Research

There have been numerous research studies based on HRV, coherent breathing, 24-hour stress and recovery, and sleep quality.  Select a heading to review the relevant research.  

• Chronic Heart Failure & COPD - 10 publications
• Coherent or Paced Breathing - 3 publications
• Hypertension - 20 publications
• Lowering Sympathetic Activity - 6 publications
• Improving Sleep Quality - 2 publications
• PTSD/Anxiety/Stress - 8 publications
• Heartmath Institute Research - 286 more publications

 Chronic Heart Failure & COPD

• Aiolfi E, Robbi E, Pinna GD, Maestri R, Cobelli F, Alter A, Gavish B, La Rovere MT. Effect of Respiratory Pacing on CHF Patients with Periodic Breathing. Journal of Cardiac Failure. 2003 Vol.9, issue 5, suppl. S59, October 01. [Abstract]
  
  

• Bilo G, Revera M, Bussotti M, Bonacina D, Styczkiewicz K, Caldara G, Giglio A, Faini A, Giuliano A, Lombardi C, Kawecka-Jaszcz K, Mancia G, Agostoni P, Parati G. Effects of slow deep breathing at high altitude on oxygen saturation, pulmonary and systemic hemodynamics. PLoS One. 2012;7(11):e49074.

• Borge CR, Mengshoel AM, Omenaas E, Mourn E, Ekman I, Lein MP, Mack U, Wahl AK,: Effects of guided deep breathing on breathlessness and the breathing pattern in chronic obstructive pulmonary disease: A double-blind randomized control study; Patient Education and Counseling 2015 ;98:182-190.
  
  
• Debicka-Dabrowska D, Lisi E, Drozdz T, Styczkiewicz K, Malfatto G, Salerno S, Bednarek A, Olszanecka A, Kielbasa G, Bilo G, Czarnecka, D, Kawecka-Jaszcz K, Parati G. Usefulness of slow breathing training in chronic heart failure. Study design and intermediate results. Journal of Hypertens 2015:33 e-Supplement1; e 462
  
  
• Drozdz T, Bilo G, Debicka-Dabrowska D, Klocek M, Malfatto G, Kielbasa G, Styczkiewicz K, Bednarek A, Czarnecka D, Parati G, Kawecka-Jaszcz K. Blood pressure changes in patients with chronic heart failure undergoing slow breathing training. Blood Press. 2016;25(1):4-10
  
  
• Ekman I, Kjellström B, Falk K, Norman J, Swedberg K. Impact of device-guided slow breathing on symptoms of chronic heart failure: a randomized, controlled feasibility study. Eur J Heart Fail. 2011;13:1000-1005.
  
  
• Kawecka-Jaszcz, Kalina & Bilo, Grzegorz & Drożdż, Tomasz & Dębicka-Dąbrowska, Dorota & Kiełbasa, Grzegorz & Malfatto, Gabriella & Styczkiewicz, Katarzyna & Lombardi, Carolina & Bednarek, Agnieszka & Salerno, Sabrina & Czarnecka, Danuta & Parati, Gianfranco. (2017). Effects of device-guided slow breathing training on exercise capacity, cardiac function and respiratory patterns during sleep in male and female patients with chronic heart failure. Polskie Archiwum Medycyny Wewnetrznej. 127. 10.20452/pamw.3890.
  
  
• Lachowska K, Bellwon J, Moryś J, Gruchała M, Hering D. Slow breathing improves cardiovascular reactivity to mental stress and health-related quality of life in heart failure patients with reduced ejection fraction. Cardiol J. 2019 Jan 30. doi: 10.5603/CJ.a2019.0002 [Epub ahead of print]
  
  
• Lachowska, K., Bellwon, J., Narkiewicz, K. et al. Long-term effects of device-guided slow breathing in stable heart failure patients with reduced ejection fraction. Clin Res Cardiol (2018)
  
  
• Parati G, Malfatto G, Boarin S, Branzi G, Caldara G, Giglio A, Bilo G, Ongaro G, Alter A, Gavish B, Mancia G. Device-Guided Paced Breathing in the Home Setting. on Exercise Capacity, Pulmonary and Ventricular Function in Patients With Chronic Heart Failure: A Pilot Study. Circulation: Heart Failure. 2008;1:178-183

Coherent or Paced Breathing

• Anderson DE, McNeely JD, Windham BG. Device-guided slow-breathing effects on end-tidal CO(2) and heart-rate variability. Psychol Health Med. 2009 Dec;14(6):667-79
  
  
• Huang AJ, Grady D, Mendes WB, Hernandez C, Schembri M, Subak LL. Controlled Trial of Device Guided Slow-Paced Respiration in Women with Overactive Bladder Syndrome. J Urol. 2019 Oct; 202(4): 787–794.
   
