WEBVTT
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Hi guys, Welcome to another episode
of The Factor podcast. I'm your host,
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Jessica Riddle. Welcome and thanks for
listening. Today we kick off a
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new two part training on harnessing the
science of heart rate variability or HRV for
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enhanced patient Care with doctor David Hopper. When it comes to the science of
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studying heart rate variability, it's more
than just a data point or a health
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marker. HRV is a comprehensive gauge
of our nervous system's flexibility and our overall
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physiological resilience. In this fascinating two
episode series, our guest instructor, doctor
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David Hopper, will share the significance
of understanding both the sympathetic and parasympathetic nervous
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systems for achieving optimal bodily functions and
discuss the potential of HRV in predicting illnesses
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and enhancing patient care. We will
also explore how this powerful tool helps athletes
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adjust training schedules and assists medical practitioners
in planning better patient care strategies, all
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while steering through day to day physiological
shifts. Whether you're a healthcare professional or
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someone interested in wellness and body metrics, this episode is packed with valuable insights
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on using HRV to its full potential, so be sure to hit that download
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button and grab something to take note
with. Let's dive in all right,
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Well, thank you so much for
having me today, Jessica. I'm very
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excited to be talking to all of
you about my absolute favorite topic, which
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is howay variability. So let's get
in here, and first things first,
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I want to introduce myself. So
I am a practicing chiropractor as well as
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an oral malfunctional therapist. So for
those of you who aren't familiar with the
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second term there, think somebody who
does rehabilitation or the airway, mouth and
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face. That's kind of my zone. I do a lot with sleep at
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mea TMJ and all of that as
well in practice as well. I'm a
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father of two. Those are my
children right there, Droven and Petunia,
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and my beautiful life there Brook.
And we are located outside of Chicago land
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here, and we have a few
clinics doing different things out here, so
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chiropractic that, we have occupational therapy, physical therapy, speech therapy, and
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then of course I T as well, and I am a as well an
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instructor at the National University Health Sciences, So I'm in there a doctor of
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program helping to bring chiropractors and naturopathic
doctors out into the field. So lots
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of fun that we get to have
over there. And then basically anything heart
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rate variability certification wise that you can
possibly have or get gone through as as
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much as I could. And I
get to talk about HRV everywhere I go
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to, which is real fun.
So that is me and one more thing
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that I would like to mention as
well, I am associated my passion for
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HRV has driven me to start an
app, so I am part owner of
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an app within HRV as well.
We do have a device as well,
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So I just want to be for
with my disclosures on that that I am
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involved financially with an application as well. For this what would the basics of
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heart variability? So, by no
means by the end of this course will
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you be in a place where you
can turn around and start using HRV very
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confidently in practice. For that want
you to go through our extent we will
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have up here in the next coming
weeks here and but what we will learn
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today is the basics, so that
way you will know the path to using
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HRV in practice and at least what
you will have when you leave here today.
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Is it good enough understanding to start
experimenting on your own and know what
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you are looking at. So again
just in general overview here, but the
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first thing that we're going to dive
into is the history and the power behind
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hearty variability as well. We're going
to define heartway variability. So with heartway
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variability, this is a new science. Although it is a hot topic rate
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now. That is just because as
of rate now, technology is getting to
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the point where now it is an
easy to find thing, so it's an
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easy metric that we can measure all
of a sudden, whereas before it wasn't
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the case. So it's actually eighteen
ninety five was when ezgs were first came
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out and hit the world, and
we can actually see that variance. Prior
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to that, we knew that there
was a variance in your heart rate,
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but then we saw that at eighteen
ninety five. Now, in nineteen thirties
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they came out with this thing called
PPG or photoposmography, and that is actually
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the most commonly used way to detect
heart rate from any source. So anybody
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who's wearing an Apple watch, whip
band or a ring, anything like that.
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That light sensor is a PPG center, is what it's called. And
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that's the preferred method of collection nowadays, without a doubt. The chest strap
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monitor that Polar came out within the
nineteen seventies, and that was another excellent
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way for collecting this kind of data, and I'm sure you all are familiar
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with that one. And then in
the nineteen nineties we started to get these
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wearable heart rate trackers and this was
a huge step forward, a huge leap
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forward. But then it wasn't until
just recently again that we started to have
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wearables that were able to precise enough
that we could actually pick up the R
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to our intervals. And we're going
to see what that means. But essentially
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they were capable of transmitting HRV data. So again by no means a new
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topic. Right, we have over
thirty thousand articles at this point. I'm
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sure this is an old side,
so I'm sure there's over thirty thousand at
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this point to publish articles on HRV
and that is literally google HRV and anything,
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look up HRV and connect it to
any disease process anything like that,
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and it's there HRV is very well
tied to everything inside. It's a marker
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for all cause mortalities we will see. And just in the past eight years,
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this technology has caught up where we
can really start using this powerful metric.
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Here. This is my guy right
here, This is how I feel
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every day when I talk about HRV. I'm just so excited about it because
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it's such a powerful thing and it
advances us all so much in our understanding
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of human physiology. And now that
it is so accessible, we can use
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this so greatly with our patients.
What is heart rate variability? So for
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starters, it's not heart rate,
And that's the biggest thing that we have
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to get across, because that's my
biggest challenge, my biggest hurdle. When
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I talk to people as I say, oh, you know HRV heart rate
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variability, and people say yes,
yes, And then about ten minutes into
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the conversation, I realize that they
were leaving that V off the end and
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they assumed I was talking about heart
rate. So when we put that beyond,
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it changes what we are talking about, so they are not the same
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thing. When we add then in
right, heart rate is talking about just
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beat per minute or bpm. And
then we add in that variability. Now
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we're talking about something that is able
to apt or vary, right, so
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we can change with our environments.
