Understanding the role of rhythm: Effects of VR-based breathing meditation on anxiety, stress, and mindfulness

Breathing meditation (BM), particularly when delivered via virtual reality (VR), has shown promise in reducing anxiety and stress and enhancing mindfulness. Recent evidence suggests that embedding rhythmic elements, such as temporally structured inhalation, exhalation, and breath-holding, may further regulate BM’s effectiveness. However, the specific role of rhythm in VR-based breathing meditation (VRBM) remains underexplored. To address this gap, we developed BreathMe, a VRBM system featuring four distinct rhythm (4-2-4 G , 4-7-8 G , 5-0-5 G , 5-0-5 A ) of breathing that varied in temporal structure and interaction mode (natural, guided, and adaptive). A mixed-design experiment was conducted with 40 college students to examine the differential effects (mindfulness, perceived stress, and anxiety) of these modes on psychological outcomes and physiological markers. Results indicated that the 5-0-5 A rhythm consistently enhanced mindfulness and reduced both stress and anxiety; whereas 4-2-4 G produced moderate reduction both stress and anxiety, and the 5-0-5 G and 4-7-8 G mainly impacted stress reduction. Regarding interaction modes, adaptive breathing elicited the largest increases in mindfulness and the greatest reductions in stress and anxiety, guided breathing showed moderate benefits, and natural breathing yielded the least pronounced effects. These findings demonstrate that both breathing rhythm and interaction mode independently and interactively shape psychological and physiological responses in VRBM, providing empirical guidance for designing personalized and effective immersive meditation interventions.