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

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

Karmin

Active Member
Wow I see a new study has just been announced. Sounds like it's looking at the possibility of using HRV to manage the illness - in a similar way to what I have been doing.

“What is promising is that we have proposed an illness model to potentially identify the factors that lead to relapse or improvement,” said Dr. Friedberg. “If a predictor of relapse is discovered, such as heart rate variability in conjunction with certain activity patterns, we may be able to prevent or reduce relapse by adjusting such activity patterns in advance. This could potentially be the first biomarker of illness worsening or improvement in this illness.”

Dr. Friedberg expects that the data collected from the study will be used to generate a new, potentially more effective self-management program that ultimately helps patients avoid relapses and feel and function better."

http://www.newswise.com/articles/getting-to-the-heart-of-chronic-fatigue-syndrome
 

Karmin

Active Member
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.
Yes yoga is magical! I have an amazing graph to share in another blog. I'm bedridden so I'm limited to yoga in bed for now. I use yoga studio (app). http://yogastudioapp.com/

Yes it's the Weil 4,7,8 breathing I use for high LF/HF. I also find box (square) breathing great but only when I need to raise HRV.
 
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Abrin

Well-Known Member
I actually use a Fitbit to track heart rate since because of physical reasons I am unable to use a chest strap and I do think that it is better then nothing.

The important thing with the Fitbit tracking is you have to remember that it is averaging out all your heart beats so you can not really see it go up and down as easily. I am able to notice 'major crashes' though with it.
 

Karmin

Active Member
I actually use a Fitbit to track heart rate since because of physical reasons I am unable to use a chest strap and I do think that it is better then nothing.

The important thing with the Fitbit tracking is you have to remember that it is averaging out all your heart beats so you can not really see it go up and down as easily. I am able to notice 'major crashes' though with it.
Early on I was using Health Patch for my hrv measurements. It's a small adhesive patch that you simply stick to your chest. But then they made it available through Drs only.

I haven't used it and know nothing about it, but there is now this hand held device that is compatible with SweetBeat if it interests you Abrin - just so you know there are options.

http://www.vernier.com/products/sensors/heart-rate-sensors/gw-hr/
 

Onslow

Active Member
Wow I see a new study has just been announced. Sounds like it's looking at the possibility of using HRV to manage the illness - in a similar way to what I have been doing.

“What is promising is that we have proposed an illness model to potentially identify the factors that lead to relapse or improvement,” said Dr. Friedberg. “If a predictor of relapse is discovered, such as heart rate variability in conjunction with certain activity patterns, we may be able to prevent or reduce relapse by adjusting such activity patterns in advance. This could potentially be the first biomarker of illness worsening or improvement in this illness.”

Dr. Friedberg expects that the data collected from the study will be used to generate a new, potentially more effective self-management program that ultimately helps patients avoid relapses and feel and function better."

http://www.newswise.com/articles/getting-to-the-heart-of-chronic-fatigue-syndrome
Here is Fred Friedberg's recovery protocol:

http://www.cfidsselfhelp.org/library/fred-friedberg%25E2%2580%2599s-seven-step-protocol-treating-cfs-fm
 

Onslow

Active Member
Thanks I read his book early on.
I didn't know about Fred Freidberg when I had CFS, but his steps for recovery match pretty well with the own things that I found helpful for recovery. The only thing he doesn't seem to mention (at least in that cfsidsselfhelp post) is the importance of building up your life again with positive activities. He touches on it with his "Scheduling Pleasant Events" step, but that seems to be more about reducing stress than anything else. In my experience, the key to recovery is increasing positive activities after you remove the stresses from your life.
 

Karmin

Active Member
I didn't know about Fred Freidberg when I had CFS, but his steps for recovery match pretty well with the own things that I found helpful for recovery. The only thing he doesn't seem to mention (at least in that cfsidsselfhelp post) is the importance of building up your life again with positive activities. He touches on it with his "Scheduling Pleasant Events" step, but that seems to be more about reducing stress than anything else. In my experience, the key to recovery is increasing positive activities after you remove the stresses from your life.
The effect of positive activities can also be measured via HRV. It's not about stress reduction - it's about identifying (quantitatively) and eliminating the bad, and increasing the good
 

Carollynn

Active Member
Did I miss something? I'd like to see the scientific studies HRV tracking is based upon. Can anyone provide some links? If I don't have something from PubMed, it's hard to share this with my doctors in a meaningful way. Thanks!
 

Laura L

Member
I've been using a Polar heart monitor for a year to keep myself below my anerobic threshold. I feel somewhat in control with this, but now I can't wait to start monitoring my HRV. One question tho, I have POTS and OI like many of us, occasionally I use a beta blocker like Propranolol, so would this interfere with my HRV in any way? Thanks so much!
 

