Heart rate variability is enhanced during mindfulness practice: A randomized controlled trial involving a 10-day online-based mindfulness intervention

Moderate cardiac vagal tone is associated with more cooperation in children

Childhood is a crucial period for prosocial development, including cooperative behaviors. Recent studies have shown a quadratic relation (inverted U-shape curve) between cardiac vagal tone (CVT) and various prosocial emotions and behaviors in children, but data are lacking on cooperative behaviors. In a sample of 111 school-aged children (M = 7.77; SD = 1.24, range: 6-11), we tested the association between the root mean square of successive differences in interbeat intervals (RMSSD) at rest, and cooperative behavior in a task designed to be comparable to a stag hunt game. We found evidence for an association between RMSSD and cooperation that follows an inverted U-shape. In addition, older children were more likely to cooperate than younger children. Lastly, we found an interaction between RMSSD and age such that the association between RMSSD and cooperation behavior was present for younger but not older children. In addition, we proposed an extension of the Johnson-Neyman test to assess the significant region of interaction between age and the linear and quadratic RMSSD. These results add to a growing literature suggesting that moderate RMSSD is associated with greater prosocial behavior and provide novel evidence that this association extends to children's cooperation.

Meditation-type specific reduction in infra-slow activity of electroencephalogram

Purpose

Meditation is renowned for its positive effects on cognitive abilities and stress reduction. It has been reported that the amplitude of electroencephalographic (EEG) infra-slow activity (ISA, < 0.1 Hz) is reduced as the stress level decreases. Consequently, we aimed to determine if EEG ISA amplitude decreases as a result of meditation practice across various traditions.

Methods

To this end, we analyzed an open dataset comprising EEG data acquired during meditation sessions from experienced practitioners in the Vipassana tradition-which integrates elements of focused attention and open monitoring, akin to mindfulness meditation-and in the Himalayan Yoga and Isha Shoonya traditions, which emphasize focused attention and open monitoring, respectively.

Results

A general trend was observed where EEG ISA amplitude tended to decrease in experienced meditators from these traditions compared to novices, particularly significant in the 0.03-0.08 Hz band for Vipassana meditators. Therefore, our analysis focused on this ISA frequency band. Specifically, a notable decrease in EEG ISA amplitude was observed in Vipassana meditators, predominantly in the left-frontal region. This reduction in EEG ISA amplitude was also accompanied by a decrease in phase-amplitude coupling (PAC) between the ISA phase and alpha band (8-12 Hz) amplitude, which implied decreased neural excitability fluctuations.

Conclusion

Our findings suggest that not only does EEG ISA amplitude decrease in experienced meditators from traditions that incorporate both focused attention and open monitoring, but this decrease may also signify a diminished influence of neural excitability fluctuations attributed to ISA.

Incorporating biofeedback into the Mindfulness in Motion Intervention for health care professionals: Impact on sleep and stress

CONTEXT

Health care providers (HCP) experience high stress and burnout rates. Mindfulness Based Interventions (MBI) with biofeedback may help improve resiliency but require further research.

DESIGN AND STUDY PARTICIPANTS

Aims were to evaluate changes in sleep patterns, nocturnal physiology, stress, mood disturbances, and perceived experience with biofeedback during the Mindfulness in Motion (MIM) intervention. Data from 66 HCP were included after removing those below 75 % compliance with wearable sensors and wellness surveys. Participants were enrolled in MIM, including eight weekly one-hour virtually delivered synchronous group meetings and ∼10 min of mindfulness home practice at least 3 times per week using a mobile application. Participants wore wearable sensors to monitor sleep and nocturnal physiology and completed short daily stress and mood disturbances.

RESULTS

According to mixed effect models, no sleep nor physiological metrics changed across MIM (p > 0.05). More time was spent in bed after MIM sessions (8.33±1.03 h) compared to night before (8.05±0.93 h; p = 0.040). Heart rate variability was lower nights after MIM (33.00±15.59 ms) compared to nights before (34.50±17.04 ms; p = 0.004) but was not clinically meaningful (effect= 0.033). Significant reductions were noted in perceived stress at weeks 3 through 8 compared to Baseline and lower Total Mood Disturbance at weeks 3, 5, 6, and 8 compared to Baseline (p < 0.001).

CONCLUSIONS

Participating in the MIM with mobile applications and wearable sensors reduced perceived stress and mood disturbances but did not induce physiological changes. Additional research is warranted to further evaluate objective physiological outcomes while controlling for confounding variables (e.g., alcohol, medications).

Augmenting complex and dynamic performance through mindfulness-based cognitive training: An evaluation of training adherence, trait mindfulness, personality and resting-state EEG

Human performance applications of mindfulness-based training have demonstrated its utility in enhancing cognitive functioning. Previous studies have illustrated how these interventions can improve performance on traditional cognitive tests, however, little investigation has explored the extent to which mindfulness-based training can optimise performance in more dynamic and complex contexts. Further, from a neuroscientific perspective, the underlying mechanisms responsible for performance enhancements remain largely undescribed. With this in mind, the following study aimed to investigate how a short-term mindfulness intervention (one week) augments performance on a dynamic and complex task (target motion analyst task; TMA) in young, healthy adults (n = 40, age range = 18-38). Linear mixed effect modelling revealed that increased adherence to the web-based mindfulness-based training regime (ranging from 0-21 sessions) was associated with improved performance in the second testing session of the TMA task, controlling for baseline performance. Analyses of resting-state electroencephalographic (EEG) metrics demonstrated no change across testing sessions. Investigations of additional individual factors demonstrated that enhancements associated with training adherence remained relatively consistent across varying levels of participants' resting-state EEG metrics, personality measures (i.e., trait mindfulness, neuroticism, conscientiousness), self-reported enjoyment and timing of intervention adherence. Our results thus indicate that mindfulness-based cognitive training leads to performance enhancements in distantly related tasks, irrespective of several individual differences. We also revealed nuances in the magnitude of cognitive enhancements contingent on the timing of adherence, regardless of total volume of training. Overall, our findings suggest that mindfulness-based training could be used in a myriad of settings to elicit transferable performance enhancements.

