Resource Your Crash in a Graph? How Heart Rate Variability Testing Could Help You Improve Your Health

[Obie]

Obie the FitBit definitely won’t be sufficient for HRV measurement. You’ll get poor quality data that will lead you astray. Unless you have sound data to work with, you’re not going to benefit from HRV tracking.

Regarding crashes: You’re not going to be able to prevent every crash. There are too many variables that you can’t control, that can send you spiralling downwards. However, I definitely crash less since I’ve been using HRV tracking, and often when I do crash I can say ‘Well you could see this coming, but you didn’t act soon enough’.

The other factor is that I am running a myriad of experiments on individual factors, and now have good data I can use to help me turn around bad numbers. (This is all coming in a future blog). For example: if my HF (parasympathetic) numbers are low when I take my waking measurements, I will plan my day around that. I will do up a plan adding in factors that my data has shown helps me to increase my HF (such as Mestinon). If my LF/HF is high I will add in factors that help lower it (such as Weil breathing). Working like this gives you a lot of control.

Thanks for your response. I'm fascinated with the idea of trying HRV readings as another tool.

I am confused because I went on the Wahoo website and read the reviews which were contradictory. One person said they got accurate HRV readings and another said they didn't. How do you tell if a chest strap is giving you accurate HRV readings, other than taking someone's word on a review or blog? Karmin, I am not doubting you, I'm just trying to ascertain how you figured which ones were accurate. I guess since you feel that you are getting useful information from the Wahool that correlates with how you are feeling, that may be one way.

You also mentioned that the Polar H7 didn't work well because you had a small frame. How small? I am 5'3" and 123 lbs. I used to consider myself medium sized , but these days even my teen granddaughters are taller and weigh more than I do as is my daughter.

 

[Obie]

I did. I have to reread it. Lot's to absorb.

I haven't ventured into any graphing, but I have been taking HRV readings, usually in the morning, and sometimes at other times. My sympathetic nervous system is always dominant. Not sure what I can do to change that, that I haven't already tried.

Have you tried meditation or yogic breathing? Stanford Center for Compassion has done some incredible work using yogic breathing techniques (alternate nostril and square breathing) with vets who have PTSD creating long-term change decreasing their blood pressure and heart rate. The projects are The Art of Living and Welcome Home Troops. I imagine that breathing work changed their sympathetic dominance. Personally, I have successfully used those breathing techniques for pain, insomnia, or anxiety. If you are interested, I would recommend working with a good yoga teacher or attending one of the programs listed above. Emma Seppala and Dr. James Doty talk about the programs on a recent Youtube for the Stanford Center for Compassion.

 

[Karmin]

This HRV stuff looks very interesting to me. However when I looked into Sweetbeats, Garmin wasn't listed as an approved chest strap.

I use Garmin Vivofit for tracking steps and sleep. The wristband works great and the HRM chest strap does too, but I rarely wear the HRM part anymore. It might be worth dusting off.... But is there a HRV app that will work with Garmin?

After dropping $ on the Garmin, I can't justify buying another chest strap just to experiment. Not sure how much usefulness I'd get out of it until I've tried it.

So far I've found I can reasonably determine / predict crashy days by my step count patterns. Does this HRV stuff add anything significant to that? Beyond the obvious of waving a bunch of data points at an unsuspecting GP who may not understand it.

I only ask because early on I saw a cardio specialist and was dismissed as "fine" after wearing a holtzer monitor for 24 hours. Despite the obvious POTS. And all the crazy spikes were dismissed as "artifacts" ... whatever that means. Problems with HRV were never mentioned, so I have no clue if this is worth doing in my case.

Lissa I don’t know of any apps that the Garmin is compatible with unfortunately. To explain the compatibility problem Elite says this:
“To accurately measure Heart Rate Variability, your heart rate monitor of choice must:

• Capture and transmit accurate R-R Intervals (also called Inter-beat Intervals or IBIs)
• Transmit the unaltered R-R intervals via Bluetooth 4.0

If you do not see your heart rate monitor in the list below, the manufacturer of the monitor should be able to tell you if their device meets these criteria.
Example message: “Hello Customer Service. I have your XYZ heart rate monitor. Does this monitor capture accurate R-R intervals? If so, does it alter or smooth the R-R intervals in any way? (These are different than just basic heart rate). Thank you!”
If the manufacturer is not able to answer this question, run!”
http://www.elitehrv.com/compatible-devices/

Understandably many heart rate monitors are designed for just that – monitoring heart rate. It doesn’t mean it’s not a good HR monitor. But unless it is designed as above to accurate R-R intervals and not alter them, it won’t be suitable for HRV.

