Gaming Away Stress: Using Biofeedback Games to Learn Paced Breathing

Biofeedback games are an attractive alternative to standard techniques for learning short-term relaxation skills. In this paper, we present the design, implementation, and evaluation of three respiratory biofeedback games. To validate these games, we compared breathing rate across 100 male participants (23 years +/- 3.2 years) playing biofeedback and audio pacing versions of these games as well as a paced breathing app. The games were placed between repeat runs of a cognitively stressful Stroop-based task and the impact of the games on breathing and cognitive performance in the task also assessed. Our results showed that 1) differences in gameplay did not impact player performance; 2) biofeedback not only led to better breath control during play but also during the subsequent cognitively stressful task; and 3) biofeedback led to better attentional-cognitive performance in the subsequent task. Our multi-game experiments show that using respiratory biofeedback in video games is an effective strategy to learn paced breathing-on par with the standalone technique of paced breathing-and to self-regulate stress levels in later stressful scenarios. Furthermore, owing to its entertainment value, our relaxation solution has the potential to be more engaging and accessible than standalone paced breathing, for use over longer durations.