Detecting effects of yoga therapy on heart rate variability and autonomic nervous system functioning in adults after cancer treatment: results from a study using single-subject experimental methods
Aug 2026· BioPsychoSocial Medicine· Vol 20· 0 citations· 81 references
Medicine
TL;DR
Though mixed, results establish an initial proof-of-concept required to justify larger studies investigating the effects of YT on HRV and self-reported ANS functioning in adults after cancer treatment and establish an initial proof-of-concept required to justify larger studies investigating the effects of YT on HRV and self-reported autonomic nervous system functioning.
Abstract
Cancer is a source of physiological and psychological stress. Heart rate variability (HRV) is a measure of autonomic reactivity to physiological and psychological stress. For an initial proof-of-concept, we investigated the effects of a yoga therapy (YT) intervention on HRV metrics and self-reported autonomic nervous system (ANS) functioning using single-subject experimental methods. Data from 20 adults (Mage (years) = 55.7 [SD = 8.6], 85% female, Myears from diagnosis = 2.8 [SD = 3.5]) were analyzed. Participants received an initial 90-min 1:1 YT session followed by 6 weekly 60-min small group YT sessions. Hexoskin Smart Shirts captured single lead electrocardiographic data suitable for HRV analysis, and questionnaires were used to assess self-reported state and trait ANS functioning. Data collected prior to (weeks − 6, −3, and 0a), during (immediately after the 1:1 YT session [week 0b] and before the first group session [week 1]), and after (weeks 7 and 12) the YT intervention were analyzed. Hierarchical linear modeling (HLM) was used to estimate average baseline levels (intercept), linear slopes (time), YT initiation effect on levels (phase), and YT intervention effect on linear slopes (time-by-phase) for each outcome. HLM yielded mixed results. Significant (p < 0.05) time, phase, and time-by-phase effects for state ANS, coefficient of variation and high frequency power, time-by-phase effect for trait ANS, and time and phase effects for sample entropy were observed. No significant effects were observed for remaining analyzed HRV metrics. Though mixed, results establish an initial proof-of-concept required to justify larger studies investigating the effects of YT on HRV and self-reported ANS functioning in adults after cancer treatment. ISRCTN registry. ISRCTN64763228. December 12, 2021. This study was retrospectively registered. https://www.isrctn.com/ISRCTN64763228.
BACKGROUND
Schizophrenia is associated with autonomic nervous system dysfunction and reduced heart rate variability (HRV). Antipsychotics, especially second-generation agents, may further impair cardiovascular autonomic regulation, raising the risk of cardiovascular disease and sudden cardiac death. Yoga, a structured mind-body intervention, has shown promise in improving autonomic function.
OBJECTIVE
To evaluate the effect of add-on yoga therapy on HRV and psychopathology in patients with schizophrenia.
METHODS
This open-label pilot study enrolled 45 participants: 15 patients in a Yoga Group (YG), 15 in a Control Group (CG), and 15 healthy controls (HC). The YG received a validated 10-day yoga intervention (60 min/day) added to standard pharmacotherapy; the CG continued treatment as usual. Outcomes included HRV parameters (SDRR, RMSSD, LF power, HF power, LF/HF ratio), SAPS, SANS, BPRS, and BMI.
RESULTS
At baseline, SDRR (F(2,42) = 16.52, p < 0.01) and RMSSD (F(2,42) = 6.72, p = 0.003) were markedly lower in both patient groups than HC. Post-intervention, the YG showed a significant reduction in LF/HF ratio (p = 0.039; Cohen's d = 0.60), indicating a shift toward parasympathetic predominance. Within-group improvements were significant for BPRS, SAPS, SANS, and BMI (all p < 0.01). Post-intervention SDRR and RMSSD remained significantly lower in the YG than HC (Hedges' g = 1.86 and 1.20), reflecting persistent autonomic deficits.