Laura L

Member
Thank you for the medscape article. So if I check my HRV first thing in the morning before I use propranolol, then I will still get an idea about how my day will go.
 

Karmin

Active Member
Did I miss something? I'd like to see the scientific studies HRV tracking is based upon. Can anyone provide some links? If I don't have something from PubMed, it's hard to share this with my doctors in a meaningful way. Thanks!
Hi Carollyn, I am currently staying offline - hoping to bank some energy so I can somehow be present for a little of my daughter's wedding next month. Fingers crossed!

You'd find there are literally 1000s of HRV articles on PubMed - particularly in cardiology journals. Likewise there are many articles showing reduced HRV in ME/CFS. I don't know of any studies using HRV to monitor or manage ME/CFS. However there is a link above for a just announced NIH-funded study looking at this aspect. I hope that is of some help.
 

Karmin

Active Member
Thank you for the medscape article. So if I check my HRV first thing in the morning before I use propranolol, then I will still get an idea about how my day will go.
Thank you for the medscape article. So if I check my HRV first thing in the morning before I use propranolol, then I will still get an idea about how my day will go.
Great question Laura! Yes - the important thing is to keep all factors as constant as possible. I take beta blockers too. I take them at fixed times so that their effect on my HRV is constant, and my morning dose is always after my HRV readings are done.

If you ever forget your bedtime dose that will likely have an effect, so you should tag that result as being affected by a missed dose.
 

Sue Stevenson

Active Member
I'm feeling really confused about the Hf and LF scores. I know what they refer to but what does it mean if they are both low? Does it mean that your ANS is more "offline" the lower the scores are?

From Baffled in Belgrave
 

Remy

Administrator
I'm feeling really confused about the Hf and LF scores. I know what they refer to but what does it mean if they are both low? Does it mean that your ANS is more "offline" the lower the scores are?

From Baffled in Belgrave
I *think* it means that autonomic inputs to the heart are reduced in general. But I'll ask my new friend at SweetBeat to make sure. It's a little confusing, for sure.

Of note, I have always referred to LF as a market of sympathetic activity only but it seems like it is actually a mixture of both SNS and PNS activity. Therefore it makes more sense to put out attention on improving the HF rather than worrying about the ratio.
 

Karmin

Active Member
I'm feeling really confused about the Hf and LF scores. I know what they refer to but what does it mean if they are both low? Does it mean that your ANS is more "offline" the lower the scores are?

From Baffled in Belgrave

Hi baffled in Belgrave

HF and LF scores do tend to both be high or low. That makes more sense if you consider that the LF/HF ratio is normal at around 2. So if HF is very low (say 30), you'd be in deep trouble if your LF was 1000. As well consider that LF actually represents (mainly) sympathetic, but also some parasympathetic. So if parasympathetic is low, it will also somewhat affect LF.

Age, health, fitness and sex will affect both LF and HF. Elite young athletes have very high LF and HF scores - both scores can be in the thousands. Whereas the average female Sweetbeat user aged over 40 has an LF of around 330 and a HF of around 156.

Sweetbeat calls HF + LF your power number - an indicator of the power in your autonomic nervous system. It is an interesting thing to track - giving you some interesting and useful graphs. I talk about those a little in the next blog.
 
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Karmin

Active Member
I *think* it means that autonomic inputs to the heart are reduced in general. But I'll ask my new friend at SweetBeat to make sure. It's a little confusing, for sure.

Of note, I have always referred to LF as a market of sympathetic activity only but it seems like it is actually a mixture of both SNS and PNS activity. Therefore it makes more sense to put out attention on improving the HF rather than worrying about the ratio.

Remy I had the same thought when I began tracking - i expected I could make great progress if I just found what factors improved my HF, and then applied them.

In practice it has not been that simple. When I add my HF improvers, they do improve HF quite significantly but most of those factors also tend to throw the other numbers more and more out of whack - especially LF/HF.

So what I am finding works best for me is to each day work on what's most out of whack. So I may go days of being able to push HF, but then get to a stage where LF/HF gets very high, and I need to switch my focus to that for a while. It's a see-sawing type of procedure.
 

Remy

Administrator
Remy I had the same thought when I began tracking - i expected I could make great progress if I just found what factors improved my HF, and then applied them.

In practice it has not been that simple. When I add my HF improvers, they do improve HF quite significantly but most of those factors also tend to throw the other numbers more and more out of whack - especially LF/HF.

So what I am finding works best for me is to each day work on what's most out of whack. So I may go days of being able to push HF, but then get to a stage where LF/HF gets very high, and I need to switch my focus to that for a while. It's a see-sawing type of procedure.
This is the article I read that made me re-think the importance of LF and the LF/HF ratio. Dr James Heathers was interviewed for a podcast a year or so ago on HRV and it was fascinating.

