What Is Heart Rate Variability Feedback Thesis

Pages: 20 (6639 words)  ·  Style: APA  ·  Bibliography Sources: 20  ·  Level: Doctoral  ·  Topic: Medical / Medicine

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[. . .] Gas exchange is also a bodily process that is affected by heart rate variability biofeedback (Lehrer, 2013).

The major role players in the coordination of this type of breathing exercise include the baroreflex and the baroreceptors. The former plays an essential role in the control of blood pressure and heart rate in individuals, while the latter operate as receivers of the signals of changes in blood pressure and enable a trigger response in the tone of the blood vessels that impacts heart rate. When blood pressure rises, heart rate decelerates and vascular dilation takes place. Conversely, decreases in blood pressure lead to the opposite reaction (i.e., an acceleration of the heart rate and a constriction of the blood vessels). In this regard, Lehrer (2013) demonstrated that the baroreflex can be measured by identifying the heart rate’s change for every 1 millimeter of alteration in blood pressure. HRVB in this light has been shown to be a particularly effective technique for stimulating the baroreflex and enabling a person to obtain more effective control of the body’s functions.

When an individual inhales, heart rate accelerates; during exhalation, heart rate decelerates. This act is what is known as a naturally occurring regulatory phenomenon within the body. It is governed by the operation of the vagus nerve which impacts lung and heart activity. The process is defined as respiratory sinus arrhythmia (RSA) and the exchange of gas through the action of inhaling/exhaling is the primary purpose of RSA. Regulating the heart rate during the process of inhalation and exhalation is integral to establishing a flow of control of the airways through which the gas exchange is conducted.

Knowing Some but Not All of the Mechanisms for Resilience

The mechanisms for resilience are myriad—and the medical community is aware of some of them, but not all of them. In the meta-analytic review conducted for this study, numerous conditions were identified as being treated by applying the HRVB technique, including the following disorders:

· Asthma;

· Anxiety (Trait);

· Cognitive Dysfunction;

· Coronary Artery Disease;

· Depression;

· Emotional Disturbances;

· Hypertension;

· Insomnia;

· Menopausal Symptoms;

· PTSD;

· Stress;

· Substance use/craving;

· Cardiac Conditions; and,

· Gastric Conditions.

The meta-analysis was conducted to provide a greater understanding of the manner in which HRVB can be used effectively as a tool in strengthening resilience. Currently there is a need to assess the efficacy of HRVB/Slow Paced Breathing as a treatment intervention in various health conditions. The reason for the review is that many clinical outcome measures have been studied and can be linked to resilience.

Several of the Reflexes Have Modulatory Functions

The baroreflex is one example of the reflexes that have modulatory functions. The baroreflex gives a quick negative feedback loop that allows an elevated blood pressure to reflexively bring the heart rate down, which leads to a corresponding decrease in blood pressure. The decrease in the blood pressure causes the baroreflex activity to decrease, which in turn allows the heart rate to elevate and bring blood pressure levels back up to normal. This is the body’s way of regulating itself.

Respiratory sinus arrhythmia itself is a heart rate variability that syncs with respiration and can be defined as a modulatory activity. Heart rate typically accelerates when breathing in and decelerates when breathing out, resulting in a synchronization of heart rate and breathing results in respiratory sinus arrhythmia which is positively associated with individual health levels (Lehrer, 1997).

HRVB has a significant role in modulating the process of breathing and controlling the body when it is attacked by stressors. Heart rate variability biofeedback/Slow Paced Breathing techniques allow individuals to assume control of the body’s most automatic functions. In a way, the process is analogous to switching off the autopilot in a jet airliner and putting the captain at the controls. In a case where the flight has hit turbulence, for example, the captain can moderate and modulate the flight by taking direct action. Likewise, people can do the same with their bodies when the nervous system has come into contact with stressors that are placing some type of pressure on the body.

The method of engaging with the body’s nervous system and consciously conducting the breathing process is the essence of the HRVB technique. The HRVB/Slow Paced Breathing technique allows the individual to gain and maintain greater control over the breathing process and, just as the pilot does with the aircraft during turbulence, bring the body back to a steady position in a process that uses the types of negative feedback loops that are characteristic of Systems Theory as discussed below.

