Greater high-frequency heart rate variability (HF HRV), an indicator of parasympathetic nervous system activity, during mindfulness meditation, was found to be associated with reduced pain unpleasantness, according to study results published in the Journal of Pain.

A total of 62 healthy individuals (age 18 to 55 years; mean age, 31 years) were randomly assigned to follow four 25-minute sessions of mindfulness or sham-mindfulness meditation training. Participants also attended pre- and post-intervention sessions. There were no significant demographic differences between groups at baseline.

Prior to meditation sessions, the researchers administered noxious and innocuous heat to participants’ right calves. HF HRV and respiration rate were recorded during stimulation, and pain intensity and unpleasantness ratings were evaluated before and after sessions.

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The cohort’s mean HF HRV was 8.11±0.97. Reductions in pain unpleasantness — but not in pain intensity — were more strongly associated with greater HF HRV in participants practicing mindfulness vs sham mindfulness (P =.04). In secondary analyses, reductions in pain rating reductions and respiration rates and increases in HF HRV were comparable in participants practicing real and sham mindfulness (P <.05 for all).

Study limitations include the lack of experimenters’ blinding to group assignments.

“Growing evidence demonstrates that one’s ability to sustain non-reactive attention in the present moment (ie, mindfulness) uniquely modulates the elaboration of maladaptive pain-related appraisals and improves parasympathetic processes, factors that may serve as a buffer for the exacerbation of clinical pain,” concluded the study authors.

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Adler-Neal AL, Waugh CE, et al. The role of heart rate variability in mindfulness-based pain relief [published online August 1, 2019]. J Pain. doi:10.1016/j.jpain.2019.07.003