Key result
One-month wearable mindfulness improves HRV complexity vs control in first responders.
Why the study?
First responders often encounter high-stress environments challenging autonomic regulation, prompting evaluation of whether a wearable-based mindfulness intervention impacts HRV complexity.
Does a wearable-based mindfulness intervention improve HRV complexity in first responders?
RCT (n=87)
individual
Does a wearable-based mindfulness intervention improve HRV complexity in first responders?
Absolute Event Rate: 1.42% vs 1.39%
p-value: p=0.007
A 1-month wearable-based mindfulness intervention significantly improved HRV complexity metrics in first responders, suggesting enhanced autonomic regulation and adaptive capacity.
May support HRV resilience in first responders; leaves open clinical adoption pending randomized trials.
Background/Objectives: First responders frequently encounter high-stress environments that challenge physiological resilience and autonomic regulation. Heart rate variability (HRV) complexity is a critical marker of adaptive capacity and stress regulation. This study assessed the impact of a wearable-based mindfulness intervention on HRV complexity among first responders using a smartwatch. Methods: A total of 87 first responders participated in a one-month wearable-based intervention. Participants wore Garmin Vivosmart 5 devices to continuously collect PPG data (photoplethysmogram), focusing on beat-to-beat intervals (BBIs). The intervention involved daily Ecological Momentary Assessments (EMAs) and individual randomization to either a mindfulness message, a prompt to access an audio exercise, or no-treatment/control; interventions were delivered via the MYAPT.MIND mobile application. HRV metrics, including Sample Entropy, Multiscale Entropy (MSE), Recurrence Rate (RR), and Determinism (Det), were analyzed pre- and post-intervention/control using paired-samples t-tests. Results: Significant improvements were observed in HRV complexity metrics post-intervention. Sample Entropy increased (M = 1.42, SD = 0.11) compared to pre-intervention (M = 1.39, SD = 0.10; p = 0.007). MSE also showed significant gains (p = 0.038), particularly at lower scales, indicating enhanced short-term autonomic flexibility. Reductions were noted in RR (p = 0.025) and Det (p = 0.018), suggesting improved cardiovascular adaptability and reduced physiological rigidity. Other traditional time-domain metrics, such as Mean HR, SDNN, and RMSSD, did not exhibit significant changes. Conclusions: The wearable-based intervention significantly enhanced HRV complexity, reflecting improved autonomic regulation and adaptive capacity in first responders. These findings support the integration of digital mindfulness strategies for stress management in high-risk occupations. Future research should explore the longitudinal effects and mechanisms mediating these autonomic adaptations.
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Lockhart et al. (2026) conducted an RCT in High stress (First responders) (n=87). Wearable-based mindfulness intervention vs. No-treatment/control was evaluated on Sample Entropy (p=0.007). A one-month wearable-based mindfulness intervention significantly increased Sample Entropy from 1.39 to 1.42 (p=0.007) and improved other HRV complexity metrics in first responders.
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