Heart Rate Variability and Capnometry

Heart Rate Variability (HRV) and Capnometry training enhances human performance by impacting three main physiological systems: the respiratory system, the autonomic nervous system, and the central nervous system. All three of these systems work together when using HRVC: respiration to achieve optimal Respiratory-Sinus Arrhythmia (RSA), autonomic nervous system to achieve optimal resonant frequency (RF), and cognition to process body sensations resulting in improved emotional, physical and mental performance.

Heart Rate Variability (HRV) is a mechanism of the cardiovascular system whereby the heart rate varies between heartbeats. Capnometry uses a device to measure CO2 concentrations in respired gases. Training individuals using HRVC biofeedback helps optimize gas exchange in the lungs, reduce anxiety, improve awareness and focus, and supports cognitive skills development. An individual can regulate their body chemistry, pH, electrolyte balance, blood flow, hemoglobin chemistry, and kidney function, resulting in improved behavior, motivation, emotion regulation, attention, perception and memory. Good breathing technique is required to overcome defensive behavior, triggering emotions, dissociating from trauma, reducing fear, all of which are not associated with healthy respiratory chemistry.

What a session is like

HRV biofeedback is a procedure where the individual’s breathing and heart rate are monitored and fed back through a computer to the client to they can see real-time results and learn to achieve optimal performance in themselves. The training protocol typically consists of five office training sessions (one per week) with a qualified therapist who is trained and certified in HRV. There is also client homework between sessions in the form of daily practice of breathing at the RF for 20 minutes twice a day.

The first session typically is devoted to assessing the individual’s general psychophysiology and determining their optimal RSA and RF. The individual is instructed to breath at various rates from 4.5 to 7 breaths per minute until the point is determined at which the heart inter-beat interval begins to correlate with the breathing pattern. The second and third sessions are focused on fine tuning the RF, training on proper abdominal breathing with a breath pacer, and shaping the breath (timing of the inhale and exhale). The percentage of CO2 is evaluated with a capnometer. The fourth and fifth sessions focus on RF breathing without a pacer while attempting to achieve synchronous RSA.

We track progress by monitoring the task duration, peak-valley difference in heart rate, the phase relationship of heart rate and respiration, and the emotional response during the session.

What happens in our brain and body

HRV is controlled by the baroreflex response, which enables a homeostatic balance between blood pressure and heart rate. Baroreceptors, located in the aorta and the carotid artery, send information about blood pressure to the nucleus tractus solitaries in the brain stem. In return, this area sends acetylcholine to the vagus nerve, which innervates the heart. The vagus nerve is also linked to parts of the brain that regulate social engagement, attention, motion, emotion and communication expression and vocalization.

Respiration was also discovered to have a parasympathetic effect on heart rate through the vagus nerve. During inhalation, IBI oscillation increases and during exhalation IBI oscillation decreases; this is called Respiratory Sinus Arrhythmia (RSA). When the baroreflex and IBI oscillations are 180 degrees out of phase with each other, gas exchange efficiency is most efficient in the lungs. The breathing rate at this point is about 6 breaths per minute.

The medulla oblongata is the control center in the brain for breathing and has two respiratory nuclei called the inspiratory center and expiratory center. Chemoreceptors in the brainstem and arteries monitor pH, CO2, and O2 levels and adjust our rate of breathing to keep everything in balance; we hyperventilate when the pH is low to get rid of CO2. The levels of CO2 in the blood influence our sense of anxiety. When anxiety and panic occur, people may overreact and autonomic processes causes restriction in bronchial muscles to inhibit breathing even further.

If you suffer from anxiety, optimizing your blood chemistry with HRV training is a highly effective place to start obtaining relief.