  
• Huang AJ1, Phillips S, Schembri M, Vittinghoff E, Grady D. Device-guided slow-paced respiration for menopausal hot flushes: a randomized controlled trial. Obstet Gynecol. 2015;125:1130-1138
  
  

Hypertension

• Altena MR, Kleefstra N, Logtenberg SJ, Groenier KH, Houweling ST, Bilo HJ. Effect of device-guided breathing exercises on blood pressure in patients with hypertension: a randomized controlled trial. Blood Press 2009;18:273–9
  
  
• Anderson DE, McNeely JD, Windham BG. Regular slow-breathing exercise effects on blood pressure and breathing patterns at rest. J Hum Hypertens 2010;24:807–813.
  
  
• Aydin L et al, J Hyperten 2008; 26 (suppl 2): S371-S372.
  
  
• Bae JH, Kim JH, Choe KH, Hong SP, Kim KS, Kim CH, Ko JK, Kim CH, Kim KS. Blood pressure change following 8-week, 15-minute daily treatment with paced breathing guided by a device: a Korean multi-center study. J Clin Hypertens 2006;8:79 [Korean with abstract in English in Korean Hyperten J 2006;1:19-23]
  
  
• Brook RC et al. A Scientific Statement From the American Heart Association Beyond Medications and Diet: Alternative Approaches to Lowering Blood Pressure. Hypertension. 2013;61(6):1360-1383
  
  
• Elliott WJ, Izzo JL Jr, White WB, Rosing DR, Snyder CS, Alter A, et al. Graded blood pressure reduction in hypertensive outpatients associated with use of a device to assist with slow breathing. J Clin Hypertens (Greenwich) 2004;6:553–559.
  
  
• Grossman E, Grossman A, Schein MH, Zimlichman R, Gavish B. Breathing-control lowers blood pressure. J Hum Hypertens 2001;15:263–9.
  
  
• Gusmão Josiane Lima de; Carminatte, Deise Aparecida. Device-guided slow breathing reduces the post hemodialysis blood pressure in hypertensive patients with chronic kidney disease. J Hypertension: September 2012 – p e141[Abstract]
  
  
• Hering D, Kucharska W, Kara T, Somers VK, Parati G, Narkiewicz K. Effects of acute and long-term slow breathing exercise on muscle sympathetic nerve activity in untreated male patients with hypertension. J Hypertens. 2013;31:739-746.
  
  
• Howorka K, Pumprla J, Tamm J, Schabmann A, Klomfar S, Kostineak E, et al. Effects of guided breathing on blood pressure and heart rate variability in hypertensive diabetic patients. Auton Neurosci 2013;179:131–137.
  
  
• Kim JH, Yoo BS, Lee SH, Yoon J, Choe KH, The Changes of Noninvasive Hemodynamic Parameters after Device-Guided Slow Breathing Exercise in Hypertensive Patients. J Korean Soc Hypertens 2013;19:55-62
  
  
• Landman GW, Drion I, van Hateren KJ, van Dijk PR, Logtenberg SJ, Lambert J, et al. Device-guided breathing as treatment for hypertension in type 2 diabetes mellitus: a randomized, double-blind, sham-controlled trial. JAMA Intern Med 2013;173:1346–1350
   
• Logtenberg SJ, Kleefstra N, Houweling ST, Groenier KH, Bilo HJ. Effect of device-guided breathing exercises on blood pressure in hypertensive patients with type 2 diabetes mellitus: a randomized controlled trial. J Hypertens 2007;25:241–6.
  
  
• Matura LA, Fargo J, Fritz JS, Smith KA, Vaidya A, Pinder D, Archer-Chicko C, Palevsky HI, Pack AI, Sommers MS, Kawut SM. Slow-paced respiration therapy to treat symptoms in pulmonary arterial hypertension. Heart Lung. 2017;46:7-13.
  
  
• Meles E, Giannattasio C, Failla M, Gentile G, Capra A, Mancia G. Nonpharmacologic treatment of hypertension by respiratory exercise in the home setting. Am J Hypertens 2004;17:370–4.
  
  
• Rosenthal T, Alter A, Peleg E, Gavish B. Device guided breathing exercises reduce blood pressure: ambulatory and home measurements. Am J Hypertens 2001;14:74–76.
  
  
• Schein MH, Gavish B, Baevsky T, Kaufman M, Levine S, Nessing A, et al. Treating hypertension in type II diabetic patients with device-guided breathing: a randomized controlled trial. J Hum Hypertens 2009; 23:325–331.
  
  
• Schein MH, Gavish B, Herz M, Rosner-Kahana D, Naveh P, Knishkowy B, Zlotnikov E, Ben-Zvi N, Melmed RN. Treating hypertension with a device that slows and regularises breathing: a randomised, double-blind controlled study. J Hum Hypertens. 2001;15:271-278.
  
  
• Viskoper R, Shapira I, Priluck R, Mindlin R, Chornia L, Laszt A, et al. Nonpharmacologic treatment of resistant hypertensives by device-guided slow breathing exercises. Am J Hypertens 2003;16:484–487.
  
  
• Wojcicki JM, Geissler JD, Stokes CW, Heyman MB, Tran CT. The use of the RESPeRATE device to lower blood pressure in inner city obese adolescents and children: a pilot feasibility study. High Blood Press Cardiovasc Prev. 2013 Jun;20(2):89-92.

