Thank you very much for this piece. Not sure if this matters, but in terms of the timing of measurement after moving - would you recommend that HRV be measured immediately after moving positions from lying to sitting? Or leave a little delay, for example, wait in a sitting position for a few minutes and then measure HRV?
thank you and great question, I would not measure immediately, but leave 30 seconds, or if you see a need for a longer period, a minute or two are also fine in my opinion.
Similar question from me. We know the response gets blunted after a certain period of time. In previous posts, you mention urinating before HRV. (We also know that a full bladder elevates BP slightly.) So I was trying to figure out what is more important, urinating, or position. My compromise was to get up, urinate, and then lay back down for 30-60 seconds, then sit up and measure. This would trigger the orthostatic response again. I'm definitely getting more variability in my HRV measurements, but not sure if you think I'm doing to much. I could alter this by just getting up, taking a measurement, and then urinating afterwards. I'm wondering what the exact protocol was in any studies you mentioned above.
I like your protocol, and I do something similar, but I think that it could also be sufficient to go to the bathroom, urinate, and maybe measure there while sitting, or simply going back to the bedroom and then measuring while sitting, without the part in which you lie down again and then sit. Basically, I think that ones you get moving, you are already triggering the response we are looking for (i.e. not one at complete rest), while the exact change in body position (lying down to sitting) might be "less essential".
I've similar question, after waking up I go to washroom (sometimes it takes 5-10 mins, it depends on the situation) and then come back to bedroom and sit for 1-2 minutes quietly and then measure HRV. Is this protocol is ok to go ahead? or any changes should be made to it prior to HRV measurement? Thanking you in advance for your support.
Ah nuts! I've been measuring immediately al this time! I mis read your blogs and thought the stressor was actually moving from lying to sitting up. I can feel my HR normalise once I'm sitting up. So that's why I have such a large delta between laying and seated measurements!
Is it normal for there to be large differences between lying and standing, even when hrv4training says that my trend is stable and to proceed as planned? My lying average rmsdd is around 120 but my standing average is around 25? Also when hrv4training shows my average rmsdd in population comparison or monthly summary, is that lying, standing, or both?
The app is super helpful, just trying to understand a little deeper, thanks Marco!
thanks William! Yes it can be normal to have these differences, you could try maybe to measure while sitting, which I think is the best trade off when using the orthostatic stressor (https://medium.com/@altini_marco/how-should-you-measure-your-morning-heart-rate-variability-hrv-de5c6a1f33a2). Or give it a minute or two after standing, but then the transition time will impact the data and should be always the same, hence sitting remains in my view easier to do correctly. When you look at the population comparison, it is lying down data typically.
Could you explain or point me to any links about why you recommend using the single test vs. the orthostatic measurement in the app? When I read the above link on how to measure, I assumed that your recommendation was to use the orthostatic measurement, but I saw that you've said to use a single measurement while sitting.
hi Will, I believe you can rely on the orthostatic stressor without measuring the different phases, especially when looking at HRV, more than just resting heart rate. This means that we normally recommend to sit up, and measuring within about a minute. This way you rely on the same mechanism, but with a shorter test. What matters is measuring your response to the stressor (sitting up), while I do not think that having the data for both phases adds information (nor there is any evidence that it does). Open to change my mind as always, but this is how I currently see it.
Makes sense, appreciate the response! When users use the orthostatic measurement and measure both lying and standing, do both of those measurements get used for the daily advice and baseline?
thank you Will. In that case we actually use only data collected while lying down for the advice. This was a choice made many years ago, not sure if I would do it the same now, but we need to keep it consistent for users.
so you can pull the OURA / WHOOP data into the HRV4TRAINING ? I use my WHOOP to take my AM readings.. in KUBIOS + ELITEHRV... but the HRV4TRAINING APP does not always connect with the WHOOP. SO I am now doing my finger light camera on your APP when I sit in the AM.
CONVERSELY . . . HRV should be HIGHER when you go from a sitting position to the laying position. to create more parapsymp flow. that is why the Romans reclined after eating ?
So if the recommendation is to measure HRV while sitting and measure it first thing in the morning, would it be wise to measure it while sitting on the toilet, right after waking up? Asking for a friend.
This was very informative, thank you. I’m wondering what you suggest for those with POTS - the HRV4 app is recommended widely in the POTS / MECFS community to assist with pacing. In the case of POTS, heart rate goes up significantly upon sitting or standing (in my case usually by around 40-50bpm immediately). Would you suggest taking two measurements, or still sticking with sitting?