So heart rate variability is a heart rate
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that changes, right, or we
can give it a proper definition, and
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heart rate variability is the variation of
time intervals between successive heart beats measured over
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a given period of time. So
what exactly does that mean? If we
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have a heart beat of sixty beats
per minute, most people would assume that
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your heart rate is beat one second, one beat, two seconds, two
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beats, three seconds, three beats, and so on and so forth.
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And actually that is not at all
how it happens, and we don't want
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it to ever be like that.
That would actually give you an HRV of
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zero, which would be a very
bad place. How it works is more
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like this picture rate. Here we
have a heart beat, and that's what
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this graph is showing. And these
are called QRS complexes for those of you
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who might not be familiar. And
a QRS complex is this peak. And
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we can call this to our spike. Right there between this our spike and
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this our spike would be our R
to ur interval. And we want to
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measure that time distance right there,
and as it shows here, this first
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interval might be eight hundred and fifty
milliseconds, and the next one nine hundred
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and eighty milliseconds, and then down
to seven hundred and forty milliseconds. And
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that variation of time intervals is what
we are talking about when we say HRV.
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So it is that change in time
between each heart beat, and that
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is very healthy. That is what
we want to have. So in fact,
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a higher variation is better than a
lower variation. When we talk about
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our HRV, what is being measured. Those are to our intervals, and
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this is our HRV. Now we
are talking. We are talking about not
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just a simple number here, but
what this number is a measure of is
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our autonomic nervous system. So that
is why it is so powerful, the
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system of our body that runs and
governs everything that goes on in the background,
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which is majority of what is happening
with our body any given moment.
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We have a measure of this,
a very easily accessible measure of this with
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HRV. So we're looking at autonomic
nervous system regulation, or in other words,
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our ability to adapt to any given
thing in our environment. But why
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should you care about it. Well, low HRV is associated with all cause
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mortality. Back to that, right, if if we look at HRV and
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pair it with anything, we will
see that as HRV goes down, your
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chances of dying from anything goes up, and it's associated with the nine of
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the top ten killers. Can look
at this list here of the top ten
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killers in the United States, and
low HRV is associated with nine of the
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top ten. The only one that
isn't directly correlated with is motor vehicle accidents
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or unintentional death or injury. And
I argue that, and the reason why
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I argue that is because a low
HRV means that you're re action time is
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actually lower. If you are driving
down the street and somebody pulls out in
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front of you, and your HRV
is higher, and therefore you have a
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higher reaction time. Might you be
able to pull the steering wheel out of
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the way at the last minute and
avoid that life altering car accident? Right?
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Might you be able to change the
way that you step off the curb
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and rather than injuring or rolling your
ankle, you actually just walk away and
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stumble. So we know that HRV
may actually be associated with ten of the
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ten top tenank killers. So that's
my argument for it. If earning a
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show notes or visit online dot Sports
Hyphenseminars dot com today. Now back to
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the show. What is this again? Autonomic nervous system adaptability, as seen
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in HB will help us determine a
patient's ability to heal and recover. So
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when we get a patient in clinic
talking to I didn't get to see all
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the different healthcare practitioners that are on
here, but it looks like chiropractors.
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So when we get a patient clinic
and we have a good idea of where
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their autonomic nervous system is because we
are looking at their HRV, then we
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can determine their ability to heal or
recover from whatever is that brought them in
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our door. So somebody with a
higher HRV is going to heal faster from
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whatever they walk in the door with. We know that they are going to
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have a better response. Somebody with
a lower HRV is going to have is
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going to have a slower or delayed
response, So that can help us with
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our care planning, and that somebody
with a lower HIV is probably going to
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need a longer care plan versus somebody
with a higher HIV who we can expect
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might recover quicker and not need as
long of a care plan. And then
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as well, when we are going
through whatever care plan it is, if
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we see somebody's HIV going down throughout
our care plan, then that gives us
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time to reflect on our care plan
and say, are we challenging this person
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too much? Possibly, and maybe
do we want to back off with what
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we're doing, or maybe talk to
them about some of their other lifestyle factors
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that might be playing in and overwhelming
this person's nervous system. And the opposite
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might also be true. Right that
we can confirm that our care plan is
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going very well and that we are
doing the right thing, and that this
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person's HIV is continuing to climb as
they come out of pain, as they
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continue to improve their life. So
HIV has a powerful per day to ability
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as well. HRV can actually predict
the onset of illness or injury up to
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two days prior to the onset of
symptoms. And that sounds pretty crazy,
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but when we think about it,
it's not all that crazy, right,
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because our autonomic nervous system is going
to be dealing with some of these things
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before it ever comes to our conscious
awareness, okay, or before we start
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to experience symptoms. So this is
true with illness, this is true with
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overuse injuries. Obviously, if you
fall off your bicycle, HRV probably couldn't
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predict injury so much, but this
is what we're talking about with illness over
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use injuries. And then it can
also predict performance, and we're not talking
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just about physical performance, but mental
and emotional performance as well. If HRV
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is a measure of how well our
body is dealing with all of life stressors,
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then we can assume that and this
is also fact, is that somebody
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who has a higher HRV is going
to perform better mentally, They're going to
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perform and better emotionally, meaning that
they can have more on their plate before
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they start to break down and then
of course physical as well, and we
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see this in the physical in sports, and that's where HRV has become very
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popular, is that we see athletes
training based on their HIV the best training
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programs out there. We see that
they are reacting and adjusting their training program
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based on their heart rate variability,
and they are having unbelievable outcomes, which
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is so cool to see, all
right. And one of the more powerful
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things that we get out of HIV, even more so than that predictive factor,
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is the deeper insights and the deeper
connections that we get with our patients.
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So when a patient comes in and
we see that their HIV is trending
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in the wrong direction and we're pretty
confident that we are doing everything correctly,
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it gives us that opportunity to talk
to our patients to the next level.
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It opens the door to that conversation
where we can say, Hey, Mary,
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what is going on that we are
seeing this trend down? We are
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doing everything right here in the office, so what's going on at home?
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Is there something else outside of here
that isn't going the way that we want?
