Heart Rate Variability (HRV) Biofeedback

hrv biofeedback

Putting You in Charge:  Treatment Without Medication

What is HRV?

 

Heart rate variability is where the amount of time between your heartbeats fluctuates slightly. Even though these fluctuations are undetectable except with specialized devices, they can still indicate current or future health problems, including heart conditions and mental health issues like anxiety and depression.

Your brain and nervous system support your heart. Your senses — sight, sound, smell, taste and touch — feed information to your brain about everything around you. Your brain has a direct line to your heart, telling your heart when it needs to speed up and work harder.

This direct line to your heart is your autonomic (pronounced “auto-nom-ick”) nervous system. This is a part of your brain and a set of nerves that operate without you thinking of them, even when you’re asleep. It’s divided into two main parts: your sympathetic nervous system and your parasympathetic nervous system.

In general, the sympathetic and parasympathetic nervous systems work like so:

  • Sympathetic. This is where your “fight-or-flight” response comes from. It manages increases in heart rate and blood pressure in emergency situations.
  • Parasympathetic. This helps balance out the sympathetic nervous system and controls the natural relaxation response, especially after you’ve been in fight-or-flight mode. It controls slowing your heart rate and blood pressure, among other things, especially when you’re taking it easy.

 

Why it Matters

HRV can help you by acting as a health indicator to understand your body’s stress and recovery levels, and by guiding decisions about training, lifestyle, and health. A higher HRV generally indicates a more resilient body that is better at handling stress and recovering, while a lower HRV may signal stress, overtraining, or oncoming illness. 

Understand and manage your body’s stress and recovery 

  • Measure stress: Your HRV can show how your body is coping with daily stress. A consistently low HRV may be a sign that your stress levels are too high.
  • Optimize recovery: A higher HRV is associated with better recovery and a healthy “rest-and-digest” state, indicating your body is well-rested and resilient.
  • Identify oncoming illness: A drop in your HRV, even without other changes, can sometimes be an early indicator of illness. 

Guide training and lifestyle choices

  • Train smarter: HRV data can help you decide when to push harder in your workouts and when to prioritize rest to avoid overtraining.
  • Inform health decisions: It can help you see how different factors, like diet or sleep, affect your body, allowing you to make adjustments to improve your overall well-being.
  • Support recovery: People recovering from injury or surgery, or those managing chronic inflammation, can use HRV to track their progress and build strength. 

Improve long-term health 

  • Improve cardiovascular health: By helping to balance the sympathetic (“fight-or-flight”) and parasympathetic (“rest-and-digest”) nervous systems, managing your HRV can lead to better cardiovascular functioning and may reduce risks.
  • Build resilience: Regularly improving your HRV can lead to a greater sense of control over your body and improve its ability to handle both physical and mental stress. 

 

Our Approach

 

At the Peak Performance Institute, we offer Heart Rate Variability as a form of biofeedback therapy, a process where patients learn to consciously control their physiological responses using real-time monitoring instruments. 

The training, a form of biofeedback, is a safe, non-invasive and holistic approach to healthcare that provides the client practical, economical and drug-free ways to improve mood and well-being.

We encouraged our clients’ independence and offer psychoeducational education about their conditions, encouraging agency and autonomy as well as treatment without medication.

What to Expect

  1. First Session / IntroductionThe process generally involves the following steps:

    1. Initial Assessment and Goal Setting

    Dr. Mustin conducts a comprehensive consultation to understand the client’s health history, symptoms (e.g., anxiety, chronic pain, stress), lifestyle habits, and goals. A baseline HRV measurement is established, often taking daily readings over a week. 

    2. Determining the Optimal Breathing Rate (Resonant Frequency) 

    A core component of HRV training is finding the client’s unique resonant frequency, the specific breathing rate (typically around 6 breaths per minute, or a full cycle every 7.5 to 13.5 seconds) at which the heart rate and breathing rhythms synchronize and maximize the HRV amplitude. 

    • The clinician attaches sensors (e.g., a photoplethysmograph on a finger or earlobe to monitor the client’s heart rate and breathing in real-time.
    • The client is guided to breathe at different slow rates for a few minutes each while the system records which rate produces the greatest increase in their HRV. 

    3. In-Office Biofeedback Sessions

    During subsequent sessions (typically 6 to 10 sessions of 30-60 minutes), the client practices breathing at their optimal frequency with real-time audio and/or visual feedback on a computer screen. 

    • The software displays the client’s heart rhythm and respiration pattern, allowing them to see how their breathing directly affects their heart rate variability.
    • The practitioner guides the client through techniques, such as diaphragmatic (belly) breathing, to help them achieve a state of high physiological coherence.
    • As the client improves, they learn to associate their internal physical and mental state with the positive changes on the screen, building awareness and the ability to self-regulate their nervous system. 

    4. Home Practice and Integration

    Clients are usually given a stand-alone device such as the EMwave or an app for their smartphone to continue practicing at home. 

    • Daily home practice (e.g., two 20-minute sessions per day) is crucial for integrating the skills learned and making self-regulation an ingrained habit.
    • The practitioner uses follow-up sessions to review progress, analyze data, address challenges, and help the client transfer these self-regulation skills to daily life situations, without relying on the monitoring equipment. 
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Benefits

  • Chronic stress or burnout

  • Anxiety, panic, or hyperarousal

  • Emotional dysregulation

  • Autonomic imbalances (e.g. low HRV)

  • Performance under pressure (cognitive, sports, artistic)

  • Trauma recovery & nervous system recalibration

Why Choose Peak Performance Institute for HRV Biofeedback?

  • Seasoned clinician trained in psychophysiology
  • Use of validated biofeedback instrumentation
  • Tailored protocols based on individual physiology
  • Integration with psychotherapy and holistic care
  • Focus on sustainable, skill-based changes