For more reading

Bertnston, G. G., Quigley, K. S., & Lozano, D. (2007). Cardiovascular psychophysiology. In J. Cacioppo, L. G. Tassinary, & G. G. Bertnston (Eds.), Handbook of psychophysiology (3rd ed., pp. 182–210). New York: Cambridge University Press. Retrieved from books.google.com

Gevirtz, R., Lehrer, P., & Schwartz, M. S. (2016). Cardiorespiratory biofeedback. In M. S. Schwartz & F. Andrasik (Eds.), Biofeedback: A practitioner’s guide (4th ed.). New York, NY: The Guilford Press.

Leffey, J., & Kavanagh, M. B. (2002). Hypocapnia. New England Journal of Medicine, 347(1), 43–53.

Lehrer, P. (2013). How does heart rate variability biofeedback work? Resonance, the baroreflex, and other mechanisms. Biofeedback, 41(1), 26–31.

Lehrer, P., Vaschillo, B., Zucker, T., Graves, J., Katsamanis, M., Aviles, M., & Wamboldt, F. (2013). Protocol for heart rate variability biofeedback training. Biofeedback, 41(3), 98–109.

Lehrer, P., Woolfolk, R. L., & Sime, W. E. (2007). Principles and practice of stress management (3rd ed.). New York, NY: Guilford Press.

Litchfield, P. (2010). CapnoLearning: Respiratory fitness adn acid-base regulation. Psyhophysiology Today, 7(1), 1–6.

Porges, S. W. (2001). The polyvagal theory: phylogenetic substrates of a social nervous system. International Journal of Psychophysiology, 42(2), 123–146.

Strack, B. W., Linden, M. K., & Wilson, V. S. (2011). Biofeedback adn neurofeedback applications in sport psychology. Wheat Ridge, CO: Association for Applied Pscyhophysiology and Biofeedback.

Vaschillo, E., Vaschillo, B., & Lehrer, P. (2006). Characteristics of resonance in heart rate variability stimulated by biofeedback. Biofeedback, (31), 129–142.

For more reading

Bertnston, G. G., Quigley, K. S., & Lozano, D. (2007). Cardiovascular psychophysiology. In J. Cacioppo, L. G. Tassinary, & G. G. Bertnston (Eds.), Handbook of psychophysiology (3rd ed., pp. 182–210). New York: Cambridge University Press. Retrieved from books.google.com

Gevirtz, R., Lehrer, P., & Schwartz, M. S. (2016). Cardiorespiratory biofeedback. In M. S. Schwartz & F. Andrasik (Eds.), Biofeedback: A practitioner’s guide (4th ed.). New York, NY: The Guilford Press.

Leffey, J., & Kavanagh, M. B. (2002). Hypocapnia. New England Journal of Medicine, 347(1), 43–53.

Lehrer, P. (2013). How does heart rate variability biofeedback work? Resonance, the baroreflex, and other mechanisms. Biofeedback, 41(1), 26–31.

Lehrer, P., Vaschillo, B., Zucker, T., Graves, J., Katsamanis, M., Aviles, M., & Wamboldt, F. (2013). Protocol for heart rate variability biofeedback training. Biofeedback, 41(3), 98–109.

Lehrer, P., Woolfolk, R. L., & Sime, W. E. (2007). Principles and practice of stress management (3rd ed.). New York, NY: Guilford Press.

Litchfield, P. (2010). CapnoLearning: Respiratory fitness adn acid-base regulation. Psyhophysiology Today, 7(1), 1–6.

Porges, S. W. (2001). The polyvagal theory: phylogenetic substrates of a social nervous system. International Journal of Psychophysiology, 42(2), 123–146.

Strack, B. W., Linden, M. K., & Wilson, V. S. (2011). Biofeedback adn neurofeedback applications in sport psychology. Wheat Ridge, CO: Association for Applied Pscyhophysiology and Biofeedback.

Vaschillo, E., Vaschillo, B., & Lehrer, P. (2006). Characteristics of resonance in heart rate variability stimulated by biofeedback. Biofeedback, (31), 129–142.