Effects of daily walking on subjective symptoms, mood and autonomic nervous function

It is well known that moderate exercise is beneficial to health. However, the effects of exercise on subjective symptoms in relation to mood and autonomic nervous function have not yet been fully examined. The purpose of this study was to investigate the effects of daily walking on subjective symptoms as well as on mood and autonomic nervous function in people who take no medication but have some general physical complaints. We assessed their symptoms by the Cornell Medical Index (CMI), and mood states by a profile of mood states (POMS) and a frontal alpha laterality ratio. Autonomic nervous function was evaluated by a supine rest basal level, reactivity to orthostatic challenge (physiological stimulus) and to a self-programmed videogame (psychophysiological stimulus) of heart rate (HR), heart rate variability (HRV), baroreflex sensitivity and blood pressure (BP). Repeated measures analysis of variance showed no significant group (control and walking group) x time (pre- and post- walking period) interaction of CMI scores. In contrast, the A-H sub-scale (anger and hostility) of POMS and basal HR significantly decreased after a 4-week walking period in a walking group compared to a control group. Negative mood score of POMS reduced, and basal high-frequency component of HRV and reactivity to orthostatic challenge of baroreflex sensitivity increased marginally significantly compared to the control group. Multiple regression analysis revealed a significant contribution of A-H to the physical score of CMI, which showed a marginally significant reduction after the experimental period in the walking group. These results suggest that daily walking can improve mood states and shift autonomic balance to parasympathetic predominance, and may consequently contribute to the reduction of subjective symptoms.     

Yoga Ameliorates Performance Anxiety and Mood Disturbance in Young Professional Musicians

Yoga and meditation can alleviate stress, anxiety, mood disturbance, and musculoskeletal problems, and can enhance cognitive and physical performance. Professional musicians experience high levels of stress, performance anxiety, and debilitating performance-related musculoskeletal disorders (PRMDs). The goal of this controlled study was to evaluate the benefits of yoga and meditation for musicians. Young adult professional musicians who volunteered to participate in a 2-month program of yoga and meditation were randomized to a yoga lifestyle intervention group (n = 15) or to a group practicing yoga and meditation only (n = 15). Additional musicians were recruited to a no-practice control group (n = 15). Both yoga groups attended three Kripalu Yoga or meditation classes each week. The yoga lifestyle group also experienced weekly group practice and discussion sessions as part of their more immersive treatment. All participants completed baseline and end-program self-report questionnaires that evaluated music performance anxiety, mood, PRMDs, perceived stress, and sleep quality; many participants later completed a 1-year followup assessment using the same questionnaires. Both yoga groups showed a trend towards less music performance anxiety and significantly less general anxiety/tension, depression, and anger at end-program relative to controls, but showed no changes in PRMDs, stress, or sleep. Similar results in the two yoga groups, despite psychosocial differences in their interventions, suggest that the yoga and meditation techniques themselves may have mediated the improvements. Our results suggest that yoga and meditation techniques can reduce performance anxiety and mood disturbance in young professional musicians.     

Interactive effects of task difficulty and personality on mood and heart rate variability

Susceptibility to stress would presumably be different from person to person and be affected by the cause of the given stress. The purpose of this study was to investigate the interactive effects of task difficulty and subject's personality on mood and autonomic nervous function when stress was induced experimentally by tasks involving 3 degrees of difficulty: easy (Task A), difficult but controllable (Task B), and very difficult and uncontrollable (Task C). Twelve healthy female subjects volunteered for the experiment. We assessed their personalities using the Minnesota Multiphasic Personality Inventory (MMPI) questionnaire. Mood states were evaluated by a profile of mood states and a frontal alpha laterality ratio (FALR). Autonomic nervous function was estimated by a spectral analysis of heart rate variability (HRV). Repeated measures analysis of variance applied to two groups (low- and high-) divided by a median split of MMPI clinical scales, revealed significant interactions of time course x task difficulty x Hs (hypochondriasis) in FALR and time course x task difficulty x Pt (psychasthenia) in a low-frequency component and in a high-frequency component of HRV, and in FALR. The differences between low- and high-Hs, and low- and high-Pt were more obvious in Task B session. High-Hs group, whose members tend to place overemphasis on existing physical disorders, showed more negative FALR throughout the session, which would indicate prolonged negative mood possibly due to the task. High-Pt group, whose members tend to be susceptible to stress, showed sympathetic predominance during task period and parasympathetic predominance after task period, which would imply a tendency to overreact. These results suggest that task difficulties would affect mood states assessed by FALR and/or autonomic nervous function differently depending on the subject's personality, especially on Hs and Pt.     

