4.2 Article

Short-term efficacy of home-based heart rate variability biofeedback on sleep disturbance in patients with incurable cancer: a randomised open-label study

Journal

BMJ SUPPORTIVE & PALLIATIVE CARE
Volume 13, Issue 2, Pages 190-198

Publisher

BMJ PUBLISHING GROUP
DOI: 10.1136/bmjspcare-2020-002324

Keywords

complementary therapy; education and training; home care; psychological care; symptoms and symptom management

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This study aimed to establish a self-coping system for home-based HRV-BF with resonant breathing in patients with sleep disturbance and evaluate its short-term efficacy and feasibility. The results showed that home-based HRV-BF significantly improved sleep efficiency, duration, and autonomic function. Therefore, it demonstrated high short-term efficacy and feasibility for a self-coping system.
ObjectivesEarly palliative care reportedly contributes to the quality of life by improving coping skills in patients with cancer. The aims of the study are to (1) Build a self-coping system that makes it possible to perform a session of home-based heart rate variability biofeedback (HRV-BF) with resonant breathing in patients with sleep disturbance and to acquire its techniques early on, and (2) Examine its short-term efficacy and feasibility. MethodsA randomised, open-label, comparative study was conducted in the presence or absence of home-based HRV-BF with resonant breathing using a portable HRV-BF device prior to bedtime. The participants were 50 patients with incurable cancer with sleep disturbance who underwent a hospital practice of HRV-BF with resonant breathing. The primary end point was the rate of change in sleep efficiency for 10-14 days. The Japanese version of the Pittsburgh Sleep Quality Index (subjective indicator) and actigraphy sleep parameters (objective indicators) were used for sleep assessments. ResultsThe completion rate and implementation rate in the home-based HRV-BF group (n=25) were 96.0% and 91.4%, respectively. This group showed a significant improvement in sleep efficiency, sleep duration and the low-frequency component of HRV. Sleep latency worsened in this group, but a significant difference was not observed. ConclusionsA home practice of HRV-BF with resonant breathing made it possible to acquire its techniques early on and improve sleep and autonomic function; therefore, our study showed high short-term efficacy and feasibility required for a self-coping system.

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