Regarding usefulness of HRV: It has completely changed my management of my illness. (Predicting crashes is not what I am interested in). With HRV I can make decisions based on my actual results, rather than on assumptions. It also makes me accountable with my pacing. It helps me enormously with tailoring the quantity and type of exercise I can manage.

But having said that, it is not treating anything. The underlying illness is not going to change by tracking HRV. Though I do think it helps me support my body more effectively, and maybe in time that will make a difference.

Perhaps just keep it in mind, if the Garmin needs replacing at some stage.

PS I sympathise about the cardiologist missing your POTS. I had the same experience, and I believe if it had been picked up and treated at that stage I might be in a much more abled state of health right now.

 

[Karmin]

I did. I have to reread it. Lot's to absorb.

I haven't ventured into any graphing, but I have been taking HRV readings, usually in the morning, and sometimes at other times. My sympathetic nervous system is always dominant. Not sure what I can do to change that, that I haven't already tried.

It's really tough to get it down isn't it?! It felt like a bit of a lost cause to me too til I started recording the numbers i was getting with various factors, and that made it clearer that some things were helping. My numbers for this are too early to make definite calls on, and they might be different for you anyway, but, so far, things that help me reduce LF/HF are: Weil breathing, GABA supplement, and yoga.

 

[Karmin]

Thanks for your response. I'm fascinated with the idea of trying HRV readings as another tool.

I am confused because I went on the Wahoo website and read the reviews which were contradictory. One person said they got accurate HRV readings and another said they didn't. How do you tell if a chest strap is giving you accurate HRV readings, other than taking someone's word on a review or blog? Karmin, I am not doubting you, I'm just trying to ascertain how you figured which ones were accurate. I guess since you feel that you are getting useful information from the Wahool that correlates with how you are feeling, that may be one way.

You also mentioned that the Polar H7 didn't work well because you had a small frame. How small? I am 5'3" and 123 lbs. I used to consider myself medium sized , but these days even my teen granddaughters are taller and weigh more than I do as is my daughter.

The HRV apps test sensors for HRV accuracy, when coming up with their recommended sensors. SweetBeat also gives a signal strength result which helps to rule out connection problems. But the only real way to test accuracy would be to run it simultaneously with ECG. I believe a few tests have been done on Polar H7 vs ECG with good results.

I do also feel very solid with the numbers I am getting. I was skeptical when I started, but some of the numbers were just so spot on, I was a bit blown away. I tried a lot of apps, and sensors, and found that helped me zero in on the best. A couple of them gave results which were just all over the place and made no sense – they were the apps that used camera flash, or non-chest strap sensors. 2 or 3 apps with their recommended sensors gave numbers that correlated well with my subjective experience, correlated well with each other, and were very consistent. The two I have stuck with are SweetBeat and Elite. Sweetbeat is my pick, but I use Elite as well for some of its features.

Re size: go on your chest measurement (at position where you would wear the strap). I had the Medium size (fits chest 30” and above), and my chest size is 31”. I would say anything in that 29-31” range might be iffy with the Polar H7.

 

[Karmin]

Have you tried meditation or yogic breathing? Stanford Center for Compassion has done some incredible work using yogic breathing techniques (alternate nostril and square breathing) with vets who have PTSD creating long-term change decreasing their blood pressure and heart rate. The projects are The Art of Living and Welcome Home Troops. I imagine that breathing work changed their sympathetic dominance. Personally, I have successfully used those breathing techniques for pain, insomnia, or anxiety. If you are interested, I would recommend working with a good yoga teacher or attending one of the programs listed above. Emma Seppala and Dr. James Doty talk about the programs on a recent Youtube for the Stanford Center for Compassion.

It's interesting, with testing, that different breathing techniques have somewhat different effects on me. I find square breathing best for improving HRV, and Weil breathing best for reducing LF/HF, Alternate nostril helps a little with LF/HF, but has slight negative effect on HF & HRV (though for Alternate Nostril I don't yet have enough data to say that for sure)

 

[Lissa]

Lissa I don’t know of any apps that the Garmin is compatible with unfortunately. To explain the compatibility problem Elite says this:
“To accurately measure Heart Rate Variability, your heart rate monitor of choice must:

• Capture and transmit accurate R-R Intervals (also called Inter-beat Intervals or IBIs)
• Transmit the unaltered R-R intervals via Bluetooth 4.0

If you do not see your heart rate monitor in the list below, the manufacturer of the monitor should be able to tell you if their device meets these criteria.
Example message: “Hello Customer Service. I have your XYZ heart rate monitor. Does this monitor capture accurate R-R intervals? If so, does it alter or smooth the R-R intervals in any way? (These are different than just basic heart rate). Thank you!”
If the manufacturer is not able to answer this question, run!”
http://www.elitehrv.com/compatible-devices/

Understandably many heart rate monitors are designed for just that – monitoring heart rate. It doesn’t mean it’s not a good HR monitor. But unless it is designed as above to accurate R-R intervals and not alter them, it won’t be suitable for HRV.