Please, I have a question: how do you calculate this baseline (this gray shaded area, indicating the window)? Would it be standard deviation??? How many SD points up and down?
Hello Renata, thank you for your interest. If you use the HRV4Training app, it will do it automatically for you. You can also see the normal range then in the website, which you can access from here: https://hrv4training.web.app/ - Thank you for your support
Hello Marco! I’m wondering if you could comment on why my body seems to react the opposite way to this article? My HRV is lower when I am asleep, and my heart rate is higher than it is during the day! If I get up to use the washroom in the middle of the night my heart rate will drop afterwards and stay down and my HRV (as per my Oura ring) rises and stays higher than before I woke. I am not an athlete… I am a 59 year old woman with extra weight.
thank you Sue, difficult to say when it comes to wearables as some of the changes could just be poor quality data, when we move - any tiny movement, even just typing, so small muscular movements included - typical also of moving in bed - the data becomes of poor quality and artifacts always lead to artificially high HRV (just because the artifact creates a disruption in the data, and this can only be captured as a high HRV - not physiologically higher, just the poor quality data causes this). Hence always difficult to see if there is an actual physiological change or not when looking at anything other than a night average, there can often be artifacts especially when we move or go to the bathroom in the night, making the data not interpretable. Normally the circadian rhythm makes it so that heart rate tends to be lower in the night and higher in the day, this is normally less artifact prone, hence it would be surprising to see a lower heart rate during the day than in the night, even though peiods of rest during the day should be pretty aligned with night data if no other strong stressors are present.
Thanks for your reply. I have been wondering about the heart rate, asked my doctor, had a sleep apnea test (nope)… I think maybe I am just a vigorous dreamer. The Oura app does quote you, so I thought you might find them more accurate than a wrist band. Thanks again!
thank you Sue, I do a agree that it is a good system for night data, but unfortunately all optical sensors suffer from these issues with movement, hence difficult to be sure. Thank you agan and all the best!
Thank you very much for this piece. Not sure if this matters, but in terms of the timing of measurement after moving - would you recommend that HRV be measured immediately after moving positions from lying to sitting? Or leave a little delay, for example, wait in a sitting position for a few minutes and then measure HRV?
thank you and great question, I would not measure immediately, but leave 30 seconds, or if you see a need for a longer period, a minute or two are also fine in my opinion.
Similar question from me. We know the response gets blunted after a certain period of time. In previous posts, you mention urinating before HRV. (We also know that a full bladder elevates BP slightly.) So I was trying to figure out what is more important, urinating, or position. My compromise was to get up, urinate, and then lay back down for 30-60 seconds, then sit up and measure. This would trigger the orthostatic response again. I'm definitely getting more variability in my HRV measurements, but not sure if you think I'm doing to much. I could alter this by just getting up, taking a measurement, and then urinating afterwards. I'm wondering what the exact protocol was in any studies you mentioned above.
I like your protocol, and I do something similar, but I think that it could also be sufficient to go to the bathroom, urinate, and maybe measure there while sitting, or simply going back to the bedroom and then measuring while sitting, without the part in which you lie down again and then sit. Basically, I think that ones you get moving, you are already triggering the response we are looking for (i.e. not one at complete rest), while the exact change in body position (lying down to sitting) might be "less essential".
I've similar question, after waking up I go to washroom (sometimes it takes 5-10 mins, it depends on the situation) and then come back to bedroom and sit for 1-2 minutes quietly and then measure HRV. Is this protocol is ok to go ahead? or any changes should be made to it prior to HRV measurement? Thanking you in advance for your support.
all good
Thank you for your prompt response.
Ah nuts! I've been measuring immediately al this time! I mis read your blogs and thought the stressor was actually moving from lying to sitting up. I can feel my HR normalise once I'm sitting up. So that's why I have such a large delta between laying and seated measurements!
Is it normal for there to be large differences between lying and standing, even when hrv4training says that my trend is stable and to proceed as planned? My lying average rmsdd is around 120 but my standing average is around 25? Also when hrv4training shows my average rmsdd in population comparison or monthly summary, is that lying, standing, or both?
The app is super helpful, just trying to understand a little deeper, thanks Marco!
thanks William! Yes it can be normal to have these differences, you could try maybe to measure while sitting, which I think is the best trade off when using the orthostatic stressor (https://medium.com/@altini_marco/how-should-you-measure-your-morning-heart-rate-variability-hrv-de5c6a1f33a2). Or give it a minute or two after standing, but then the transition time will impact the data and should be always the same, hence sitting remains in my view easier to do correctly. When you look at the population comparison, it is lying down data typically.
