#79 - The Science of HRV: Advanced Analysis for Healthcare Providers, Part 1

[00:00:00] Hi guys, welcome to another episode of The FAKTR Podcast.

[00:00:18] I'm your host Jessica Riddle.

[00:00:20] Welcome and thanks for listening.

[00:00:21] Today we kick off a new two part training on Harnessing the Science of Heart Rate Variability

[00:00:25] or HRV for enhanced patient care with Dr. David Hopper.

[00:00:29] When it comes to the science of studying heart rate variability, it's more than just a data

[00:00:33] point or a health marker.

[00:00:35] HRV is a comprehensive gauge of our nervous system's flexibility and our overall physiological

[00:00:40] resilience.

[00:00:41] In this fascinating two episode series, our guest instructor Dr. David Hopper will

[00:00:45] share the significance of understanding both the sympathetic and parasympathetic nervous

[00:00:49] systems for achieving optimal bodily functions and discuss the potential of HRV in predicting

[00:00:55] illnesses and enhancing patient care.

[00:00:58] We will also explore how this powerful tool helps athletes adjust training schedules and

[00:01:03] assists medical practitioners in planning better patient care strategies, all while

[00:01:08] steering through day to day physiological shifts.

[00:01:10] Whether you're a healthcare professional or someone interested in wellness and body

[00:01:14] metrics, this episode is packed with valuable insights on using HRV to its full potential,

[00:01:20] so be sure to hit that download button and grab something to take note with.

[00:01:23] Let's dive in!

[00:01:28] Alright, well thank you so much for having me today Jessica.

[00:01:36] I'm very excited to be talking to all of you about my absolute favorite topic, which

[00:01:41] is heart rate variability.

[00:01:43] So let's get in here and first things first, I want to introduce myself.

[00:01:49] So I am a practicing chiropractor as well as an oral malfunctional therapist.

[00:01:54] So for those of you who aren't familiar with the second term there, think somebody who

[00:01:58] does rehabilitation for the airway mouth and face.

[00:02:02] That's kind of my zone.

[00:02:03] I do a lot with sleep apnea, TMJ, and all that as well in practice.

[00:02:07] As well, I am a father of two.

[00:02:09] Those are my children right there, Jobin and Petunia, and my beautiful wife there,

[00:02:13] Brooke.

[00:02:14] And we are located outside of Chicagoland here and we have a few clinics doing different

[00:02:19] things out here.

[00:02:20] So chiropractic, then we have occupational therapy, physical therapy, speech therapy,

[00:02:23] and then of course, I'm an EMT as well.

[00:02:25] And I am a as well an instructor at the National University of Health Sciences.

[00:02:29] So I'm in their doctorate program helping to bring chiropractors and naturopathic

[00:02:34] doctors out into the field.

[00:02:36] So lots of fun that we get to have over there.

[00:02:38] And then basically anything heart rate variability certification wise that you can

[00:02:42] possibly have or get, I've gone through as much as I could.

[00:02:45] And I get to talk about HRV everywhere I go to, which is real fun.

[00:02:49] So that is me.

[00:02:51] One more thing that I would like to mention as well, I am associated my passion for HRV

[00:02:55] has driven me to to start an app.

[00:02:58] So I am part owner of an app within HRV as well.

[00:03:02] We do have a device as well.

[00:03:03] So just want to be forward with my disclosures on that, that I am involved financially

[00:03:08] with an application as well for this.

[00:03:11] What were the basics of heart rate variability?

[00:03:13] So by no means by the end of this course, will you be in a place where you can

[00:03:17] turn around and start using HRV very confidently in practice?

[00:03:21] For that, I want you to go through our extended.

[00:03:23] We will have up here in the next coming weeks here.

[00:03:26] And but what we will learn today is the basics.

[00:03:30] So that way you will know the path to using HRV in practice and at least what

[00:03:36] you will have when you leave here today is a good enough understanding to start

[00:03:40] experimenting on your own and know what you are looking at.

[00:03:44] So again, just in general overview here.

[00:03:47] But the first thing that we're going to dive into is the history and the power

[00:03:51] behind heart rate variability as well.

[00:03:53] We're going to define heart rate variability.

[00:03:57] So with heart rate variability, this is not a new science, although it is a

[00:04:01] hot topic right now, that is just because as of right now, technology is

[00:04:07] getting to the point where now it is an easy to find thing.

[00:04:10] So it's an easy metric that we can measure all of a sudden, whereas

[00:04:13] before it wasn't the case.

[00:04:16] So it was actually 1895 was when ECGs were first came out and hit the world

[00:04:21] and we can actually see that variance.

[00:04:23] Prior to that, we knew that there was a variance in your heart rate,

[00:04:26] but then we saw that in 1895.

[00:04:28] Now in 1930s, they came out with this thing called PPG or photoplasmography.

[00:04:34] And that is actually the most commonly used way to detect heart

[00:04:39] rate from any source.

[00:04:41] So anybody who's wearing an Apple watch, a loop band, or a ring,

[00:04:44] anything like that, that light sensor is a PPG sensor is what it's called.

[00:04:50] And that's the preferred method of collection nowadays, without a doubt.

[00:04:54] The chest strap monitor that Polar came out with in the 1970s.

[00:04:59] And that was another excellent way for collecting this kind of data.

