Max-HR Min, and LF power than the other conditions. The experimental findings supported our predictions. Both RSMT conditions produced greater HR, HR Max-HR Min, and LF power than the control condition. Wrist-core-ankle yielded greater HR and HR Max-HR Min than wrist-ankle RSMT. Future research should compare wrist-ankle and wrist-core-ankle RSMT with legs crossed. The practical implication for HRV biofeedback training is that wrist-core-ankle RSMT with legs crossed may more powerfully stimulate the baroreflex than wrist-ankle RSMT with legs uncrossed.

RESEARCH ARTICLE: Heart Rate Variability Biofeedback: Managing Disorders of Gut-Brain Interaction by Improving Autonomic Homeostasis

Disorders of gut-brain interaction, previously called functional gastrointestinal disorders, are prevalent, disabling, expensive, and difficult to treat. In this review, I trace the available scientific knowledge on the pathophysiology of these disorders and describe how the proposed pathways are integrated into treatment approaches. A novel treatment approach, heart rate variability biofeedback (HRVB), is described, and outcome literature is reviewed. It is concluded that an approach such as HRVB offers benefits beyond more traditional treatment approaches.

Comparing heart rate variability biofeedback and simple paced breathing to inform the design of guided breathing technologies

IntroductionA goal of inbodied interaction is to explore how tools can be designed to provide external interactions that support our internal processes. One process that often suffers from our external interactions with modern computing technology is our breathing. Because of the ergonomics and low-grade-but-frequent stress associated with computer work, many people adopt a short, shallow breathing pattern that is known to have a negative effect on other parts of our physiology. Breathing guides are tools that help people match their breathing patterns to an external (most often visual) cue to practice healthy breathing exercises.However, there are two leading protocols for how breathing cues are offered by breathing guides used in non-clinical settings: simple paced breathing (SPB) and Heart Rate Variability Biofeedback (HRV-b). Although these protocols have separately been demonstrated to be effective, they differ substantially in their complexity and design. Paced breathing is a simpler protocol where a user is asked to match their breathing pattern with a cue paced at a predetermined rate and is simple enough to be completed as a secondary task during other activities. HRV-b, on the other hand, provides adaptive, real-time guidance derived from heart rate variability, a physiological signal that can be sensed through a wearable device. Although the benefits of these two protocols have been well established in clinical contexts, designers of guided breathing technology have little information about whether one is better than the other for non-clinical use.MethodsTo address this important gap in knowledge, we conducted the first comparative study of these two leading protocols in the context of end-user applications. In our N=28 between-subject design, participants were trained in either SPB or HRV-b and then completed a 10-minute session following their training protocol. Breathing rates and heart rate variability scores were recorded and compared between groups.Results and discussionOur findings indicate that the exercises did not significantly differ in their immediate outcomes – both resulted in significantly slower breathing rates than their baseline and both provided similar relative increases in HRV. Therefore, there were no observed differences in the acute physiological effects when using either SPB or HRV-b. Our paper contributes new findings suggesting that simple paced breathing – a straightforward, intuitive, and easy-to-design breathing exercise – provides the same immediate benefits as HRV-b, but without its added design complexities.

자율신경검사의 해석과 임상적용

Autonomic nervous system (ANS) consists of sympathetic and parasympathetic components. ANS has a role in heart function and contraction and relaxation of smooth muscle in various internal organs. Several tests were introduced to assess ANS function. Heart rate variability (HRV) is the most common method to evaluate ANS function. HRV is defined as a physiologic variation between sinus beats, which is calculated into standard deviation of N-N interval. The indices derived from beat-to-beat variation are calculated based on time-domain analysis. Fourier transformation visualizes frequency-based graphs from the time-domain tachograms. Areas in the low frequency represent sympathetic predominant function, while high frequency areas show parasympathetic tone. Despite absence of the reference ranges of the HRV indices, studies have shown the ranges of the indices in their populations. Decrease in HRV may be a poor prognostic factor for heart disease, infection, and neuropsychiatric disorders. It is reported that HRV biofeedback improved various disorders related to ANS function. In addition, the results of HRV tests may guide functional approaches. In conclusion, the awareness on ANS function and HRV may help to provide patients with risk stratification and proper management.

