Resonant breathing shows promise as a low-burden intervention to improve autonomic regulation, anxiety and insomnia in acutely ill psychiatric inpatients with severe somatic symptoms

While slow-paced breathing is widely used to reduce stress and anxiety, its more targeted form—resonant breathing, designed to optimise heart rate variability—has rarely been investigated in acutely ill psychiatric inpatients. Prior research has demonstrated benefits for healthy individuals and patients with somatic diseases. Yet, no randomised controlled trial has specifically examined its therapeutic potential for hospitalised patients with severe, persistent somatic symptoms, a population marked by high autonomic dysregulation and substantial symptom burden. A recent study published in General Psychiatry addressed this gap by rigorously evaluating resonant breathing as an adjunctive, physiologically focused intervention in early inpatient treatment.

This trial enrolled 78 adult inpatients diagnosed with somatic symptom disorder or depressive episodes with somatic features. Participants were randomised to receive 10 sessions of either light-guided resonant breathing or a sham light-therapy control. Morning and evening sessions were delivered over consecutive weekdays beginning approximately 11 days after admission.

Although resonant breathing did not improve the primary outcomes of somatic well-being or arousal, both groups showed general improvements across the treatment week, likely reflecting broader inpatient care effects. Importantly, the intervention significantly reduced anxiety and insomnia symptoms and produced substantial acute increases in heart rate variability, indicating enhanced parasympathetic regulation.

Traditionally viewed as a relaxation technique, resonant breathing may offer unique advantages for psychiatric inpatients with high symptom load, as it requires minimal cognitive effort, is well-tolerated and can be implemented early in hospitalisation—before patients can engage in more complex psychotherapeutic work. Findings suggest resonant breathing as a simple, scalable and safe intervention capable of targeting autonomic dysfunction, anxiety and insomnia in populations where treatment options are often limited. Researchers propose that extending the intervention duration and combining it with objective physiological measures (e.g., polysomnography, long-term HRV) may further clarify its therapeutic potential.

“For clinicians working with hospitalized patients with psychiatric disorders and persistent somatic symptoms, this research offers a practical, low-demand tool that can be implemented early in treatment,” explained the study’s first author, Dr Markus Canazei, University of Innsbruck, Austria.​​“The simplicity of the intervention makes it particularly suitable for patients with a high symptom burden who may initially struggle to engage in more complex psychosocial therapies.”