top of page

Heart rate variability (HRV)

HRV measures and trains coherence or synchrony between breathing and heartbeat. Higher HRV resonance has been shown to result in improvement in the ability to mediate life’s stressors. HRV is efficacious in the reduction of stress, depression, PTSD, sleep disorders, hypertension and improves mind-body awareness.


The body is a finely integrated operating system involving the interaction of many systems. These systems do not work independently of one another but are interdependent.

One such system is the Autonomic Nervous system (ANS) which regulates body systems on an unconscious level. Blood pressure, blood glucose levels, levels of stress hormones, digestion, heart rate and others are regulated without conscious awareness during wakefulness and sleep.

Basic Heart Rate Variability (HRV) measurements are the changes seen in time between successive heartbeats called inter-beat-intervals (see diagram below).

Mean heart rate variability has become an indicator of fitness as well as a predictor of enhanced vitality and health. These measurements have been shown to indicate a direct link to the Autonomic Nervous System providing insight into the nervous system’s response to stress and its ability to recover.

The body constantly adjusts to the environment by either “speeding up” or “slowing down” in order to maintain balance and homeostasis and attend to the demands of the environment. When the Autonomic Nervous System gets stuck and speeds up and does not slow down when appropriate, detrimental health effects can result.


FIGURE 1. A typical HRV biofeedback screen showing the transition from normal breathing to 7 breaths per minute breathing.

Image by Robina Weermeijer

In the Psychophysiological research field, HRV originally focused on balancing of the Autonomic Nervous System. The medical field continues to focus on HRV as the indicator of adaptability and Baroreflex sensitivity. Researchers have investigated the impact of HRV on vagus nerve activity in various disorders such as asthma, chronic pain and anxiety disorders.

Many research projects are underway to look at the effect of the heart on the brain/CNS. Research shows that there is a stronger impact of the heart on the brain than vice versa.


The procedure of HRV training consists of feeding back beat by beat heart rate data during slow breathing manoeuvres. 

Respiratory Sinus Arrhythmia (RSA) is the heart pattern that occurs when heart rate increases during inhalation and decreases during exhalation - as can be seen in Figure 1. During this slower breathing the participant tries to maximize their Respiratory Sinus Arrhythmia (RSA) and create a sine-wave-like curve of peaks and valleys, and to match RSA to heart rate patterns. The participant uses feedback or a breath pacing device to produce the characteristic maximized RSA.


Breathing at your Resonant Breathing Rate increases HRV.

HRV training is an evidence-based training modality (Biofeedback) used to increase the active control over the body’s response to stress. It creates the bridge between the heart and the brain / nervous system, bringing into consciousness the processes that are influenced by the ANS.

Biofeedback training allows accurate feedback mirroring of what your heart is communicating to the rest of your nervous system. In time, learning occurs, enabling one to gain better control over how the body reacts to stress stimuli. Gaining better control also builds resilience to such stress stimuli.  Combining HRV with other modalities like With Together with Psychotherapy, CBT and stress management strategies your clients enable themselves to better self-regulate in day to day situations.


HRV Biofeedback training teaches clients to access some of the following benefits:

  • Enhanced cardiac health

  • Reduction in anxiety and performance anxiety symptoms

  • Reduced muscle tension

  • Improvement in general energy and mood

  • Clearer cognitive abilities

  • Calmness and faster reaction times

  • Improved hormone balance

  • Improved immune system activity

  • Improve on recovery rate after intense physical training


Gevirtz (2013) recently reviewed all of the available literature on the outcomes of HRVB. He looked at the following application categories: asthma, COPD, IBS, cyclic vomiting, recurrent abdominal pain, fibromyalgia, cardiac rehabilitation, hypertension, chronic muscle pain, and pregnancy induced hypertension, depression, anxiety, PTSD, insomnia, and performance. While few areas have extensive support by way of controlled studies, the overall picture seems to be very promising for this intervention. As can be seen, the applications are quite varied. We have begun to explore what physiological and/or psychological mechanisms might be contributing to these positive outcomes.

bottom of page