Psychophysiological effects of heart rate variability biofeedback versus sham biofeedback: A randomized controlled trial

First published online March 27, 2026. In 47 healthy adults, 24 days of heart rate variability biofeedback improved positive affect and reduced depression-symptom scores more than a credible sham program. It did not improve measured autonomic activity at rest, during a stress task or during recovery. This small short-term study does not establish treatment effectiveness for people with a diagnosed condition.

Minjoz S, Jeanne R, Pellissier S, Hot P.
Biological Psychology · Publication date: 2026-03-27
Added to site: 2026-11-02
DOI: 10.1016/j.biopsycho.2026.109254

First published online March 27, 2026 and assigned to the April 2026 issue. Added to Neurofeedback.com November 2, 2026 after comparison with fresh and reserve candidates. This is a historical addition, not a newly published November 2 study.

Modalities

Heart rate variability biofeedback, Biofeedback, Slow-paced breathing

Clinical focus

Psychological distress, Autonomic physiology, Sham-controlled evidence

Population

Healthy adults without frequent relaxation practice

Sample

47 participants randomized to HRV biofeedback (n=24) or sham biofeedback (n=23)

Intervention / method

After a 24-day pre-training observation period, participants practiced for five minutes three times daily for 24 days. The active group used HRV biofeedback intended to support resonance-frequency breathing; the sham condition mimicked biofeedback without access to the participant's breathing resonance frequency.

Comparator

Credible sham biofeedback practiced on the same daily schedule

Clinician summary

Positive-affect change favored HRV biofeedback, t(43)=2.83, p=.007, d=0.84, and depression-symptom change also favored the active group, p=.021, r=.34. Perceived stress did not differ significantly, p=.184, and the intervention did not improve HRV or electrodermal measures across rest, reactivity or recovery. Exploratory analyses did not show that greater respiratory-mediated HRV during practice consistently produced larger psychological benefits.

How to interpret the findings

The trial was small, short and conducted in healthy adults, with only 10 men across both groups. It relied on several self-reported psychological outcomes, did not include a follow-up period and cannot establish benefit for a clinical diagnosis. The autonomic outcomes were null, perceived stress did not improve significantly and several other psychological measures did not differ. The authors noted that the training format may have been inadequate to detect physiological change. No adverse-event result was identified in the checked article or PubMed record.

Equipment and disclosures

The checked records do not establish superiority for a specific commercial device or identify equipment suitable for clinical selection. No equipment is attributed to BrainMaster.

Supported by NeuroCog IDEX UGA under France's Investing for the Future program and Fondation Universite Savoie Mont Blanc for the Heart-brain project; the authors stated that the funders had no role in study design, data collection, analysis or reporting. The authors declared no known competing financial interests or personal relationships. No correction, retraction or expression-of-concern relation appeared in the checked PubMed, Crossref and bounded DOI/title records on November 2, 2026. AI-assisted source review, not independent human clinical review.

Related evidence

Compare findings from the same clinical area, including mixed results.

• “Markers of benefit”: the influence of physiological and physical factors on the relationship between slow-paced breathing and heart rate variability · Positive with limitations
• Acute Psychophysiological Effects Of 4-7-8 And Nadi Shodhana Breathing: A Randomized Crossover Study. · Mixed