24 Comments

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?

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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.

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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.

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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".

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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.

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all good

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Thank you for your prompt response.

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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!

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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.

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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.

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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.

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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?

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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.

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How did you measure the night HRV with the HRV4TRAING APP ?

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hello Joe, normally with an Oura ring.

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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.

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for night data, only from Oura

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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 ?

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Excellent article. Thank you very much.

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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.

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yes, no problem with that protocol!

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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?

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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.

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Ok, ok you’ve finally convinced new to do a morning measurement sitting! Excellent article thanks

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