Biofeedback

How Breathing and Biofeedback Work Together

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Breathing is a body signal you can change at will, and it pulls your heart rhythm along with it. Biofeedback uses that link in two ways: sensors can show your breathing itself, and heart rate variability biofeedback shows your heart rate rising and falling as you breathe slowly, so you can find the pace at which that rise and fall is largest for you.

Why does breathing change the heart?

Because of a pattern called respiratory sinus arrhythmia, in which heart rate rises as you breathe in and falls as you breathe out. In their review of heart rate variability biofeedback, Paul Lehrer and Richard Gevirtz explain that this pattern is controlled by the vagus nerve, whose signals to the heart arrive mainly during exhalation.

They add that longer exhalations and slower breathing may also increase the size of the pattern, possibly independently of vagus nerve activity, because each breath gives the vagus nerve a longer stretch of output. In short, how you breathe changes the rhythm of your heart rate.

How can a sensor show your breathing?

In two ways. According to the Wikipedia article on biofeedback, a flexible band around the chest, abdomen or both shows how each expands and contracts and counts your breaths per minute. A capnometer measures the carbon dioxide in the air you breathe out, through a small tube at the nostril; the article calls it a sensitive index of the quality of breathing.

With either one, you can see what you are doing rather than guess, including how the pattern changes when you slow down.

How does heart rate variability biofeedback combine the two?

By using the heart as the display. Lehrer and Gevirtz describe the method as showing heart rate beat by beat while the person breathes slowly, aiming for a smooth, wave-like curve of peaks and valleys. A breath pacing device can set the rhythm. Their example of a typical training screen shows the change from normal breathing to 7 breaths per minute.

The best pace is personal. They describe early research in which each person had a specific frequency at which heart rate changed the greatest amount for each change in blood pressure, and that frequency varied from one person to the next. Training is partly a search for your own rate.

Do you need a device?

Not to breathe slowly. The device helps you find your rate and confirm what is happening, and Wikipedia notes that no equipment is necessarily required to practice biofeedback. Lehrer and Gevirtz are also candid about the limits of the science: they describe parts of their account of why the breathing-heart timing matters as speculative.

If slow breathing feels uncomfortable, or if you have a heart or lung condition, talk with your clinician before starting a training program.

A two-minute check

Sit comfortably and count your breaths for one minute. Then, for the next minute, breathe in gently and let each breath out a little longer than the breath in, without forcing it, and count again. Notice the difference in pace and in how you feel. That is the raw material a biofeedback session works with.

This article is general information, not medical or psychological advice; talk with a licensed clinician about your own situation.

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