Researching how music affects the autonomic nervous system and influences wound healing processes in trauma patients

An area of increasing interest continues to be the interaction between music therapy and its impacts on the autonomic nervous system (ANS) and wound repair in patients who have experienced trauma. This study intended to quantify the effect of music therapy on ANS regulation and wound healing. A cross-sectional observational study from March to December 2023 was undertaken involving 500 trauma patients. A control group received standard care, and an experimental group received daily 30-min music therapy sessions. Heart rate variability (HRV), cortisol levels, wound healing rates and patient-reported outcomes regarding pain, tension and well-being were among the critical parameters assessed. After 1 month, the experimental group exhibited a statistically significant rise in HRV (p < 0.05), suggesting increased parasympathetic activity. The experimental group exhibited a significant decrease in cortisol levels in comparison to the control group, with notable reduction observed after 1 month (p < 0.05). At 9 months, the experimental group exhibited significantly faster wound healing than the control group, with 85% wound recovery as opposed to 75% in control group. There was notable decrease in pain and stress scores at all time intervals in the music therapy group, with the greatest reduction occurring at the 9-month mark (p < 0.05). A significant positive correlation (p < 0.05) was identified between the number of completed music therapy sessions and patient outcomes, with individuals attending more than 20 sessions experiencing 33.6% positive outcomes. In trauma patients, music therapy substantially enhanced ANS regulation and accelerated wound healing. As evidenced by the elevated HRV and decreased cortisol levels, the therapy induced a physiologically tranquil state that is conducive to recovery. The considerable enhancements in the rates of wound healing, in conjunction with the substantial decreases in pain and tension levels, highlighted the therapeutic capacity of music therapy as intervention in trauma care. Additionally, the observed dose-response relationship indicated that customised music therapy regimens are crucial for achieving the best possible results for patients.

Museum-based art activities to stay young at heart? Results of a randomized controlled trial

Background

Health benefits have been reported with art activities. Heart rate is a biomarker of health state. The aim of this randomized controlled trial (RCT) was to compare the changes in heart rate over a 3 month-period in older adults participating in art-based activities at the Montreal Museum of Fine Arts (MMFA, Quebec, Canada) and in their control counterparts.

Methods/design

Participants (mean age 71.0 ± 5.1; 84.9% female) were a subset of older community dwellers recruited in a RCT in two parallel groups (n = 28 in the intervention group and n = 25 in the control group) who had their heart rate recorded. They attended weekly participatory MMFA-based art activities over a 3-month period. Heart rate was collected via the smart watch Fitbit Alta HR at baseline (M0) and at 3 months (M3). The outcomes were mean heart rate per hour for the full day, including active and inactive hours.

Results

Heart rate for full day (p = 0.018) and active hours (p = 0.028) were slower in the intervention group compared to the control group. Decrease in mean heart rate for full day between M0 and M3 in the intervention group was higher than in the control group (p = 0.030). The linear regression showed that MMFA-based art activities decreased full day heart rate (Coefficient of regression Beta = -6.2 with p = 0.010).

Conclusion

MMFA-based art activities significantly decreased full day heart rate, suggesting a health benefit in older community dwellers who participated in the RCT.Clinical trial registration: NCT03679715.

Effectiveness of Paced Breathing Guided by Biofeedback on Clinical and Functional Outcomes Patients with Chronic Obstructive Pulmonary Disease: An Uncontrolled Pilot Study

To investigate the effectiveness of paced breathing guided by biofeedback on clinical and functional outcomes of patients with chronic obstructive pulmonary disease (COPD). An uncontrolled pilot study comprising a training with paced breathing guided by biofeedback (three sessions of 35 min per week) was conducted over four weeks (12 sessions). Assessments included respiratory muscle strength (using a manovacuometer), anxiety (Beck Anxiety Inventory), depression (Beck Depression Inventory), dyspnea (Baseline Dyspnea Index), functionality (Timed Up and Go Test), health status (COPD Assessment Test) and health-related quality of life (Saint George's Respiratory Questionnaire). The sample consisted of nine patients with a mean age of 68.2 ± 7.8 years. After intervention, patients significantly improved in health status and health-related quality of life, assessed using the COPD Assessment Test (p < 0.001) and Saint George's Respiratory Questionnaire (p < 0.001); anxiety (p < 0.001); and depression (p = 0.001). Patients also significantly improved in dyspnea (p = 0.008), TUG (p = 0.015), CC Score (p = 0.031), and maximum inspiratory (p = 0.004) and expiratory pressures (p < 0.001). An intervention with paced breathing guided by biofeedback promoted positive results on dyspnea, anxiety, depression, health status and perceived health-related quality of life in patients with COPD. Moreover, gains in respiratory muscle strength and functional performance were observed, affecting the performance of daily activities.

