Chronic cancer-related symptoms (stress, fatigue, pain, depression, insomnia) may be linked with sympathetic nervous system over-activation and autonomic imbalance. Decreased heart rate variability (HRV) is an indicator of autonomic dysregulation that is commonly observed among cancer survivors. HRV biofeedback (HRVB) training induces HRV coherence, which maximizes HRV and facilitates autonomic and cardiorespiratory homeostasis. This randomized, wait-list-controlled, pilot intervention trial tested the hypothesis that HRVB can improve HRV coherence and alleviate cancer-related symptoms. The intervention group (n = 17) received 4–6 weekly HRVB training sessions until participants demonstrated skill acquisition. Controls (n = 17) received usual care. Outcomes assessed at baseline and follow-up included 15-min HRV recordings (HRV Coherence Ratio), and symptoms of: stress, distress, post-traumatic stress disorder (PTSD), pain, depression, fatigue, and sleep disturbance. Linear mixed models for repeated measures were used to assess Group-by-Time interactions, pre- versus post-treatment differences in mean symptom scores, and group differences at follow-up. Mean HRV Coherence Ratios (± standard error) improved in the HRVB group at follow-up (baseline: 0.37 ± 0.05, post-intervention: 0.84 ± 0.18, p = 0.01), indicating intervention validity. Statistically significant Group-by-Time interactions indicated treatment-related improvements in HRV Coherence Ratios (p = 0.03, Pre-vs. post-treatment effect size [Cohen’s d]: 0.98), sleep symptoms (p = 0.001, d = 1.19), and sleep-related daytime impairment (p = 0.005, d = 0.86). Relative to controls, the intervention group experienced trends toward improvements in stress, distress, fatigue, PTSD, and depression, although no other statistically significant Group-by-Time interactions were observed. This pilot intervention found that HRVB training reduced symptoms of sleep disturbance among cancer survivors. Larger-scale interventions are warranted to further evaluate the role of HRVB for managing symptoms in this population. Registration: NCT 03692624 www.clinicaltrials.gov

中文翻译：

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癌症幸存者之间的症状管理：心率变异性生物反馈的随机先导干预试验。

慢性癌症相关症状（压力，疲劳，疼痛，抑郁，失眠）可能与交感神经系统过度活化和自主神经失调有关。心率变异性（HRV）的降低是自主神经功能异常的指示，这通常在癌症幸存者中观察到。HRV生物反馈（HRVB）训练可诱导HRV连贯性，从而最大化HRV并促进自主神经和心肺动态平衡。这项由等待名单控制的随机，先导干预的随机试验验证了HRVB可以改善HRV相干性并缓解癌症相关症状的假设。干预组（n = 17）每周接受4-6次HRVB培训，直到参与者证明自己掌握了技能。对照组（n = 17）接受常规护理。在基线和随访中评估的结果包括15分钟的HRV记录（HRV相干率），症状和体征：压力，困扰，创伤后应激障碍（PTSD），疼痛，抑郁，疲劳和睡眠障碍。重复测量的线性混合模型用于评估按时间分组的交互作用，治疗前和治疗后平均症状评分的差异以及随访时的分组差异。随访时，HRVB组的平均HRV相干率（±标准误差）有所改善（基线：0.37±0.05，干预后：0.84±0.18，p = 0.01），表明干预有效。具有统计学意义的按时间分组交互作用表明与治疗相关的HRV相干率改善（p = 0.03，相对于治疗前效果大小[Cohen d]：0.98），睡眠症状（p = 0.001，d = 1.19）以及与睡眠有关的白天障碍（p = 0.005，d = 0.86）。相对于控件，干预组经历了压力，困扰，疲劳，PTSD和抑郁症改善的趋势，尽管未观察到其他统计上显着的分组时间交互作用。这项先导干预措施发现，HRVB训练可以减少癌症幸存者中的睡眠障碍症状。有必要采取大规模干预措施，以进一步评估HRVB在控制该人群症状中的作用。注册：NCT 03692624 www.clinicaltrials.gov