title: Effects of controlled breathing, mental activity and mental stress with or without verbalization on heart rate variability.
abstract: OBJECTIVE
  To assess whether talking or reading (silently or aloud) could affect heart rate variability (HRV) and to what extent these changes require a simultaneous recording of respiratory activity to be correctly interpreted.
  
  
  BACKGROUND
  Sympathetic predominance in the power spectrum obtained from short- and long-term HRV recordings predicts a poor prognosis in a number of cardiac diseases. Heart rate variability is often recorded without measuring respiration; slow breaths might artefactually increase low frequency power in RR interval (RR) and falsely mimic sympathetic activation.
  
  
  METHODS
  In 12 healthy volunteers we evaluated the effect of free talking and reading, silently and aloud, on respiration, RR and blood pressure (BP). We also compared spontaneous breathing to controlled breathing and mental arithmetic, silent or aloud. The power in the so called low- (LF) and high-frequency (HF) bands in RR and BP was obtained from autoregressive power spectrum analysis.
  
  
  RESULTS
  Compared with spontaneous breathing, reading silently increased the speed of breathing (p < 0.05), decreased mean RR and RR variability and increased BP. Reading aloud, free talking and mental arithmetic aloud shifted the respiratory frequency into the LF band, thus increasing LF% and decreasing HF% to a similar degree in both RR and respiration, with decrease in mean RR but with minor differences in crude RR variability.
  
  
  CONCLUSIONS
  Simple mental and verbal activities markedly affect HRV through changes in respiratory frequency. This possibility should be taken into account when analyzing HRV without simultaneous acquisition and analysis of respiration.
authors.affiliation: Department of Internal Medicine, IRCCS S. Matteo-University of Pavia, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Bernardi
authors.forename: J
authors.initials: J
authors.lastname: Wdowczyk-Szulc
authors.forename: C
authors.initials: C
authors.lastname: Valenti
authors.forename: S
authors.initials: S
authors.lastname: Castoldi
authors.forename: C
authors.initials: C
authors.lastname: Passino
authors.forename: G
authors.initials: G
authors.lastname: Spadacini
authors.forename: P
authors.initials: P
authors.lastname: Sleight
mesh_terms: D001143:Arousal / Q000502:physiology*; D016477:Artifacts; D001794:Blood Pressure / Q000502:physiology; D004562:Electrocardiography; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D011340:Problem Solving / Q000502:physiology*; D012123:Pulmonary Ventilation / Q000502:physiology*; D011932:Reading; D012016:Reference Values; D012815:Signal Processing, Computer-Assisted; D013564:Sympathetic Nervous System / Q000502:physiology; D014705:Verbal Behavior / Q000502:physiology*