Thank you for the article. I am 66 now and until 2 years back, I was not active about my health. I bought a fitbit and started walking half an hour every day. I discovered that the fitbit is not very accurate if you move briskly, I had peaks of up to 160 heartbeats during walks. I didn't trust it and bought a polar h10 strap. It gave reliable results: the fitbit was not reliable. I wanted to know my progress better and found HRV4training, among others. To my shock, my HRV turned out to be between 6 and 7. But slowly, between the lines, I could read that I shouldn't infer too much about the condition of my heart from that. I welcome this article and happily continue my walks.
I always wonder how adverse childhood experiences and developmental trauma affect Hrv ranges and fluctuations through life as opposed to genetics.. how much does it relate to deep down feelings of safety? I suppose I am curious about the effects of chronic vs acute stress, and when the chronic vs acute stresses happened.
I used to apply hrv more to training, but I currently use it more for life stress management. It is sometimes hard to perceive patterns.
thank you Cecily, indeed I see your point and would think there are important associations there as well, even though it might be difficult to untangle. I do use the data similarly to you, life stress more train training stress.
I’m 71 and a cyclist logging 100 miles or so per week. My HRV is generally 17 to 30 (using Oura ring.) I’ve been taking a pill call HRV+ containing cannabadiol among other things that was discussed in this podcast. https://open.spotify.com/episode/4jVlqKgVrQURVO8tYR8id8?si=T6yp_y_KQhu-1lotTTNUxg. It may have slightly elevated my HRV. Have you seen any evidence for this type of product?
Feb 28, 2023·edited Feb 28, 2023Liked by Marco Altini
If HRV is individual, why do you show the population comparison chart in the app? It's irrelevant according to your article. Good article by the way. I have HRV on the lower end and have worried about getting it up. I heard conflicting things from my readings, but I trust your research.
thank you, and I agree with you, the population comparison is something I would not put there if I was to design the app today from scratch. Difficult to remove features though at this point, without causing major anger and negative feedback.
I've been using HRV4Training for a long time, and HRV4Biofeedback for about 6 months (the data aspect of it makes me do deep breathing to calm stress whereas I find it impossible to do meditation consistently). I have noticed that my HRV will often dip after a rest day, probably because I find it psychologically important to exercise and thus tend to adjust exercise intensity rather than rest altogether. I am particularly interested in the overlaps between HRV and stress. When I started monitoring HRV mine was lower than I would have expected given my age and fitness, but knowing there is a link with stress has helped me join a lot of dots.
And to add to this post - certain cardiac procedures like ablation for arrhythmias do result (sometimes) in vagal denervation. In some cases this goes away in some months but in some - it persists for years. Heart and hearth rhythm are Ok but it’s just that hrv is no longer a viable metric because the heart no longer has the “sensitivity” for vagal tone changes. For reference- my rmssd varies from 5 to 8 based on Oura ring, a year after ablation for PVCs.
Thanks Marco! Very insightful. I'm one of those people with relatively low rMSSD. Interestingly, last week I had a bit of a flu with runny and congested nose and my HRV was about 30-40% higher, shouldn't it be the opposite? Could it be that because of it I didn't have training stressors?
could be! Even though sometimes we see responses like that even to harder stressors (not necessarily sickness, but hard training for example), this could be due to a high parasympathetic state as the body tries to recover and get back to balance (as opposed to a high parasympathetic state because the body is already recovered). Another reason why I think it is important to consider a normal range and to avoid simplistic, higher is better, interpretations. All the best!
For me, the greatest source of variation is _when_ measurements are taken. My Apple watch randomly measures HRV throughout the day and night. Some days the measurements can vary from 5 to 200 (I am healthy and middle-aged). I've found that I can get consistent readings using the built-in Breathe app for 2 minutes, but only if the following conditions are met:
1. I've been sitting for at least 5 minutes,
2. Have not exercised in the last 2 hours or so (depending on the intensity)
3. Have been awake for at least an hour.
After deleting all of the random measurements and only keeping "good" measurements, I have very consistent day to day trends.
The most interesting thing is the natural variations that are independent of stressors. I would love to understand exactly what hormones are keeping my HRV within a fairly narrow band (under optimal stress levels and measurement consistency). My long term average is 65, but it slowly goes up and down over 3-8 days between about 60-70, again assuming no illness or unusual stress, and also assuming a light exercise routine (walks and slow jogging). When I do weight training or a run it will go down to around 55 for about a day, and work stress and illness will do the same. On my worst day of covid it went down to 40.
