Chapter 1: What is the main topic discussed in this episode?
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HRV is kind of like the new hot girl in school. Everyone's really interested in her, finding out where she's come from and what she can do and who she likes. Assume that I know nothing about HRV. What is it? What does it measure?
The funniest thing about this, Chris, is that let's say circa 10, 15 years ago, like we would have never been having this discussion. And so for someone like me, who is early to the game in the field of heart rate variability, because I was exposed to it, let's say 15 years ago when I first started doing mostly clinical work. Now, everybody has access to this.
Because of the advent of wearable technology, we all have accessibility to something that you used to have to go into, let's say, a specialized academic clinic in order to receive. I worked at the Department of Veteran Affairs as a resident. Within that context, I was exposed to it because we utilized three-lead, six-lead, 12-lead And so these are $30,000, $50,000, $60,000 worth of equipment.
And so within that context, it's great to see now that we can all obtain this data. But the problem is that nobody actually understands what the hell this thing is.
It's a cool new metric that nobody has a clue what it does.
Yeah, indeed. So the way I like to explain heart rate variability is first by giving a broad definition of what HRV actually is. And then I like to backpedal a little bit because I think that the definition that I'm going to give is probably a little bit too broad. And heart rate variability in and of itself is actually quite nuanced.
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Chapter 2: What is heart rate variability (HRV) and why is it important?
It's all about sending signals and messages to and from the brain and the spinal cord out to the body and then back up. So efferent and afferent signaling. The nervous system is not just in one location or in one area. So a lot of people when they think about nervous system, they think about what's going on within the brain. That's the central nervous system.
So the central nervous system is the brain and the spinal cord. But there are also other signaling highways, one being the peripheral nervous system, which is a larger umbrella term that people use. But within the peripheral nervous system, we have the somatic nervous system and the autonomic nervous system. Somatic nervous system is all voluntary.
So it's movement, coordination, muscular contraction, whereas the autonomic nervous system is all about involuntary, or at least we thought it used to be all involuntary. And so this is things like managing things like your respiration, your blood pressure, heart rate, digestion. It's all kind of under autonomic or automatic control. So what does the autonomic nervous system even do?
Like what do we need it? It's a threat detection signaling mechanism that we have built in from an evolutionary perspective. The great way to think about it is that it's constantly scanning our environments, receiving internal cues, external cues, and making adjustments to our physiology so that we can maintain balance, maintain homeostasis throughout the body.
Because we don't want things dysregulated in one way or another because that can cause pretty significant dysfunction from a mind-body perspective. So it's all intended to say, hey, let me zone in on which way I need to adjust. Do I need to move blood pressure up? Do I need to move it down? Do I need to increase heart rate up and down?
And it's kind of like this back and forth communication highway that we have. When people think about the nervous system, they think about it being either like the stress response or the relaxation response. And it's actually a bit more nuanced than that even.
Because when we think about the autonomic nervous system, it consists of two different branches, the sympathetic nervous system and the parasympathetic nervous system. The sympathetic nervous system is what most people see as the fight or flight or freeze response. And I actually think that that's a bit of a bastardization or overgeneralization as to what the sympathetic response is.
I actually think that to conceptualize the sympathetic response, it's much more of a way that we mobilize energy. So... If we think about mobilizing energy, why would we need to do that? We would need to mobilize energy in an effort to evade perceived threat or even potential viable threat. And then on the other side, we have the parasympathetic nervous system.
So when we think about parasympathetic nervous system, the way I was taught about this in graduate school is para is like a parachute. It helps to bring us down.
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Chapter 3: How has access to HRV data changed over time?
The whole intention behind the parasympathetic nervous system is our rest, digest, or relaxation response. But again, I like to think of it more as a way of conserving energy. So mobilizing energy, sympathetic nervous system, conserving energy, parasympathetic nervous system. And we have both of those kind of working together, not just antagonistically.
They're not just like this seesaw where we turn one on or we turn one off. And that's where a lot of people get this wrong is that there's a misconception that I turn on my stress response and I can turn it off or I turn on my relaxation response or I can turn it off. It doesn't work that way. It's not a seesaw. They actually work together.
And so kind of taking a step forward now to HRV and kind of how this relates to everything is that we can actually gain insight or window through a biometric, which is heart rate variability, which actually looks at that autonomic nervous system and whether or not it's actually making true adaptations and is resilient, or is it lacking in flexibility and potentially causing us some significant harm?
Why would the distance between heartbeats be a good indication of all of that stuff? Why is that an indication of, why is that the canary?
The nervous system is having to respond to millions of processes at any given moment. So it's having to make adaptations at any given moment, again, to keep us in that state of homeostasis. Otherwise, we become dysregulated and we experience what's called allostatic load. In other words, our nervous system can't keep up with all of the input. It's basically too much. It's too taxing.