[00:05:02] And I'm sure you all are familiar with that one.

[00:05:04] And then in the 1990s, we started to get these wearable heart rate

[00:05:09] trackers, and this was a huge step forward, a huge leap forward.

[00:05:13] But then it wasn't until just recently again, that we started to have wearables

[00:05:18] that were able to, precise enough that we could actually pick up

[00:05:23] the R to R intervals.

[00:05:24] And we're going to see what that means.

[00:05:25] But essentially they were capable of transmitting HRV data.

[00:05:31] So again, by no means a new topic, right?

[00:05:33] We have over 30,000 articles at this point.

[00:05:36] I'm sure this is an old slide.

[00:05:38] So I'm sure there's over 30,000 at this point published articles on HRV.

[00:05:41] And that is literally Google HRV and anything.

[00:05:44] Look up HRV and connect it to any disease process, anything like that.

[00:05:50] And that's there.

[00:05:51] HRV is very well tied to everything inside.

[00:05:55] It's a marker for all cause mortality as we will see.

[00:05:58] And just in the past eight years, this technology has caught up where we can

[00:06:02] really start using this powerful metric here.

[00:06:06] This is my guy right here.

[00:06:07] This is how I feel every day when I talk about HRV.

[00:06:10] I'm just so excited about it because it's such a powerful thing and it

[00:06:13] advances us all so much in our understanding of human physiology.

[00:06:17] And now that it is so accessible, we can use this so greatly with our patients.

[00:06:22] What is heart rate variability?

[00:06:24] So for starters, it's not heart rate.

[00:06:27] And that's the biggest thing that we have to get across.

[00:06:30] Cause that's my biggest challenge.

[00:06:31] My biggest hurdle when I talk to people is I say, Oh, you know,

[00:06:34] HRV heart rate variability.

[00:06:36] And people say, yes, yes.

[00:06:36] And then about 10 minutes into the conversation, I realized that they were

[00:06:41] leaving that V off the end and they assumed I was talking about heart rate.

[00:06:44] So when we put that beyond it changes what we are talking about.

[00:06:47] So they are not the same thing.

[00:06:50] When we add that in, right?

[00:06:51] Heart rate is talking about just beats per minute or BPM.

[00:06:56] And then we add in that variability.

[00:06:57] Now we're talking about something that is able to adapt or vary, right?

[00:07:01] So we can change with our environment.

[00:07:03] So heart rate variability is a heart rate that changes, right?

[00:07:07] Or we can give it a proper definition and heart rate variability is the

[00:07:11] variation of time intervals between successive heartbeats measured over

[00:07:15] a given period of time.

[00:07:18] So what exactly does that mean?

[00:07:19] If we have a heartbeat of 60 beats per minute, most people would assume

[00:07:25] that your heart rate is beat one second, one beat two seconds, two beats,

[00:07:29] three seconds, three beats, and so on and so forth.

[00:07:32] And actually that is not at all how it happens.

[00:07:35] And we don't want it to ever be like that.

[00:07:37] That would actually give you an HRV of zero, which would be a very bad place.

[00:07:42] How it works is more like this picture right here.

[00:07:45] We have a heartbeat and that's what this graph is showing.

[00:07:48] And these are called QRS complexes for those of you who might not be familiar.

[00:07:52] And a QRS complex is this peak.

[00:07:55] And we can call this the R spike right there between this R spike and

[00:07:58] this R spike would be our R to R interval.

[00:08:00] And we want to measure that time distance right there.

[00:08:04] And as it shows here, this first interval might be 850 milliseconds and the next

[00:08:11] one 980 milliseconds and then down to 740 milliseconds.

[00:08:15] And that variation of time intervals is what we are talking about when we say

[00:08:21] HRV.

[00:08:22] So what does that change in time between each heartbeat?

[00:08:26] And that is very healthy.

[00:08:27] That is what we want to have.

[00:08:29] So in fact, a higher variation is better than a lower variation when we talk about

[00:08:34] our HRV.

[00:08:36] What is being measured?

[00:08:37] Those are to our intervals and this is our HRV.

[00:08:40] Now we are talking, we are talking about not just a simple number here, but

[00:08:45] what this number is a measure of is our autonomic nervous system.

[00:08:49] So that is why it is so powerful.

[00:08:51] The system of our body that runs and governs everything that goes on in the

[00:08:57] background, which is majority of what is happening with our body in any given

[00:09:01] moment, we have a measure of this, a very easily accessible measure of this

[00:09:06] with HRV.

[00:09:07] So we are looking at autonomic nervous system regulation or in other words,

[00:09:11] our ability to adapt to any given thing in our environment.

[00:09:16] But why should you care about it?

[00:09:18] Well, low HRV is associated with all cause mortality.

[00:09:23] Back to that, right?

[00:09:24] If we look at HRV and pair it with anything, we will see that as HRV goes

[00:09:30] down, your chances of dying from anything goes up.

[00:09:33] And it's associated with the nine of the top 10 killers.

[00:09:38] You can look at this list here of the top 10 killers in the United States

[00:09:41] and low HRV is associated with nine of the top 10.

[00:09:45] The only one that isn't directly correlated with is motor vehicle

[00:09:49] accidents or unintentional death or injury.

[00:09:53] And I argue that.