The efficacy of heart rate variability biofeedback in patients with acute ischemic stroke: A protocol for systematic review and meta-analysis.

Stroke is the most common serious neurological disorder, and in high-income countries, it is the fourth-leading cause of death, long-term disability, and reduced quality of life among adults. Heart rate variability (HRV) can improve autonomic dysfunction, cognitive impairment, and psychological distress in other patient populations, but its effect in patients with acute ischemic stroke is still unclear. We conducted a protocol for systematic review and meta-analysis to evaluate the efficacy of HRV biofeedback in patients with acute ischemic stroke. A computerized literature search will be performed in the following electronic databases from their inceptions to October 2022: PubMed, EMBASE, MEDLINE, Cochrane Central Register of Controlled Clinical Trials, China Knowledge Resource Integrated Database, Wanfang Data Information, and Weipu Database for Chinese Technical Periodicals. The risk of bias in the included articles is assessed according to the Risk of Bias Assessment Tool in Cochrane Handbook of Systematic Reviews. Data are analyzed with the Review Manager Version 5.3 software. This paper will provide high-quality synthesis to assess the efficacy of HRV biofeedback in patients with acute ischemic stroke. HRV biofeedback may be a promising intervention for improving autonomic function, cognitive impairment, and psychological distress in patients with acute ischemic stroke.

Long-term benefits of heart rate variability biofeedback training in older adults with different levels of social interaction: a pilot study

To test whether heart rate variability (HRV) biofeedback training benefits older adults with different social interaction levels. Methods. 32 older adults (16 were institutionalized and 16 were not). Both groups received 14 sessions, 15 min, 3 times a week, with half of the individuals receiving HRV biofeedback training and the other half receiving control training. The following parameters were assessed immediately before and after training, and 4.5 weeks after the last session (follow-up period): aerobic conditioning, anthropometric data, emotional scores, and HRV components. Results. Before the training, the institutionalized individuals had higher scores of loneliness (p < 0.01) and depression (p < 0.0001) and lower social touches (p < 0.0001), body mass (p = 0.04), and body fat percentage (p = 0.002) than the non-institutionalized individuals. HRV biofeedback improved symptoms of depression in both groups. HRV improved only in the non-institutionalized group, and loneliness only in the institutionalized group. Lastly, all changes persisted after the follow-up period. Conclusions. HRV biofeedback training was effective in improving symptoms of depression in older adults. Improvement of HRV and loneliness was dependent on the level of social interaction.

HEART rate variability biofeedback for long COVID symptoms (HEARTLOC): protocol for a feasibility study

IntroductionLong COVID (LC), also known as post-COVID-19 syndrome, refers to symptoms persisting 12 weeks after COVID-19 infection. It affects up to one in seven people contracting the illness and causes...

Biofeedback of Heart Rate Variability in the treatment of chronic diseases: A Systematic Review

Background: HRVB (heart rate variability biofeedback) is a non-pharmacological method for chronic diseases evaluation.&#x0D; Method: Adults chronic sufferers, HRVB as the primary therapy with or without controlled circumstances, and psycho - physiological results as regression analysis were all included in a systematic search.&#x0D; Results: There were 21 publications in overall. HRVB was found to be feasible in chronic patients with no adverse reactions, according to the findings. Significant favourable impacts on hypertension and cardiovascular prognostic, inflammation condition, asthma issues, depression and anxiety, sleeping disruptions, cognitive function, and pain were reported in diverse patient characteristics that could be linked to enhanced quality of life. Increases in treatment practice were accompanied by increases in heart rate variability, implying that HRVB may have a regulatory influence on autonomic function.&#x0D; Conclusions: HRVB has the potential to help individuals with chronic conditions. More research is needed to reinforce these findings as well as identify the most efficient strategy.

Heart Rate Variability Biofeedback in Cancer Patients: A Scoping Review.

