Heart rate variability biofeedback: effects on subjective sleep quality and neurobehavioral sequelae of traumatic brain injury

A growing body of research suggests that decreased vagal activity and increased sympathetic activity contribute to an augmented risk of depression, sleep and psychological disturbances following traumatic brain injury (TBI). Heart rate variability biofeedback (HRV BFB) has been suggested as a useful therapeutic modality in this population. The present study aimed to determine whether decreased HRV is associated with decreased psychological and sleep measures, and whether HRV BFB might function to improve these indices. Resting HRV along with baseline sleep and psychological measures were assessed in five individuals with TBI (3 post-acute < 2 years post-injury; 2 chronic > 2 years post-injury). A multiple baseline design was arranged to evaluate the effects of the intervention, with each participant engaging in four to 16 sessions. At post-test, an effect of HRV BFB was observed in sleep scores for the post-acute participants only. In addition, improvements in several HRV domains and psychological measures were noted for participants across both settings. The results suggest that a relatively brief HRV BFB intervention can ameliorate autonomic dysfunctions, and improve sleep quality and psychological function in some patients with TBI.