[00:09:55] And the reason why I argue that is because a low HRV means that your

[00:09:59] reaction time is actually lower.

[00:10:02] If you are driving down the street and somebody pulls out in front of you

[00:10:07] and your HRV is higher and therefore you have a higher reaction time, might

[00:10:12] you be able to pull the steering wheel out of the way at the last

[00:10:15] minute and avoid that life altering car accident?

[00:10:19] Right.

[00:10:19] Might you be able to change the way that you step off the curb and rather

[00:10:22] than injuring or rolling your ankle, you actually just walk away and stumble.

[00:10:27] So we know that HRV may actually be associated with 10 of the

[00:10:32] 10 top 10 killers.

[00:10:33] So that's my argument for it.

[00:10:41] If earning a certification is on your CE plan this year, then you're in luck.

[00:10:45] Southeast professional education group just launched four new certifications

[00:10:49] on our online learning platform.

[00:10:51] You can complete your certification in dry needling, functional nutrition,

[00:10:55] chiropractic acupuncture or clinical human performance with immediate access

[00:11:00] to get started learning right away.

[00:11:03] To learn more and get started, click the new certifications link

[00:11:06] in our show notes or visit online.sports-seminars.com today.

[00:11:11] Now back to the show.

[00:11:17] What is this again?

[00:11:18] Autonomic nervous system adaptability as seen in HRV will help us

[00:11:24] determine a patient's ability to heal and recover.

[00:11:27] So when we get a patient in clinic talking to, I didn't get to see all the

[00:11:32] different healthcare practitioners that are on here, but it looks like chiropractors.

[00:11:35] So when we get a patient in clinic and we have a good idea of where their

[00:11:38] autonomic nervous system is because we are looking at their HRV, then we can

[00:11:43] determine their ability to heal or recover from whatever it is that

[00:11:48] brought them in our door.

[00:11:49] So somebody with a higher HRV is going to heal faster from whatever they walk

[00:11:56] in the door with.

[00:11:57] And we know that they are going to have a better response, whereas

[00:12:00] somebody with a lower HRV is going to have a slower or delayed response.

[00:12:04] So that can help us with our care planning and that somebody with a

[00:12:07] lower HRV is probably going to need a longer care plan versus somebody

[00:12:11] with a higher HRV who we can expect might recover quicker and not need

[00:12:15] as long of a care plan.

[00:12:18] And then as well, when we are going through whatever care plan it is, if we

[00:12:23] see somebody's HRV going down throughout our care plan, then that gives us time

[00:12:28] to reflect on our care plan and say, are we challenging this person too much?

[00:12:32] Possibly.

[00:12:33] And maybe do we want to back off with what we're doing or maybe talk to

[00:12:37] them about some of their other lifestyle factors that might be playing

[00:12:40] in overwhelming this person's nervous system.

[00:12:43] And the opposite might also be true, right?

[00:12:44] That we can confirm that our care plan is going very well and that we are

[00:12:48] doing the right thing and that this person's HRV is continuing to climb as

[00:12:53] they come out of pain, as they continue to improve their life.

[00:12:57] So HRV has a powerful predictive ability as well.

[00:13:01] HRV can actually predict the onset of illness or injury up to two days

[00:13:07] prior to the onset of symptoms.

[00:13:10] And that sounds pretty crazy, but when we think about it, it's not

[00:13:14] all that crazy.

[00:13:14] Right?

[00:13:15] Cause our autonomic nervous system is going to be dealing with some of these

[00:13:18] things before it ever comes to our conscious awareness.

[00:13:22] Okay.

[00:13:22] Or before we start to experience symptoms.

[00:13:25] So this is true with illness.

[00:13:27] This is true with overuse injuries.

[00:13:28] Obviously, if you fall off your bicycle, HRV probably couldn't

[00:13:32] predict injury so much.

[00:13:34] But this is what we're talking about with illness, overuse injuries.

[00:13:37] And then it can also predict performance and we're not talking just

[00:13:40] about physical performance, but mental and emotional performance as well.

[00:13:44] If HRV is a measure of how well our body is dealing with all of life

[00:13:49] stressors, then we can assume that, and this is also fact, is that somebody

[00:13:55] who has a higher HRV is going to perform better mentally.

[00:13:58] They're going to perform better emotionally, meaning that they can

[00:14:01] have more on their plate before they start to break down.

[00:14:04] And then of course, physical as well.

[00:14:06] And we see this in the physical in sports.

[00:14:09] And that's where HRV has become very popular is that we see athletes

[00:14:14] training based on their HRV with the best training programs out there.

[00:14:18] We see that they're, they're reacting and adjusting their training program

[00:14:22] based on their heart rate variability.

[00:14:23] And they are having unbelievable outcomes, which is so cool to see.

[00:14:26] All right.

[00:14:26] And the one of the more powerful things that we get out of HRV, even

[00:14:31] more so than that predictive factor is the deeper insights and the deeper

[00:14:34] connections that we get with our patients.

[00:14:37] So when a patient comes in and we see that their HRV is trending

[00:14:41] in the wrong direction, and we're pretty confident that we are doing

[00:14:45] everything correctly, it gives us that opportunity to talk to our

[00:14:48] patients to the next level.

[00:14:50] It opens the door to that conversation where we can say, Hey Mary, what

[00:14:54] is going on that we are seeing this trend down?