The important thing is that the random measurements of my Apple watch are almost useless because a single very low or high measurement (typically while I'm asleep) completely skews the averages, making day-to-day trending impossible. But that is easily fixed by keeping only controlled measurements, and deleting the random measurements. Note, prior to adopting the habit of deleting the random measurements, my long term average was about 40.
Very thorough analysis. I actually used your app many years ago before Apple added the feature to the watch, so I blame you for my interest in this QS measurement. :-)
My experience with morning HRV is perhaps different than yours. If I am startled awake, e.g., by an alarm or other noise, and especially if I'm in a deep sleep cycle, my waking HRV reading is much lower (around 30) than if I wake up naturally after a good sleep. Then it will be about 50. In fact, I can predict that my HRV will be low because my breath is shakier, as if my diaphragm is slightly vibrating. In general, when I can feel my breath is "smoother" my HRV is higher. However, regardless of my waking HRV, within about 2 hours my HRV will increase to whatever that day's norm will be, typically between 60-70. Note, working from home allows me to see these patterns. If I worked in an office, there would be too many variables I think and my averages would be much lower. Just my .02.
Feb 3, 2023·edited Feb 3, 2023Liked by Marco Altini
Hey Marco! Thank you. I was curious to know a bit more on the opposite: what does it mean to have a continuous high(er) HRV? Aspects of a low HRV are often highlighted whereas the meaning of a high HRV remains unclear to me. Thank you! Great fan!!!
thank you Elsie, I think that similarly to the case of a low HRV, we also know very little about the opposite side of the spectrum. I would in general simply advise to use the data in relative terms, also for that case.
My son (20) and I (49) both, most usually, have low HRV's and we're both in great shape and train regularly. After looking and researching for many years - we both found a better indicator for us and our recovery - is our resting heart rate. For us, and I'm sure many others, it could be a better indicator of current health.
I've read interesting research on this as we are just genetically different or variant as mentioned in this article.
All this to say : don't over emphasize HRV, Vo2 max and all these metrics companies are absolutely trying to sell us using a bunch of gadgets - keep training, stay strong and adapt. Cheers.
Hi Marco - thank you so much for writing this, I’m a fit 34 year old female and hover around 30 - 40 HRV. The one day I did a water fast, my HRV shot up to 75. I’ve been very concerned with a great number of articles I’ve read correlating low HRV with high comorbidity + cardiovascular issues. How can a published study like this one live in parallel with the information in the published studies you have posted. Why are there many clinical studies tying low HRV to poor clinical outcomes low HRV in absolute terms is not a concern?
thank you Ashley, it is only associations that are reported in literature, no causality. In the first one you link, they report a lower heart rate (typically a good thing) to be associated with increased risk for afib: another pointer that things are much more complex than we understand (as a high heart rate, on the other hand, is associated with a number of cardiovascular conditions). I think a healthy lifestyle is more important than our absolute HRV (yours is within population ranges, not particularly low either), and as a healthy lifestyle I do not mean only sleep, activity and eating well, but also managing stress in our lives. When we are healthy and we get stressed because of "metrics" of which we really do not know much about in terms of their implications for health, then maybe we can be healthier without such metrics :) Take care!
Thank you - is there ANY evidence of people with low HRV who live long lives without cardiovascular morbidity? That is a study I would be interested in.
For reference, I have MS, an autoimmune disease and I do believe I have a disregulated autonomic nervous system (trying to heal). I eat incredibly clean, very active, yoga, quit job, low stress life etc. Needless to say, I do feel like in my instance low HRV is an indicator of my suboptimal health. I’ve gotten it up 35% avg in the past 3 months since having Oura/Whoop but I don’t really understand why or how a low HRV could still exist in someone who has great health. Isn’t it also a marker of inflammation?
Thank you for the article. I am 66 now and until 2 years back, I was not active about my health. I bought a fitbit and started walking half an hour every day. I discovered that the fitbit is not very accurate if you move briskly, I had peaks of up to 160 heartbeats during walks. I didn't trust it and bought a polar h10 strap. It gave reliable results: the fitbit was not reliable. I wanted to know my progress better and found HRV4training, among others. To my shock, my HRV turned out to be between 6 and 7. But slowly, between the lines, I could read that I shouldn't infer too much about the condition of my heart from that. I welcome this article and happily continue my walks.