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And then we can start to talk
about nutrition, we can start to
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talk about sleep, We can start
to talk about their relationships at another level,
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and then of course we can make
a referral if that's what's going to
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be necessary, or we can help
them with some of those other adjustments outside
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of what we are already working on. So it really helps us make that
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deeper connection with our patients with that, which I think is just amazing.
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And the increased self responsibility too,
because patients will deny all day long that
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having a couple of drinks at the
end of the day is really affecting their
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health. Right, But then when
you see an objective number staring you in
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the face saying that, yeah,
in fact, when you do that,
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your body performs much worse the next
day. And same with skipping sleep.
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Right while I'm fine, I don't
need to sleep seven hours, I don't
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need to sleep eight hours a night. Well, let's look at what your
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HRV looks like when you do versus
when you don't. And then there is
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no argument anymore. That is an
objective number that tells you both that,
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yes, you actually perform better when
you have selected properly. What about the
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science of our variability? So we're
going to jump into this very quick and
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again we are going to skim the
surface of this. But what is HIV
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looking at. I've said several times
what we would define as homeostasis, right,
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and that is the maintenance of a
constant internal environment despite our ever changing
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internal and external environments that we have
around us. Okay, so we need
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to maintain that homeostasis. And how
we do that. The work that we
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put in to maintain homeostasis, well
we label at alostasis. Okay, those
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are our alostatic processes. And then
we have the concept of your allostatic load.
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And how I like to think of
this is like your load of bricks.
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So at any given time, ground
is our load of bricks. We
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have these basic things that we're around, and then when somebody hands us something
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extra so and that weighs us down
a little bit. And then we get
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something extra piled on, right,
call it finances, call it work,
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call it family stress, whatever it
is, it pushes us down a little
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bit more. So we have this
weight coming on us. And you can
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call these stressors, but I hate
the word stressors, so I like to
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call them life metrics because it makes
a lot more sense to me. We
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have all of these bricks and this
is our alostatic load, right, and
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this is what's weighing us down.
So you can imagine that somebody with a
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very large load of bricks, if
they're walking down the sidewalk, it's going
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to be difficult for them to move
from side to side. It's going to
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be difficult for them to react to
something in their environment. If somebody asks
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them a difficult question, it's going
to be harder for them to come up
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with an answer, right. It's
going to be harder for a mental task,
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even when you have a large load. If somebody says something upsetting,
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they're probably going to react in a
more emotional way. And then, of
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course, if something like a soccer
ball came flying out in front of them,
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they would probably have a very difficult
time with that physical task when you
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are carrying this big load. Now, let's look at the exact opposite,
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and somebody just walking down the street
and they just have their one little brick
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and they're walking along all jollity,
right, and somebody comes up and ask
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them a difficult mental question. They
can think about that pretty easily, and
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they can be very agile mentally,
and if something emotionally taxing happen, they
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would probably deal with it in a
very positive way. And same with that
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soccer ball comes kicking back out again, maybe that person could stop it right,
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smile, wave to whoever it was, kick it back, maybe even
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play a little bit of soccer right
and then get back to walking down the
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street. And it's the same thing
with our allostatic load that we are talking
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about with HIV. The more that
we have on our plate, the more
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it's weighing us down, the less
adaptable we are to everything in life.
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And that is what our HIV is
reflecting for us. Is that allostatic lode
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or how many stressors we have,
or how adaptable we are to everything in
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life? Here it is HRV.
This is what allows the body to be
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adaptable and maintain homeostasis in the face
of our ever changing environments. Okay,
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so we thrive with high adaptability or
high HRV. So that's what we are
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always aiming for, all right,
So what A is being measured? Why
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I already clue into this and talking
about the autonomic nervous system. That is
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what we're looking at, is the
function of our autonomic nervous system. And
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as a quick refresher for those of
you who may have been out of school
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for quite some time. We have
our two main sides of the autonomic nervous
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system. Right, we're gon we're
gonna ignore the enteric nervous system for the
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time being, but of our sympathetic
nervous system, right, And we can
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think about that as our gas pedal
or our fight flight freeze response. And
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this one often gets a bad rap, and I know for sure as as
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chiropractors, we often talk about this
in a negative way, and it's a
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lot of negative wrap in other as
well. And it's not all bad because
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if it wasn't for a sympathetic nervous
system, we wouldn't get up in the
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morning, we wouldn't move or do
anything right, we'd never go to the
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gym. And granted, if we
found ourselves to the gym, it's our
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sympathetic nervous system that makes us exercise, that actually gets us moving and doing
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these wonderful things for our body.
Right. But it gets a negative wrap
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when it is left on too long. And that's exactly it is that in
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the long term, our sympathetic nervous
system left on for a long time becomes
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problematic. That's when we start to
see a decreased immune function, we see
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decrease mental, physical, emotional.
All of that starts to ramp down when
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this gas pedal is left on too
long. And you can just imagine if
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you were stepping on the gas pedal
in your car and you were just sitting
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there revving your gas pedal for hours
on end, something's going to break.
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And it's no different with your body. Eventually something ends up breaking. And
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that's what we see. Right.
Our sympathetic nervous system was not meant for
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that. It's meant for acute,
quick processes. Let's take care of this
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and then let's go back to rest
in recovery. Okay, So that's what
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our sympathetics were meant for. So
then we have our parasympathetics the opposite side,
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or a brake pedal. So this
is our rest dies relaxed recover.