[00:14:57] We are doing everything right here in the office.

[00:15:00] So what's going on at home?

[00:15:02] Is there something else outside of here that isn't going the way

[00:15:06] that we want?

[00:15:07] And then we can start to talk about nutrition.

[00:15:08] We can start to talk about sleep.

[00:15:09] We can start to talk about their relationships at another level.

[00:15:12] And then of course, we can make a referral if that's

[00:15:14] what's going to be necessary.

[00:15:16] Or we can help them with some of those other adjustments outside

[00:15:21] of what we are already working on.

[00:15:22] So it really helps us make that deeper connection with our patients

[00:15:25] with that, which I think is just amazing and the increased self

[00:15:28] responsibility too, because patients will deny all day long that having

[00:15:32] a couple of drinks at the end of the day is really affecting their

[00:15:36] health. Right.

[00:15:37] But then when you see an objective number staring you in the face,

[00:15:41] saying that, yeah, in fact, when you do that, your body performs

[00:15:46] much worse the next day and same with skipping sleep, right?

[00:15:49] Well, I'm fine.

[00:15:50] I don't need to sleep seven hours.

[00:15:52] I don't need to sleep eight hours a night.

[00:15:54] Well, let's look at what your HRV looks like when you do

[00:15:57] versus when you don't.

[00:15:58] And then there is no argument anymore.

[00:16:01] That is an objective number that tells you both that yes, you

[00:16:05] actually perform better when you have slept properly.

[00:16:09] What about the science of our variability?

[00:16:11] So we're going to jump into this very quick.

[00:16:13] And again, we are going to skim the surface of this.

[00:16:16] But what is HRV looking at?

[00:16:18] I've said several times what we would define as homeostasis.

[00:16:22] Right.

[00:16:22] And that is the maintenance of a constant internal environment,

[00:16:26] despite our ever changing internal and external environments

[00:16:30] that we have around us.

[00:16:31] OK, so we need to maintain that homeostasis and how we do

[00:16:35] that, the work that we put in to maintain homeostasis.

[00:16:38] Well, we label that elostasis.

[00:16:40] OK, those are our elostatic processes.

[00:16:43] And then we have the concept of your elostatic load.

[00:16:48] And how I like to think of this is is like your load of bricks.

[00:16:53] So at any given time, Brown is our load of bricks.

[00:16:58] We have these basic things that we're carrying around.

[00:17:00] And then when somebody hands us something extra, so that

[00:17:02] weighs us down a little bit and then we get something extra piled

[00:17:05] on, right. Call it finances, call it work, call it family

[00:17:08] stress, whatever it is.

[00:17:09] It pushes us down a little bit more.

[00:17:10] Right.

[00:17:10] So we have this weight coming on us and you can call these

[00:17:14] stressors, but I hate the word stressors.

[00:17:16] So I like to call them life metrics because it makes

[00:17:19] a lot more sense to me.

[00:17:20] We have all of these bricks and this is our elostatic load.

[00:17:24] Right.

[00:17:24] And this is this is what's weighing us down.

[00:17:27] So you can imagine that somebody with a very large

[00:17:30] load of bricks, if they're walking down the sidewalk,

[00:17:33] it's going to be difficult for them to move from side to side.

[00:17:36] It's going to be difficult for them to react to something

[00:17:39] in their environment.

[00:17:41] If somebody asks them a difficult question, it's going

[00:17:43] to be harder for them to come up with an answer.

[00:17:46] Right.

[00:17:46] It's going to be harder for a mental task even when

[00:17:48] you have a large load.

[00:17:50] If somebody says something upsetting, they're probably

[00:17:52] going to react in a more emotional way.

[00:17:55] And then, of course, if something like a soccer ball

[00:17:57] came flying out in front of them, right, they would

[00:18:00] probably have a very difficult time with that physical task.

[00:18:03] When you are carrying this big load.

[00:18:05] Now, let's look at the exact opposite.

[00:18:07] Somebody just walking down the street and they just

[00:18:09] have their one little brick and they're walking

[00:18:12] along all jolly.

[00:18:13] Right.

[00:18:13] And somebody comes up and ask them a difficult mental

[00:18:15] question.

[00:18:16] They can think about that pretty easily and they can

[00:18:19] be very agile mentally.

[00:18:22] And if something emotionally taxing happened, right,

[00:18:25] they would probably deal with it in a very positive way.

[00:18:29] And same with that soccer ball comes kicking back

[00:18:31] out again.

[00:18:31] Maybe that person could stop it, right.

[00:18:33] Smile, wave to whoever it was, kick it back, maybe

[00:18:35] even play a little bit of soccer.

[00:18:37] Right.

[00:18:38] And then get back to walking down the street.

[00:18:40] And it's the same thing with our allostatic load

[00:18:42] that we are talking about with HRV.

[00:18:44] The more that we have on our plate, the more

[00:18:46] it's weighing us down, the less adaptable we

[00:18:49] are to everything in life.

[00:18:52] And that is what our HRV is reflecting for us

[00:18:55] is that allostatic load or how many stressors

[00:18:58] we have or how adaptable we are to everything

[00:19:02] in life.

[00:19:04] Here it is, HRV.

[00:19:06] This is what allows the body to be adaptable

[00:19:08] and maintain homeostasis in the face of our

[00:19:12] ever changing environments.

