The effects of Rajyoga mindfulness meditation training on heart rate variability in panic disorder: A randomized controlled trial

Background: Panic disorder is associated with autonomic nervous system dysfunction and reduced heart rate variability (HRV). Enhancing HRV may help mitigate symptoms of panic disorder. This study investigated the effects of Rajyoga mindfulness meditation training on HRV in patients with panic disorder. Methods: This prospective randomized controlled trial included 110 patients with panic disorder recruited from a psychiatry department in India. Participants were randomized to either an 8-week Rajyoga meditation intervention (n = 55) or a waitlist control group (n = 55) receiving standard treatment alone. HRV was measured at baseline and after 8 weeks using time domain (SDRR, RMSSD, pNN50) and frequency domain (total power, HF, LF, LF/HF ratio) parameters. Results: At baseline, there were no significant differences in demographics or HRV parameters between groups. After 8 weeks, the Rajyoga group showed significant increases in SDRR, RMSSD, pNN50, and total power compared to controls (P < 0.05), indicating improved parasympathetic activity. The LF/HF ratio decreased in the Rajyoga group versus controls, suggesting a shift toward parasympathetic predominance. Conclusions: Eight weeks of Rajyoga mindfulness meditation training improved HRV and parasympathetic activity in patients with panic disorder compared to standard treatment alone. Rajyoga meditation may be a beneficial adjunctive intervention for enhancing autonomic regulation in panic disorder.