Prefrontal cortical hemodynamics and functional network organization during Tai Chi standing meditation: an fNIRS study

Introduction

Tai Chi standing meditation (Zhan Zhuang, also called pile standing) is characterized by meditation, deep breathing, and mental focus based on theories of traditional Chinese medicine. The purpose of the present study was to explore prefrontal cortical hemodynamics and the functional network organization associated with Tai Chi standing meditation by using functional near-infrared spectroscopy (fNIRS).

Methods

Twenty-four channel fNIRS signals were recorded from 24 male Tai Chi Quan practitioners (54.71 ± 8.04 years) while standing at rest and standing during Tai Chi meditation. The general linear model and the SPM method were used to analyze the fNIRS signals. Pearson correlation was calculated to determine the functional connectivity between the prefrontal cortical sub-regions. The small world properties of the FC networks were then further analyzed based on graph theory.

Results

During Tai Chi standing meditation, significantly higher concentrations of oxygenated hemoglobin were observed in bilateral dorsolateral prefrontal cortex (DLPFC), ventrolateral prefrontal cortex (VLPFC), frontal eye field (FEF), and pre-motor cortex (PMC) compared with the values measured during standing rest (p < 0.05). Simultaneously, significant decreases in deoxygenated hemoglobin concentration were observed in left VLPFC, right PMC and DLPFC during Tai Chi standing meditation than during standing rest (p < 0.05). Functional connectivity between the left and right PFC was also significantly stronger during the Tai Chi standing meditation (p < 0.05). The functional brain networks exhibited small-world architecture, and more network hubs located in DLPFC and VLPFC were identified during Tai Chi standing meditation than during standing rest.

Discussion

These findings suggest that Tai Chi standing meditation introduces significant changes in the cortical blood flow and the brain functional network organization.

App-Based Mindfulness for Attenuation of Subjective and Physiological Stress Reactivity in a Population With Elevated Stress: Randomized Controlled Trial

BACKGROUND

Stress-related mental health disorders have steadily increased and contributed to a worldwide disease burden with up to 50% experiencing a stress-related mental health disorder worldwide. Data suggest that only approximately 20%-65% of individuals receive treatment. This gap in receiving treatment may be attributed to barriers such as limited treatment access, negative stigma surrounding mental health treatment, approachability (ie, not having a usual treatment plan or provider), affordability (ie, lack of insurance coverage and high treatment cost), and availability (ie, long waits for appointments) leaving those who need treatment without necessary care. To mitigate the limited access mental health treatment, there has been a rise in the application and study of digital mental health interventions. As such, there is an urgent need and opportunity for effective digital mental health interventions to alleviate stress symptoms, potentially reducing adverse outcomes of stress-related disorders.

OBJECTIVE

This study examined if app-based guided mindfulness could improve subjective levels of stress and influence physiological markers of stress reactivity in a population with elevated symptoms of stress.

METHODS

The study included 163 participants who had moderate to high perceived stress as assessed by the Perceived Stress Scale (PSS-10). Participants were randomly allocated to 1 of 5 groups: a digital guided program designed to alleviate stress (Managing Stress), a digital mindfulness fundamentals course (Basics), digitally delivered breathing exercises, an active control intervention (Audiobook), and a Waitlist Control group. The 3 formats of mindfulness interventions (Managing Stress, Basics, and Breathing) all had a total duration of 300 minutes spanning 20-30 days. Primary outcome measures were perceived stress using the PSS-10, self-reported sleep quality using the Pittsburgh Sleep Quality Index, and trait mindfulness using the Mindful Attention Awareness Scale. To probe the effects of physiological stress, an acute stress manipulation task was included, specifically the cold pressor task (CPT). Heart rate variability was collected before, during, and after exposure to the CPT and used as a measure of physiological stress.

RESULTS

The results showed that PSS-10 and Pittsburgh Sleep Quality Index scores for the Managing Stress (all P<.001) and Basics (all P≤.002) groups were significantly reduced between preintervention and postintervention periods, while no significant differences were reported for the other groups. No significant differences among groups were reported for Mindful Attention Awareness Scale (P=.13). The physiological results revealed that the Managing Stress (P<.001) and Basics (P=.01) groups displayed reduced physiological stress reactivity between the preintervention and postintervention periods on the CPT. There were no significant differences reported for the other groups.

CONCLUSIONS

These results demonstrate efficacy of app-based mindfulness in a population with moderate to high stress on improving self-reported stress, sleep quality, and physiological measures of stress during an acute stress manipulation task.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05832632; https://www.clinicaltrials.gov/ct2/show/NCT05832632.

The effectiveness of a single session of mindfulness-based cognitive training on cardiac vagal control and core symptoms in children and adolescents with attention-deficit/hyperactivity disorder (ADHD): a preliminary randomized controlled trial

