Benefits of heart rate variability biofeedback training on medical students' mental health

Background: Heart rate variability biofeedback (HRV-BF) has emerged as a promising non-pharmacological intervention for stress and emotional regulation. This study aimed to evaluate the longitudinal effects of HRV-BF on perceived stress, depression, and anxiety among international medical students over 12 weeks. 
Methods: A total of 47 international medical students participated in the study, with psychological assessments conducted at two time points (February and May) over a 12-week period, using the Perceived Stress Scale (PSS), Beck Depression Inventory (BDI), Zung Self-Rating Anxiety Scale (SAS), and Beck Anxiety Inventory (BAI). Statistical analyses included the Wilcoxon Signed-Rank Test to assess changes over time within each group. 
Results: The results revealed significant reductions in all measured psychological parameters within the biofeedback group, with stress (p = 0.007), depression (p = 0.002), and anxiety (p < 0.001) levels showing notable improvement over time. The control group exhibited minimal change over time, supporting the observed improvements within the biofeedback group. 
Conclusions: These findings support the integration of HRV-BF training into medical education as a strategy for enhancing students' mental well-being. Future research should explore long-term effects and optimize intervention protocols to maximize benefits. HRV-BF may serve as a valuable tool in mitigating the psychological burden associated with rigorous academic environments.

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