CONCLUSION
A 10-day structured yoga intervention may improve autonomic balance and reduce psychopathology in schizophrenia. Adequately powered randomised controlled trials with longer follow-up are needed to confirm these findings.
Bhavit Bansal, V. Shivakumar, Kankan Gulati et al.· Asian Journal of Psychiatry· 0 citations
Background: College students experience academic demands, sedentary behaviour, irregular lifestyle patterns and psychosocial stressors that may influence cardiovascular autonomic regulation. Heart rate variability (HRV) provides a non-invasive measure of cardiac autonomic function. Hatha Yoga, through its combination of asanas, pranayama, relaxation and meditation, may improve cardiovascular regulation. However, evidence regarding chronic effects of Hatha Yoga on HRV remains inconsistent. Objective: To evaluate the effect of a four-month structured Hatha Yoga intervention on cardiac autonomic function, heart rate variability, resting heart rate and blood pressure among healthy male college students aged 19–23 years. Methods: A randomized controlled parallel-group study was designed with 180 male college students aged 19–23 years. Participants were allocated into a Hatha Yoga group (n=90) and a control group (n=90). The Hatha Yoga group participated in a structured 60-minute programme five days per week for four months, while the control group continued their usual routine. Primary outcomes included HRV parameters: RMSSD, SDNN, high-frequency (HF) power, low-frequency (LF) power and LF/HF ratio. Secondary outcomes included resting heart rate, systolic blood pressure and diastolic blood pressure. Pre- and post-intervention data were compared within and between groups. Results: In the simulated dataset, the Hatha Yoga group demonstrated reductions in resting heart rate, systolic blood pressure and diastolic blood pressure and increases in RMSSD, SDNN and HF power. Resting heart rate decreased from 80.05 ± 7.37 to 70.72 ± 5.69 beats/min, while RMSSD increased from 28.53 ± 7.52 to 36.89 ± 8.42 ms. Compared with controls, between-group differences in change were significant for resting heart rate, systolic blood pressure, diastolic blood pressure, RMSSD, SDNN, HF power and LF/HF ratio. The between-group difference for LF power did not reach statistical significance. Conclusion: The simulated findings demonstrate a pattern consistent with improved cardiovascular autonomic regulation following four months of Hatha Yoga. The results support further investigation of structured Hatha Yoga as a potentially useful non-pharmacological approach for cardiovascular health promotion among young adults. However, the numerical findings presented in this manuscript are simulated and must be replaced by analyses of actual participant data before publication.
P. K., Subbulakshmi Velusamy· Adolescência e Saúde· 0 citations
Objective Alterations in autonomic nervous system activity – measured by heart rate variability (HRV) and heart rate (HR) - have been proposed as a relevant biopsychological mechanism in several psychiatric disorders. However, only few studies have examined these parameters in OCD, and evidence from pediatric samples is particularly limited. The aim of this study was to investigate autonomic activity in pediatric OCD. Methods A five minute resting state electrocardiogram was recorded in adolescents with OCD (n = 64) and age- and IQ-matched healthy controls (HC, n = 52). Autonomic activity was compared using the logarithmized root mean square of differences between successive R-R intervals (logRMSSD), the logarithmized high-frequency HRV (logHF-HRV), the percentage of adjacent NN intervals differing from each other by more than 50 ms (pNN50) and HR. Associations with psychotropic medication status and symptom severity were assessed. Results Adolescents with OCD showed lower logRMSSD and higher HR than HC, whereas logHF-HRV and pNN50 did not differ between groups. No associations were found between cardiac measures and OCD symptom severity. Exploratory subgroup analyses suggested lower logHF-HRV and logRMSSD in medicated adolescents with OCD. Conclusions Our findings add to evidence for altered autonomic activity in pediatric OCD, reflected by elevated HR and lower RMSSD. The observed reduction in HRV did not increase with greater symptom severity and appeared most pronounced among medicated adolescents with OCD. Significance The autonomic imbalance observable in adolescents with OCD is common across anxiety disorders and has been linked to cardiovascular risk.