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That's the opposite side, and this
one. Although we always talk about this
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side so highly, it's not all
good either, right. We need that
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perfect balance of the two. That's
what we are always aiming for. We
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need great function of both sides of
the nervous system. If this were only
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parasympathetic function, yeah, we'd have
a huge lack of motivation, we'd have
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poor circulation. Right, we never
do anything in life. And this picture
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is a great one. This is
actually my son and he was really sick,
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so his body was in full recovery
right break pedal, and then he
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needed to go to the bathroom,
so another big break pedal action. And
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he was so parasympathetic that he actually
fell asleep on the twiet. I like
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to say he crapped out on the
crapper. And this is a pretty fun
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way to find him. Makes me
good anyway. So this is our long
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term survival strategies, is our parasympathetic
nervous system. So these are the things
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that, yes, they do take
longer amounts of time, and it does
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take a lot of energy for this
side. So we see things like our
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digestion, our absorption, our excretion
of all that parasympathetic side, a major
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part of our immune function, our
sleep repair, recovery processes. All of
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that stuff is happening over here.
Oh and we have a higher heart rate
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variability when we have a well functioning
parasympathetic nervous system. That does go hand
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in hand, all right, And
we can't talk about our parasympathetics without talking
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about our vegus nerve. Our vagus
nerve is our tenth cranial nerve, and
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it got its name vegas because it's
the vagabond or the wandering nerve, and
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it does it wanders from our brains
so way up in our skull, and
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it makes it way all the way
down into our abdomen, making a true
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brain gut connection, and it does
parasympathetic nervous system innervation to all of the
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major organs along the way down.
That is, over eighty percent of our
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parasympathetic nervous system's function is just in
this one nerve, just in this Vegas
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nerve. And another really interesting thing
is that over eighty percent of that information
318
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from our vegas nerve is a farent
information. So a farent information is that
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information coming back towards our central nervous
system. And the reason why this is
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significant is because that means that our
parasympittic nerveous system can be stimulated. And
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if we think about anatomically where that
nerve feeds, we can easily influence this
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nerve and we can stimulate our parasympathetic
nerve system and in turn raise our HRV
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and in turn make our ability to
handle everything in life much better. Vaguel
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tone is actually what we are measuring
with HRV, and that's specifically when we
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see what most things will measure HRV
in is that URMSSD And we're going to
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get there in one second, but
that is a very strong measure of vaguel
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tone or the strength or activity level
of your vagus nerve. That is very
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much what we are looking at.
Moving on, we're going to get onto
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how to measure HRV. So the
actual process of measuring HIV. So anybody
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on this call who wants to measure
their HeartWare variability can follow these steps to
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successfully start measuring HIV. First things, First, you need to download your
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app, so you can go to
the app store on Apple or whatever you
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Android people call it, I'm not
sure, but I'm sure it has a
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weird name like Android. So then
you need to get yourself a device,
335
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and then once you have both of
those things, you can connect your device
336
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to your app and you can actually
start taking HIV measurements. Okay, and
337
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how we would do that. We
have many apps on the marketplace, so
338
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this is some of the better apps
out there that you could find. And
339
00:25:06.759 --> 00:25:08.960
thank you Jessday. Yes, the
Google Place or an androids, that's what
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it's called. I could not recall
it, but it wasn't Apple, so
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I wasn't very concerned. But these
apps rate here are some of the better
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ones out there at the moment for
measuring HRV, So I would highly recommend
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using any of those. Starting off
with any of those, these are some
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of the devices that you can use, and the best thing to do is
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get an open source Bluetooth device,
meaning a device that is capable of connecting
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to any app, so that way
you can try several different apps and you
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can decide which one you like.
The best things to be cautious of when
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you get these types of devices is
things like your Apple Watch, things like
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an order ring, a whoopstrap.
Those are closed. So that means that
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even though you can get a reading
from those and get an HRV reading from
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those, we can't really understand what
that information was without some higher lie level
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of software that can do investigation essentially
into those readings. So like I know
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the or ring has it or a
cloud where you can see some more of
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that information. It can be challenging
to get that information out to your provider,
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So especially for those of you on
this call who are providers, it's
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tough to get that information from your
patients apple measures on their Apple Watch.
357
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Their measurements are done in a very
different way than anybody else does their measurements,
358
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and they throw in a lot of
random measure measurements, which makes it
359
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quite confusing. So I encourage people
to go away from the Apple Watch they're
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looking to do HRV readings and use
it for anything with their patients or even
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just for themselves. The Polar straps
are excellent. The Polar H nine and
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00:26:42.799 --> 00:26:47.920
H ten are excellent straps, and
those are very accurate, easy to use
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readers. So anything like that works. We have our device as well,
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the optimal device, and then there's
a couple others out there on the market.
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What are we looking at. So
when you want to actually go and
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take your heart revert ability measurement,
you want this to happen first thing in
367
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the morning. So in overnight reading, as we're kind of finding out here,
368
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the overnight readings aren't as good as
the morning readings. We want to
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see everybody taking their readings first thing
in the morning. And when we say
370
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first thing in the morning, we
literally first thing in the morning. Use
371
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your restroom if you need to,
but otherwise it's rolling out of bed.
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You're going to sit up and preferably
take this reading in a seated position,
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and you're going to open up your
app. You're going to connect your reader,
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and you're going to sit there and
you're going to take most apps or
375
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a three or five minute reading first
thing in the morning, and then that's
376
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it. That's all you need,
just that one simple reading. And we
377
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want you to breathe at a natural
pace throughout that. We want you to
378
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keep your mind on neutral thoughts.
