The effect of heart rate variability biofeedback training on stress and anxiety: a meta-analysis.
This review found reductions in self-reported stress and anxiety associated with HRV biofeedback. The authors called for more well-controlled studies.
Goessl VC, Curtiss JE, Hofmann SG.
Psychological medicine · Publication date: 2017-05-08
Added to site: 2026-09-09
DOI: 10.1017/s0033291717001003
Publication date recorded by Europe PMC; online and issue dates may differ.
- Modalities
- Biofeedback, HRV
- Clinical focus
- Stress, Anxiety
- Population
- Participants in studies of stress and anxiety
- Sample
- 24 studies; 484 participants receiving HRV biofeedback
- Intervention / method
- Heart rate variability biofeedback
- Comparator
- Comparators varied across included studies
Clinician summary
The meta-analysis reported large pooled within-group and between-group effects. The 484 figure refers to biofeedback recipients, not necessarily all participants across comparison arms.
How to interpret the findings
Study quality and comparator differences limit interpretation. Do not interpret 24 included studies as 24 randomized trials.
Equipment and disclosures
Equipment details were not verified from the reviewed abstract.
Funding and competing-interest disclosures were not verified from the reviewed abstract.
Related evidence
Compare findings from the same clinical area, including mixed results.
- The effects of swLORETA Z-score neurofeedback for patients comorbid with major depressive disorder and anxiety symptoms. · Positive with limitations
- Effects of swLORETA Z-score neurofeedback in Z-coherence of the fronto-limbic circuit in patients with major depressive disorder. · Positive with limitations
- The potential of infra-low frequency neurofeedback training in peak performance: The first double-blinded placebo-controlled longitudinal study in healthy adults. · Neutral / negative
- Regulation in acute stress experience through functional near-infrared spectroscopy neurofeedback of the prefrontal cortex. · Positive with limitations
- Modulation of neuroendocrine and autonomic responses to competitive stress by slow cortical potentials training in golfers: An exploratory randomized controlled trial. · Mixed
- Acute Psychophysiological Effects Of 4-7-8 And Nadi Shodhana Breathing: A Randomized Crossover Study. · Mixed
- The Effects of Alpha-Theta EEG Biofeedback Training on Anxiety and Stress: Novel Use of Hair Cortisol Concentration as a Biomarker · Positive with limitations
- Psychological and physiological changes following a mindfulness-based intervention integrating breathing training and HRV biofeedback in adults with anxiety disorders · Mixed
Summary prepared with AI assistance. Source verification does not imply an independent replication or a clinician's endorsement. Read our review method.