Heart Rate Variability Training in U.S. Military Veterans and their Caregivers¿The Power of Two

Abstract

Research Question: In United States Armed Forces veterans with invisible wounds of war, such as posttraumatic stress (PTS) and traumatic brain injury (TBI), does training Heart Rate Variability (HRV) in sessions with a trusted companion going through the training with the participant lead to significant further improvement in self-reported executive cognitive function, and general mental and physical well-being for the veteran when compared to the improvements seen in veterans who are trained in one-on-one sessions with a licensed coach?

Background and Significance: HRV, which is a measurement of how ¿in sync¿ our bodily systems are, is an important indicator of health, fitness, and stress resilience. Low variability can indicate that an individual is functioning below optimal physical, cognitive, or emotional levels. Conversely, optimal HRV reflects a healthy balance between both branches of the autonomic nervous system (ANS) and represents an individual¿s resilience and ability to adapt to physical and mental stress. Negative emotions such as stress, anger, and worry foster ANS imbalance. In contrast, sincere, positive feeling states result in balance, order, and stability that, when practiced regularly, with deep breathing, improve HRV. While there have been many studies that have illustrated the benefits of HRV training for those coping with emotional distress, there is a lack of robust research exploring the effects of simultaneously training close friends or family in HRV.

Materials and Methods: A prospective cohort study was performed. Veterans enrolled in Boot Campaign's Stress and Resilience program and an identified trusted caregiver/companion underwent an individual, but simultaneous, interactive HRV-training program based upon a standardized, culturally competent curriculum for a period of 5 weeks. This program, led by a credentialed and experienced coach teaches evidence-based tools that can be used in real-time to help manage stress, build resilience capacity, and optimize performance. Outcomes were collected prior to the commencement of the coaching protocol and again at the conclusion of training. Standardized self-report outcome measures were then utilized to assess program efficacy. We compared pre and post intervention survey results to measure participant progress over the course of our study using both paired t-tests and nonparametric independent t-tests.

Results: We found that veterans who have a trusted companion (caregiver or significant other) that simultaneously undergoes the HRV training had greater improvements in a reduction of stress, anxiety, fatigue, burnout, and depression and a greater improvement in executive cognitive function, and general mental and physical well-being when compared to their baseline values obtained before the simultaneous training began.

Conclusion: We believe that these improvements were due to improvements in the HRV measures of the veterans. While these results can be used by Boot Campaign and similar veteran-centered organizations to drive treatment, other professional groups such as first responders and physicians, who deal with high rates of stress, including posttraumatic stress, could also benefit from the therapeutic implications of this study.