We don't want you to interact with other
379
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people. We definitely don't want you
talking because that changes your breath pace,
380
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and ideally not interacting with pets or
anything like that either, and definitely not
381
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checking social media or emails during or
before you're reading, because we know that
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is very capable of sending our nervous
systems into a spiral. All right,
383
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So we want to see where you're
resting. Physiology is first thing in the
384
00:28:10.160 --> 00:28:15.799
morning, and that when taken over
time consistently, can give us great insights
385
00:28:15.880 --> 00:28:19.640
into the direction that this person's health
is going. Now we want to move
386
00:28:19.680 --> 00:28:23.480
into interpretation of ATY. We understand
the science a little bit right, and
387
00:28:23.559 --> 00:28:26.880
we understand how to take a measurement. Now, how are we going to
388
00:28:27.759 --> 00:28:33.640
actually interpret our heart rate variability reading. We can say hire is better,
389
00:28:33.279 --> 00:28:37.720
and that's a very basic way of
looking at it, but that's only true
390
00:28:38.519 --> 00:28:42.039
most of the time. So really, if we look at this and we
391
00:28:42.160 --> 00:28:48.400
just say consistent is better, that
might be the best way of looking at
392
00:28:48.440 --> 00:28:52.799
it. What we are going to
do. You can't diagnose anything with heart
393
00:28:52.880 --> 00:28:57.079
rate variability, So you can't look
at somebody's HRV and say you're having a
394
00:28:57.079 --> 00:29:02.640
heart attack right or you're going to
diabetes. We can't say that. It's
395
00:29:02.640 --> 00:29:07.359
definitely not for diagnosing anything, but
it's a marker for health, so we
396
00:29:07.400 --> 00:29:11.960
can use it as a great indication
of which direction somebody's health is going.
397
00:29:12.480 --> 00:29:17.680
And as we said, it's a
very good as a predictive metric. We
398
00:29:17.720 --> 00:29:22.720
can look at that and see that
somebody's health is drastically changing and they may
399
00:29:22.759 --> 00:29:25.799
be getting sick or they may be
setting themselves up for injury. Then we
400
00:29:25.839 --> 00:29:29.799
need to mix in these subjective data
along with that, and then we can
401
00:29:29.839 --> 00:29:33.599
make a very good call as to
what may be happening with this person.
402
00:29:34.160 --> 00:29:37.799
Okay, so not for diagnosis,
but it is a monitoring tool and a
403
00:29:37.880 --> 00:29:45.119
very accurate monitoring tool. What we
are looking for is a rolling average.
404
00:29:45.119 --> 00:29:48.000
So you got quickly. So we
want to establish a rolling average on our
405
00:29:48.039 --> 00:29:52.759
heart rate variability and that is going
to help us with our interpretation. So
406
00:29:52.200 --> 00:29:56.119
over four to seven days, we're
going to get a good idea of where
407
00:29:56.160 --> 00:30:00.640
somebody's nervous system is sitting at and
we want them to maintain a about that
408
00:30:00.680 --> 00:30:02.839
same number. If they go up
a little bit, that is great,
409
00:30:02.880 --> 00:30:06.000
and especially if they go up and
they maintain that up, that is even
410
00:30:06.079 --> 00:30:08.440
better. That means that we made
a very positive change for this person and
411
00:30:08.480 --> 00:30:12.720
that they were able to maintain the
positive change for their nervous system. Okay,
412
00:30:12.720 --> 00:30:15.400
so these are good things. That's
what we want to look for,
413
00:30:15.039 --> 00:30:18.319
all right. But when we start
to look at these things, we're going
414
00:30:18.359 --> 00:30:22.680
to see these different numbers pop up. The first one is time domains.
415
00:30:22.839 --> 00:30:29.920
A time domain is looking at that
actual time difference between our to R intervals.
416
00:30:29.920 --> 00:30:32.640
So that's what we talked about way
in the beginning of this presentation,
417
00:30:33.200 --> 00:30:37.880
and those can be represented in one
of two ways, the RMSSD or the
418
00:30:37.000 --> 00:30:45.119
SDNN, and we would always prefer
to see that RMSSD. That is the
419
00:30:45.480 --> 00:30:49.000
more common measure, and especially when
we talk about short term measures, RMSSD
420
00:30:49.119 --> 00:30:53.160
is going to be a better measure
to use. SDNN is proving itself well,
421
00:30:53.200 --> 00:30:56.680
but it's better used over a twenty
four hour measure. So most devices,
422
00:30:56.720 --> 00:31:00.480
with the exception of Apple, will
measure an RMILD and that's what you're
423
00:31:00.519 --> 00:31:04.839
going to see. So whenever you
get your HRV on pretty much any device,
424
00:31:06.160 --> 00:31:10.039
it is actually just in RMSSD the
number, especially if it says milliseconds,
425
00:31:10.319 --> 00:31:22.240
that's what we're talking about. That's
it for today's episode. Be sure
426
00:31:22.240 --> 00:31:26.440
to tune in for part two of
this training, where doctor Hopper will discuss
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00:31:26.640 --> 00:31:32.319
HRV trends in various populations such as
athletes and individuals under high stress. We
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00:31:32.400 --> 00:31:34.880
will also learn how to use this
data to measure visceral stress and how to
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00:31:34.880 --> 00:31:38.680
optimize care plans based on HRV data
you've gathered. You won't want to miss
430
00:31:38.720 --> 00:31:41.960
it. Episode eighty drops in two
weeks. Be sure to check out our
431
00:31:42.000 --> 00:31:45.440
show note for a link to the
full webinar featured in today's episode, as
432
00:31:45.480 --> 00:31:49.039
well as any links to special offers
from our sponsors. We'll see you next
433
00:31:49.039 --> 00:31:55.359
time. Hey guys, if you
like what you heard today, I encourage
434
00:31:55.359 --> 00:32:00.960
you to visit our website at Factor
hyphenstore dot com that's spelled a k tr
435
00:32:01.559 --> 00:32:07.279
hyphenstore dot com to find out more
information about all that we have to offer.
436
00:32:07.480 --> 00:32:09.960
We have a variety of online offerings
as well as our hands on Factor
437
00:32:10.000 --> 00:32:15.079
Rehab System course scheduled in cities around
the globe. Be sure to also check
438
00:32:15.079 --> 00:32:19.759
out our event calendar and bookmark any
of these upcoming live webinar dates coming up
439
00:32:19.759 --> 00:32:22.440
in the near future so you can
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440
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the biggest compliment we can receive is
for you to help us spread the word
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00:32:24.799 --> 00:32:29.680
to your friends, colleagues, and
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as well as info about our sponsors
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443
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sure to check those out.
