By definition respiratory sinus arrhythmia (RSA) is the alternate increase in heart rate during inspiration and decrease in heart rate during expiration so that heartbeat is synchronized with respiratory rhythm [1-3]. The autonomic nervous system has been indicated to play a major role in the interaction of respiration and circulation to coordinate the events happening during RSA [2]. Respiratory sinus arrhythmia has also been linked to serve as an index of cardiac vagal tone [4] and good health [3]. This phenomenon that is
RSA is observed in many species including human beings where RSA is found to be strongest (i.e. a larger difference between inspiration heart rate and expiration heart rate) in the young and fit meaning that professional athletes would generally be found to have a much greater RSA compared to the general population [3,5]. Conversely, lower RSA is linked to several human diseases and conditions shyness or reticence in toddlers [6], substance use disorder [7], stress [8], and autism spectrum disorder [9]. Therefore, this review seeks to discuss the significance of RSA in human health and disease.