Lowering Sympathetic Activity

• Adler TE, Coovadia Y, Cirone D, Khemakhem ML, Usselman CW. Device-guided slow breathing reduces blood pressure and sympathetic activity in young normotensive individuals of both sexes. J Appl Physiol (1985). 2019 Oct 1;127(4):1042-1049.
  
  
• de Barros S, da Silva GV, de Gusmão JL, de Araujo TG, Mion D Jr. Reduction of sympathetic nervous activity with device-guided breathing. J Clin Hypertens (Greenwich). 2014 Aug;16(8):614-5.;
  
  
• de Barros S, da Silva GV, de Gusmão JL, de Araújo TG, de Souza DR, Cardoso CG Jr, Oneda B, Mion D Jr. Effects of long term device-guided slow breathing on sympathetic nervous activity in hypertensive patients: a randomized open-label clinical trial. Blood Press. 2017 Dec;26(6):359-365.
  
  
• Harada D, Asanoi H, Takagawa J, Ishise H, Ueno H, Oda Y et al. Slow and deep respiration suppresses steady-state sympathetic nerve activity in patients with chronic heart failure: from modeling to clinical application. American Journal of Physiology-Heart and Circulatory Physiology. 2014;307(8):H1159-H68
  
  
• Oneda B, Ortega KC, Gusmão JL, Araújo TG, Mion D Jr. Sympathetic nerve activity is decreased during device-guided slow breathing. Hypertens Res. 2010 Jul;33(7):708-712.
  
  
• Parati G et al, In Hypertension Primer Eds. Izzo et al.Lippincott Williams & Wilkins. 3rd Edition 2003, pp. 117-120.
  
  

Improving Sleep Quality

• Huang AJ, Grady D, Mendes WB, Hernandez C, Schembri M, Subak LL. Controlled Trial of Device Guided Slow-Paced Respiration in Women with Overactive Bladder Syndrome. J Urol. 2019 Oct; 202(4): 787–794.
  
  
• Savoie MB, Lee KA, Subak LL, Hernandez C, Schembri M, Fung CH, Grady D, Huang AJ. Beyond the bladder: poor sleep in women with overactive bladder syndrome. Am J Obstet Gynecol. 2020 Jun;222(6):600.e1-600.e13.

PTSD/Anxiety/Stress

• de Jong MC, Boersma CH. Device-guided breathing as a possible tool to improve the outcome of exposure therapy.Mental Illness 2010;2:e6 [pp.25-27]
  
  
• Fonkoue IT, Hu Y, Jones T, et al. Eight weeks of device-guided slow breathing decreases sympathetic nervous reactivity to stress in posttraumatic stress disorder. Am J Physiol Regul Integr Comp Physiol. 2020;319(4):R466-R475.
  
  
• Fonkoue IT, Marvar PJ, Norrholm SD, Kankam ML, Li Y, DaCosta D, Rothbaum BO, Park J. Acute effects of device-guided slow breathing on sympathetic nerve activity and baroreflex sensitivity in posttraumatic stress disorder. Am J Physiol Heart Circ Physiol. 2018 Jul 1;315(1):H141-H149
  
  
• Gabriely R, Tarrasch R, Velicki M, Ovadia-Blechman Z. The influence of mindfulness meditation on inattention and physiological markers of stress on students with learning disabilities and/or attention deficit hyperactivity disorder. Res Dev Disabil. 2020 May;100:103630. Res Dev Disabil. 2020 May;100:
  
  
• Morarend QA, Spector ML, Dawson DV, Clark SH, Holmes DC. The use of a respiratory rate biofeedback device to reduce dental anxiety: an exploratory investigation. Appl Psychophysiol Biofeedback. 2011 Jun;36(2):63-70
  
  
• Ouseph R, Calvin Croy C,Natvig C, Simoneau T, Laudenslager ML. Decreased mental health care utilization following a psychosocial intervention in caregivers of hematopoietic stem cell transplant patients. Mental Illness 2014; 6:5120 [pp. 9-13]
  
  
• Simoneau TL, Kilbourn K, Spradley J, Laudenslager ML. An evidence-based stress management intervention for allogeneic hematopoietic stem cell transplant caregivers: development, feasibility and acceptability. Support Care Cancer. 2017 Aug;25(8):2515-2523.

• Wahbeh H, Goodrich E, Goy E, Oken BS. Mechanistic Pathways of Mindfulness Meditation in Combat Veterans With Posttraumatic Stress Disorder. J Clin Psychol. 2016 Apr;72(4):365-83.
  

HeartMath Institute Research 

The HeartMath Institute has sponsored numerous research studies about HRV, coherent breathing, and other related topics.  You can check out their research page or review their research library which includes 286 research publications.  A FREE special publication is also available, Science of the Heart.  It includes coverage of the HeartMath Autonomic Assessment Report which is available as an add-on to most measurement packages sold in the store.  Research about the 24-hour assessment is available here.