1
00:00:15.119 --> 00:00:18.800
Hi guys, Welcome to another episode
of The Factor podcast. I'm your host,
2
00:00:18.920 --> 00:00:22.559
Jessica Riddle. Welcome and thanks for
listening. Today we kick off a
3
00:00:22.600 --> 00:00:26.760
new two part training on harnessing the
science of heart rate variability or HRV for
4
00:00:26.879 --> 00:00:30.559
enhanced patient Care with doctor David Hopper. When it comes to the science of
5
00:00:30.600 --> 00:00:34.560
studying heart rate variability, it's more
than just a data point or a health
6
00:00:34.600 --> 00:00:39.759
marker. HRV is a comprehensive gauge
of our nervous system's flexibility and our overall
7
00:00:39.799 --> 00:00:45.159
physiological resilience. In this fascinating two
episode series, our guest instructor, doctor
8
00:00:45.240 --> 00:00:50.079
David Hopper, will share the significance
of understanding both the sympathetic and parasympathetic nervous
9
00:00:50.119 --> 00:00:56.359
systems for achieving optimal bodily functions and
discuss the potential of HRV in predicting illnesses
10
00:00:56.600 --> 00:01:00.359
and enhancing patient care. We will
also explore how this powerful tool helps athletes
11
00:01:00.399 --> 00:01:07.840
adjust training schedules and assists medical practitioners
in planning better patient care strategies, all
12
00:01:07.879 --> 00:01:11.400
while steering through day to day physiological
shifts. Whether you're a healthcare professional or
13
00:01:11.400 --> 00:01:17.519
someone interested in wellness and body metrics, this episode is packed with valuable insights
14
00:01:17.560 --> 00:01:21.400
on using HRV to its full potential, so be sure to hit that download
15
00:01:21.439 --> 00:01:34.400
button and grab something to take note
with. Let's dive in all right,
16
00:01:34.400 --> 00:01:37.480
Well, thank you so much for
having me today, Jessica. I'm very
17
00:01:37.480 --> 00:01:41.719
excited to be talking to all of
you about my absolute favorite topic, which
18
00:01:41.760 --> 00:01:47.680
is howay variability. So let's get
in here, and first things first,
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00:01:47.680 --> 00:01:51.760
I want to introduce myself. So
I am a practicing chiropractor as well as
20
00:01:51.799 --> 00:01:56.200
an oral malfunctional therapist. So for
those of you who aren't familiar with the
21
00:01:56.319 --> 00:02:00.239
second term there, think somebody who
does rehabilitation or the airway, mouth and
22
00:02:00.400 --> 00:02:04.400
face. That's kind of my zone. I do a lot with sleep at
23
00:02:04.439 --> 00:02:07.840
mea TMJ and all of that as
well in practice as well. I'm a
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father of two. Those are my
children right there, Droven and Petunia,
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and my beautiful life there Brook.
And we are located outside of Chicago land
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here, and we have a few
clinics doing different things out here, so
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chiropractic that, we have occupational therapy, physical therapy, speech therapy, and
28
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then of course I T as well, and I am a as well an
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instructor at the National University Health Sciences, So I'm in there a doctor of
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00:02:30.919 --> 00:02:36.639
program helping to bring chiropractors and naturopathic
doctors out into the field. So lots
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of fun that we get to have
over there. And then basically anything heart
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rate variability certification wise that you can
possibly have or get gone through as as
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much as I could. And I
get to talk about HRV everywhere I go
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to, which is real fun.
So that is me and one more thing
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that I would like to mention as
well, I am associated my passion for
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HRV has driven me to start an
app, so I am part owner of
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an app within HRV as well.
We do have a device as well,
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So I just want to be for
with my disclosures on that that I am
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involved financially with an application as well. For this what would the basics of
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heart variability? So, by no
means by the end of this course will
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you be in a place where you
can turn around and start using HRV very
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confidently in practice. For that want
you to go through our extent we will
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00:03:23.800 --> 00:03:29.039
have up here in the next coming
weeks here and but what we will learn
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00:03:29.080 --> 00:03:32.719
today is the basics, so that
way you will know the path to using
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HRV in practice and at least what
you will have when you leave here today.
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Is it good enough understanding to start
experimenting on your own and know what
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you are looking at. So again
just in general overview here, but the
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first thing that we're going to dive
into is the history and the power behind
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hearty variability as well. We're going
to define heartway variability. So with heartway
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variability, this is a new science. Although it is a hot topic rate
51
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now. That is just because as
of rate now, technology is getting to
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the point where now it is an
easy to find thing, so it's an
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easy metric that we can measure all
of a sudden, whereas before it wasn't
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the case. So it's actually eighteen
ninety five was when ezgs were first came
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out and hit the world, and
we can actually see that variance. Prior
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to that, we knew that there
was a variance in your heart rate,
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but then we saw that at eighteen
ninety five. Now, in nineteen thirties
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00:04:30.160 --> 00:04:35.439
they came out with this thing called
PPG or photoposmography, and that is actually
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the most commonly used way to detect
heart rate from any source. So anybody
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00:04:41.720 --> 00:04:46.240
who's wearing an Apple watch, whip
band or a ring, anything like that.
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00:04:46.240 --> 00:04:49.560
That light sensor is a PPG center, is what it's called. And
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that's the preferred method of collection nowadays, without a doubt. The chest strap
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monitor that Polar came out within the
nineteen seventies, and that was another excellent
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00:05:00.399 --> 00:05:02.519
way for collecting this kind of data, and I'm sure you all are familiar
65
00:05:02.600 --> 00:05:08.240
with that one. And then in
the nineteen nineties we started to get these
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wearable heart rate trackers and this was
a huge step forward, a huge leap
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00:05:12.879 --> 00:05:16.560
forward. But then it wasn't until
just recently again that we started to have
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wearables that were able to precise enough
that we could actually pick up the R
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to our intervals. And we're going
to see what that means. But essentially
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00:05:26.839 --> 00:05:32.439
they were capable of transmitting HRV data. So again by no means a new
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topic. Right, we have over
thirty thousand articles at this point. I'm
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00:05:35.439 --> 00:05:39.720
sure this is an old side,
so I'm sure there's over thirty thousand at
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00:05:39.720 --> 00:05:44.560
this point to publish articles on HRV
and that is literally google HRV and anything,
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look up HRV and connect it to
any disease process anything like that,
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and it's there HRV is very well
tied to everything inside. It's a marker
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00:05:56.240 --> 00:05:59.920
for all cause mortalities we will see. And just in the past eight years,
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this technology has caught up where we
can really start using this powerful metric.
