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Heart Rate VariabilityBiofeedback
Part 1 Background and Research
Presented to GGSC Meet-upJuly 10, 2013
By Linda Hartstrom
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“If I’d known I was going to live this long, I’d have taken better care of myself”
US comedian Eubie Blake on his 100th birthday
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Outline of Presentation
• Heart Facts• Heart Rate Variability
– Why is it important• Vagal Tone• Respiratory Sinus Arrhythmia• Cardiac Coherence• Heart Rate Variability Biofeedback
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4
The Heart
Just the facts…
• What is a heart rate?• What determines
heart rate?• What is Heart Rate
Variability?
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0 1 2-0.5
0
0.5
1
1.5
2
m V
olts
2.5 seconds of heartbeat data
.859 sec. .793 sec. .726 sec.
70 BPM 76 BPM 83 BPM
Electrocardiograph
Heart Rate Variability (HRV)
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High vs Low HRV
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Heart Rate Variability (HRV) Why is it important?
• Higher levels of resting HRV have been associated with:– Well balanced ANS– Greater overall health– Greater emotion regulation– Effective stress coping strategies– Increased resilience under stress– Increased attention control
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• Low HRV predicts worsening:– Coronary heart disease– Atherosclerosis (Wennerblom, et al 2000)
– Elevated triglycerides (Jensen-Urstad M, et al 1998)
• Low HRV Correlates with:– Diabetes (Laitinen T, et al 1999)
– Obesity (Karason K, et al 1999)
– Multiple metabolic syndrome (Liao D, et al: 1998)
– Hypertension (Schroeder EB, et al 2003)
Heart Rate Variability (HRV) Why is it important?
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• Low HRV linked with:– Depression (Carney RM et al. 2001)
– Social isolation (Hughes JW et al. 2000)
– Suppressed anger (Inmaculada L et al. 2009)
• Increased risk of mortality (Framington Heart Study: Singh et al., 1998).
Heart Rate Variability (HRV) Why is it important?
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Heart Rate Variability (HRV) Intervention Results
• Reduced blood pressure in hypertension (McConville, 2012)
• Improved asthma (Lehrer, 2000)
• Reduced symptoms of stress (Nolan RP, 2005)
• Increased calmness and well-being (Friedman, 2000)
• Increased emotional stability (McCraty, 2001)
• Improved cognitive performance (McCraty, 2001)
• Improves hormonal balance (McCraty, 1998)
• PTSD symptom reduction (Zucker et al. 2009)
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Heart Rate Variability
• Influences– Extrinsic
• Physical Activity• Physical Stress • Mental/Psychological Stress
– Intrinsic• Respiratory Sinus Arrhythmia (breathing)• Baroreceptor reflex (blood pressure)• Hormones
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12
HEA
RT R
ATE
(BPM
)
Seconds
100
90
80
70
60
50
40
30
20
10
0 8 10 12 14 16 18 20 22 24
Heart Rate Variability (HRV)
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13
Incoherence: Impairs Performance— Drains Energy
Coherence: Promotes Optimal Performance—Builds Resilience
HEA
RT R
ATE
HEA
RT R
ATE
InhibitsBrain Function(Incoherence)
FacilitatesBrain Function(coherence)
TIME (SECONDS)
100 –
90 –
80 –
70 –
60 –
50 –
100 –
90 –
80 –
70 –
60 –
50 –
1 50 100 150 200
Heart Rate Variability (HRV)
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Heart Rate Variability- Typical Day
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A Police Officer HRV During a High-Speed Pursuit Scenario
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A Police Officer HRV During a Domestic Violence Scenario
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Vagal ToneDefinition
• Vagal – Referring to the action of the vagus nerve; the 10th
cranial nerve, which relays information between the brainstem and most of the internal organs
• Tone– Tone is a term commonly used to refer to systems in
continuous and partial states activity, such as “muscle tone”
– In this context it means something similar to “tension” or “strength”
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Low Vagal Tone
• Linked to high inflammation (Thayer & Sternberg, 2006)
and;• Forecasts higher risk for myocardial infarction
and decreased odds of survival after heart failure (Bibevski & Dunlap, 2011).
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High Vagal Tone
• Is associated with superior abilities to regulate emotions (Thayer, Hansen, Saus-Rose, & Johnson, 2009)
• Show greater positive emotionality (Oveis, Cohen,
Gruber, Shiota, Haidt, & Kelther, 2009) and; • Show greater gains over time in their positive
emotions (Kok & Fredrickson, 2010).
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Vagal Tone Physiology
RestingHR 70 BPM
MaximumHR 200 BPM
IntrinsicHR 100 BPM Potential
HRV - 30
SNSActivation
PNS VagusNerve
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AGE IHR MAX Heart Rate
20 106.7 19430 101.0 18740 95.3 18050 89.6 17360 83.9 16670 78.2 15980 72.5 152
Maximal/Intrinsic HR and Age
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20 30 40 50 60 700
50
100
150
200
250
Intrinsic Heart BeatMaximum Heart Beat
Maximal/Intrinsic HR and Age
BPM
AGE
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20 30 40 50 60 700
50
100
150
200
250
Intrinsic Heart BeatMaximum Heart Beat
Maximal/Intrinsic HR and Age
BPM
AGE
Resting Heart Beat
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20 30 40 50 60 700
50
100
150
200
250
Intrinsic Heart BeatMaximum Heart Beat
Maximal/Intrinsic HR and Age
BPM
AGE
Resting Heart Beat36
8
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Improving HRV
• Lifestyle adjustments:– Exercise – Omega-3 intake – Yoga/qigong– Acupuncture– Emotional self- management (positive emotions)– Breathing practices (resonant frequency breathing)– HRV Biofeedback– Wine
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Heart Rate Variability
• HRV 3 domains– Sympathetic component;– Parasympathetic component coupled with
respiration (RSA) … bottom-up;– Parasympathetic component independent from
respiration… top-down cortex influence
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Top Down Central Autonomic Network (CAN)
PFC
ACC Insula
Amyg
Brain Stem
SympatheticActivation
ParasympatheticSuppression
Inhibits/down-regulates Activation
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Bottom Up Respiratory Sinus Arrhythmia (RSA)
TidesBreathing
Inha
le
Exhale
Inha
le
Exhale
Inha
le
Exhale
Oscillations
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Respiratory Sinus Arrhythmia(RSA)
• Respiratory = Breath Oscillations• Sinus = Sinus node Oscillations• Arrhythmia = Heart Rate Changes
Inha
le
Inha
le
Exha
le
Exha
le
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Oscillations-Heart Rate Variability
Heart Rate
Breathing
Blood Pressure
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What is Resonant Frequency?
• Current research suggests that every individual has a “resonant frequency” at which heart rate variability is the greatest.
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Cardiac Coherence
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12 breaths per minute
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7 breaths per minute
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5 breaths per minute
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Heart Rate Variability Biofeedback
Part 2
Demonstration