Regarding usefulness of HRV: It has completely changed my management of my illness. (Predicting crashes is not what I am interested in). With HRV I can make decisions based on my actual results, rather than on assumptions. It also makes me accountable with my pacing. It helps me enormously with tailoring the quantity and type of exercise I can manage.

But having said that, it is not treating anything. The underlying illness is not going to change by tracking HRV. Though I do think it helps me support my body more effectively, and maybe in time that will make a difference.

Perhaps just keep it in mind, if the Garmin needs replacing at some stage.

PS I sympathise about the cardiologist missing your POTS. I had the same experience, and I believe if it had been picked up and treated at that stage I might be in a much more abled state of health right now.

Thanks @Karmin for your detailed reply! I appreciate your suggestions and your explanation of how useful it is in daily life. It certainly seems like a very worthy endeavor. I'll make sure my next HRM is capable!

 

[Sarah R.]

Thank you so much, @Karmin, for such a clear explanation of HRV and why it's important. Also for your great examples and review of products you've tried. I would so love not to be wired when it's time to sleep. Actually I'd like not to be wired most of the time. It's exhausting. Do you think recording HRV would help with this?

 

[Remy]

Actually I'd like not to be wired most of the time. It's exhausting. Do you think recording HRV would help with this?

No, it probably would just confirm what you already know...that you are in sympathetic dominance at an inappropriate time (i.e. when you want to sleep!).

Things that would likely help are the meditation and breathing techniques mentioned above and potentially some supplements (phosphatidylserine, GABA, CBD) etc.

 

[Karmin]

Thank you so much, @Karmin, for such a clear explanation of HRV and why it's important. Also for your great examples and review of products you've tried. I would so love not to be wired when it's time to sleep. Actually I'd like not to be wired most of the time. It's exhausting. Do you think recording HRV would help with this?

Like Remy said: recording HRV won't do anything to improve the wired feeling Sarah. However it does give you a window into the Autonomic Nervous System so that you can see and quantify what is going on. Then what I found was that, by trying different treatments and measuring their effects, I could determine which most helped to calm down the sympathetic (fight/flight) side, and boost the parasympathetic (rest/digest) side. I plan my day according to what my body needs. Eg today my sympathetic is up, so I will be doing all the things my data indicates will help bring it down. And I know that, all else being stable, tomorrow it will improve.

 

[Sarah R.]

Thanks, @Remy.

 

[Obie]

The HRV apps test sensors for HRV accuracy, when coming up with their recommended sensors. SweetBeat also gives a signal strength result which helps to rule out connection problems. But the only real way to test accuracy would be to run it simultaneously with ECG. I believe a few tests have been done on Polar H7 vs ECG with good results.

I do also feel very solid with the numbers I am getting. I was skeptical when I started, but some of the numbers were just so spot on, I was a bit blown away. I tried a lot of apps, and sensors, and found that helped me zero in on the best. A couple of them gave results which were just all over the place and made no sense – they were the apps that used camera flash, or non-chest strap sensors. 2 or 3 apps with their recommended sensors gave numbers that correlated well with my subjective experience, correlated well with each other, and were very consistent. The two I have stuck with are SweetBeat and Elite. Sweetbeat is my pick, but I use Elite as well for some of its features.

Re size: go on your chest measurement (at position where you would wear the strap). I had the Medium size (fits chest 30” and above), and my chest size is 31”. I would say anything in that 29-31” range might be iffy with the Polar H7.

Thanks, Karmin,
Reading the Elite write-up was very helpful. I'm glad a company has actually done the testing for us and we don't have to reinvent the wheel.

I plan to order the Wahoo as my chest measurement is 31". Will probably be back with more questions when I get everything set up, but your write-up has been so informative. I like how you give options followed by recommendations to help newbies get started along with being so encouraging.

 

[Upgrayedd]

@Karmin @Obie

I've tried lot's of breathing/meditation techniques without much success. I'll keep trying, but in general, I find it hard to release tension through these exercises.

As for supplements that calm, I do take, and have tried, quite a number of them. Not sure they've done that much for me. Theanine, Phosphatidyl Serine, Picamilon, magnesium, herbals, and others...

I will say this... I've been experimenting with phenibut, which is basically an analogue of GABA that can cross the blood/brain barrier. I have never felt strong effects from phenibut whiletaking it, but this morning, after having taken it yesterday, for the first time my parasympathetic system was dominant, at least according to the Elite HRV app.

 

[Remy]

Also, huperzine and galantamine are both options to help increase acetylcholine which may increase parasympathetic activity.