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Here. This is my guy right
here, This is how I feel
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00:06:08.480 --> 00:06:12.000
every day when I talk about HRV. I'm just so excited about it because
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it's such a powerful thing and it
advances us all so much in our understanding
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of human physiology. And now that
it is so accessible, we can use
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this so greatly with our patients.
What is heart rate variability? So for
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00:06:25.360 --> 00:06:29.759
starters, it's not heart rate,
And that's the biggest thing that we have
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to get across, because that's my
biggest challenge, my biggest hurdle. When
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00:06:31.519 --> 00:06:34.600
I talk to people as I say, oh, you know HRV heart rate
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00:06:34.680 --> 00:06:38.160
variability, and people say yes,
yes, And then about ten minutes into
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the conversation, I realize that they
were leaving that V off the end and
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they assumed I was talking about heart
rate. So when we put that beyond,
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00:06:45.680 --> 00:06:48.279
it changes what we are talking about, so they are not the same
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00:06:48.319 --> 00:06:53.439
thing. When we add then in
right, heart rate is talking about just
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beat per minute or bpm. And
then we add in that variability. Now
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we're talking about something that is able
to apt or vary, right, so
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we can change with our environments.
So heart rate variability is a heart rate
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that changes, right, or we
can give it a proper definition, and
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heart rate variability is the variation of
time intervals between successive heart beats measured over
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a given period of time. So
what exactly does that mean? If we
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00:07:19.279 --> 00:07:26.000
have a heart beat of sixty beats
per minute, most people would assume that
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00:07:26.040 --> 00:07:29.439
your heart rate is beat one second, one beat, two seconds, two
99
00:07:29.480 --> 00:07:31.160
beats, three seconds, three beats, and so on and so forth.
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00:07:31.199 --> 00:07:35.439
And actually that is not at all
how it happens, and we don't want
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it to ever be like that.
That would actually give you an HRV of
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zero, which would be a very
bad place. How it works is more
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00:07:43.800 --> 00:07:46.959
like this picture rate. Here we
have a heart beat, and that's what
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00:07:46.959 --> 00:07:49.959
this graph is showing. And these
are called QRS complexes for those of you
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00:07:50.000 --> 00:07:55.240
who might not be familiar. And
a QRS complex is this peak. And
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00:07:55.319 --> 00:07:58.480
we can call this to our spike. Right there between this our spike and
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00:07:58.480 --> 00:08:01.600
this our spike would be our R
to ur interval. And we want to
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00:08:01.720 --> 00:08:07.040
measure that time distance right there,
and as it shows here, this first
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00:08:07.040 --> 00:08:11.040
interval might be eight hundred and fifty
milliseconds, and the next one nine hundred
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00:08:11.040 --> 00:08:16.000
and eighty milliseconds, and then down
to seven hundred and forty milliseconds. And
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00:08:16.279 --> 00:08:22.399
that variation of time intervals is what
we are talking about when we say HRV.
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00:08:22.720 --> 00:08:26.519
So it is that change in time
between each heart beat, and that
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is very healthy. That is what
we want to have. So in fact,
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00:08:28.720 --> 00:08:33.679
a higher variation is better than a
lower variation. When we talk about
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00:08:33.679 --> 00:08:37.759
our HRV, what is being measured. Those are to our intervals, and
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this is our HRV. Now we
are talking. We are talking about not
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00:08:43.759 --> 00:08:46.679
just a simple number here, but
what this number is a measure of is
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00:08:46.679 --> 00:08:52.799
our autonomic nervous system. So that
is why it is so powerful, the
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00:08:52.840 --> 00:08:56.960
system of our body that runs and
governs everything that goes on in the background,
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which is majority of what is happening
with our body any given moment.
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00:09:01.279 --> 00:09:05.639
We have a measure of this,
a very easily accessible measure of this with
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00:09:07.200 --> 00:09:11.799
HRV. So we're looking at autonomic
nervous system regulation, or in other words,
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00:09:11.039 --> 00:09:16.720
our ability to adapt to any given
thing in our environment. But why
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should you care about it. Well, low HRV is associated with all cause
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mortality. Back to that, right, if if we look at HRV and
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pair it with anything, we will
see that as HRV goes down, your
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00:09:31.039 --> 00:09:35.639
chances of dying from anything goes up, and it's associated with the nine of
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the top ten killers. Can look
at this list here of the top ten
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killers in the United States, and
low HRV is associated with nine of the
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00:09:43.720 --> 00:09:48.799
top ten. The only one that
isn't directly correlated with is motor vehicle accidents
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or unintentional death or injury. And
I argue that, and the reason why
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00:09:54.720 --> 00:10:00.919
I argue that is because a low
HRV means that you're re action time is
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00:10:00.960 --> 00:10:05.919
actually lower. If you are driving
down the street and somebody pulls out in
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00:10:05.919 --> 00:10:09.480
front of you, and your HRV
is higher, and therefore you have a
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00:10:09.559 --> 00:10:13.559
higher reaction time. Might you be
able to pull the steering wheel out of
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00:10:13.559 --> 00:10:18.360
the way at the last minute and
avoid that life altering car accident? Right?
