Heart Rate Variability Biofeedback Can Help Improve Cancer Patients' Sleep

By Reuters Staff

October 13, 2020

NEW YORK (Reuters Health) - A home-based practice of heart-rate-variability biofeedback (HRV-BF) with resonant breathing rapidly improves sleep in terminally ill cancer patients, according to new findings.

"Since patients with incurable cancer have limited remaining lifetime and face physical challenges, it is significant that results were obtained within 2 weeks after intervention for severe sleep disturbances," Dr. Hideaki Hasuo of Kansai Medical University in Osaka, Japan, and colleagues write in BMJ Supportive and Palliative Care.

Approaches to help cancer patients with sleep problems such as cognitive-behavioral therapy and yoga require six to 12 weekly training sessions, the authors note. HRV-BF with resonant breathing has been shown to reduce sleep disturbances in healthy individuals in three to six weekly sessions.

The authors previously conducted a randomized controlled trial of HRV-BF in family caregivers of cancer patients, and found two weeks of daily home practice improved sleep. The current study included 50 terminally ill cancer patients with disturbed sleep who underwent a hospital-based HRV-BF session lasting up to 30 minutes.

The patients were randomly assigned to daily home practice of HRV-BF for two weeks or to a control group. The study's primary outcome was rate of change in sleep efficiency for 10 to 14 days based on the Pittsburgh Sleep Quality Index, Japanese version (PSQI-J), and actigraphy.

One patient in each group left the study due to cancer progression, while an additional control-group patient discontinued due to a lost actigraph. Completion rate for the HRV-BF group was 96% and implementation rate was 91.4%.

Patients in the intervention group practiced HRV-BF for six days, on average. Their total PSQI-J scores dropped from 11.4 to 6.3 (out of 21) on average, while the control group's scores dropped from 11.8 to 9.9, representing a significant between-group difference. Habitual sleep efficacy decreased, but all other sleep parameters improved significantly more in the home HRV-BF group.

However, a total of 5.5 or more on the PSQI-J is considered to indicate poor sleep.

"This study suggests that a decrease in parasympathetic activity may be a major pathogenic mechanism of primary insomnia disorder," Dr. Hasuo and colleagues write. "A home practice of HRV-BF with resonant breathing prior to bedtime can potentially maintain high HRV during sleep by elevating HRV before bedtime."

The study did not have commercial support, and the researchers declared no conflicts of interest.

Dr. Hasuo was not available for an interview by press time.

SOURCE: https://bit.ly/3npNvh4 BMJ Supportive and Palliative Care, online September 21, 2020.