Effects of a 12-Week Hatha Yoga Intervention on Metabolic Risk and Quality of Life in Hong Kong Chinese Adults with and without Metabolic Syndrome

Objective

To determine the efficacy of a 12-week Hatha yoga intervention to improve metabolic risk profiles and health-related quality of life (HRQoL) in Chinese adults with and without metabolic syndrome (MetS).

Methods

We conducted a controlled trial within an university-affiliated hospital. 173 Chinese men and women aged 18 or above were assigned to either the yoga intervention group (n = 87) or the control group (n = 86). Primary outcomes included 12-week change in metabolic risk factors and MetS z score. Secondary outcome was HRQoL (Medical Outcomes Short Form Survey at 12 weeks).

Results

The mean age of participants was 52.0 (SD 7.4, range 31-71) years. Analysis involving the entire study population revealed that the yoga group achieved greater decline in waist circumference (p<0.001), fasting glucose (p<0.01), triglycerides (p<0.05), and MetS z score (p<0.01). Yoga training also improved general health perceptions (p<0.01), physical component score (p<0.01), and social functioning (p<0.01) domains score of HRQoL. However, no significant differences between groups were observed in the mean change of systolic/diastolic blood pressures or high-density lipid protein cholesterol (all p>0.05). There were no significant differences in the intervention effects on waist circumference and MetS z score between the MetS subgroups (both p>0.05).

Conclusion

A 12-week Hatha yoga intervention improves metabolic risk profiles and HRQoL in Chinese adults with and without MetS.

Trial Registration

Australian New Zealand Clinical Trials Registry ACTRN12613000816752     

Welfare implication of measuring heart rate and heart rate variability in dairy cattle: literature review and conclusions for future research

Heart rate (HR) measurements have been used to determine stress in livestock species since the beginning of the 1970s. However, according to the latest studies in veterinary and behaviour–physiological sciences, heart rate variability (HRV) proved to be more precise for studying the activity of the autonomic nervous system. In dairy cattle, HR and HRV indices have been used to detect stress caused by routine management practices, pain or milking. This review provides the significance of HR and HRV measurements in dairy cattle by summarising current knowledge and research results in this area. First, the biological background and the interrelation of the autonomic regulation of cardiovascular function, stress, HR and HRV are discussed. Equipment and methodological approaches developed to measure interbeat intervals and estimate HRV in dairy cattle are described. The methods of HRV analysis in time, frequency and non-linear domains are also explained in detail emphasising their physiological background. Finally, the most important scientific results and potential possibilities for future research are presented.     