Manuel Burkart, Sophie P. Scheer, Lea L. Backhausen et al.· Clinical Neurophysiology Pra...· 0 citations
Longer periods (>6min) of substantial increases in aHR (aHR periods) in 24-hour recordings of electrocardiogram and accelerometer signals in a healthy sample are identified and their association with individual characteristics and affective states is examined.
S. V. D. van de Ven, Martin J. Gevonden, N. A. Huizinga et al.· Biological Psychology· 1 citation
Fatigue is a debilitating symptom in multiple sclerosis (MS) associated with autonomic nervous system (ANS) dysfunction. Heart rate variability (HRV) provides a non-invasive measure of ANS function; yet the relative sensitivity of linear and nonlinear HRV parameters in capturing specific ANS (dys)function remains unclear. This study investigated the factorial structure of HRV parameters, their response to biopsychological interventions, and their relationship with MS-related fatigue. Data from two clinical trials (N = 78) were pooled. Exploratory factor analysis (EFA) was applied to time-domain, frequency-domain, and nonlinear HRV parameters. Repeated-measures ANOVAs examined the effects of self-alert training (SAT; activating), deep breathing (DB; relaxing), and progressive muscle relaxation (PMR; intermediate) on HRV, controlling for age, depression, and disability. Subsequent regression analyses investigated whether HRV changes during a vigilance task predicted MS-related fatigue. EFA revealed two factors, likely reflecting parasympathetic (PNS) or sympathetic (SNS) activity. SAT decreased HRV parameters loaded onto both factors, DB increased parameters related to the factor interpreted as mainly reflecting SNS activity, and PMR affected both factors. Reduced SDNN change during the vigilance task predicted higher trait fatigue, whereas state fatigue was not associated with HRV. HRV offers the potential to monitor PNS-SNS-related activity during psychological interventions and to measure reduced autonomic adaptability in MS-related trait fatigue.
G. Garis, Carina Sander-Sandersfeld, Andrea Hildebrandt et al.· Multiple Sclerosis and Relat...· 1 citation
Introduction Combat-related stress is associated with autonomic nervous system (ANS) dysregulation—sympathetic predominance, reduced vagal tone, and decreased heart rate variability (HRV)—linked to increased cardiovascular risk. Non-pharmacological interventions targeting autonomic regulation show promise, but controlled studies in combat-exposed populations remain limited. We assessed whether adding a structured breathing–meditation protocol, the Technique of Mental Relaxation (TMR), to standard rehabilitation is associated with changes in HRV and electrocardiogram (ECG)-derived indices of autonomic regulation in Ukrainian servicemen. Methods A controlled, non-randomized study screened 84 male servicemen; 77 were allocated to a TMR group (n = 37; TMR plus standard treatment) or a control group (n = 40; standard treatment alone). Paired baseline and post-treatment 5-min supine recordings, obtained over a 14-day rehabilitation period, were available for 74 participants (TMR n = 35, control n = 39); a civilian reference group (n = 89) provided baseline comparison. Primary HRV outcomes were SDNN, RMSSD, the Baevsky Stress Index, and heart rate; ECG analysis added repolarization intervals, with Hedges’ g. Results At baseline, both military groups showed impaired autonomic regulation versus civilians (all p < 0.0001). After intervention, the TMR group improved (SDNN 23→30 ms, p < 0.001; RMSSD 12→19 ms, p < 0.001; Stress Index 422→253, p < 0.001), whereas controls deteriorated; post-treatment between-group differences were significant for all primary outcomes (p ≤ 0.008). Conclusion Heart-rate-adjusted analyses attenuated part of this difference, the Stress Index remaining most robust. Given the non-randomized design, these findings warrant caution and support randomized trials, with HRV as an objective monitoring tool.
Viktor S Matsyshyn, A. Kravchenko, Nataliia M. Ovodiuk et al.· Frontiers in Network Physiol...· 0 citations
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