This study examined the effectiveness of a mindfulness-based intervention (MBI) on Conners' continuous performance test scores (CPTs), cardiac vagal control (CVC) assessed by vagally mediated heart rate variability (HRV), and mood in children and adolescents with ADHD. We conducted a randomized controlled trial (RCT) recruiting 70 children and adolescents (M age 11.03, SD 2.78) with a clinical diagnosis of ADHD, which were allocated to either 1 session of mindfulness cognitive training, or an active control condition and were examined at baseline, post-treatment and 4-week follow-up. See clinicaltrials.gov: NCT04316832. There was a significant main effect of time on the primary outcomes measured by CPT scores of attention-related problems (omission errors, reaction time) and hyperactivity-impulsivity (commission errors). However, time-by-group interaction did not achieve statistical significance for commission errors and hit RT, indicating that the changes over time in these outcomes were not significantly different between the MBI and Control conditions. In addition, there was a significant time-by-group interaction for omission errors. Relative to control, MBI resulted in a small (d = 0.011) non-statistically significant reduction in omission errors post-treatment. Furthermore, there were no significant differences in detectability. Secondary outcomes were CVC and mood. A small treatment effect on CVC (d = 0.37) was observed; there was a slight increase in vagally mediated HRV measure post-treatment. There were no significant differences in mood improvement over time between conditions. One brief session of MBI effectively enhances CVC but does not significantly improve CPT scores of attention-related problems and hyperactivity-impulsivity or mood in children with ADHD.Clinicaltrials.gov: NCT04316832.

Effects of Induced Mindfulness at Night on Repetitive Negative Thinking: Ecological Momentary Assessment Study

BACKGROUND

Repetitive negative thinking (RNT) is a cognitive risk factor for various disorders. Although brief mindfulness-based interventions (MBIs; lasting 20-30 minutes or shorter) are effective tools to reduce RNT, the effect of a minimal (5-minute) MBI remains largely unknown.

OBJECTIVE

We investigated the acute changes in RNT induced by a 10-day minimal MBI (body scan before sleeping) using an ecological momentary assessment (EMA) administered during the MBI training phase. In addition, we examined longer-term effects on the postintervention and 2-month follow-up assessments for questionnaire-based RNT and psychological distress.

METHODS

A total of 68 participants (community sample, aged 18-55 years; n=58, 85% women) were randomly allocated to either the intervention group (n=35, 51%) or the no-training control group (n=33, 49%). Both groups completed a 10-day EMA phase of RNT, during which only the intervention group performed a daily 5-minute body scan before sleeping.

RESULTS

The intervention group showed a significantly larger reduction in questionnaire-based RNT than the control group at the follow-up assessment (for growth-curve modeling analysis [GMA], d_GMA=-0.91; P<.001), but this effect was not observed during the EMA phase or at the postintervention assessment. Furthermore, the intervention group showed significantly larger decreases in stress both at the postintervention (d_GMA=-0.78; P<.001) and follow-up (d_GMA=-0.60; P<.001) assessments than the control group. We found no intervention effects on depressive and anxiety symptoms.

CONCLUSIONS

A 5-minute body scan before sleeping reduces RNT and stress when continued for at least 10 days; however, the results suggest that this effect only appears with some time lag because no acute changes during and immediately after the intervention emerged for RNT.

A brief body scan mindfulness practice has no positive effect on the recovery of heart rate variability and cognitive tasks in female professional basketball players

Introduction

In this study, we examined the acute effects of a short video-based body scan mindfulness practice on the heart rate variability (HRV) and cognitive performance of professional female basketball players after the first half of a simulated basketball game.

Methods

In this crossover randomized controlled trial, nine professional athletes completed a physical loading protocol on two separate days. The protocol consisted of a 10-min Yo-Yo Intermittent Recovery Test Level 1 in the first quarter, followed by a 10-min basketball game in the second quarter. Immediately afterward, they were asked to engage in a 10-min mindfulness practice or watch a 10-min nature-based documentary as a type of mental intervention. Their HRV, Rating of Perceived Exertion (RPE), National Aeronautics and Space Administration Task Load Index 2 (NASA TLX-2), and Go/No-Go test scores were recorded immediately before and after the physical loading and after the mental intervention.

Results

The physical demand, effort, and frustration level subscales of the NASA TLX-2 and the RPE scores were found to be significantly higher after the physical loading, and they returned to the baseline level after both types of mental intervention. The Go/No-Go test scores did not differ depending on the measurement time. All time- and frequency-domain heart rate variability parameters, except the low-to-high frequency ratio, were found to be significantly high immediately after the physical loading protocol. However, these parameters returned to their initial levels after both types of mental intervention.

Discussion

Completing the tests involved in the study protocol successfully induced physical fatigue, as evidenced by consistent measurement tools, but the one-time and short-term mindfulness practice had no additional benefits for the recovery of heart rate variability, cognitive tasks, or subjective assessment methods, such as RPE and NASA TLX-2, in basketball players with no previous experience of mindfulness practice.

Effect of environmental enrichment on relapse rates in patients with severe alcohol use disorder: protocol for a randomised controlled trial

INTRODUCTION

Alcohol use disorder (AUD) ranks among the most prevalent psychiatric disorders worldwide. Despite current treatments, more than half of patients relapse within weeks after treatment. In animal models, exposure to environmental enrichment (EE) has been shown to be a promising approach to reduce relapse. However, controlled, multimodal EE is difficult to transpose to humans. To address this gap, this study aims at assessing the effectiveness of exposure to a newly designed EE protocol during AUD treatment in reducing relapse to alcohol use. Our EE will allow an enhancement of the standard intervention, and will combine several promising enrichment factors identified in the literature-physical activity, cognitive stimulation, mindfulness and virtual reality (VR).