Heart Rate Variability (HRV) Biofeedback (BFB) has been shown to improve autonomic balance and wellbeing in chronic diseases. As cardiac variability represents an index of cognitive and emotional regulation, HRV-BFB has been shown to lead to improvements in physiological and psychological adaptability and quality of life. However, knowledge of HRV-BFB in cancer patients is lacking, and available results are diversified according to methods and outcomes. The present paper undertakes a scoping review, exploring the use of HRV-BFB to modulate autonomic balance, cancer symptom management, and quality of life in cancer. This scoping review analyzes empirical evidence considering study designs, BFB methods, and psychophysiological outcomes. Research that focused on HRV-BFB effects in cancer patients was selected (79%). In addition, a systematic review and meta-analysis (31%) focusing on HRV, or BFB in chronic conditions, including cancer, were considered. The studies examined BFB treatment for thyroid, lung, brain or colon cancer, hematologic cancer, and survivors or terminal cancer patients. Retrieved studies reported physiological and psychological indices as primary outcomes: they included HRV values, sleep, pain, fatigue, depression, anxiety, and quality of life. Although the heterogeneity of publications makes it difficult to generalize the effectiveness of HRV-BFB, the training has been proven to improve cancer symptoms and well-being.

Neuromodulation Applied to Diseases: The Case of HRV Biofeedback.

The vagus or “wandering” nerve is the main branch of the parasympathetic nervous system (PNS), innervating most internal organs crucial for health. Activity of the vagus nerve can be non-invasively indexed by heart-rate variability parameters (HRV). Specific HRV parameters predict less all-cause mortality, lower risk of and better prognosis after myocardial infarctions, and better survival in cancer. A non-invasive manner for self-activating the vagus is achieved by performing a slow-paced breathing technique while receiving visual feedback of one’s HRV, called HRV-biofeedback (HRV-B). This article narratively reviews the biological mechanisms underlying the role of vagal activity and vagally mediated HRV in hypertension, diabetes, coronary heart disease (CHD), cancer, pain, and dementia. After searching the literature for HRV-B intervention studies in each condition, we report the effects of HRV-B on clinical outcomes in these health conditions, while evaluating the methodological quality of these studies. Generally, the levels of evidence for the benefits of HRV-B is high in CHD, pain, and hypertension, moderate in cancer, and poor in diabetes and dementia. Limitations and future research directions are discussed.

Presleep Heart-Rate Variability Biofeedback Improves Mood and Sleep Quality in Chinese Winter Olympic Bobsleigh Athletes.

To evaluate the effectiveness of heart-rate variability (HRV) biofeedback in improving autonomic function, mood, and sleep in elite bobsleigh athletes. Eight Chinese Winter Olympic bobsleigh athletes (age: 24 [2]y, body mass: 89 [15]kg, and height: 184 [5]cm) completed a randomized crossover study with and without HRV biofeedback before a single night's sleep. HRV biofeedback was provided 35minutes prior to bedtime in the experimental condition. The assessment of HRV took place 45 and 10minutes before bedtime. The Profile of Mood States questionnaire was completed 50 and 15minutes prior to bedtime. Sleep duration and quality were measured through an air-mattress sleep-monitoring system. Sleep efficiency (P = .020; F = 7.831; CI, 0.008 to 0.072) and the percentage of deep sleep duration increased (P = .013; F = 10.875; CI, 0.006 to 0.035), while the percentage of light sleep decreased (P = .034; F = 6.893; CI, -0.038 to -0.002). Presleep HRV biofeedback increased parasympathetic and decreased sympathetic activity. Mood states of anger (P = .006, F = 7.573), panic (P = .031, F = 4.288), tension (P = .011, F = 6.284), depression (P = .010, F = 6.016), fatigue (P = .000, F = 16.901), and total mood disturbance (P = .001, F = 11.225) were reduced before sleep. Presleep HRV biofeedback improved some measures of autonomic function, mood, and sleep quality in Chinese Olympic bobsleigh athletes. Presleep HRV biofeedback provides a practical strategy that may help reduce sleep disturbances during periods of training and competition.

The Effect of Heart Rate Variability Biofeedback Training on Vagal Tone in Athletically Talented Secondary School Students.