Systems Theory and Negative Feedback Loops

Systems Theory has wide applicability and this theoretical model has been used in numerous fields—from psychology to biology to sociology (Lehrer, 2013). Systems Theory in fact grew out of a mathematical approach developed by Wiener in the 1940s through seminal work on antiaircraft systems during World War II, suggesting that the analogy of the body being like an aircraft is especially relevant. The theory focuses on the way in which negative feedback loops, oscillations and control all work together within a system to maintain a desired state (Lehrer, 2013).

What is a system? A system has been defined as “a variety of elements that interact with one another to form a whole entity” (Lehrer, 2013, p. 90). In addition, viable systems are entities that cannot be broken up into their characteristic constituent elements but must rather be taken as a whole (Lehrer, 2013). Likewise, negative feedback has been defined as the “hallmark of homeostatic regulatory activity” (Lehrer, 2013, p. 90).

The diverse systems that employ negative feedback loops all show the characteristic of oscillation. When oscillatory patterns emerge, it is the result of multiple feedback loops operating in conjunction with one another within a system. Oscillatory negative feedback loops all figure prominently in both biological and behavioral controls, from processes in cells to whole, functioning societies (Lehrer, 2013). Therefore, feedback loops, oscillations and control all play an important role in maintaining many bodily systems, including those described below.

Oxygen Metabolism and Parasympathetic Responses 

As Gallego, Nsegbe and Durand (2001) have shown, the arterial pressure regulation feedback system provided by the relationship of carbon dioxide, oxygen and blood acid levels in effect is articulated via the metabolic control that is the breathing process. The parasympathetic response is essential in metabolizing oxygen and keeping the body in rhythm. In addition, Panneton (2013) has shown that parasympathetic responses are important in the body’s regulation as well, especially with regard to the way in which the cardiovascular system assists in addressing the problem of anoxia:

A controlled reflex of onset bradycardia, a parasympathetic response, is foremost and reduces cardiac output dramatically, which by itself would induce a precipitous drop in arterial blood pressure. Thus the sympathetic nervous system counteracts the ensuing pressure drop, and a massive peripheral vasoconstriction commences redistributing circulating blood by reducing blood flow in cutaneous, muscular, and splanchnic circulations, but a maintained or augmented flow to the central nervous system and heart. (Panneton, 2013, p. 284)

The interplay of the central nervous system and the breathing process is therefore evident in this case as well as others.

Measure of the Parasympathetic Function

One common autonomic testing term is the cardiovagal (Gibbons, Cheshire & Fife, 2014). In this application, the parasympathetic response is measured by way of the cardiac function that is controlled by the vagus nerve which in turn impacts the variability of the heart rate. Likewise, Zygmunt and Stanczyk (2010) have pointed out that “changes in heart rate during orthostatic testing and Valsalva manoeuvre, as well as during deep breathing or diving reflex, reflect parasympathetic modulation” (p. 11). Essentially, the cardiovascular system works because the vagal brake acts as a modulator: it is a restraint, as described by Dr. Stephen Porges in his Polyvagal Theory. As Porges (2001) has noted, the vagus places a limitation on the heart rate, though when vagal tone is taken away, rapid escalation of stress can result. Consequently, it is also important to understand how heart rate is controlled as discussed below.

Heart Rate Control

Heart rate is controlled by the autonomic nervous system’s two branches: (a) the sympathetic nervous system and (b) the parasympathetic nervous system. The former produces hormones (epinephrine and norepinephrine) to boost heart rate while the latter produces acetylcholine to decelerate heart rate. Heart rate can be impacted by various external factors such as stress, coffee (or other caffeinated beverages), anxiety, excitement, environment, etc.

Some typical exercises that are used to lower or steady the heart rate when it is affected by stressors such as these include meditation and slow breathing and this is where the idea of HRV originates: the practice of taking slow, deliberate, thoughtful and purposeful breaths that can help the body regain… [END OF PREVIEW]

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