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Tracking my Heart Rate Variability (HRV)

Cheesus

Senior Member
Messages
1,292
Location
UK
I am starting an experiment to track my heart rate variability (HRV) because I want to see how it is influenced by various treatment strategies. I decided to start this thread so I can share my experience with others.

According to wikipedia, HRV is:
the physiological phenomenon of variation in the time interval between heartbeats. It is measured by the variation in the beat-to-beat interval.

So, HRV is a very finely tuned measurement of the time from one heartbeat to the next. If person A and person B both have a heart rate of 60 beats per minute, it is very likely that they still have a different HRV. Person A could have a heart beat exactly once every second, whereas person B might have a heart beat at 0.97 second, then 1.05 second, then 0.91 seconds that ultimately averages out at 60 BPM. In this scenario, person A would have a very low HRV whereas person B would have a high HRV.

A high HRV is desirable as it suggests that the autonomic nervous system can adjust quickly to varying demands on the body. Moreover, a high HRV suggests that a person has good vagal tone, whereas a low HRV suggests poor vagal tone. Good vagal tone is desirable as it suggests that the autonomic nervous system is more capable of balance between parasympathetic and sympathetic states.

By measuring my HRV I hope to be able to track which treatments improve or worsen HRV, and by proxy learn what increases or worsens vagal tone. My aim is to increase my vagal tone and thereby, hopefully, contribute towards rebalancing my autonomic nervous system. There have been a couple of studies of HRV in CFS, and in particular how HRV influences sleep quality. It seems that patients with a higher HRV typically sleep better, whereas those with lower HRV are more likely to wake frequently in the night and feel unrefreshed in the morning. This is probably because the parasympathetic nervous system is more active in the patients with a high HRV, so they are able to get restorative sleep.

I am measuring my HRV using a heart-rate monitor strapped around my chest which connects to an iPhone app via bluetooth. I also own a Fitbit HR, which monitors heart rate via the wrist, however the Fitbit is not sufficiently accurate to measure the minute differences in heart beats needed to get an accurate HRV measurement.

There are a number of different ways to calculate HRV, however the value I will be focusing on here is the rMSSD (root mean square of successive differences), because it is supposedly a good way to measure HRV over short time intervals of a minute or two.

Here is a very rough idea of normal rMSSD values from an article by HRV4Training so you can get an idea of what the values mean:

70 to 120 - Young, highly athletic people
60s - Young, physically active people
Mid-30s to 50s - Young, sedentary people
20s - Patient populations (e.g. chronic heart failure patients)

Further analysis of normal values by HRV4Training can be found here.

I have only just started measuring my HRV so I do not want to share my results yet as it is good to get a few measurements so I can establish my baseline. Needless to say, however, that after being bedridden for two years my HRV is not looking too good! The best time to take measurements for the purposes of establishing a baseline is first thing in a morning, so I will establish my baseline over the next few days then report back.

The first treatment intervention I will test is a trans-cutaneous vagus nerve stimulator, which should arrive in the mail later this week. Vagus nerve stimulation supposedly directly increases vagal tone and should have a measurable impact on HRV.
 
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Marco

Grrrrrrr!
Messages
2,386
Location
Near Cognac, France
@Cheesus

You might find the linked paper below useful?

Post concussion patients have similar patterns autonomic disturbance including reduced HRV that limits exercise and there are early indications that a very gentle programme of graded exercise (yes I know - but this is individually tailored to AVOID provoking symptoms) may help restore autonomic balance and cerebral blood flow :

http://www.academia.edu/20023456/Ce...al_Postconcussion_Syndrome_in_Female_Athletes
 
Messages
33
I am measuring my HRV using a heart-rate monitor strapped around my chest which connects to an iPhone app via bluetooth. I also own a Fitbit HR, which monitors heart rate via the wrist, however the Fitbit is not sufficiently accurate to measure the minute differences in heart beats needed to get an accurate HRV measurement.

i didnt think you could do that yet.
how accurate is that?
 

Dechi

Senior Member
Messages
1,454
I have been monitoring my HRV with the Elite HRV free app for five months now. I haven't found the HRV numbers by themselves a good measure to track progress.