This study examines whether twelve sessions of heart rate variability biofeedback training would improve vagally mediated heart rate variability. If so, it would go some way in explaining why breathing-based interventions reduce clinical symptoms and improve non-clinical performance outcomes. Methods: Thirty participants (N = 30, Nfemale = 13) aged 14–13-year-old, all talented athletes, from a sport specialist school in SE London UK, were randomly divided into three groups, a control group, a psychology skills training combined with heart rate variability biofeedback training group, and a heart rate variability biofeedback only group. For the combined group, a variety of typical psychological skill training techniques were also used. Results: Paired participant t-test and the Wilcoxon Signed Rank test found non-significant differences between pre- and post-intervention measurements of heart rate variability. Non-significant results remained even after pooling the biofeedback training groups (n = 19). Conclusions: Our results do not indicate that beneficial effects associated with focused breathing training can be attributed to improved vagal tone. Further investigation into the underlying mechanisms of the benefits of focused breathing techniques is necessary to maximize clinical and non-clinical outcomes.

Respiratory sinus arrhythmia during biofeedback is linked to persistent improvements in attention, short-term memory, and positive self-referential episodic memory.

BackgroundHeart rate variability (HRV) biofeedback, an intervention based on the voluntary self-regulation of autonomic parameters, has been shown to affect prefrontal brain functioning and improve executive functions. The interest in using HRV biofeedback as cognitive training is typically ascribed to parasympathetic activation and optimized physiological functioning deriving from increased cardiac vagal control. However, the persistence of cognitive effects is poorly studied and their association with biofeedback-evoked autonomic changes has not yet been explored. In addition, no study has so far investigated the influence of HRV biofeedback in adults on long-term episodic memory, which is particularly concerned with self-referential encoding processing.MethodsIn the present study, a novel training system was developed integrating HRV and respiratory biofeedback into an immersive virtual reality environment to enhance training efficacy. Twenty-two young healthy adults were subjected to a blinded randomized placebo-controlled experiment, including six self-regulation training sessions, to evaluate the effect of biofeedback on autonomic and cognitive changes. Cardiac vagal control was assessed before, during, and 5 min after each training session. Executive functions, episodic memory, and the self-referential encoding effect were evaluated 1 week before and after the training program using a set of validated tasks.ResultsLinear mixed-effects models showed that HRV biofeedback greatly stimulated respiratory sinus arrhythmia during and after training. Moreover, it improved the attentional capabilities required for the identification and discrimination of stimuli ( = 0.17), auditory short-term memory ( = 0.23), and self-referential episodic memory recollection of positive stimuli ( = 0.23). Episodic memory outcomes indicated that HRV biofeedback reinforced positive self-reference encoding processing. Cognitive changes were strongly dependent on the level of respiratory sinus arrhythmia evoked during self-regulation training.ConclusionThe present study provides evidence that biofeedback moderates respiration-related cardiac vagal control, which in turn mediates improvements in several cognitive processes crucial for everyday functioning including episodic memory, that are maintained beyond the training period. The results highlight the interest in HRV biofeedback as an innovative research tool and medication-free therapeutic approach to affect autonomic and neurocognitive functioning. Finally, a neurocognitive model of biofeedback-supported autonomic self-regulation as a scaffolding for episodic memory is proposed.

Heart Rate Variability Biofeedback for Substance Use Disorder: Health Policy Implications

Substance use disorder (SUD) exacts massive individual and public health burdens, in part because of its relapsing nature. First-line SUD treatments aim to strengthen affective and cognitive control to help individuals override impulses to use alcohol and other drugs, yet automatic physiological processes compromised by SUD interact with affective states and the environment, compromising effortful cognitive control and undermining attempts to avoid substance use. While existing first-line SUD treatments may indirectly help offset these vulnerabilities, none target them. Heart rate variability biofeedback (HRVB) involves rhythmic breathing that directly targets these deficits, complementing first-line SUD treatments. HRVB has evolved from a clinic-based treatment to an ambulatory intervention utilizing wearable biosensors and smartphone applications with capacity for just-in-time support of affective and behavioral self-regulation. There is evidence supporting the efficacy of HRVB for SUD, but more research is needed to fully assess HRVB's potential to support SUD recovery and inform policy.