And so therefore, when we look at heart rate variability and the distance between successive heartbeats, and I think that actually probably I should offer that definition now and explain why those distances relate actually to dysregulation or regulation of the nervous system.
it gives us insight into is it making those fine-tune adjustments and adaptations so let me back up now and explain heart rate variability from a definition perspective and the way i like to explain this to the heuristic of heart rate that most people understand so for instance chris you know if i were to look at your you know a wearable that you have on let's say with your whoop and i open up your phone and in your phone i see that your heart is beating at a rate of 60 beats per minute
So we take some really easy math here and we say, okay, so if your heart is beating at a rate of 60 beats per minute, that's one beat that's occurring every single second. And so therefore we're approximating that across a 60 second window, your heart is beating once every single second, 60 beats per minute, easy math. Is that actually what's going on? And the answer is no.
The heart actually doesn't operate like a metronome. When the heart starts to operate like a metronome, that's actually when we run into some struggle, when we run into trouble. Because the thermostat is starting to adjust to say, there's a lot of chaos that's going on right now. I need to kind of like hone in, back in, and regulate the system to kind of a consistent, constant beat.
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Chapter 4: What does HRV actually measure and what does it indicate?
It should always be progressing in an upward direction. When in fact, and this actually comes from my really close friend, his name's Dr. Marco Lautini, Italian researcher, brilliant in this space. He actually says that a good HRV is actually a normal HRV. It is a HRV that doesn't change across time very much. So it's actually one that remains stable. And we can get into that if you want.
But HRV is a metric that shouldn't just be taken out of context and looking at just what is it right now, but what is it across time?
Is a high HRV always good and is a low one always bad then?
I had a dollar for every email I got asking that question of whether or not, you know, my HRV is good because it is said number or bad because of said number. I'd be a very rich man right now. So I would say that this is a little nuanced. High HRV is good, but it's only good when it's relative to you. It's not good when we're saying, hey, I want to compare my HRV to someone else.
That's actually where we can get into trouble. High HRV as it is relative to you could be good. That could be a sign of adaptation for you. So let's say, Chris, for instance, easy math, your HRV typically is 50 milliseconds. So if we see that across time, that number is going from 50 to 60 to 65 to 70, well, relative to you, that's pretty good.
But I may look at someone else whose HRV, their baseline is 100 milliseconds. And over the course of time, it's actually gone from 100 milliseconds to 90 to 85, well, the absolute value is still much higher than yours. But I would say that you're showing way better adaptations from a nervous system perspective than they are. So high isn't what we're aiming for here because this is not a...
It's not a metric of virtue. And I think that this is where people get into a lot of trouble. They see whoever health influencer posts their aura or whoop score on their Instagram page. And they've got a heart rate variability score of 150 milliseconds. And like, shit, like I've got mine is like 25. And that's when I get the email like, am I going to die?
Like, am I going to have like some cardiovascular issues or panic attacks that are going to cause me to die? And I always say, hey, let's pump the brakes. Let's pump the vagal brake here and just relax for a second. Like what's most important here is not looking at whether or not it's high or low. It's looking at stability across time.
And one metric that's not used very often, but I use this a lot within my clinic. So I work with a lot of pro athletes, you know, ranging from individuals in the MLB, NFL, Formula One, et cetera. And one of the metrics that I use for them with recovery is actually not looking at just the daily absolute value score that you might get from WHOOP, Aura, et cetera.
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Chapter 5: How does the autonomic nervous system impact HRV?
Mm-hmm. But if you've got somebody who's got a very well dynamically trained nervous system to adapt to stress, and so their inherent physiology knows what to do when it encounters stress and almost does it subconsciously, you might experience that, especially if you had a high propensity towards things like anxiety, stress, even depression.
Mm-hmm. Interesting. What about the modifiable ones?
Well, let me mention one more non-modifiable, because this is another one that I get to pick on females about. Good. We don't do enough of that on this podcast. Right, exactly. Another tall white guy coming to pick on females. Men, so sex differences is the non-modifiable. Again, another one that we can get in trouble about. Sex differences. The...
We know from literature, men typically have a higher average heart rate variability than women do. And actually, six foot five guy here, taller guys typically have higher heart rate variabilities and actually lower resonant frequency rates of breathing. I'm sure we're going to talk about resonant frequency rates as well. And this is just a sex difference that we see.
And one of the main reasons is that women, as we know, go through a 28-day cycle. And so because of this menstruation cycle or menstrual cycle that they go through, we actually know that different phases of their cycle can influence different hormonal expressions. So mostly stark drops in things like progesterone and in estrogen, especially during like the late luteal phase.
can increase sympathetic drive and reduce heart rate variability pretty significantly. So when you average that out across time, we see that women's, especially pre-menopausal women, their HRV tends to be quite lower than men's. Okay, modifiable. Yeah, modifiable. The biggest one is cardiorespiratory fitness.