Pre-referral rectal artesunate in severe malaria: flawed trial

Introduction

Irritable bowel syndrome affects as many as 14% of high school-aged students. Symptoms include discomfort in the abdomen, along with diarrhea and/or constipation and other gastroenterological symptoms that can significantly impact quality of life and daily functioning. Emotional stress appears to exacerbate irritable bowel syndrome symptoms suggesting that mind-body interventions reducing arousal may prove beneficial. For many sufferers, symptoms can be traced to childhood and adolescence, making the early manifestation of irritable bowel syndrome important to understand. The current study will focus on young people aged 14-26 years with irritable bowel syndrome. The study will test the potential benefits of Iyengar yoga on clinical symptoms, psychospiritual functioning and visceral sensitivity. Yoga is thought to bring physical, psychological and spiritual benefits to practitioners and has been associated with reduced stress and pain. Through its focus on restoration and use of props, Iyengar yoga is especially designed to decrease arousal and promote psychospiritual resources in physically compromised individuals. An extensive and standardized teacher-training program support Iyengar yoga's reliability and safety. It is hypothesized that yoga will be feasible with less than 20% attrition; and the yoga group will demonstrate significantly improved outcomes compared to controls, with physiological and psychospiritual mechanisms contributing to improvements.

Methods/Design

Sixty irritable bowel syndrome patients aged 14-26 will be randomly assigned to a standardized 6-week twice weekly Iyengar yoga group-based program or a wait-list usual care control group. The groups will be compared on the primary clinical outcomes of irritable bowel syndrome symptoms, quality of life and global improvement at post-treatment and 2-month follow-up. Secondary outcomes will include visceral pain sensitivity assessed with a standardized laboratory task (water load task), functional disability and psychospiritual variables including catastrophizing, self-efficacy, mood, acceptance and mindfulness. Mechanisms of action involved in the proposed beneficial effects of yoga upon clinical outcomes will be explored, and include the mediating effects of visceral sensitivity, increased psychospiritual resources, regulated autonomic nervous system responses and regulated hormonal stress response assessed via salivary cortisol.

Trial registration

ClinicalTrials.gov NCT01107977.     

Cardiorespiratory and Metabolic Changes during Yoga Sessions: The Effects of Respiratory Exercises and Meditation Practices

The novelty of this study was to investigate the changes in cardiorespiratory and metabolic intensity brought about by the practice of pranayamas (breathing exercises of yoga) and meditation during the same hatha-yoga session. The technique applied was the one advocated by the hatha-yoga system. Nine yoga instructors-five females and four males, mean age of 44+/-11, 6, were subjected to analysis of the gases expired during three distinct periods of 30 min: rest, respiratory exercises and meditative practice. A metabolic open circuit computerized system was applied (VO2000, MedGraphics-USA). The oxygen uptake (VO(2)) and the carbon dioxide output (VCO(2)) were statistically different (P 相似文献   

Evaluation of sleep architecture in practitioners of Sudarshan Kriya yoga and Vipassana meditation

Yoga is an ancient Indian science and way of life that has been described in the traditional texts as a systematic method of achieving the highest possible functional harmony between body and mind. Yogic practices are claimed to enhance the quality of sleep. Electrophysiological correlates associated with the higher states of consciousness have been reported in long-term practitioners of transcendental meditation during deep sleep states. The present study was carried out to assess sleep architecture in Sudarshan Kriya Yoga (SKY) and Vipassana meditators. This was to ascertain the differences, if any, in sleep architecture following yogic practices. Whole night polysomnographic recordings were carried out in 78 healthy male subjects belonging to control and yoga groups. The groups studied were aged between 20 and 30-years-old (younger) and 31 to 55-years-old (middle-aged). The sleep architecture was comparable among the younger control and yoga groups. While slow wave sleep (non-REM (rapid eye movement) S₃ and S₄) had reduced to 3.7 percent in the middle-aged control group, participants of the middle-aged yoga groups (both SKY and Vipassana) showed no such decline in slow wave sleep states, which was experienced by 11.76 and 12.76 percent, respectively, of the SKY and Vipassana groups. However, Vipassana practitioners showed a significant enhancement (P < 0.001) in their REM sleep state from that of the age-matched control subjects and also from their SKY counterparts. Yoga practices help to retain slow wave sleep and enhance the REM sleep state in the middle age; they appear to retain a younger biological age as far as sleep is concerned. Overall, the study demonstrates the possible beneficial role of yoga in sleep-wakefulness behavior.