SPECIAL ISSUE: Do Biofeedback, Neurofeedback, and Neuromeditation Have a Role in Psychedelic-Assisted Therapies?

SPECIAL ISSUE: Do Biofeedback, Neurofeedback, and Neuromeditation Have a Role in Psychedelic-Assisted Therapies?

Heart rate variability (HRV) changes and cortical volume changes in a randomized trial of five weeks of daily HRV biofeedback in younger and older adults

Previous studies indicate that the structure and function of medial prefrontal cortex (PFC) and lateral orbitofrontal cortex (OFC) are associated with heart rate variability (HRV). Typically, this association is assumed to reflect the PFC's role in controlling HRV and emotion regulation, with better prefrontal structural integrity supporting greater HRV and better emotion regulation. However, as a control system, the PFC must monitor and respond to heart rate oscillatory activity. Thus, engaging in regulatory feedback during heart rate oscillatory activity may over time help shape PFC structure, as relevant circuits and connections are modified. In the current study with younger and older adults, we tested whether 5 weeks of daily sessions of biofeedback to increase heart rate oscillations (Osc+ condition) vs. to decrease heart rate oscillations (Osc− condition) affected cortical volume in left OFC and right OFC, two regions particularly associated with HRV in prior studies. The left OFC showed significant differences in volume change across conditions, with Osc+ increasing volume relative to Osc−. The volume changes in left OFC were significantly correlated with changes in mood disturbance. In addition, resting low frequency HRV increased more in the Osc+ than in the Osc− condition. These findings indicate that daily biofeedback sessions regulating heart rate oscillatory activity can shape both resting HRV and the brain circuits that help control HRV and regulate emotion.

Heart Rate Variability Biofeedback to Treat Anxiety in Young People With Autism Spectrum Disorder: Findings From a Home-Based Pilot Study.

BackgroundPeople with autism spectrum disorder (ASD) frequently experience high levels of anxiety. Despite this, many clinical settings do not provide specialist ASD mental health services, and demand for professional support frequently outstrips supply. Across many sectors of health, investigators have explored digital health solutions to mitigate demand and extend the reach of professional practice beyond traditional clinical settings.ObjectiveThis critical appraisal and pilot feasibility study examines heart rate variability (HRV) biofeedback as an approach to help young people with ASD to manage anxiety symptoms outside of formal settings. The aim is to explore the use of portable biofeedback devices to manage anxiety, while also highlighting the risks and benefits of this approach with this population.MethodsWe assessed the feasibility of using home-based HRV biofeedback for self-management of anxiety in young people with ASD. We adopted coproduction, involving people with ASD, to facilitate development of the study design. Next, a separate pilot with 20 participants with ASD (n=16, 80% male participants and n=4, 20% female participants, aged 13-24 years; IQ>70) assessed adoption and acceptability of HRV biofeedback devices for home use over a 12-week period. Data were collected from both carers and participants through questionnaires and interviews; participants also provided single-lead electrocardiogram recordings as well as daily reports through smartphone on adoption and use of their device.ResultsPre-post participant questionnaires indicated a significant reduction in anxiety in children (t6=2.55; P=.04; Cohen d=0.99) as well as adults (t7=3.95; P=.006; Cohen d=0.54). Participant age was significantly negatively correlated with all HRV variables at baseline, namely high-frequency heart rate variability (HF-HRV: P=.02), the root mean square of successive differences in normal heartbeat contractions (RMSSD: P=.02) and the variability of normal-to-normal interbeat intervals (SDNN: P=.04). At follow-up, only SDNN was significantly negatively correlated with age (P=.05). Levels of ASD symptoms were positively correlated with heart rate both before (P=.04) and after the intervention (P=.01). The majority (311/474, 65.6%) of reports from participants indicated that the devices helped when used. Difficulties with the use of some devices and problems with home testing of HRV were noted. These initial findings are discussed within the context of the strengths and challenges of remotely delivering a biofeedback intervention for people with ASD.ConclusionsHRV biofeedback devices have shown promise in this pilot study. There is now a need for larger evaluation of biofeedback to determine which delivery methods achieve the greatest effect for people with ASD.Trial RegistrationClinicalTrials.gov NCT04955093; https://clinicaltrials.gov/ct2/show/NCT04955093