What I do is I take the morning readiness test (in a semi lying down position) and compare my heart rate and HRV from that measure to my heart rate and HRV from a 1 minute standing messure that I take right after. I then look at the variations from the lying down heart rate and HRV and the standing up heart rate and HRV. The less variation, the better.

I make my own statistics and I have found the monthly trend to be the best for my use. I do the stats weekly so I get an early heads up and can adjust. I find that the sleep patterns are what affects the heart rate data the most.

Every case is unique, it might be different for you. This is definitely going to be very useful in managing your ME.
 

Cheesus

Senior Member
Messages
1,292
Location
UK
@Marco
That is interesting, particularly as cerebral blood flow is thought to be an issue for a subset of people with ME. It is my understanding that vasodilation and vasoconstriction are functions of the autonomic nervous system, so it wouldn't be at all surprising if neural or general hypo-perfusion in ME are at least in part caused by low vagal tone.

@markiz2001
The short answer is that I do not know. I am not sure that there have been any proper studies comparing heart-rate straps to ECGs. However the same guy that I cite in my initial post, Marco Altini, conducted an n=1 study by taking HRV readings simultaneously from an ECG, a heart-rate strap and a wrist-worn device. He found that the strap was very accurate, but that the device worn on the wrist was not:

http://www.hrv4training.com/blog/hardware-for-hrv-what-sensor-should-you-use

I'll be honest with you, I do not understand most of what he is talking about in that article. I set out with the assumption that these chest-straps were accurate. His small investigation seems to suggest that they are.

@Dechi
I am using the same app. I had planned on looking at the long-term trends primarily, so it is good to know that you also tend to see the most useful data from those time-periods.

It is interesting when you say that it is sleeping patterns which effect your HRV the most. What exactly do you mean by sleep patterns? Could causality run in the opposite direction? I.e that your HRV determines sleep patterns?

Have you compared any other variables to your HRV, such as activity levels, certain supplements, or other treatments?
 

ScottTriGuy

Stop the harm. Start the research and treatment.
Messages
1,402
Location
Toronto, Canada
I wonder if this device would help with HRV and / or ANS normalization:

http://www.heliusmedical.com/divisions/neurohabilitation/pons-device

The PoNS device is based on almost 40 years of research in the field of neuromodulationthe use of external stimulation to intentionally change and regulate the electrochemical environment of the brain. It is believed that neuromodulation enhances neuroplasticity, the brain’s ability to restructure or relearn in response to new experiences, sensory input, and functional demands. Research has shown that the process of neuroplasticity underlies all cerebral learning, training and rehabilitation.
 

Cheesus

Senior Member
Messages
1,292
Location
UK
@Dechi
What is your baseline rMSSD? I noticed that Elite HRV offers a headline number that differs from rMSSD in addition to various other possible measures, but there is no information on what that number is or how it can compare to other people. I am looking specifically at rMSSD as I have been able to put it into context.

@ScottTriGuy
I read about the PoNS device in Norman Doidge's book The Brain's Way of Healing. It certainly seems like an interesting possibility, however the premise of the device seems to be that you engage in whatever activity you have a neurological deficit with, such as walking or speaking, whilst using the device. Have you come across anything to suggest that it can increase HRV independently of whatever activity you are trying to rehabilitate?

Another possibility is that low-level laser therapy could increase vagal tone, which is another method that pops up in Doidge's book, as I believe you are aware. I recently bought an LLLT device, so that is something else that I will measure against my HRV, however I do not want to do it all at once as I would not know what is influencing HRV.
 

voner

Senior Member
Messages
592
@Dechi
What is your baseline rMSSD? I noticed that Elite HRV offers a headline number that differs from rMSSD in addition to various other possible measures, but there is no information on what that number is or how it can compare to other people. I am looking specifically at rMSSD as I have been able to put it into context.

@Cheesus, I contacted the Elite HRV people and here is what one of the founders said about that headline number (a scale of 0-100).......

[We simply multiple the lnRMSSD by 15.38 to establish a 1-100 score.

