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Category: Project

Description: Interoceptive dysfunctions are increasingly implicated in a number of physical and mental health conditions. Accordingly, there is a pertinent need for therapeutic interventions which target interoceptive deficits. Heartrate and heartrate variability biofeedback therapy (HR(V)-BF), interventions which train individuals to regulate their cardiovascular signals through breathing, could enhance the functioning of interoceptive pathways via stimulation of the vagus nerve. Consequently, this narrative systematic review sought to synthesise the current state of the literature with regards to the effects of HR(V)-BF on interoception across behavioural, physiological and neural interoceptive outcome measures. In total, 77 papers were included in this review, with the majority using physiological outcome measures. Effects of HR(V)-BF on interoception were mixed across outcome measures, however, trends suggested that effects on interoception were stronger when resonance frequency breathing and an intense treatment protocol were employed. Based upon these findings, we propose a three-stage model by which HR(V)-BF may improve interoception, as well as specific directions for future research that we believe will serve to advance the current knowledge state.