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Regulation of Heart Rates01:31

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Related Experiment Video

Updated: Feb 10, 2026

Calculating Heart Rate Variability from ECG Data from Youth with Cerebral Palsy During Active Video Game Sessions
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Current Evidence on Heart Rate Variability Biofeedback as a Complementary Anticraving Intervention.

Nour Alayan1, Lucille Eller2, Marsha E Bates3

  • 11 Hariri School of Nursing, American University of Beirut , Beirut, Lebanon .

Journal of Alternative and Complementary Medicine (New York, N.Y.)
|May 22, 2018
PubMed
Summary

Heart rate variability biofeedback (HRVB) and controlled breathing (CB) show promise as drug-free methods to reduce cravings. Further research with improved methodology is needed to confirm their therapeutic potential.

Keywords:
anticraving interventioncomplementarycravingheart rate variability biofeedbacksubstance use disorder

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Area of Science:

  • Integrative medicine
  • Behavioral science
  • Psychophysiology

Background:

  • Conventional anticraving interventions have limited success, prompting research into novel strategies.
  • Heart rate variability biofeedback (HRVB), utilizing slowed breathing, has demonstrated efficacy in managing symptom severity across various conditions.
  • HRVB and controlled breathing (CB) present potential as complementary, drug-free options for managing substance craving.

Purpose of the Study:

  • To review existing evidence on the effectiveness of HRVB and CB training as complementary interventions for reducing substance craving.
  • To evaluate the methodological quality and effect sizes of studies investigating HRVB and CB for craving reduction.

Main Methods:

  • Systematic review adhering to Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols.
  • Inclusion of studies assessing cardiorespiratory feedback or CB interventions with substance craving as an outcome.
  • Evaluation of study quality using the Scale for Assessing Scientific Quality of Investigations in Complementary and Alternative Medicine and calculation of effect sizes.

Main Results:

  • Eight articles were included, encompassing controlled and noncontrolled trials.
  • Most studies reported positive outcomes, though methodological quality and effect sizes varied.
  • HRVB studies demonstrated moderate methodological rigor with inconsistent effect sizes (0.074-0.727); the largest effect was observed in nonclinical participants with high food cravings after 240 minutes of HRVB training.

Conclusions:

  • Preliminary evidence suggests HRVB and CB training hold significant therapeutic potential for managing cravings.
  • Larger clinical trials are recommended to enhance methodological rigor, including longer treatment durations, appropriate control conditions, adherence measures, and longitudinal craving assessments.