Reducing Anxiety and Social Stress in Primary Education: A Breath-Focused Heart Rate Variability Biofeedback Intervention

Primary school students suffer from high levels of anxiety and stress. Having emotional regulation abilities can help them to manage challenging emotional situations. Conscious and slow breathing is a physiological, emotional regulation strategy that is feasible for primary school students to learn. Following Polyvagal Theory and PMER Theory, this research presents the results of a breath-focused heart rate variability biofeedback intervention. The intervention aimed to reduce anxiety and physiological and social stress in primary school children. A total of 585 students (46.4% girls and 53.6% boys) from the same public school, aged between 7 and 12 years (M = 8.51; SD = 1.26), participated in this study. To assess the impact of training, a mixed design was used with two groups (Treatment and Control groups), two evaluation phases (Pretest and Post-test), and three educational cycles (first, second and third cycles). To examine heart rate variability, emWave software was used and anxiety and social stress were measured by the BASC II test. The results showed that after the intervention, the students learned to breathe consciously. Moreover, they reduced their levels of anxiety (M(SD)pretest = 12.81(2.22) vs. M(SD)posttest = 13.70(1.98)) and stress (M(SD)pretest = 12.20(1.68) vs. M(SD)posttest = 12.90(1.44)). The work also discusses the limitations and benefits of this type of intervention in primary schools.

Post-awakening salivary alpha-amylase as modulator of treatment response in patients with burnout and major depression

Around 50% of patients with major depression do not respond to standard first-line treatments, such as psychotherapy and pharmacotherapy. At the same time, a subgroup exhibits altered functioning of stress-responsive bodily systems, such as the central locus coeruleus/sympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis. Given that these systems impact arousal and cognition, it is possible that this subgroup contributes to the high rates of non-responders. Our aim was to investigate whether sympathetic and HPA axis activity modulate treatment outcomes in patients with stress-related major depression. A total of N = 74 inpatients (median age: 50, 62% male) with signs of burnout who fulfilled diagnostic criteria for major depression were recruited. Saliva samples were collected at awakening as well as 30 and 45 min later. Alpha-amylase activity and cortisol concentrations were determined before patients underwent evidence-based multimodal treatment. Non-responders were defined as patients exhibiting a <50% decrease in depression on the Beck Depression Inventory. Non-responders had significantly higher post-awakening alpha-amylase activity than responders (p = .025). In addition, alpha-amylase activity increased significantly over the course of treatment (p = .004), irrespective of responder status. Post-awakening cortisol was neither a predictor nor an indicator of treatment response. If future research confirms alpha-amylase activity as a modulator of treatment response, this may indicate a subgroup of patients with major depression which may benefit from augmentative treatments, such as heart rate variability biofeedback and/or cognitive interventions targeting high arousal.

“The tonic’s not always in a bottle”: a qualitative study investigating a heart rate variability biofeedback coherence intervention for individuals with gastrointestinal disorders

Gastrointestinal disorders (GID) affect psychological and physical health and can be impacted by stress and ability to self-regulate emotions. The aim of this study was to gain an in-depth understanding of individuals with GID experiences of a Heart Rate Variability biofeedback (HRV-BF) coherence intervention. Six patients, who had already been diagnosed with GID, were interviewed using a semi-structured interview schedule to investigate how engaging in an HRV-BF coherence intervention affected their levels of stress and their GID condition. All transcripts were explored using Interpretative Phenomenological Analysis (IPA). Analysis of the accounts indicated four superordinate themes: (1) Autonomy, (2) Self-regulation, (3) Acceptance, (4) Mind-Body-Spirit. The field of HRV-BF interventions in the area of gastroenterology is promising. However, it is recommended that further studies involving psycho-physiological interventions, with mixed-method designs and larger samples, are undertaken.