The unique autonomic signatures of savoring meditation for anxiety reduction: A pilot randomized controlled trial

Anxiety disorders are often characterized by excessive sympathetic activation and dysfunction. While breathing relaxation reliably reduces anxiety by dampening sympathetic activity and enhancing parasympathetic tone, the autonomic signatures underlying positive emotion interventions, such as savoring meditation, remain less understood. In this pilot randomized controlled trial, we recruited 44 participants with probable generalized anxiety disorders (GAD) by questionnaires (GAD-7 score ≥ 10, which represents moderate or higher anxiety severity), who were assigned to a savoring meditation (n = 22) or a breathing relaxation (n = 22) intervention. We measured heart rate variability (HRV) indicators (respiratory sinus arrhythmia, RSA; low-frequency HRV, LF; the low-frequency/high-frequency ratio, LF/HF) and self-reported emotional states (happiness, anxiety, sadness, calmness) before and after the intervention. Linear mixed models with multiple imputation examined outcome change between and within conditions. The savoring group exhibited increased sympathetic and decreased parasympathetic activity (significantly lower RSA, higher LF and LF/HF), contrasting with the relaxation group's pattern. Both interventions resulted in significant and similar reductions in anxiety after worrying. These preliminary results suggest that savoring meditation for anxiety reduction may have unique autonomic signatures, offering novel insights for positive emotion interventions in anxiety research.