[00:19:14] So we thrive with high adaptability or high

[00:19:17] HRV.

[00:19:18] So that's what we are always aiming for.

[00:19:21] All right.

[00:19:21] So what is being measured?

[00:19:22] Well, I already clued into this and talking

[00:19:24] about the autonomic nervous system.

[00:19:26] That is what we're looking at is the function

[00:19:28] of our autonomic nervous system.

[00:19:30] And as a quick refresher, for those of you

[00:19:32] who may have been out of school for quite

[00:19:34] some time, we have our two main sides of

[00:19:38] the autonomic nervous system.

[00:19:39] Right.

[00:19:39] We're going to ignore the enteric nervous

[00:19:41] system for the time being.

[00:19:44] But of our sympathetic nervous system.

[00:19:47] Right.

[00:19:47] And we can think about that as our gas

[00:19:48] pedal or our fight flight freeze response.

[00:19:52] And this one often gets a bad rap.

[00:19:54] And I know for sure as chiropractors, we

[00:19:56] often talk about this in a negative way.

[00:19:58] And it's a lot of negative rap in other

[00:19:59] realms as well.

[00:20:01] And, and it's not all bad.

[00:20:04] Right.

[00:20:04] Cause if it wasn't for our sympathetic

[00:20:05] nervous system, we wouldn't get up in

[00:20:06] the morning, we wouldn't move or do

[00:20:09] anything, right?

[00:20:09] That we'd never go to the gym.

[00:20:11] And granted, if we got ourselves to

[00:20:12] the gym, it's our sympathetic nervous

[00:20:13] system that makes us exercise, that

[00:20:15] actually gets us moving and doing these

[00:20:18] wonderful things for our body.

[00:20:19] Right.

[00:20:19] But it gets a negative rap when it is

[00:20:21] left on too long.

[00:20:23] And that's exactly it is that in the

[00:20:27] long term, our sympathetic nervous

[00:20:29] system left on for a long time becomes

[00:20:33] problematic.

[00:20:34] That's when we start to see a decreased

[00:20:36] immune function.

[00:20:37] We see decreased mental, physical,

[00:20:39] emotional, all of that starts to ramp

[00:20:41] down when this gas pedal is left

[00:20:43] on too long.

[00:20:43] And you can just imagine, right?

[00:20:45] If you were stepping on the gas

[00:20:46] pedal in your car and you were just

[00:20:48] sitting there revving your gas pedal

[00:20:50] for hours on end, something's going

[00:20:52] to break and it's no different with

[00:20:55] your body.

[00:20:56] Right.

[00:20:56] Eventually something ends up

[00:20:59] breaking and that's what we see.

[00:21:01] Right.

[00:21:01] Our sympathetic nervous system was

[00:21:02] not meant for that.

[00:21:03] It's meant for acute quick processes.

[00:21:06] Let's take care of this and then

[00:21:07] let's go back to rest and

[00:21:09] recovery.

[00:21:09] Okay.

[00:21:09] So that's, that's what our

[00:21:11] sympathetics were meant for.

[00:21:13] So then we have a pair of

[00:21:14] sympathetics, the opposite side or

[00:21:15] a brake pedal.

[00:21:16] So this is our rest, digest, relax,

[00:21:18] recover.

[00:21:18] That's the opposite side.

[00:21:21] And this one, although we always

[00:21:24] talk about this side so highly,

[00:21:26] it's not all good either.

[00:21:28] Right.

[00:21:28] We need that perfect balance of

[00:21:31] the two.

[00:21:31] That's what we are always aiming

[00:21:32] for.

[00:21:33] We need great function of both

[00:21:35] sides of the nervous system.

[00:21:36] If this were only parasympathetic

[00:21:38] function, yeah, we'd have a

[00:21:39] huge lack of motivation.

[00:21:40] We had poor circulation, right?

[00:21:41] We never do anything in life.

[00:21:43] And this picture is a great one.

[00:21:45] This is actually my son and he

[00:21:47] was really sick.

[00:21:48] So his body was in full

[00:21:49] recovery, right?

[00:21:50] Brake pedal.

[00:21:51] And then he needed to go to the

[00:21:53] bathroom.

[00:21:54] So another big brake pedal

[00:21:56] action.

[00:21:57] And he was so parasympathetic

[00:21:59] that he actually fell asleep on

[00:22:01] the toilet.

[00:22:01] I like to say he crapped out

[00:22:02] on the crapper and this is a

[00:22:03] pretty fun way to find him.

[00:22:05] Makes me good.

[00:22:06] Anyway, so this is our long

[00:22:09] term survival strategies as our

[00:22:11] parasympathetic nervous

[00:22:12] system.

[00:22:12] So these are the things that

[00:22:14] yes, they do take longer

[00:22:15] amounts of time.

[00:22:16] And it does take a lot of energy

[00:22:18] for this side.

[00:22:18] So we see things like our

[00:22:20] digestion, our absorption, our

[00:22:21] excretion, all the parasympathetic

[00:22:23] side, a major part of our immune

[00:22:24] function, our sleep, repair,

[00:22:26] recovery processes, all of that

[00:22:28] stuff is happening over here.

[00:22:30] Oh, and we have a higher

[00:22:33] heart rate variability when we

[00:22:35] have a well functioning

[00:22:37] parasympathetic nervous system

[00:22:39] that does go hand in hand.