Could you explain or point me to any links about why you recommend using the single test vs. the orthostatic measurement in the app? When I read the above link on how to measure, I assumed that your recommendation was to use the orthostatic measurement, but I saw that you've said to use a single measurement while sitting.
hi Will, I believe you can rely on the orthostatic stressor without measuring the different phases, especially when looking at HRV, more than just resting heart rate. This means that we normally recommend to sit up, and measuring within about a minute. This way you rely on the same mechanism, but with a shorter test. What matters is measuring your response to the stressor (sitting up), while I do not think that having the data for both phases adds information (nor there is any evidence that it does). Open to change my mind as always, but this is how I currently see it.
Makes sense, appreciate the response! When users use the orthostatic measurement and measure both lying and standing, do both of those measurements get used for the daily advice and baseline?
thank you Will. In that case we actually use only data collected while lying down for the advice. This was a choice made many years ago, not sure if I would do it the same now, but we need to keep it consistent for users.
How did you measure the night HRV with the HRV4TRAING APP ?
hello Joe, normally with an Oura ring.
so you can pull the OURA / WHOOP data into the HRV4TRAINING ? I use my WHOOP to take my AM readings.. in KUBIOS + ELITEHRV... but the HRV4TRAINING APP does not always connect with the WHOOP. SO I am now doing my finger light camera on your APP when I sit in the AM.
for night data, only from Oura
CONVERSELY . . . HRV should be HIGHER when you go from a sitting position to the laying position. to create more parapsymp flow. that is why the Romans reclined after eating ?
Excellent article. Thank you very much.
So if the recommendation is to measure HRV while sitting and measure it first thing in the morning, would it be wise to measure it while sitting on the toilet, right after waking up? Asking for a friend.
yes, no problem with that protocol!
This was very informative, thank you. I’m wondering what you suggest for those with POTS - the HRV4 app is recommended widely in the POTS / MECFS community to assist with pacing. In the case of POTS, heart rate goes up significantly upon sitting or standing (in my case usually by around 40-50bpm immediately). Would you suggest taking two measurements, or still sticking with sitting?
thank you. In this case I think lying down is fine, and would sit only if the response re-normalizes within a few minutes, only then I would measure.
Ok, ok you’ve finally convinced new to do a morning measurement sitting! Excellent article thanks
Please, I have a question: how do you calculate this baseline (this gray shaded area, indicating the window)? Would it be standard deviation??? How many SD points up and down?
Hello Renata, thank you for your interest. If you use the HRV4Training app, it will do it automatically for you. You can also see the normal range then in the website, which you can access from here: https://hrv4training.web.app/ - Thank you for your support
Hello Marco! I’m wondering if you could comment on why my body seems to react the opposite way to this article? My HRV is lower when I am asleep, and my heart rate is higher than it is during the day! If I get up to use the washroom in the middle of the night my heart rate will drop afterwards and stay down and my HRV (as per my Oura ring) rises and stays higher than before I woke. I am not an athlete… I am a 59 year old woman with extra weight.
thank you Sue, difficult to say when it comes to wearables as some of the changes could just be poor quality data, when we move - any tiny movement, even just typing, so small muscular movements included - typical also of moving in bed - the data becomes of poor quality and artifacts always lead to artificially high HRV (just because the artifact creates a disruption in the data, and this can only be captured as a high HRV - not physiologically higher, just the poor quality data causes this). Hence always difficult to see if there is an actual physiological change or not when looking at anything other than a night average, there can often be artifacts especially when we move or go to the bathroom in the night, making the data not interpretable. Normally the circadian rhythm makes it so that heart rate tends to be lower in the night and higher in the day, this is normally less artifact prone, hence it would be surprising to see a lower heart rate during the day than in the night, even though peiods of rest during the day should be pretty aligned with night data if no other strong stressors are present.
Thanks for your reply. I have been wondering about the heart rate, asked my doctor, had a sleep apnea test (nope)… I think maybe I am just a vigorous dreamer. The Oura app does quote you, so I thought you might find them more accurate than a wrist band. Thanks again!
thank you Sue, I do a agree that it is a good system for night data, but unfortunately all optical sensors suffer from these issues with movement, hence difficult to be sure. Thank you agan and all the best!