Evidence map›Paper›PMID 42526901›Full record

SynthesisAddiction (Abingdon, England)2026

Controlled breathing and heart rate variability biofeedback for substance use-related outcomes: A systematic review and meta-analysis.

Ariel Dart Roxburgh, Bosco Rowland, Dan I Lubman, Sukhjit Kaur Bains, May Anne Pek, Bernard Tso, Victoria Manning, Shalini Arunogiri

Abstract readSystematic ReviewMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Addiction (Abingdon, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Ariel Dart RoxburghMonash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.
Bosco RowlandMonash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.
Dan I LubmanMonash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.
Sukhjit Kaur BainsMonash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.
May Anne PekEastern Health Clinical School, Monash University, Melbourne, Australia.
Bernard TsoEastern Health Clinical School, Monash University, Melbourne, Australia.
Victoria ManningMonash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.
Shalini ArunogiriMonash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimSubstance use disorders (SUDs) contribute significantly to global social and economic burden. Breathing-based interventions offer a low-cost, scalable adjunct or alternative to traditional treatment, yet their effects on substance use-related outcomes has not been systematically evaluated. This study aimed to systematically review and meta-analyse the effectiveness of controlled breathing and heart rate variability biofeedback (HRVB) interventions in improving substance use-related outcomes among people using alcohol and other drugs, including nicotine.

methodsWeb of Science, PsycINFO, MEDLINE, CINAHL, EMBASE, PubMed, Scopus and Cochrane were searched, with the final search conducted on 14 November 2025. The protocol was prospectively registered with the International Prospective Register of Systematic Reviews. Eligible studies were quantitative, with repeated-measure designs, with at least one substance use-related outcome; interventions were required to have controlled breathing as the primary mechanism and were categorised by inclusion of HRVB. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A random-effects model was used to estimate pooled effects.

resultsOf 3502 studies identified, 20 met the inclusion criteria, of which 15 were eligible for meta-analyses. Breathing-based interventions produced lower craving than controls, with a small but statistically significant and consistent effect [Hedge's g = 0.30, 95% confidence interval (CI) = 0.12-0.48, heterogeneity (I

conclusionsIn people who use substances, breathing-based interventions appear to lead to statistically significant reductions in craving compared with controls, supporting their potential as a low-cost and scalable strategy for managing craving in substance use disorders.

Indexed as

Biofeedback, PsychologyBreathing ExercisesHeart RateSubstance-Related DisordersCravingHumansRespirationaddictionbreathingcravingdependenceheart rate variability biofeedbackmeta‐analysissubstance usewithdrawal

Identifiers

PMID42526901
PMCPMC13677815

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.