     

Oxygen Consumption and Respiration During and After two Yoga Relaxation Techniques

Cyclic meditation (CM) is a technique which combines ‘stimulating’ and ‘calming’ practices, based on a statement in ancient yoga texts suggesting that such a combination may be especially helpful to reach a state of mental equilibrium. The oxygen consumption, breath rate and breath volume of 50 male volunteers (group mean age±SD, 27±6.3 years) were assessed before, during, and after sessions of CM and sessions of supine rest in the corpse posture (shavasana, SH). The sessions were one day apart and the order was alternated. The oxygen consumption, breath rate and breath volume increased during the ‘stimulating’ practices of CM, returned to the baseline during the ‘calming’ practices, and the oxygen consumption decreased by 19.3 percent below baseline values after CM. During the SH session the oxygen consumption, breath rate and breath volume reduced; however the decrease in oxygen consumption after SH was less than after CM (i.e., 4.8 percent). The results support the idea that a combination of yoga postures with supine rest (in CM) reduces the oxygen consumption more than resting supine alone does.     

Effectiveness of emWave Biofeedback in Improving Heart Rate Variability Reactivity to and Recovery from Stress

The current study examined the efficacy of heart rate variability (HRV) biofeedback using emWave, a publicly available biofeedback device, to determine whether training affected physiological tone and stress responses. Twenty-seven individuals aged 18–30 years were randomized to a treatment or no-treatment control group. Treatment participants underwent 4–8 sessions of emWave intervention, and all participants attended pre-treatment and post-treatment assessment sessions during which acute stressors were administered. Physiological data were collected at rest, during stress, and following stress. emWave treatment did not confer changes in tonic measures of HRV or in HRV recovery following stress. However, treatment participants exhibited higher parasympathetic responses (i.e., pNN50) during stress presentations at the post-treatment session than their control counterparts. No treatment effects were evident on self-reported measures of stress, psychological symptoms, or affect. Overall, results from the current study suggest that the emWave may confer some limited treatment effects by increasing HRV during exposure to stress. Additional development and testing of the emWave treatment protocol is necessary before it can be recommended for regular use in clinical settings, including the determination of what physiological changes are clinically meaningful during HRV biofeedback training.     

Generalized impairment of vasodilator reactivity during hyperinsulinemia in patients with obesity-related metabolic syndrome

Defective insulin-dependent vasodilation might contribute importantly to metabolic and vascular abnormalities of the metabolic syndrome (MetS). However, despite extensive investigation, the precise mechanisms involved in insulin's vasoactive effects have not been fully elucidated. Therefore, this study sought to better characterize insulin's physiological actions on vascular reactivity and their potential derangement in the MetS. Forearm blood flow responses to graded doses of acetylcholine, sodium nitroprusside, and verapamil were assessed by strain-gauge plethysmography in patients with obesity-related MetS (n = 20) and in matched controls (n = 18) before and after intra-arterial infusion of insulin (0.2 mU·kg(-1)·min(-1)). Possible involvement of increased oxidative stress in the impaired insulin-stimulated vasodilator responsiveness of patients with MetS (n = 12) was also investigated using vitamin C (25 mg/min). In control subjects, significant potentiation of the vasodilator responses to acetylcholine, nitroprusside, and verapamil was observed after insulin infusion (all P < 0.05). However, no significant change in vasodilator reactivity to either of these drugs was observed following hyperinsulinemia in patients with MetS (all P > 0.05). Interestingly, administration of vitamin C to patients with MetS during hyperinsulinemia significantly enhanced the vasodilator responsiveness to acetylcholine, nitroprusside, and verapamil (all P < 0.05 vs. hyperinsulinemia alone). In conclusion, insulin exerts a generalized facilitatory action on vasodilator reactivity, and this effect is impaired in patients with MetS likely because of increased oxidative stress. Given the importance of vasodilator reactivity in affecting glucose disposal and vascular homeostasis, this defect may then contribute to the development of metabolic and vascular complications in insulin-resistant states.     

