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Publication

Heart Rate Variability Biofeedback Training Can Improve Menopausal Symptoms and Psychological Well‑Being in Women with a Diagnosis of Primary Breast Cancer: A Longitudinal Randomized Controlled Trial

    • Published: 2025
    • Karina Dolgilevica1, Elizabeth Grunfeld1, and Nazanin Derakshan2
    • Curr. Oncol. 2025, 32, 150. DOI: https://doi.org/10.3390/curroncol32030150.1. Department of Psychological Sciences, Birkbeck, University of London, London.2. Resilience and Post-Traumatic Growth Centre, National Centre for Integrative Oncology (NCIO), Reading, UK.
    • Download the complete paper, click here.

Abstract

Breast cancer survivors experience numerous chronic symptoms linked to autonomic dysfunction including anxiety, stress, insomnia, menopausal symptoms, and cognitive impairment. Effective non-pharmacological solutions to address these are currently lacking.

Methods

Our three-armed longitudinal randomized controlled trial assessed the effectiveness of a 4-week remote smartphone-based heart rate variability biofeedback intervention which involved daily paced breathing at 6 breaths p/min; active (12 breaths p/min) and waitlist controls were included. Heart rate variability and self-reported cancer-related symptoms were assessed at baseline, post-, and 6 months-post intervention. Participants were 60 UK-based women with primary breast cancer history (6 to 60 months post-active treatment).

Results

The intervention group showed significant increases in low-frequency heart rate variability over time (F (4, 103.89) = 2.862, p = 0.027, d = 0.33), long-lasting improvement in sleep quality (F (4, 88.04) = 4.87, p = 0.001, d = 0.43) and cessations in night sweats (X2 (2, N = 59) = 6.44, p = 0.04, Cramer’s V = 0.33), and reduced anxiety post-intervention compared to the active and waitlist controls (F (4, 82.51) = 2.99, p = 0.023, d = 0.44). Other findings indicated that the intervention and active control participants reported lasting improvements in cognitive function, fatigue, and stress-related symptoms (all ps < 0.05). The waitlist group reported no symptom changes across time.

Conclusion

Heart rate variability biofeedback is a feasible intervention for addressing diverse chronic symptoms commonly reported by breast cancer survivors.