METHODS AND ANALYSIS

A randomised controlled trial involving 135 participants receiving treatment for severe AUD will be conducted. Patients will be randomised to an intervention enhancement group or a control group. The enhanced intervention will consist of six 40-min sessions of EE spread over 9 days. During the first 20 min of these sessions, patients will practise mindfulness in multisensory VR, in virtual environments designed to practise mindfulness and use it to regulate craving induced by virtual cues or stress. Then, participants will practise indoor cycling combined with cognitive training exercises. The control group will undergo standard management for AUD. The primary outcome is relapse assessed at 2 weeks after treatment, using a questionnaire and biological indicators. Relapse will be defined as drinking at least five drinks per occasion or drinking at least five times a week. It is predicted that the group receiving the EE intervention will have a lower relapse rate than the control group. The secondary outcomes are relapse at 1 month and 3 months after treatment, craving and drug-seeking behaviour, mindfulness skills acquisition and the effect of the intervention enhancement on the perceived richness of the daily environment, assessed by questionnaires and neuropsychological tasks.

ETHICS AND DISSEMINATION

All participants have to give written informed consent to the investigator. This study is approved by the Ethics Committee Nord Ouest IV of Lille (reference number 2022-A01156-37). Results will be disseminated through presentations, peer-reviewed journals and seminar conferences. All information on ethical considerations and open science practices can be accessed at https://osf.io/b57uj/ TRIAL REGISTRATION NUMBER: NCT05577741.

Humming (Simple Bhramari Pranayama) as a Stress Buster: A Holter-Based Study to Analyze Heart Rate Variability (HRV) Parameters During Bhramari, Physical Activity, Emotional Stress, and Sleep

Objective In this study, our goal was to understand the comparative impact of humming, physical activity, emotional stress, and sleep on several heart rate variability (HRV) parameters, including the stress index (SI), and to assess the effectiveness of humming (simple Bhramari) as a stress buster based on the HRV parameters. Methods This pilot study assessed the long-term HRV parameters of 23 participants in terms of four activities: humming (simple Bhramari), physical activity, emotional stress, and sleep. The single-channel Holter device measured the readings, and data was analyzed using Kubios HRV Premium software for time and frequency-domain HRV parameters, including the stress index. Regarding statistical analysis, single-factor ANOVA followed by paired t-test was used to compare the results of HRV parameters "during" the four activities to understand if humming generates the outcome to enhance the autonomic nervous system. Results Our findings revealed that humming generates the lowest stress index compared to all three other activities (physical activity, emotional stress, and sleep). Several additional HRV parameters also supported the positive impact on the autonomic nervous, equivalent to stress reduction. Conclusions Humming (simple Bhramari) can be an effective stress-buster based on the assessment of several HRV parameters during its practice and in comparison with other activities. A regular daily humming routine can help enhance the parasympathetic nervous system and slow down sympathetic activation.

Better forbearance, lower depression: Evidence based on heart rate variability

Background

The relationship between forbearance, a psychological resource, and depression has to date remained inconclusive. The present study investigated heart rate variability (HRV) reactivity to acute stressor tasks in participants with different levels of forbearance to discover how forbearance influences depressive emotions when facing adversity.

Method

The study examined the relationship between forbearance and depression, comparing HRV reactivity to stressor tasks in participants with different levels of forbearance. The levels of reported forbearance were assessed by the Forbearance Scale (FS). The Patient Health Questionnaire-9 (PHQ-9) was used to assessed depression severity. HRV reactivity was evaluated at five stages: baseline, the active stressor task, the period of recovery after the active stressor task, the passive stressor task, the period of recovery after the passive stressor task.

Results

FS scores had a significant negative correlation with PHQ-9 and a significant positive correlation with HRV; significant differences existed between the basal HRV in the higher and lower FS groups. In the passive stressor task and the period of recovery after the active stressor task, significantly different HRV responses were identified between the two groups.

Discussion

Forbearance was correlated with depression and HRV. The present research found differences in HRV among subjects with different levels of forbearance in the baseline as well as stressor and recovery periods, suggesting that self-regulation dysfunction may exist among persons with lower levels of forbearance. Because of the higher levels of forbearance, the negative emotions of individuals caused by adversity are mitigated.

Effect of breathwork on stress and mental health: A meta-analysis of randomised-controlled trials

Deliberate control of the breath (breathwork) has recently received an unprecedented surge in public interest and breathing techniques have therapeutic potential to improve mental health. Our meta-analysis primarily aimed to evaluate the efficacy of breathwork through examining whether, and to what extent, breathwork interventions were associated with lower levels of self-reported/subjective stress compared to non-breathwork controls. We searched PsycInfo, PubMed, ProQuest, Scopus, Web of Science, ClinicalTrials.gov and ISRCTN up to February 2022, initially identifying 1325 results. The primary outcome self-reported/subjective stress included 12 randomised-controlled trials (k = 12) with a total of 785 adult participants. Most studies were deemed as being at moderate risk of bias. The random-effects analysis yielded a significant small-to-medium mean effect size, g = - 0.35 [95% CI - 0.55, - 0.14], z = 3.32, p = 0.0009, showing breathwork was associated with lower levels of stress than control conditions. Heterogeneity was intermediate and approaching significance, χ²₁₁ = 19, p = 0.06, I² = 42%. Meta-analyses for secondary outcomes of self-reported/subjective anxiety (k = 20) and depressive symptoms (k = 18) showed similar significant effect sizes: g = - 0.32, p < 0.0001, and g = - 0.40, p < 0.0001, respectively. Heterogeneity was moderate and significant for both. Overall, results showed that breathwork may be effective for improving stress and mental health. However, we urge caution and advocate for nuanced research approaches with low risk-of-bias study designs to avoid a miscalibration between hype and evidence.

