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Lehrer, P. M., Vaschillo, E., Vaschillo, B., Lu, S. E., Eckberg, D. L., Edelberg, R., Shih, W. J., Lin, Y., Kuusela, T. A., Tahvanainen, K. U. O., & Hamer, R. M. (2003). Heart rate variability biofeedback increases baroreflex gain and peak expiratory flow. Psychosomatic Medicine, 65, 796-805. http://dx.doi.org/10.1097/01.PSY.0000089200.81962.19

has been cited by the following article:

• TITLE: Stress Management Based on Trait-Anxiety Levels and Sleep Quality in Middle-Aged Employees Confronted with Psychosocial Chronic Stress

  AUTHORS: Marion Trousselard, Dominique Steiler, Angelique Lebreton, Pascal Van Beers, Catherine Drogout, Josiane Denis, Mounir Chennaoui, Frédéric Canini

  KEYWORDS: Anxiety; Work Stress; Sleep; Stress Management

  JOURNAL NAME: Psychology, Vol.5 No.1, January 26, 2014

  ABSTRACT: A stress management program using cardiac coherence was implemented after an organizational downsizing. The study was conducted in nine voluntary workers in order to evaluate the efficiency of the program. A baseline evaluation was conducted on psychological variables (anxiety, perceived-stress, wellbeing and sleep), endocrine assessments (urinary cortisol excretion, alpha-amylase and salivary concentrations) and physiological recordings (sleep and heart rate variability). The low number of participants was due to the intrusive approach in collecting physiological and endocrine variables. The program consisted of ten sessions of cardiac coherence training during a 3-month follow-up period. At the end of the training sequence, subjects were once again exposed to the same evaluation battery. A decrease in perceived stress and a subsequent increase in well-being were observed. Sleep quality improved as suggested by the results of the subjective and objective measurements. For the entirety of the results, improvements were higher in subjects with high vs. low trait-anxiety scoring. The pattern of results for subjects prone to a high level of trait-anxiety suggested that stress and sleep are related to each other in a bidirectional way: increased anxiety is associated to poor sleep and stress reduction improves both anxiety and sleep. On the basis of these results, we suggest that trait-anxiety can be used as an indicator of which employees should be given priority for stress management intervention. We will also highlight the interest of operationally physiological recordings, used outside the laboratory, for measuring objective improvements due to this stress management intervention, as quality of sleep.