 

[Obie]

@Karmin @Obie

I've tried lot's of breathing/meditation techniques without much success. I'll keep trying, but in general, I find it hard to release tension through these exercises.

As for supplements that calm, I do take, and have tried, quite a number of them. Not sure they've done that much for me. Theanine, Phosphatidyl Serine, Picamilon, magnesium, herbals, and others...

I will say this... I've been experimenting with phenibut, which is basically an analogue of GABA that can cross the blood/brain barrier. I have never felt strong effects from phenibut whiletaking it, but this morning, after having taken it yesterday, for the first time my parasympathetic system was dominant, at least according to the Elite HRV app.

I like your positive attitude to keep trying breathing techniques. They don't always work to calm me down, but overall they have been successful enough that i keep going back to them Sometimes I find it helpful to be guided while I'm doing it especially if I haven't been successful previous times. I notice Weill narrates guided breathing for several of his techniques on his website.
Which breathing techniques are you finding useful? Karmin, is the Weill technique you use the 4-7-8?

If you can actually get out to a restorative yoga class which are passive positions with breathing or get a CD, I've experienced major shifts after classes in how I feel.

 

[Onslow]

@Karmin @Obie

I've tried lot's of breathing/meditation techniques without much success. I'll keep trying, but in general, I find it hard to release tension through these exercises.

As for supplements that calm, I do take, and have tried, quite a number of them. Not sure they've done that much for me. Theanine, Phosphatidyl Serine, Picamilon, magnesium, herbals, and others...

I will say this... I've been experimenting with phenibut, which is basically an analogue of GABA that can cross the blood/brain barrier. I have never felt strong effects from phenibut whiletaking it, but this morning, after having taken it yesterday, for the first time my parasympathetic system was dominant, at least according to the Elite HRV app.

I'm not sure if relaxation is very useful in recovering from CFS. The problem in CFS is more a lack of stress tolerance rather than too much stress. It seems to be more a case of the body deliberately reducing the parasympathetic nervous system and the sympathetic nervous system taking over, rather than too much sympathetic activity in the first place.

From what I can see, CFS is the brain's response to chronic stress. The brain deliberately shuts down the body's energy system (HPA axis, and parasympathetic nervous system, which are both linked). If you try to overcome the fatigue, your body needs to activate the sympathetic nervous system to get the necessary energy. That, however, causes symptoms such as anxiety and tachycardia.

The only way to really fix the problem seems to be to reverse the cause of the suppressed HPA axis and parasympathetic nervous system. From what I can see, negative stress causes CFS, whereas positive stress helps with recovery (but you still need to be very careful). I found that motivating activities, positive goals and flow activities were important in my own recovery, and that appears to be the case with most (or all?) people who recover.

 

[Upgrayedd]

Also, huperzine and galantamine are both options to help increase acetylcholine which may increase parasympathetic activity.

Interesting - I hadn't thought about acetycholine. I take Elavil at night for sleep. Elavil is an anticholinergic antidepressant. It works well for helping me fall and stay asleep. But I suppose it might be why my parasympathetic scores tend to be very low on HRV reatings.

 

[Sarah R.]

Like Remy said: recording HRV won't do anything to improve the wired feeling Sarah. However it does give you a window into the Autonomic Nervous System so that you can see and quantify what is going on. Then what I found was that, by trying different treatments and measuring their effects, I could determine which most helped to calm down the sympathetic (fight/flight) side, and boost the parasympathetic (rest/digest) side. I plan my day according to what my body needs. Eg today my sympathetic is up, so I will be doing all the things my data indicates will help bring it down. And I know that, all else being stable, tomorrow it will improve.

Thanks so much, @Karmin!

 

[Sarah R.]

Interesting - I hadn't thought about acetycholine. I take Elavil at night for sleep. Elavil is an anticholinergic antidepressant. It works well for helping me fall and stay asleep. But I suppose it might be why my parasympathetic scores tend to be very low on HRV reatings.

Elavil (10mg amitriptyline) works to help me sleep through the night too; however, I have to take it several hours before I want it to kick in, and it seems like I'm a bit groggy the next day. Also I'm wondering if it has the same memory-destroying properties as Benedryl (being an anticholinergic). I'm just unclear if some anticholinergics interfere with memory and some don't. I really hate how stupid I've become. And it's much worse when I've done too much physically or not slept much or both (seems as if the two occur together more often than not).

 

[Remy]

Interesting - I hadn't thought about acetycholine. I take Elavil at night for sleep. Elavil is an anticholinergic antidepressant. It works well for helping me fall and stay asleep. But I suppose it might be why my parasympathetic scores tend to be very low on HRV reatings.

Anticholinergic drugs like Elavil and Benadryl will 100% lower HRV.