Effects of laughing and weeping on mood and heart rate variability

We investigated the effects of laughing and weeping induced by watching comedy and tragedy videos on mood and autonomic nervous function. Ten healthy female subjects volunteered for the experiment. Chest electrocardiogram and respiration curve were recorded before, after, and during watching a comedy or a tragedy video. We also asked them to fill out profiles of mood states (POMS) to evaluate their mood states while watching videos. Autonomic nervous function was estimated by spectral analysis of heart rate variability (HRV). All subjects more or less laughed and wept while watching comedy and tragedy videos, respectively. Anger-hostility score of the POMS decreased and vigor score increased significantly after watching comedy videos, while depression-dejection score increased significantly after watching tragedy ones. Although both contents tended to increase a low to high frequency component ratio (LF/HF ratio) of HRV, the time course of responses was different. The LF/HF ratio which reflects cardiac sympathovagal balance increased immediately after they started watching comedy videos, and returned to the basal level right after they stopped watching, whereas the LF/HF ratio increased gradually to a lesser extent while watching tragedy videos. In contrast, the high-frequency component which reflects cardiac parasympathetic nerve activity gradually decreased while watching both videos but did not return to the basal level after watching tragedy ones. These results suggest that laughing has strong but transient effects on the autonomic nervous system, while weeping or feeling sad has moderate but sustained effects on it.     

Yoga for bronchial asthma: a controlled study.

Fifty three patients with asthma underwent training for two weeks in an integrated set of yoga exercises, including breathing exercises, suryanamaskar, yogasana (physical postures), pranayama (breath slowing techniques), dhyana (meditation), and a devotional session, and were told to practise these exercises for 65 minutes daily. They were then compared with a control group of 53 patients with asthma matched for age, sex, and type and severity of asthma, who continued to take their usual drugs. There was a significantly greater improvement in the group who practised yoga in the weekly number of attacks of asthma, scores for drug treatment, and peak flow rate. This study shows the efficacy of yoga in the long term management of bronchial asthma, but the physiological basis for this beneficial effect needs to be examined in more detail.     

Adiponectin and negative mood in healthy premenopausal and postmenopausal women

Negative mood and stress are associated with cardiovascular and metabolic disease. There are likely many physiological mechanisms underlying the poor health outcomes. The relationship of psychological states (negative mood, life stress, and stress-responsive hormones) and adiponectin, an adipokine that promotes insulin sensitivity, was investigated in two separate studies. The two groups of participants included 52 healthy, premenopausal women, and 63 postmenopausal women with a range of stress levels. The relationship between adiponectin and psychological state (perceived stress and negative mood) was examined cross-sectionally in both groups of participants, but also prospectively (1 year later) in the group of postmenopausal women.In premenopausal women, negative mood and nocturnal urinary epinephrine were significantly related to adiponectin, independent of BMI. In postmenopausal women, negative mood was not associated with adiponectin cross-sectionally, but negative mood was a significant predictor for lower levels of adiponectin 1 year later, independent of initial adiponectin concentrations and changes in body mass index. Lastly, having a depressive disorder was related to lower adiponectin. As adiponectin levels are associated with insulin resistance, obesity, and diabetes mellitus, these findings suggest there may be an adiponectin-mediated pathway explaining in part how negative mood affects metabolic health. Mechanistic studies are needed to explore this potential relationship further.     

Paraoxonase (PON)1 Q192R functional genotypes and PON1 Q192R genotype by smoking interactions are risk factors for the metabolic syndrome,but not overweight or obesity

Abstract

Background

The metabolic syndrome (MetS) is a complex of multiple risk factors that contribute to the onset of cardiovascular disorder, including lowered levels of high-density lipoprotein (HDL) and abdominal obesity. Smoking, mood disorders, and oxidative stress are associated with the MetS. Paraoxonase (PON)1 is an antioxidant bound to HDL, that is under genetic control by functional polymorphisms in the PON1 Q192R coding sequence.