Psychological Intervention Based on Mental Relaxation to Manage Stress in Female Junior Elite Soccer Team: Improvement in Cardiac Autonomic Control, Perception of Stress and Overall Health

Chronic stress may represent one of the most important factors that negatively affects the health and performance of athletes. Finding a way to introduce psychological strategies to manage stress in everyday training routines is challenging, particularly in junior teams. We also must consider that a stress management intervention should be regarded as "efficacious" only if its application results in improvement of the complex underlying pathogenetic substratum, which considers mechanistically interrelated factors, such as immunological, endocrine and autonomic controls further to psychological functioning and behavior. In this study, we investigated the feasibility of implementing, in a standard training routine of the junior team of the Italian major soccer league, a stress management program based on mental relaxation training (MRT). We evaluated its effects on stress perception and cardiac autonomic regulation as assessed by means of ANSI, a single composite percentile-ranked proxy of autonomic balance, which is free of gender and age bias, economical, and simple to apply in a clinical setting. We observed that the simple employed MRT intervention was feasible in a female junior soccer team and was associated with a reduced perception of stress, an improved perception of overall health, and a betterment of cardiac autonomic control. This data may corroborate the scientific literature that indicates psychological intervention based on MRT as an efficacious strategy to improve performance, managing negative stress effects on cardiac autonomic control.

Assessment of Virtual Mindfulness-Based Training for Health Care Professionals: Improved Self-Reported Respiration Rates, Perceived Stress, and Resilience

Background

Mindfulness in Motion (MIM) is a workplace resilience-building intervention that has shown reductions in perceived stress and burnout, as well as increased resilience and work engagement in health care workers.

Objective

To evaluate effects of MIM delivered in a synchronous virtual format on self-reported respiratory rates (RR), as well as perceived stress and resiliency of health care workers.

Methods

Breath counts were self-reported by 275 participants before and after 8 weekly MIM sessions. MIM was delivered virtually in a group format as a structured, evidence-based workplace intervention including a variety of mindfulness, relaxation, and resilience-building techniques. Participants counted their breaths for 30 seconds, which was then multiplied by 2 to report RR. Additionally, participants completed Perceived Stress Scale and Connor-Davidson Resiliency Scale.

Results

According to mixed effect analyses there were main effects of MIM Session (P < .001) and Weeks (P < .001), but no Session by Week interaction (P = .489) on RR. On average, RR prior to MIM sessions were reduced from 13.24 bpm (95% CI = 12.94, 13.55 bpm) to 9.69 bpm (95% CI = 9.39, 9.99 bpm). When comparing average Pre-MIM and Post-MIM RR throughout the MIM intervention, Week-2 (mean = 12.34; 95% CI = 11.89, 12.79 bpm) was not significantly different than Week-1 (mean = 12.78; 95% CI = 12.34, 13.23 bpm), but Week-3 through Week-8 demonstrated significantly lower average Pre-MIM and Post-MIM RR compared to Week-1 (average weekly difference range: 1.36 to 2.48 bpm, P < .05). Perceived stress was reduced from Week-1 (17.52 ± 6.25) to after Week-8 (13.52 ± 6.04; P < .001), while perceived resiliency was increased from Week-1 (11.30 ± 5.14) to after Week-8 (19.29 ± 2.58); P < .001).

Conclusion

Thus far, completion of MIM sessions has shown acute and long-term effects on self-reported RR, but more research is required to determine the extent of improved parasympathetic (relaxed) states. Collectively, this work has shown value for mind-body stress mitigation and resiliency-building in high stress acute health care environments.

Should Mindfulness for Health Care Workers Go Virtual? A Mindfulness-Based Intervention Using Virtual Reality and Heart Rate Variability in the Emergency Department

Background:

Research on burnout in the medical community has extensively studied the impact of mindfulness-based interventions (MBIs), which can include meditation, outdoor retreats, in-person didactics, and/or online wellness modules. However, in addition to these MBIs lacking objective, physiological measures for wellness, there has been little to no research involving virtual reality (VR) as an MBI modality for healthcare professionals in the United States.

Methods:

A randomized controlled intervention trial was used to study the impact of VR-based guided-meditations in the form of brief paced-breathing exercises. Heart-rate variability (HRV), a biomarker for relaxation, was measured during each session. Thirty-two participants, consisting of primarily medical students, resident physicians, and registered nurses, were recruited to complete brief guided-meditations via a VR headset or a standalone mobile app in the emergency department (ED) on-call room of a large urban academic medical center.

Results:

A total of 213 guided-meditation sessions were completed over the course of 4 weeks. Self-reported ratings of anxiety improved in both VR and mobile groups post-study. However, the VR group demonstrated higher intrasession HRV progress, indicating increased state of relaxation that also correlated with the number of sessions completed. Analysis by gender revealed disparity in HRV metrics between male and female VR participants.

Conclusion/Application to Practice:

VR-based guided meditations prove to be a feasible and accessible MBI that does not require extensive time commitment for healthcare workers. VR may be a more effective meditation platform compared with standalone mobile meditation apps, especially when used on a routine basis.

An ecological momentary music intervention for the reduction of acute stress in daily life: A mixed methods feasibility study

Background: Despite the growing potential of mobile-based technologies, innovative interventions targeting the reduction of acute stress in daily life remain under-researched. Music listening is an easy-to-administer activity that is associated with lower levels of biological and self-reported stress. However, the application of music as an intervention in moments of acute stress in daily life remains to be examined. We developed a just-in-time intervention delivering music in moments of stressful experiences in daily life and tested its feasibility using a mixed methods approach.