So we actually know that when someone increases things like stroke volume, when they increase or lower blood pressure, and especially when they lower their heart rate, resting heart rate, that this can indeed increase baseline heart rate variability.
I never say that HRV, because we should say what HRV is useful for and what it's not useful for, because this is not like a catch-all metric that can be used for everything. I actually think it's best used in conjunction with other metrics. So it's kind of like a piece of the puzzle as opposed to the full puzzle itself. Yeah. Cardiorespiratory fitness.
So as VF2 max increases, we know that resting heart rate decreases, stroke volume of the heart increases. And so therefore we actually see heart rate variability improvements. And this can be, and this can range. It can range from pretty significant changes in baseline HRV to not much at all. I don't like to set it as the goalpost. So it's like, hey, I want to raise my HRV.
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Chapter 6: What is the significance of resonance breathing in nervous system regulation?
But I've seen some of the fucking hats that people wear who attend those classes. I'm like, I know who you are from that fucking hat. I can tell. I can tell there's too much, there's too many fucking corks hanging from it. You've got too many beads on. And that's fine. That's kind of their thing in their world. But I understand. Let them be them.
It's good when you talk about functionality or I guess, how do you say, like felt sense of, interestingly, resonance, like I resonate with what that person's saying and that speaks to me and it's persona and narrative and mythology and arc, right? It brings these characters to life.
We manifest our reality out there, strength and resilience and your better self and vibrations and higher and all that stuff. doesn't necessarily show up in the data.
Chapter 7: How does the integration of technology enhance breathing practices?
And that is what your world is. And I think in the same way as we had, even though there's been a lot of pushback, a revolution in lifting where evidence-based came through, what does the science tell us about the rep range and the pacing and the loading and the frequency and the rest and so on and so forth? The same thing is now happening when it comes to breathing. Yes.
And I don't know of any data, apart from the stuff that comes out of resonance breathing, that says this is how you breathe in order to enact a trait change over time. Everybody that's tried to... When you were a kid and you would breathe in and out really fast, you go, ah, I feel a little bit lightheaded. Great, you've just done a state change. Congratulations.
But in order to be able to get to the trait change, and this is where... making claims about holographically manifesting your new vibration reality come into conflict with a little bit of the data. So yeah, I think I've been doing some form of resonance breathing low tech and slightly higher tech now for a while. But you are right, the consistency thing is so tough.
And I think that's why what you guys have done with Ohm, and like I said, I mentioned it to Huberman, and he completely agreed that he's like, this sounds fucking fantastic. To be able to give people a way to access
Chapter 8: What role does sleep play in regulating the nervous system?
Pretty advanced tech that, what, you'd have had to go into a lab to do probably only a decade ago?
Oh, yeah. And it would charge you an arm and a leg. It was like I was mentioning before when I was a resident at the VA. We did this within a pain clinic that I was working in. So we're using biofeedback. And they were very forward-thinking. But the people who understood that world were the clinicians and the academics. Right.
And so accessibility to something like that, well, that was only to veterans. But even in more of like a standard clinic, it would cost you so much money to be able to go do that because the clinician, it would cost them a lot of money to do it.
And now we have accessibility to do it like readily, like we made obviously Ohm so that people could have it live anywhere in their environment and do it at any time. But also it serves another purpose.
Do you want to explain what it is? Because I fucking fell in love with it, dude. And I think it's so cool. And thank you for sending me one. It's in... Kind of still in dark mode.
People can pre-order the lamps or whatever, but it's still pretty stealth right now, which I thought was even cooler because it made me feel like I was getting access to the new Batman utility belt before it was actually fully up. I've been playing with mine and it replaced what I was using previously. But yeah, I guess explain kind of what it is that you've done because I think it's really cool.
Yeah, so we are, I guess, still in a bit of a dark mode because we won't be shipping out anything until the latter half of this year, probably early Q3, so in August or so. But for now, we are taking pre-orders at OM.health. But the LAMP in and of itself, so I like to think about this as... We were trying to reduce as many barriers as we possibly can that caused friction for people to not do it.
So for instance, like with all the other stuff that you used before, you had to have the device that you put on, whether it was a chest strap or an arm band, wrist wearable, open up the phone, make sure, like for the love of God, please Bluetooth connect. Because that was the problem. You had to make sure all that. And there was all these friction points. And when something went awry,
then it's going to lead to what? It's going to lead to attrition. Yeah, dysregulation and then attrition. So you're like, throw it in. So it's going to meet the graveyard of all the other wearables that you have in your shelf. So, and then the other component too is that what are you looking at the whole time you're doing biofeedback on a phone? Watching your phone. Watching your phone.
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