I used a different app that allowed you to create a text file with the beat to beat timing numbers and it demonstrated a chest strap monitor to be very accurate. right now I forget which app it was etc.

One thing that I found one I monitored my heart rate variability was that while healthy people usually were looking at very small changes in the Elite hrv number (0-100 scale), my changes were very large, both day to day and after exercise or exertion, reflecting very little heart rate variability after certain types of exertion. I would do a poor mans POTS test, supine, then stand still, then supine again as my evaluation tool. on bad days, my heart rate when standing & after exertion would sometomes lock in and vary very little if I kept standing still.
 
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Dechi

Senior Member
Messages
1,454
@Marco
That is interesting, particularly as cerebral blood flow is thought to be an issue for a subset of people with ME. It is my understanding that vasodilation and vasoconstriction are functions of the autonomic nervous system, so it wouldn't be at all surprising if neural or general hypo-perfusion in ME are at least in part caused by low vagal tone.

@markiz2001
The short answer is that I do not know. I am not sure that there have been any proper studies comparing heart-rate straps to ECGs. However the same guy that I cite in my initial post, Marco Altini, conducted an n=1 study by taking HRV readings simultaneously from an ECG, a heart-rate strap and a wrist-worn device. He found that the strap was very accurate, but that the device worn on the wrist was not:

http://www.hrv4training.com/blog/hardware-for-hrv-what-sensor-should-you-use

I'll be honest with you, I do not understand most of what he is talking about in that article. I set out with the assumption that these chest-straps were accurate. His small investigation seems to suggest that they are.

@Dechi
I am using the same app. I had planned on looking at the long-term trends primarily, so it is good to know that you also tend to see the most useful data from those time-periods.

It is interesting when you say that it is sleeping patterns which effect your HRV the most. What exactly do you mean by sleep patterns? Could causality run in the opposite direction? I.e that your HRV determines sleep patterns?

Have you compared any other variables to your HRV, such as activity levels, certain supplements, or other treatments?

I should have said sleep duration more than sleep patterns. Although duration comes with pattern as well. The less I sleep, the lower my HRV is and the more variable my hr is (it can go lower or higher, I haven't dound out why that is yet). I often have bouts of insomnia where I will be awake 2-3 hours during the night. Even if I succeed in going back to sleep afterwards, it leaves me with only about 3-4 hours of restful sleep. That is a killer for me, especially since it happens most days.

I have a polar a360 watch and my stats come from it except for HRV. I take into account my hours of sleep, total time lying down, time sitting, time moving about, number of steps and calories burnt. Since I don't have severe PEM since taking nimotop, and since I am very careful to rest aggressively, I haven't noticed activity having a big impact on my symptoms or HRV. But sleep does.

Also the supplements I try will have an impact on my symptoms. Some will help, others not. Always hard to know. Right now I started taking NAG and Curcuma and I have gained 4 pounds and my HRV is lower and heart rate is higher. But otherwise I am doing ok. Go figure...

It's a very complicated puzzle, I have to admit !
 

Denise

Senior Member
Messages
1,095
@Cheesus

You might find the linked paper below useful?

Post concussion patients have similar patterns autonomic disturbance including reduced HRV that limits exercise and there are early indications that a very gentle programme of graded exercise (yes I know - but this is individually tailored to AVOID provoking symptoms) may help restore autonomic balance and cerebral blood flow :

http://www.academia.edu/20023456/Ce...al_Postconcussion_Syndrome_in_Female_Athletes



fwiw - the article is also available here:
https://www.researchgate.net/public...al_Postconcussion_Syndrome_in_Female_Athletes
 

ScottTriGuy

Stop the harm. Start the research and treatment.
Messages
1,402
Location
Toronto, Canada
Have you come across anything to suggest that it can increase HRV independently of whatever activity you are trying to rehabilitate?

Another possibility is that low-level laser therapy could increase vagal tone, which is another method that pops up in Doidge's book, as I believe you are aware. I recently bought an LLLT device, so that is something else that I will measure against my HRV, however I do not want to do it all at once as I would not know what is influencing HRV

No, the PoNS jumped into my head when you mentioned the vagal, just a quick thought I threw out.