Aims and methods

This study aimed to delineate the associations of the MetS with plasma PON1 activity, PON1 Q192R genotypes, smoking, and mood disorders (major depression and bipolar disorder), while adjusting for HDL cholesterol, body mass index, age, gender, and sociodemographic data. We measured plasma PON1 activity and serum HDL cholesterol and determined PON1 Q192R genotypes through functional analysis in 335 subjects, consisting of 97 with and 238 without MetS. The severity of nicotine dependence was measured using the Fagerström Nicotine Dependence Scale.

Results

PON1 Q192R functional genotypes and PON1 Q192R genotypes by smoking interactions were associated with the MetS. The QQ and QR genotypes were protective against MetS while smoking increased metabolic risk in QQ carriers only. There were no significant associations between PON1 Q192R genotypes and smoking by genotype interactions and obesity or overweight, while body mass index significantly increased MetS risk. Smoking and especially severe nicotine dependence are significantly associated with the MetS although these effects were no longer significant after considering the effects of the smoking by PON1 Q192R genotype interaction. The MetS was not associated with mood disorders, major depression or bipolar disorder.

Discussion

PON1 Q192R genotypes and genotypes by smoking interactions are risk factors for the MetS that together with lowered HDL and increased body mass and age contribute to the MetS.     

Effects of Heart Rate Variability Biofeedback in Subjects with Stress-Related Chronic Neck Pain: A Pilot Study

Recent studies focusing on autonomic nervous system (ANS) dysfunctions, together with theoretical pathophysiological models of musculoskeletal disorders, indicate the involvement of ANS regulation in development and maintenance of chronic muscle pain. Research has demonstrated the effectiveness of heart rate variability (HRV) biofeedback (BF) in increasing HRV and reducing the symptoms of different disorders characterized by ANS aberration. The study investigated the effects of resonance frequency HRV BF on autonomic regulation and perceived health, pain, stress and disability in 24 subjects with stress-related chronic neck-shoulder pain. Twelve subjects participated in 10 weekly sessions of resonant HRV BF and were compared to a control group. Subjective reports and HRV measures during relaxation and in response to a standardized stress protocol were assessed for both groups pre- and post-intervention. Group × time interactions revealed a significantly stronger increase over time in perceived health (SF-36) for the treatment group, including vitality, bodily pain and social functioning. Interactions were also seen for HRV during relaxation and reactivity to stress. The present pilot study indicates improvement in perceived health over a 10 week intervention with HRV-biofeedback in subjects with chronic neck-pain. Increased resting HRV as well as enhanced reactivity to hand grip and cold pressor tests might reflect beneficial effects on ANS regulation, and suggest that this intervention protocol is suitable for a larger controlled trial.     

Adverse Events Associated with Yoga: A Systematic Review of Published Case Reports and Case Series

While yoga is gaining increased popularity in North America and Europe, its safety has been questioned in the lay press. The aim of this systematic review was to assess published case reports and case series on adverse events associated with yoga. Medline/Pubmed, Scopus, CAMBase, IndMed and the Cases Database were screened through February 2013; and 35 case reports and 2 case series reporting a total of 76 cases were included. Ten cases had medical preconditions, mainly glaucoma and osteopenia. Pranayama, hatha yoga, and Bikram yoga were the most common yoga practices; headstand, shoulder stand, lotus position, and forceful breathing were the most common yoga postures and breathing techniques cited. Twenty-seven adverse events (35.5%) affected the musculoskeletal system; 14 (18.4%) the nervous system; and 9 (11.8%) the eyes. Fifteen cases (19.7%) reached full recovery; 9 cases (11.3%) partial recovery; 1 case (1.3%) no recovery; and 1 case (1.3%) died. As any other physical or mental practice, yoga should be practiced carefully under the guidance of a qualified instructor. Beginners should avoid extreme practices such as headstand, lotus position and forceful breathing. Individuals with medical preconditions should work with their physician and yoga teacher to appropriately adapt postures; patients with glaucoma should avoid inversions and patients with compromised bone should avoid forceful yoga practices.     