As always, thanks for your generous writing.
I always wonder how adverse childhood experiences and developmental trauma affect Hrv ranges and fluctuations through life as opposed to genetics.. how much does it relate to deep down feelings of safety? I suppose I am curious about the effects of chronic vs acute stress, and when the chronic vs acute stresses happened.
I used to apply hrv more to training, but I currently use it more for life stress management. It is sometimes hard to perceive patterns.
thank you Cecily, indeed I see your point and would think there are important associations there as well, even though it might be difficult to untangle. I do use the data similarly to you, life stress more train training stress.
Mille grazie, Marco! So helpful!
I’m 71 and a cyclist logging 100 miles or so per week. My HRV is generally 17 to 30 (using Oura ring.) I’ve been taking a pill call HRV+ containing cannabadiol among other things that was discussed in this podcast. https://open.spotify.com/episode/4jVlqKgVrQURVO8tYR8id8?si=T6yp_y_KQhu-1lotTTNUxg. It may have slightly elevated my HRV. Have you seen any evidence for this type of product?
thank you David, no, I am not familiar with this!
Thanks great explaining as always!
When are you adding the 60 to 70 year old range? I am in that range. It would be helpful. Thanks
thank you Edward, limited data at the moment but hopefully we’ll be able to add more in the future
Thank you.
If HRV is individual, why do you show the population comparison chart in the app? It's irrelevant according to your article. Good article by the way. I have HRV on the lower end and have worried about getting it up. I heard conflicting things from my readings, but I trust your research.
thank you, and I agree with you, the population comparison is something I would not put there if I was to design the app today from scratch. Difficult to remove features though at this point, without causing major anger and negative feedback.
I've been using HRV4Training for a long time, and HRV4Biofeedback for about 6 months (the data aspect of it makes me do deep breathing to calm stress whereas I find it impossible to do meditation consistently). I have noticed that my HRV will often dip after a rest day, probably because I find it psychologically important to exercise and thus tend to adjust exercise intensity rather than rest altogether. I am particularly interested in the overlaps between HRV and stress. When I started monitoring HRV mine was lower than I would have expected given my age and fitness, but knowing there is a link with stress has helped me join a lot of dots.
And to add to this post - certain cardiac procedures like ablation for arrhythmias do result (sometimes) in vagal denervation. In some cases this goes away in some months but in some - it persists for years. Heart and hearth rhythm are Ok but it’s just that hrv is no longer a viable metric because the heart no longer has the “sensitivity” for vagal tone changes. For reference- my rmssd varies from 5 to 8 based on Oura ring, a year after ablation for PVCs.
thank you Dobri, great point
Thanks Marco! Very insightful. I'm one of those people with relatively low rMSSD. Interestingly, last week I had a bit of a flu with runny and congested nose and my HRV was about 30-40% higher, shouldn't it be the opposite? Could it be that because of it I didn't have training stressors?
could be! Even though sometimes we see responses like that even to harder stressors (not necessarily sickness, but hard training for example), this could be due to a high parasympathetic state as the body tries to recover and get back to balance (as opposed to a high parasympathetic state because the body is already recovered). Another reason why I think it is important to consider a normal range and to avoid simplistic, higher is better, interpretations. All the best!
Glad someone is paying close attention to HRV.
For me, the greatest source of variation is _when_ measurements are taken. My Apple watch randomly measures HRV throughout the day and night. Some days the measurements can vary from 5 to 200 (I am healthy and middle-aged). I've found that I can get consistent readings using the built-in Breathe app for 2 minutes, but only if the following conditions are met:
1. I've been sitting for at least 5 minutes,
2. Have not exercised in the last 2 hours or so (depending on the intensity)
3. Have been awake for at least an hour.
After deleting all of the random measurements and only keeping "good" measurements, I have very consistent day to day trends.
The most interesting thing is the natural variations that are independent of stressors. I would love to understand exactly what hormones are keeping my HRV within a fairly narrow band (under optimal stress levels and measurement consistency). My long term average is 65, but it slowly goes up and down over 3-8 days between about 60-70, again assuming no illness or unusual stress, and also assuming a light exercise routine (walks and slow jogging). When I do weight training or a run it will go down to around 55 for about a day, and work stress and illness will do the same. On my worst day of covid it went down to 40.