Methods: In this uncontrolled pilot study, the ecological momentary music intervention (EMMI) was tested by 10 chronically stressed women aged 23.5 ± 3.3 years. Over 18 consecutive days, whenever participants reported stressful experiences, they were encouraged to listen to a self-compiled playlist. Subjective stress levels and saliva samples were assessed at three time points per stress report (T₀, upon reporting a stressful situation; T₁, directly after music listening/15 min after T₀ in case of no music listening; T₂, 15 min after T₁). We analyzed app-based log data, in-the-moment responses, questionnaire data, and semi-structured interview data.

Results: On average, participants’ compliance with the study protocol lay at 70%. Overall, 65 stressful experiences were reported, 51 of which were followed by music listening, for an average duration of 12:53 min. Complete data (i.e., self-reports and saliva samples at all three time points) were provided for 46 stressful experiences. Participants reported immediate relaxation and distraction through music listening. The interviews revealed that the intervention was easy to use and that music listening in moments of perceived stress was viewed as a new and pleasant activity. Several aspects of the protocol (e.g., number of items and prompts) were identified, which should be improved in future studies.

Conclusion: Since repeated stressful experiences in daily life can pose a threat to physical and mental integrity, interventions that are easily applicable and deliver support when needed most are necessary. Following minor adaptations, the EMMI can be considered as a feasible approach to target psychobiological stress responses in daily life, which is worthy of investigation in future larger-scale trials.

Mindfulness and music interventions in the workplace: assessment of sustained attention and working memory using a crowdsourcing approach

Background

Occupational stress has huge financial as well as human costs. Application of crowdsourcing might be a way to strengthen the investigation of occupational mental health. Therefore, the aim of the study was to assess Danish employees’ stress and cognition by relying on a crowdsourcing approach, as well as investigating the effect of a 30-day mindfulness and music intervention.

Methods

We translated well-validated neuropsychological laboratory- and task-based paradigms into an app-based platform using cognitive games measuring sustained attention and working memory and measuring stress via. Cohen’s Perceived Stress Scale. A total of 623 healthy volunteers from Danish companies participated in the study and were randomized into three groups, which consisted of a 30-day intervention of either mindfulness or music, or a non-intervention control group.

Results

Participants in the mindfulness group showed a significant improvement in the coefficient of sustained attention, working memory capacity and perceived stress (p < .001). The music group showed a 38% decrease of self-perceived stress. The control group showed no difference from pre to post in the survey or cognitive outcome measures. Furthermore, there was a significant correlation between usage of the mindfulness and music app and elevated score on both the cognitive games and the perceived stress scale.

Conclusion

The study supports the nascent field of crowdsourcing by being able to replicate data collected in previous well-controlled laboratory studies from a range of experimental cognitive tasks, making it an effective alternative. It also supports mindfulness as an effective intervention in improving mental health in the workplace.

Impact of Meditation-Based Lifestyle Modification on HRV in Outpatients With Mild to Moderate Depression: An Exploratory Study

BACKGROUND

The scientific evaluation of mind-body-interventions (MBI), including yoga and meditation, has increased significantly in recent decades. However, evidence of MBI's efficacy on biological parameters is still insufficient.

OBJECTIVES

In this study, we used HRV analysis to evaluate a novel MBI as a treatment of outpatients with mild to moderate depressive disorder. The Meditation-Based Lifestyle Modification (MBLM) program incorporates all major elements of classical yoga, including ethical principles of yoga philosophy, breathing exercises, postural yoga, and meditation.

METHODS

In this exploratory randomized controlled trial, we compared the changes in HRV indices of a MBLM group (N = 22) and a minimal treatment group (MINIMAL, drugs only, N = 17) with those of a multimodal treatment-as-usual group (TAU, according to best clinical practice, N = 22). Electrocardiogram (ECG) recordings were derived from a Holter monitoring device, and HRV indices have been extracted from nearly stationary 20-min periods.

RESULTS

Short-term HRV analysis revealed statistically significant differences in the pre-to-post changes between MBLM and TAU. In particular, the vagal tone mediating RMSSD and the Rényi entropy of symbolic dynamics indicated HRV gains in MBLM participants compared with TAU. Almost no alterations were observed in the MINIMAL group.

CONCLUSIONS

Our results suggest a benefit in selected HRV parameters for outpatients with mild to moderate depression participating in the MBLM program. For further investigations, we propose analysis of complete 24-h HRV recordings and additional continuous pulse wave or blood pressure analysis to assess long-term modulations and cardiovascular effects.