[00:22:41] All right.

[00:22:41] And we can't talk about our

[00:22:42] parasympathetics without

[00:22:43] talking about our vagus nerve.

[00:22:46] Our vagus nerve is our 10th

[00:22:48] cranial nerve and it got its

[00:22:50] name Vegas because it is the

[00:22:52] Vega bond or the wandering

[00:22:54] nerve.

[00:22:55] And it does, it wanders from

[00:22:56] our brain stem, so way up in

[00:22:57] our skull and it makes its

[00:23:00] way all the way down into our

[00:23:01] abdomen making a true brain

[00:23:04] gut connection.

[00:23:06] And it does parasympathetic

[00:23:07] nervous system innervation to

[00:23:09] all of the major organs along

[00:23:11] the way down.

[00:23:13] That is over 80% of our

[00:23:14] parasympathetic nervous

[00:23:16] system's function is just in

[00:23:17] this one nerve, just in this

[00:23:18] Vegas nerve.

[00:23:19] And another really interesting

[00:23:21] thing is that over 80% of

[00:23:24] that information from our

[00:23:25] Vegas nerve is afferent

[00:23:27] information.

[00:23:28] So afferent information is

[00:23:29] that information coming back

[00:23:31] towards our central nervous

[00:23:32] system.

[00:23:33] Okay.

[00:23:33] And the reason why this is

[00:23:34] significant is because that

[00:23:36] means that our parasympathetic

[00:23:38] nervous system can be

[00:23:40] stimulated.

[00:23:42] And if we think about

[00:23:44] anatomically where that nerve

[00:23:46] feeds, we can easily

[00:23:48] influence this nerve and we

[00:23:51] can stimulate our parasympathetic

[00:23:53] nervous system and in turn

[00:23:54] raise our HRV and in turn

[00:23:56] make our ability to handle

[00:23:58] everything in life that much

[00:24:00] better.

[00:24:00] Vagal tone is actually what

[00:24:03] we are measuring with HRV.

[00:24:05] And that's specifically when we

[00:24:07] see what most things we

[00:24:08] measure HRV in is that

[00:24:10] RMSSD and we're going to get

[00:24:11] there in one second.

[00:24:12] But that is a very strong

[00:24:15] measure of vagal tone or the

[00:24:17] strength or activity level of

[00:24:19] your Vegas nerve.

[00:24:20] That is very much what we are

[00:24:21] looking at.

[00:24:22] Moving on, we're going to get

[00:24:24] onto how to measure HRV.

[00:24:26] So the actual process of

[00:24:28] measuring HRV, so anybody on

[00:24:29] this call who wants to measure

[00:24:31] their heart rate variability

[00:24:32] can follow these steps to

[00:24:34] successfully start measuring

[00:24:35] HRV.

[00:24:37] First things first, you need

[00:24:38] to download your app.

[00:24:39] So you can go to the App Store

[00:24:41] on Apple or whatever you

[00:24:42] Android people call it.

[00:24:44] I'm not sure, but I'm sure it

[00:24:45] has a weird name like Android.

[00:24:47] So then you need to get

[00:24:48] yourself a device.

[00:24:49] And then once you have both

[00:24:51] of those things, you can

[00:24:53] connect your device to your

[00:24:55] app and you can actually

[00:24:56] start taking HRV measurements.

[00:24:58] And how we would do that.

[00:25:01] We have many apps on the

[00:25:02] marketplace.

[00:25:02] So this is some of the

[00:25:03] better apps out there that

[00:25:05] you could find.

[00:25:06] And thank you, Jessica.

[00:25:07] Yes, the Google Play Store

[00:25:08] and Android.

[00:25:09] That's what it's called.

[00:25:10] I could not recall it, but

[00:25:11] it wasn't Apple.

[00:25:12] So I wasn't very concerned.

[00:25:14] But these apps right here

[00:25:16] are some of the better ones

[00:25:17] out there at the moment

[00:25:18] for measuring HRV.

[00:25:20] So I would highly recommend

[00:25:20] using any of those starting

[00:25:22] off with any of those.

[00:25:23] These are some of the

[00:25:24] devices that you can use.

[00:25:26] And the best thing to do is

[00:25:28] get an open source Bluetooth

[00:25:30] device, meaning a device that

[00:25:31] is capable of connecting to

[00:25:33] any app.

[00:25:34] So that way you can try

[00:25:35] several different apps and you

[00:25:37] can decide which one you

[00:25:37] like the best.

[00:25:39] Things to be cautious of

[00:25:41] when you get these

[00:25:42] types of devices is things

[00:25:43] like your Apple Watch,

[00:25:44] things like an Aura Ring,

[00:25:46] a WoupStrap.

[00:25:47] Those are closed.

[00:25:48] So that means that even

[00:25:50] though you can get a

[00:25:51] reading from those and

[00:25:53] get an HRV reading from

[00:25:54] those, we can't really

[00:25:55] understand what that

[00:25:57] information was without

[00:25:59] some higher level of

[00:26:00] software that can do

[00:26:01] investigation essentially

[00:26:02] into those readings.

[00:26:04] Like I know that Aura

[00:26:05] Ring has an Aura Cloud

[00:26:06] where you can see some

[00:26:07] more of that information.