Rapid Gene Expression Changes in Peripheral Blood Lymphocytes upon Practice of a Comprehensive Yoga Program

One of the most common integrative medicine (IM) modalities is yoga and related practices. Previous work has shown that yoga may improve wellness in healthy people and have benefits for patients. However, the mechanisms of how yoga may positively affect the mind-body system are largely unknown. Here we have assessed possible rapid changes in global gene expression profiles in the peripheral blood mononuclear cells (PBMCs) in healthy people that practiced either a comprehensive yoga program or a control regimen. The experimental sessions included gentle yoga postures, breathing exercises, and meditation (Sudarshan Kriya and Related Practices – SK&P) compared with a control regimen of a nature walk and listening to relaxing music. We show that the SK&P program has a rapid and significantly greater effect on gene expression in PBMCs compared with the control regimen. These data suggest that yoga and related practices result in rapid gene expression alterations which may be the basis for their longer term cell biological and higher level health effects.     

Use of Radiological Facilities by General Practitioners

The 11,360 direct referrals to diagnostic radiological facilities by general practitioners in the Aberdeen area during 1973 were studied. These represented about 12% of the adult radiology performed in the main x-ray departments of the city, and barium meal examinations amounted to half of all such outpatient contrast examinations. Chest x-ray and barium meal examinations were the most frequently used procedures.Some abnormality was detected at 34% of all examinations, and the barium meal examinations requested by general practitioners showed a similar percentage of abnormal findings to those requested by Aberdeen hospital doctors.The average referral rate for all practices was 24·6 per 1,000 practice population per year. Singlehanded general practitioners referred fewer patients for diagnostic radiology than those working in group practices, and rural practitioners referred fewer than urban general practitioners. This trend was emphasized at a distance greater than 15 miles from the city.     

Preliminary Results of an Open Label Study of Heart Rate Variability Biofeedback for the Treatment of Major Depression

Major depressive disorder (MDD) is a common mood disorder that can result in significant discomfort as well as interpersonal and functional disability. A growing body of research indicates that autonomic function is altered in depression, as evidenced by impaired baroreflex sensitivity, changes in heart rate, and reduced heart rate variability (HRV). Decreased vagal activity and increased sympathetic arousal have been proposed as major contributors to the increased risk of cardiovascular mortality in participants with MDD, and baroreflex gain is decreased. STUDY OBJECTIVES: To assess the feasibility of using HRV biofeedback to treat major depression. DESIGN: This was an open-label study in which all eleven participants received the treatment condition. Participants attended 10 weekly sessions. Questionnaires and physiological data were collected in an orientation (baseline) session and Treatment Sessions 1, 4, 7 and 10. MEASUREMENTS AND RESULTS: Significant improvements were noted in the Hamilton Depression Scale (HAM-D) and the Beck Depression Inventory (BDI-II) by Session 4, with concurrent increases in SDNN, standard deviation of normal cardiac interbeat intervals) an electrocardiographic estimate of overall measure of adaptability. SDNN decreased to baseline levels at the end of treatment and at follow-up, but clinically and statistically significant improvement in depression persisted. Main effects for task and session occurred for low frequency range (LF) and SDNN. Increases in these variables also occurred during breathing at one's resonant frequency, which targets baroreflex function and vagus nerve activity, showing that subjects performed the task correctly. CONCLUSIONS: HRV biofeedback appears to be a useful adjunctive treatment for the treatment of MDD, associated with large acute increases in HRV and some chronic increases, suggesting increased cardiovagal activity. It is possible that regular exercise of homeostatic reflexes helps depression even when changes in baseline HRV are smaller. A randomized controlled trial is warranted.