Using Heart Rate Variability/Vagal Tone Increase Biofeedback Training to Improve Emotional & Cognitive Function in Women with Breast Cancer Diagnosis

Women with a breast cancer (BC) diagnosis suffer profound and chronic emotional vulnerability with cognitive deficits which severely impact on their quality of life and life expectancy. Evidence strongly suggests that these deficits are linked to autonomic nervous system (ANS) dysfunction caused directly by common treatments for breast cancer. Accumulating research emphasises the underlying role of the ANS dysfunction (i.e., sustained sympathetic branch overactivation) in causing severe adverse emotional and physical effects on cancer survivors' health post active oncologic treatment. Current therapeutic approaches do not target the ANS imbalance nor do they sufficiently address the complex, severe comorbidity of emotional and cognitive symptoms in the breast cancer population. Slow breathing techniques, especially breathing at the resonance frequency of ~ 6 breaths per minute, are known to directly stimulate the parasympathetic branch of the ANS improving physical health as well as emotional and cognitive functioning. The primary aim of this research is therefore, to assess the long-term efficacy of a non-invasive, accessible Heart Rate Variability (HRV) biofeedback training intervention, involving paced breathing, which has been shown to directly influence ANS activity/balance, i.e., improvement in cardiac vagal tone (increase parasympathetic activity, and associated sympathetic inhibition) showing significant improvements in psychological and physical health outcomes across populations.

My research will utilise the novel non-invasive HRV biofeedback practice tool to improve emotional and cognitive resilience in female breast cancer survivors. The research will combine high precision physiological (HRV measures), behavioural methods and use self-report and advanced quantitative measures to study the biofeedback training effects on measures of emotion regulation and cognitive control. The study will collect qualitative data and use the Framework Method for a comprehensive examination of underlying psychopathology (emotional and cognitive). This is a robust method will be used to analyse the impact of HRV biofeedback training on the health and quality of life indices associated with ANS dysfunction in BC survivors including sleep, pain, mood, fatigue, stress, resting heart rate variability and heart rate. Any treatment-related changes and interactions between psychological and physical symptoms will be measured across time and examined in depth. This will help to contextualise the psychological/experiential phenomena, help make sense of individual lived experience of cancer and psychological and physical symptoms to provide insights into future rehabilitation and optimal application of the HRV increase biofeedback intervention (i.e., resonance frequency breathing). This research falls firmly in line with demands for new complementary, accessible interventions as well as calls for systematic research into existing low intensity manipulations such as breathing techniques, to provide a mechanistic understanding of evidence-based interventions improving public health outcomes.