[00:26:08] It can be challenging to

[00:26:09] get that information out

[00:26:10] to your provider.

[00:26:11] So especially for those

[00:26:12] of you on this call who

[00:26:13] are providers, it's tough

[00:26:15] to get that information

[00:26:16] from your patients.

[00:26:17] Apple measures on their

[00:26:19] Apple Watch.

[00:26:20] Their measurements are done

[00:26:21] in a very different way

[00:26:23] than anybody else does

[00:26:24] their measurements and they

[00:26:25] throw in a lot of

[00:26:26] random measurements,

[00:26:27] measurements, which makes

[00:26:28] it quite confusing.

[00:26:30] So I encourage people to

[00:26:32] go away from the

[00:26:33] Apple Watch.

[00:26:34] They're looking to do

[00:26:36] HRV readings and use it

[00:26:38] for anything with their

[00:26:39] patients or even just

[00:26:40] for themselves.

[00:26:41] The polar straps are

[00:26:42] excellent.

[00:26:42] The polar H9 and H10 are

[00:26:44] excellent straps and those

[00:26:46] are very accurate, easy

[00:26:47] to use readers.

[00:26:48] So anything like that

[00:26:49] works.

[00:26:50] We have our device as

[00:26:51] well, the Optimal device.

[00:26:52] And then there's a

[00:26:53] couple others out there

[00:26:54] on the market.

[00:26:55] What are we looking at?

[00:26:56] So when you want to

[00:26:58] actually go and take your

[00:26:59] heart rate variability

[00:27:00] measurement, you want this

[00:27:01] to happen first thing

[00:27:02] in the morning.

[00:27:02] So in overnight reading,

[00:27:04] as we're kind of finding

[00:27:05] out here, the overnight

[00:27:06] readings aren't as good

[00:27:09] as the morning readings.

[00:27:10] We want to see everybody

[00:27:13] taking their readings

[00:27:14] first thing in the

[00:27:15] morning.

[00:27:16] And when we say first

[00:27:17] thing in the morning,

[00:27:17] we literally first thing

[00:27:18] in the morning.

[00:27:19] Use your restroom if you

[00:27:20] need to, but otherwise

[00:27:22] it's rolling out of bed.

[00:27:23] You're going to sit up

[00:27:24] and preferably take this

[00:27:25] reading in a seated

[00:27:26] position and you are

[00:27:28] going to open up your app.

[00:27:30] You're going to connect

[00:27:30] your reader and you're

[00:27:32] going to sit there and

[00:27:32] you're going to take most

[00:27:34] apps are a three or

[00:27:35] five minute reading.

[00:27:36] First thing in the morning.

[00:27:37] And then that's it.

[00:27:38] That's all you need.

[00:27:39] Just that one simple

[00:27:40] reading and we want you

[00:27:41] to breathe at a natural

[00:27:43] pace throughout that.

[00:27:44] We want you to keep

[00:27:45] your mind on neutral

[00:27:46] thoughts.

[00:27:46] We don't want you to

[00:27:47] interact with other

[00:27:48] people.

[00:27:48] We definitely don't want

[00:27:49] you talking because that

[00:27:50] changes your breath

[00:27:51] pace and ideally not

[00:27:52] interacting with pets

[00:27:53] or anything like that

[00:27:54] either.

[00:27:54] And definitely not

[00:27:55] checking social media

[00:27:57] or emails during or

[00:27:58] before your reading.

[00:27:59] Because as we know,

[00:28:00] that is very capable of

[00:28:02] sending our nervous

[00:28:03] systems into a spiral.

[00:28:04] All right, so we want to

[00:28:05] see where your resting

[00:28:08] physiology is first thing

[00:28:09] in the morning and that

[00:28:12] when taken over time

[00:28:13] consistently can give

[00:28:15] us great insights into

[00:28:17] the direction that this

[00:28:18] person's health is going.

[00:28:19] Now we want to move

[00:28:20] into interpretation of

[00:28:21] HRE.

[00:28:22] We understand the science

[00:28:23] a little bit, right?

[00:28:24] And we understand how

[00:28:25] to take a measurement.

[00:28:26] Now, how are we going

[00:28:27] to actually interpret

[00:28:29] our heart rate

[00:28:30] variability reading?

[00:28:31] We can say higher is

[00:28:33] better and that's a

[00:28:34] very basic way of

[00:28:36] looking at it.

[00:28:37] But that's only true

[00:28:39] most of the time.

[00:28:41] So really if we look

[00:28:42] at this and we just say

[00:28:44] consistent is better.

[00:28:46] That might be the

[00:28:47] best way of looking

[00:28:48] at it.

[00:28:49] What we are going to

[00:28:49] do, you can't diagnose

[00:28:51] anything with heart

[00:28:52] rate variability.

[00:28:53] So you can't look at

[00:28:55] somebody's HRV and

[00:28:56] say you're having a

[00:28:58] heart attack, right?

[00:28:58] Or you're going to

[00:28:59] get diabetes.

[00:29:00] We can't say that.

[00:29:02] It's definitely not

[00:29:03] for diagnosing anything,

[00:29:04] but it's a marker

[00:29:06] for health.

[00:29:07] So we can use it

[00:29:08] as a great indication

[00:29:10] of which direction

[00:29:11] somebody's health is going.