Nov 28, 2012 | HRV Research, Product Updates | 3 comments
by James AJ Heathers
Ph.D. Cand., M.Sc., B.Ec.


Short answer:

Because low frequency power isn’t a good measure of ‘sympathetic activity’, and low/high frequency (LF/HF) power isn’t a good measure of ‘sympathovagal balance’. What we’re interested in as an index of recovery is a controlled measure of high frequency (HF) power.
Long answer:

Frequently with my own research, and about heart rate variability in general, people often ask me: “Do you measure LF/HF balance?” I do not. Here’s why:
Over a long enough period of time, anywhere from a few minutes upwards, heart rate isn’t stable. It exists in an environment of continual modification due to the inter-connections between spontaneously generated autonomic rhythms, the vasculature (blood vessels), breathing and any kind of imposed stress – exercise, focused attention, etc. This provides us with two dominant frequencies (two speeds of regular fluctuation in beat-to-beat variability), and because one is faster than the other, they’re called high and low frequency.
High frequency

HF rhythms are mediated primarily by the vagus nerve’s innvervation of the sinoatrial node on the top of the heart. This reflects respiratory sinus arrhythmia, the process where breathing in increases heart rate, and breathing out decreases heart rate. And as the vagus nerve contains the primary parasympathetic outflow to the heart, this allows us to measure HF rhythm as a measure of parasympathetic dominance – the resting state of the autonomic nervous system.
Low frequency

LF rhythms are less well understood. Original research from the 80s proposed that that LF, proportional to HF, measured the state of autonomic balance in the heart. However, this research has been persistently misunderstood. The original papers used this in the context of a tilt-table test, not a normal standing or lying HR measurement. That is, to get their ‘sympathetic’ changes the researchers tilted the experimental participant on a flat table to various angles, and measured the relative HRV present.
This provides various degrees of postural stress, which is carefully compensated by the activity of the baroreflex – the body’s system for regulating blood pressure. Research since strongly supports the fact that LF power is best understood as measuring the outflow of the baroreflex response to regular changes in blood pressure. While this definitely involves the sympathetic nervous system – which controls both the size of the blood vessels and heart rate – it isn’t by any means a straightforward relationship where we can measure sympathetic activity at the heart by measuring LF HRV power.

Now, while LF power is useful for research and an interesting phenomenon, it isn’t much good for making determinations about your training state for several reasons.
Firstly, it’s poorly understood and there is a lot of debate surrounding the mechanisms involved. Also, at rest we are more concerned with the absence of parasympathetic activity than the presence of sympathetic activity. If you are overtrained, your primary concern is the absence of parasympathetic activity. While the autonomic nervous system is usually either dominated by one or the other, there are a variety of situations where this isn’t the case. Lastly, we can control the parasympathetic signal we measure by the simple task of breathing at a certain rate – this gives us a consistent situation in which to measure our HF activity over time.

As a consequence, the most informative and replicable measure of HRV in the short term is a paced breathing HF task. And that is what we use.
About the Author

James is doing a Ph.D in cardiovascular psychophysiology, improving HRV methods and applications. In his spare time, he lifts things up and puts them down.

@Karmin, what do you do in particular when you push HF? And when you switch are you trying to push LF? Or suppress it? Are you finding when you try to boost the parasympathetic system, you also get a sympathetic boost too? I'm a little confused by what you wrote!
 

Karmin

Active Member
This is the article I read that made me re-think the importance of LF and the LF/HF ratio. Dr James Heathers was interviewed for a podcast a year or so ago on HRV and it was fascinating.




@Karmin, what do you do in particular when you push HF? And when you switch are you trying to push LF? Or suppress it? Are you finding when you try to boost the parasympathetic system, you also get a sympathetic boost too? I'm a little confused by what you wrote!
Thanks Remy, I had seen that article. Because there are different opinions amongst the experts, I have tried not to get too attached to the idea of precisely what HF, LF etc represent. It seems a bit of a strange thing to say, but I'm not sure it matters too much to me. My reasoning is that: I know that (compared to norms) my HF is very low, and that my LF/HF sometimes gets very high ie the numbers are not 'normal' regardless of what they represent. I'm not so much getting caught up in the meaning of the numbers as trying to improve the numbers themselves.

Yes, for me, (generally) the things that increase my HF numbers (eg Mestinon and box/square breathing) also increase LF/HF to abnormal levels. Weil breathing works better for reducing LF/HF - so when it is high I switch from box to Weil breathing. But Weil doesn't work well to increase HF. So it becomes quite a complex puzzle!

I have wondered about ignoring LF/HF and concentrating on HF but I become symptomatic when LF/HF is elevated (buzzing/vibration sensations, adrenaline dumps, nightmares) so my feeling is that I shouldn't ignore it, and I certainly don't feel comfortable when I do. So each day I work on whatever is most out of whack.
 

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