Effect of Yoga-based Interventions on Heart Rate Variability and Anxiety Among Students: A Systematic Review and Meta-analysis

Abstract

Background: Previous studies have shown improvement in anxiety and cardiac parameters among university students. However, no systematic review and meta-analysis have examined the effect of yoga-based interventions on heart rate variability (HRV) and anxiety among students. Purpose: To synthesise the evidence regarding the effects of yoga-based intervention on improving HRV and anxiety among students. Methods: A systematic search was conducted in accordance with PRISMA 2020 guidelines in PubMed, Scopus, Cochrane Library, and Web of Science for randomised controlled trials (RCTs) that assessed the effects of yoga on anxiety and HRV up to March 2025. We included the RCTs that assess both HRV and subjective measures of anxiety in the student population. The quality of the included studies was evaluated by the Cochrane ‘risk of bias’ tool (version 2019). Meta-analyses were conducted using RevMan software. Results: The search identified 255 studies, out of which five studies met the inclusion criteria. Four studies were included in the meta-analysis, which show a positive impact of yoga on anxiety and HRV measures among the students. Conclusion: Yoga reduces anxiety and improves HRV among the students. Further rigorous studies are needed to identify the optimal characteristics of yoga for the students.