Resonance frequency versus fixed 0.1 Hz breathing in HRV biofeedback: a four-week randomized comparison

Heart rate variability biofeedback (HRVB) is increasingly examined as an adjunctive method for reducing psychological symptoms. Standard protocols involve identifying each participant's resonance frequency (RF); however, it remains unclear whether this individualized calibration offers advantages over training at a fixed breathing rate of 0.1 Hz. We conducted a randomized trial with three groups (RF, 0.1 Hz, Control) to compare the effectiveness of a four-week HRVB intervention using an individually determined RF versus a fixed breathing frequency of 0.1 Hz. Participants (N = 88) completed pre- and post-intervention assessments of perceived stress, anxiety, depressive symptoms (DASS-21), and resting HRV. Both HRVB groups showed significant reductions in stress, anxiety, and depressive symptoms relative to the control group, with no meaningful differences between them. Bayesian analysis provided anecdotal evidence favoring the null hypothesis of no difference between groups. The intervention did not produce significant changes in resting HRV. The present study does not permit firm conclusions regarding whether breathing at the RF confers additional benefits over breathing at a fixed rate of 0.1 Hz or whether the two approaches differ in effectiveness. Future studies aimed at detecting small differences between these approaches should include larger samples.Trial registration: The study was retrospectively registered at isrctn.com (Identifier ISRCTN17808563 date of first registration 20/01/2026, https//doi.org/10.1186/ISRCTN17808563). The full trial protocol and statistical analysis plan can be accessed via the registry.