I'll be interested to see if your LLLT helps - I think I mentioned elsewhere that a physician with ME had significant (or was it 'substantial'?) improvement - and half her dozen or so ME patients also experienced improvement, while the other half had no results.

It would seem, like so many ME treatments, that a subset respond well. It would be interesting to try to tease out any commonalities in her patients. I'll see that doc at the ME Conference this weekend and will ask her if she's noted any patterns.
 

Cheesus

Senior Member
Messages
1,292
Location
UK
@voner
That makes a lot of sense. Thanks for checking that out!

I had wondered about the variability in HRV itself and whether that is significant. It seems we need a heart rate variability variability test :D

What is your baseline score?

@Dechi
Thanks for the info. What kind of reading do you generally get from the figure they provide?

@ScottTriGuy
Yes, I think you might be right about different subsets responding to different treatments. A lot of people say NAC helps them with the wired but tired feeling, but in my instance NAC makes everything about my condition 100 times worse. I've never been so ill as when I tried it.

I am feeling more confident about the vagus nerve stimulator I am about to receive in the mail than anything. It should be the perfect intervention for HRV (other than a great deal of physical training, which is obviously not open to the likes of us).
 

voner

Senior Member
Messages
592
@voner
That makes a lot of sense. Thanks for checking that out!

I had wondered about the variability in HRV itself and whether that is significant. It seems we need a heart rate variability variability test :D

What is your baseline score?.......

I am feeling more confident about the vagus nerve stimulator I am about to receive in the mail than anything. It should be the perfect intervention for HRV (other than a great deal of physical training, which is obviously not open to the likes of us).

my baseline score is all over the map. It can vary from in the 20s up into the 80s.

I used the elite HRV app to see the effects of some pharmaceuticals I was trialing to improve my autonomic functions. Never did find much that helped significantly. I have attached a screenshot of one of the graphs where I do a supine, stand, supine, Pots test. this graph is somewhat reflective of common results of the test, however the results were just extremely variable. There was even one or two times for my HRV states relatively steady. The red is my heart rate and the yellow is my HRV. time scale is along the bottom, heart rate is along the right vertical side and HRV is along the left vertical side.

What type of vagal stimulator are you trying?
 

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Dechi

Senior Member
Messages
1,454
I mean what is your HRV generally. Tell me using the figure they provide rather than rMSSD.

It used to be around 60, then it decreased a bit to 58 and lately it's more around 54-55. But my lying down/standing up ratio is the same. I haven't figured out what it means yet. If I was getting worse, I figure my standing up figures would be worse too, but they aren't, they're stable. So why is my HRV going down ?
 

Cheesus

Senior Member
Messages
1,292
Location
UK
@voner
That is interesting. I am starting to wonder whether or not I am going to get much useful information out of this. So far my morning values are very stable, but they can vary a lot at other times of day. I actually tested the impact of meditation the other day. The meditation itself was very, very relaxing and I almost feel asleep a number of times during it, however when I retested my HRV at the end it had actually dropped compared to where it was at the beginning. It makes no sense.

The vagus nerve stimulator is called Nervana. I have made a post about it before: http://forums.phoenixrising.me/inde...-vagus-nerve-stimulation-via-earphones.46593/

@Dechi
I hope that was a rhetorical question, because I have no idea :D Has the quality of your sleep changed over that time?
 

ahimsa

ahimsa_pdx on twitter
Messages
1,921
Disclaimer - I know next to nothing about Heart Rate Variability (HRV) other than seeing it come up in research studies from time to time. But I thought I'd pass on some info.

I happened to read something about tracking HRV with various software earlier this year. I remembered it when I read this thread. It was a blog on Cort Johnson's Health Rising website. Here's the link, in case it helps:

http://www.healthrising.org/forums/...sting-could-help-you-improve-your-health.353/
 

Dechi

Senior Member
Messages
1,454
[USER=23974 said:
@Dechi
I hope that was a rhetorical question, because I have no idea :D Has the quality of your sleep changed over that time?

@Cheesus Yes It was ! My sleep quality has been poor ever since I have been sick, no change unfortunately.