The important thing is that the random measurements of my Apple watch are almost useless because a single very low or high measurement (typically while I'm asleep) completely skews the averages, making day-to-day trending impossible. But that is easily fixed by keeping only controlled measurements, and deleting the random measurements. Note, prior to adopting the habit of deleting the random measurements, my long term average was about 40.
thanks Chris, indeed the Apple Watch and automatically collected data are very problematic, glad you figured that out and were able to use the data.
Some other resources you might find useful: https://medium.com/@altini_marco/how-to-make-sense-of-your-apple-watch-heart-rate-variability-hrv-data-89bf4a510438
and also in general on ideal measurement protocols: https://medium.com/@altini_marco/how-should-you-measure-your-morning-heart-rate-variability-hrv-de5c6a1f33a2
have a good weekend
Very thorough analysis. I actually used your app many years ago before Apple added the feature to the watch, so I blame you for my interest in this QS measurement. :-)
My experience with morning HRV is perhaps different than yours. If I am startled awake, e.g., by an alarm or other noise, and especially if I'm in a deep sleep cycle, my waking HRV reading is much lower (around 30) than if I wake up naturally after a good sleep. Then it will be about 50. In fact, I can predict that my HRV will be low because my breath is shakier, as if my diaphragm is slightly vibrating. In general, when I can feel my breath is "smoother" my HRV is higher. However, regardless of my waking HRV, within about 2 hours my HRV will increase to whatever that day's norm will be, typically between 60-70. Note, working from home allows me to see these patterns. If I worked in an office, there would be too many variables I think and my averages would be much lower. Just my .02.
Hey Marco! Thank you. I was curious to know a bit more on the opposite: what does it mean to have a continuous high(er) HRV? Aspects of a low HRV are often highlighted whereas the meaning of a high HRV remains unclear to me. Thank you! Great fan!!!
thank you Elsie, I think that similarly to the case of a low HRV, we also know very little about the opposite side of the spectrum. I would in general simply advise to use the data in relative terms, also for that case.
My son (20) and I (49) both, most usually, have low HRV's and we're both in great shape and train regularly. After looking and researching for many years - we both found a better indicator for us and our recovery - is our resting heart rate. For us, and I'm sure many others, it could be a better indicator of current health.
I've read interesting research on this as we are just genetically different or variant as mentioned in this article.
All this to say : don't over emphasize HRV, Vo2 max and all these metrics companies are absolutely trying to sell us using a bunch of gadgets - keep training, stay strong and adapt. Cheers.
Hi Marco - thank you so much for writing this, I’m a fit 34 year old female and hover around 30 - 40 HRV. The one day I did a water fast, my HRV shot up to 75. I’ve been very concerned with a great number of articles I’ve read correlating low HRV with high comorbidity + cardiovascular issues. How can a published study like this one live in parallel with the information in the published studies you have posted. Why are there many clinical studies tying low HRV to poor clinical outcomes low HRV in absolute terms is not a concern?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5260487/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9685533/
Thank you!
thank you Ashley, it is only associations that are reported in literature, no causality. In the first one you link, they report a lower heart rate (typically a good thing) to be associated with increased risk for afib: another pointer that things are much more complex than we understand (as a high heart rate, on the other hand, is associated with a number of cardiovascular conditions). I think a healthy lifestyle is more important than our absolute HRV (yours is within population ranges, not particularly low either), and as a healthy lifestyle I do not mean only sleep, activity and eating well, but also managing stress in our lives. When we are healthy and we get stressed because of "metrics" of which we really do not know much about in terms of their implications for health, then maybe we can be healthier without such metrics :) Take care!
Thank you - is there ANY evidence of people with low HRV who live long lives without cardiovascular morbidity? That is a study I would be interested in.
For reference, I have MS, an autoimmune disease and I do believe I have a disregulated autonomic nervous system (trying to heal). I eat incredibly clean, very active, yoga, quit job, low stress life etc. Needless to say, I do feel like in my instance low HRV is an indicator of my suboptimal health. I’ve gotten it up 35% avg in the past 3 months since having Oura/Whoop but I don’t really understand why or how a low HRV could still exist in someone who has great health. Isn’t it also a marker of inflammation?
Thanks!
Hi Ashley, MS was left out of the first message, obviously that’s different and the data might track your condition
For those who have increased their HRV, outside of exercise, what has improved your Heart Rate Variability? Thank you in advance.