[00:29:13] And as we said,

[00:29:14] it's a very good

[00:29:14] as a predictive metric.

[00:29:17] We can look at that

[00:29:18] and see that

[00:29:20] somebody's health

[00:29:20] is drastically changing

[00:29:22] and they may be

[00:29:22] getting sick or they

[00:29:23] may be setting

[00:29:24] themselves up for injury.

[00:29:25] Then we need to mix

[00:29:26] in the subjective data

[00:29:27] along with that.

[00:29:28] And then we can make

[00:29:29] a very good call

[00:29:31] as to what may be

[00:29:33] happening with this person.

[00:29:35] OK, so not for diagnosis,

[00:29:36] but it is a monitoring

[00:29:38] tool and a very

[00:29:39] accurate monitoring tool.

[00:29:41] What we are looking

[00:29:42] for is a rolling average.

[00:29:45] So I'll talk to you about quickly.

[00:29:46] So we want to establish

[00:29:47] a rolling average

[00:29:48] on our heart rate variability,

[00:29:49] and that is going to

[00:29:50] help us with

[00:29:51] our interpretation.

[00:29:52] So over four to seven days,

[00:29:54] we're going to get

[00:29:54] a good idea of where

[00:29:56] somebody's nervous

[00:29:56] system is sitting at.

[00:29:58] And we want them

[00:29:58] to maintain about

[00:30:00] that same number.

[00:30:01] If they go up a little bit,

[00:30:02] that is great.

[00:30:02] And especially if they go up

[00:30:03] and they maintain that up,

[00:30:05] that is even better.

[00:30:06] That means that we made

[00:30:06] a very positive change

[00:30:08] for this person

[00:30:09] and that they were able

[00:30:10] to maintain

[00:30:11] that positive change

[00:30:12] for their nervous system.

[00:30:13] OK, so these are good things.

[00:30:14] That's what we want to look for.

[00:30:16] All right.

[00:30:16] But when we start to look

[00:30:18] at these things,

[00:30:18] we're going to see

[00:30:19] these different numbers pop up.

[00:30:21] The first one is time domains.

[00:30:23] A time domain is looking

[00:30:25] at that actual time difference

[00:30:28] between our to our intervals.

[00:30:29] That's what we talked about

[00:30:30] way in the beginning

[00:30:31] of this presentation.

[00:30:33] And those can be represented

[00:30:34] in one of two ways,

[00:30:35] the RMS SD or the SDNN.

[00:30:39] And we would always

[00:30:41] prefer to see that RMS SD.

[00:30:44] That is the more common

[00:30:46] measure.

[00:30:47] And especially when we talk

[00:30:48] about short term measures,

[00:30:49] RMS SD is going to be

[00:30:50] a better measure to use.

[00:30:52] SDNN is proving itself well,

[00:30:54] but it's better used

[00:30:55] over a 24 hour measure.

[00:30:56] So most devices

[00:30:57] with the exception of Apple

[00:30:58] will measure an RMS SD.

[00:31:00] And that's what you're going to see.

[00:31:01] So whenever you get your HRV

[00:31:04] on pretty much any device,

[00:31:06] it is actually just an RMS SD

[00:31:08] number, especially if it says

[00:31:09] milliseconds.

[00:31:10] That's what we're talking about.

[00:31:20] That's it for today's episode.

[00:31:22] Be sure to tune in

[00:31:23] for part two of this training

[00:31:24] where Dr.

[00:31:25] Hopper will discuss HRV trends

[00:31:27] in various populations,

[00:31:29] such as athletes and individuals

[00:31:30] under high stress.

[00:31:32] We will also learn

[00:31:33] how to use this data

[00:31:34] to measure visceral stress

[00:31:35] and how to optimize care plans

[00:31:36] based on HRV data you've gathered.

[00:31:38] You won't want to miss it.

[00:31:39] Episode 80 drops in two weeks.

[00:31:42] Be sure to check out our show note

[00:31:43] for a link to the full webinar

[00:31:44] featured in today's episode,

[00:31:46] as well as any links

[00:31:47] to special offers from our sponsors.

[00:31:49] We'll see you next time.

[00:31:52] Hey guys, if you like

[00:31:53] what you heard today,

[00:31:54] I encourage you to visit

[00:31:55] our website at factor-store.com.

[00:31:58] That's spelled F-A-K-T-R-

[00:32:02] hyphen store dot com

[00:32:04] to find out more information

[00:32:05] about all that we have to offer.

[00:32:07] We have a variety

[00:32:08] of online offerings,

[00:32:09] as well as our hands on

[00:32:10] factor rehab system course

[00:32:12] scheduled in cities

[00:32:13] around the globe.

[00:32:14] Be sure to also check out

[00:32:15] our event calendar

[00:32:16] and bookmark any of these

[00:32:17] upcoming live webinar dates

[00:32:19] coming up in the near future.

[00:32:20] So you can join us live.

[00:32:21] And of course,

[00:32:22] the biggest compliment

[00:32:23] we can receive is for you

[00:32:24] to help us spread the word

[00:32:25] to your friends,

[00:32:26] colleagues and classmates.

[00:32:28] You'll find all the important links

[00:32:29] as well as info about our sponsors

[00:32:31] in the show notes.

[00:32:32] So be sure to check those out.