Effects of Three Genres of Focus Music on Heart Rate Variability and Sustained Attention

Previous research has demonstrated restorative effects of music, showing that exposure to music yields mental health benefits that include improvement in stress management. However, it remains unclear whether the benefits of “on the spot” music interventions extend to cognitive performance. The present study explored whether music can be applied as a low-cost, non-invasive “on the spot” intervention to improve cognitive performance and physiological effects. Specifically, studies has yet to examine whether the effects of different genres of focus music extend beyond stress management to include cognitive performance and physiological effects. To address this gap in the literature, the current study recruited 120 healthy adults in a fully randomized procedure involving three experimental groups of participants and a control group. Each experimental group was exposed to one specific genre of focus music compared to a no-music control group. In a between-group design, the study exposed three separate groups to jazz music, piano music, and lo-fi music respectively. The fourth group was a no-music control group. The study employed a 3-day experimental procedure and a follow-up procedure in which participants completed two attention monitoring tasks. Participants completed focus music interventions with a duration of 15 and 45 min. The follow-up procedure aimed to experimentally induce music familiarity and probe its effect on cognitive performance. To assess cardiovascular effects, heart rate variability (HRV) data was collected during the music intervention period and during a baseline period. Results showed performance differences across the three active music groups on the sustained attention to response task (SART) compared to the no-music control group. Furthermore, the study showed a physiological effect in the direction of increased parasympathetic activity indexed as an increased HRV response in the three active music groups compared to the no-music control group, adding to convergent lines of evidence suggesting that music can enhance parasympathetic activity and cognitive performance. In addition, the study found that music familiarity (relative to music unfamiliarity) influenced cognitive performance in the direction of faster reaction times (RTs) during the music intervention period in which participants were exposed to the attentional network task (ANT) and an increase in the physiological response in the familiar relative to the unfamiliar music condition. In summary, the study found evidence of a pronounced effect of three types of focus music on both cognitive performance and the underlying physiological response. Thus, focus music holds promise as an evidence-based intervention offering mental health benefits through physiological improvements and enhancement of cognitive processing.

A Mixed-Method Assessment of a 10-Day Mobile Mindfulness Intervention

Mobile mindfulness interventions represent a promising alternative to traditional in-person interventions that are resource demanding and have limited accessibility, preventing use by many populations. Despite greater accessibility and popularity of mobile mindfulness applications (apps), research is needed testing the effectiveness of brief interventions delivered via these platforms. The present study assessed the efficacy of a brief mobile mindfulness intervention compared to an active control for increasing state and trait mindfulness and improving mood, as well as the acceptability of the app, in a sample of undergraduate students. Participants (N=139; M_age=19.43years, 80.6% female, 83.5% White) were randomly assigned to either a 10-day mobile mindfulness (Headspace) or cognitive training (Peak) condition. Trait mindfulness was measured pre- and post-intervention. During the 10-day intervention, participants completed 10-min daily exercises on the assigned app, responded to daily questionnaires of state mindfulness and mood, and completed a daily written log of their reactions to the app exercises. Attrition was low (90% completion rate) and did not differ by condition. Participants in the mindfulness condition spent an average of 88.15min (SD=24.75) meditating out of the full 100min prescribed by the intervention. State mindfulness significantly increased across the 10-day intervention for participants in the mindfulness, but not the cognitive training, condition beginning around days 5 and 6. Some aspects of trait mindfulness increased and mood improved from pre- to post-intervention, but these changes were observed in both conditions (i.e., no significant differences were observed by condition). Qualitative analysis of open-ended reactions to the mindfulness app indicated that participants reported more likes than dislikes. Common themes for likes were that participants experienced feelings of calm and focus following the daily mindfulness exercises. Dislikes included discomfort and anxiety associated with increased awareness of thoughts and physical sensations. These findings suggest that while a brief mobile mindfulness intervention is acceptable to undergraduate college students and effective at increasing state mindfulness, a longer intervention may be needed in order to elicit corresponding changes in trait-level mindfulness or mood.

Effects of music on the cardiovascular system

Although music is predominantly utilized for religious, enjoyment or entertainment purposes, it is gradually emerging as a promising non-pharmacological intervention for improving health outcomes in both healthy and diseased populations, especially in those with cardiovascular diseases. As such, music of various genres and types has been postulated to possess features that stimulate or inhibit the autonomic nervous system, which leads to variable effects on cardiovascular function. However, music intervention has not been adequately explored as a cardiovascular therapeutic modality due to the lack of extensive studies with quality methodology. Thus, the aim of this systematic review is to explore the available literature on the effect of music on the cardiovascular system, discuss the limitations of current research, and suggest future directions in this field.

Eligibility Classification as a Factor in Understanding Student-Athlete Responses to Collegiate Volleyball Competition

The current study examined differences in heart rate variability (HRV) across student-athletes of different eligibility classifications and analyzed differences in HRV when competing at home or away. Fourteen female collegiate volleyball players volunteered for the study. Data collection encompassed an entire collegiate season, with comparisons in HRV made between home and away games, as well as pre-gameday, gameday, and post-gameday recordings for the whole squad. Comparisons were also made between student-athlete eligibility classification, with self-reported measures of sleep quality, fatigue, muscle soreness, stress, and mood recorded at the time of HRV measurement. Freshman athletes reported a significantly (p < 0.05, η² = 0.17) lower HRV (80.3 ± 9.7) compared to sophomore (85.7 ± 7.2), junior (91.2 ± 8.3), and senior (86.5 ± 7.2) athletes, while junior athletes had a significantly higher HRV when compared to sophomore and senior athletes. All athlete classifications reported similar HRV for home and away games, and there was no difference in HRV for any athlete classification group when comparing pre-gameday, gameday, and post-gameday measures. Freshman athletes reported significantly (p < 0.05, η² = 0.23) worse mood states compared to the other eligibility classifications, while self-reported stress was significantly (p < 0.05) worse in junior and senior athletes. Results suggest that monitoring the workload of student-athletes based on their eligibility classification holds merit. Collegiate coaching and support staff should be aware of the academic and competitive demands placed on their student-athletes. In particular, freshman athletes adjusting to the increased demands placed on them as collegiate student-athlete may warrant additional support.