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HRV-Biofeedback FAQ for Patients

I feel lightheaded or dizzy, is that ok?

It’s not uncommon to feel lightheaded or dizzy initially. This could be a sign that you are “overbreathing” or hyperventilating somewhat. If you notice your chest or shoulders moving a lot while training, you might be overbreathing. To alleviate lightheadedness or dizziness, try some of the following:

  • See if you can use less effort when you breathe.
  • Breathe less deeply.
  • Think: “Low and slow”.
  • Breathe through pursed lips.
  • See if using the audio cues helps you breathe with less effort.

During training, put your hands on either side of your low ribs. Tune into the feeling of slow, steady expansion, using the breath to move your hands outward.
If you need more support or want to know more about overbreathing, read our post on “Overbreathing during HRV-B”.

I felt pain while breathing, what can I do?

Pain activates the stress response, something we are trying to quiet during HRV-B. HRV-B training should not be painful, and there is no need to push through pain to benefit from it. Take the modifications you need that will help you train comfortably.

Pain in the earlobe due to the sensor

  • Try moving the device to different sections of the soft part of the earlobe, higher and lower.
  • Try warming the earlobe before training with a cupped hand or warm washcloth.
  • Unfortunately, the device cannot be used on another part of your body (like a finger).

Pain in your body due to sitting

  • HRV-B is sensitive to your back posture, which should be upright and not tilted or slouching.
  • Your leg position can be whatever is comfortable (sitting in a chair, on the floor or sitting upright in bed)
  • Try using props (cushions, bolsters, yoga blocks) to support your body position in a way that keeps your comfortable.

Pain in lungs or ribcage

  • Try training after a warm shower to alleivate congestion.
  • HRV-B is safe for individuals with COPD and asthma, if you need any medications for these conditions they may impact your HRV, but training is still effective and beneficial.

I am concerned I may have medical isues that might interfere with HRV Biofeedback.

HRV-B is generally low-risk. Still, if you have any of these pre-existing conditions, it is safer for you not to practice HRV-B without first consulting your physician:


  • You have a pacemaker.
  • During an active episode of Atrial Fibrillation.
  • You have sharp, severe, or long-lasting pain, especially in your heart or chest.
  • You continue to experience light-headedness or dizzy spells, even after trying these tips for overbreathing and consulting your therapist.
  • You have frequent (3 or more per minute) premature ventricular contractions. Occasional PVCs are not a major cause for concern; while they may impact your metrics, they should not prevent you from doing HRV-B.


You can read more about HRV-B and medical conditions on our blog post.

I find it difficult to get into or stay in resonance.

Some Meru participants find it very difficult to get into resonance. This can evoke feelings of frustration, worries about health, or even a sense of hopelessness. If your sessions feel emotionally challenging, know that you are not alone. We are here to help you on your journey to healing.

Frustration during HRV-B activates your stress response, which can lead to a cycle where your frustration at not being in resonance makes it even harder to get into resonance. The first step to interrupting this cycle is letting go of self-criticism and blame. Your HRV is a little like muscular flexibility: you cannot force a muscle to lengthen. Similarly, you cannot force your HRV into resonance. Realistically, it may take you a week or two of regular practice to train your nervous system, especially if you have had disruptions in your routine or health. Just like stretching a tense muscle that is having trouble lengthening, you are still getting benefit from your HRV-B training even if you aren’t always in resonance.

Read our blog post “Strategies to increase time in resonance” to learn more.

I am almost always in resonance. Is there a way to make HRV-B more challenging?

Occasionally, people who are younger, physically fit, or experienced with slow breathing find that they are nearly always in resonance no matter what they do. Most people breathe around 12-20 breaths per minute when resting, so they would only be in resonance, according to Meru’s algorithm, when breathing closer to 6 breaths per minute. However, people who have practiced a lot of meditation, slow breathing, or yoga, may unconsciously tend to breathe slower when they are “in the zone”. In such moments, this could make your breathing pace approach your resonant frequency even when you are not intentionally following the pacer.


If you need more challenge, you could try alternate nostril breathing while doing biofeedback. You can also try doing HRV-B during your workday or other times when your stress response might be a little more active and see if you can quiet it with your training.

Still have questions? Let's talk.