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00:10:18.440 --> 00:10:20.799
Might you be able to change the
way that you step off the curb
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00:10:22.120 --> 00:10:26.840
and rather than injuring or rolling your
ankle, you actually just walk away and
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00:10:26.879 --> 00:10:31.559
stumble. So we know that HRV
may actually be associated with ten of the
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00:10:31.639 --> 00:10:41.879
ten top tenank killers. So that's
my argument for it. If earning a
141
00:10:41.919 --> 00:10:46.200
certification is on your CE plan this
year, then you're in luck. Southeast
142
00:10:46.240 --> 00:10:52.000
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certifications on our online learning platform. You
143
00:10:52.039 --> 00:10:56.919
can complete your certification in dry needling, functional nutrition, chiropractic acupuncture, or
144
00:10:56.960 --> 00:11:01.279
clinical human performance with a meat We
get access to get started learning right away.
145
00:11:03.279 --> 00:11:07.039
To learn more and get started,
click the new certifications link in our
146
00:11:07.080 --> 00:11:11.879
show notes or visit online dot Sports
Hyphenseminars dot com today. Now back to
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00:11:11.919 --> 00:11:22.759
the show. What is this again? Autonomic nervous system adaptability, as seen
148
00:11:22.879 --> 00:11:26.879
in HB will help us determine a
patient's ability to heal and recover. So
149
00:11:26.919 --> 00:11:31.960
when we get a patient in clinic
talking to I didn't get to see all
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00:11:31.960 --> 00:11:35.519
the different healthcare practitioners that are on
here, but it looks like chiropractors.
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00:11:35.600 --> 00:11:37.440
So when we get a patient clinic
and we have a good idea of where
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00:11:37.480 --> 00:11:43.120
their autonomic nervous system is because we
are looking at their HRV, then we
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00:11:43.240 --> 00:11:48.600
can determine their ability to heal or
recover from whatever is that brought them in
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00:11:48.679 --> 00:11:54.000
our door. So somebody with a
higher HRV is going to heal faster from
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00:11:54.080 --> 00:11:58.600
whatever they walk in the door with. We know that they are going to
156
00:11:58.639 --> 00:12:01.559
have a better response. Somebody with
a lower HRV is going to have is
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00:12:01.600 --> 00:12:05.879
going to have a slower or delayed
response, So that can help us with
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00:12:05.919 --> 00:12:09.120
our care planning, and that somebody
with a lower HIV is probably going to
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00:12:09.159 --> 00:12:13.399
need a longer care plan versus somebody
with a higher HIV who we can expect
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00:12:13.559 --> 00:12:18.320
might recover quicker and not need as
long of a care plan. And then
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00:12:18.360 --> 00:12:22.279
as well, when we are going
through whatever care plan it is, if
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00:12:22.320 --> 00:12:28.039
we see somebody's HIV going down throughout
our care plan, then that gives us
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00:12:28.080 --> 00:12:31.919
time to reflect on our care plan
and say, are we challenging this person
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00:12:31.960 --> 00:12:35.879
too much? Possibly, and maybe
do we want to back off with what
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00:12:35.919 --> 00:12:37.919
we're doing, or maybe talk to
them about some of their other lifestyle factors
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00:12:39.120 --> 00:12:43.759
that might be playing in and overwhelming
this person's nervous system. And the opposite
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00:12:43.840 --> 00:12:46.399
might also be true. Right that
we can confirm that our care plan is
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00:12:46.679 --> 00:12:50.519
going very well and that we are
doing the right thing, and that this
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00:12:50.600 --> 00:12:54.919
person's HIV is continuing to climb as
they come out of pain, as they
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00:12:54.919 --> 00:13:00.639
continue to improve their life. So
HIV has a powerful per day to ability
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as well. HRV can actually predict
the onset of illness or injury up to
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two days prior to the onset of
symptoms. And that sounds pretty crazy,
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but when we think about it,
it's not all that crazy, right,
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because our autonomic nervous system is going
to be dealing with some of these things
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before it ever comes to our conscious
awareness, okay, or before we start
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to experience symptoms. So this is
true with illness, this is true with
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overuse injuries. Obviously, if you
fall off your bicycle, HRV probably couldn't
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predict injury so much, but this
is what we're talking about with illness over
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use injuries. And then it can
also predict performance, and we're not talking
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just about physical performance, but mental
and emotional performance as well. If HRV
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is a measure of how well our
body is dealing with all of life stressors,
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then we can assume that and this
is also fact, is that somebody
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who has a higher HRV is going
to perform better mentally, They're going to
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perform and better emotionally, meaning that
they can have more on their plate before
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they start to break down and then
of course physical as well, and we
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see this in the physical in sports, and that's where HRV has become very
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popular, is that we see athletes
training based on their HIV the best training
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programs out there. We see that
they are reacting and adjusting their training program
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based on their heart rate variability,
and they are having unbelievable outcomes, which
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is so cool to see, all
right. And one of the more powerful
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things that we get out of HIV, even more so than that predictive factor,
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is the deeper insights and the deeper
connections that we get with our patients.
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So when a patient comes in and
we see that their HIV is trending
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in the wrong direction and we're pretty
confident that we are doing everything correctly,
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it gives us that opportunity to talk
to our patients to the next level.
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It opens the door to that conversation
where we can say, Hey, Mary,
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what is going on that we are
seeing this trend down? We are
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doing everything right here in the office, so what's going on at home?
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Is there something else outside of here
that isn't going the way that we want?
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And then we can start to talk
about nutrition, we can start to
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talk about sleep, We can start
to talk about their relationships at another level,
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and then of course we can make
a referral if that's what's going to
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be necessary, or we can help
them with some of those other adjustments outside
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of what we are already working on. So it really helps us make that
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deeper connection with our patients with that, which I think is just amazing.
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And the increased self responsibility too,
because patients will deny all day long that
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having a couple of drinks at the
end of the day is really affecting their
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health. Right, But then when
you see an objective number staring you in
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the face saying that, yeah,
in fact, when you do that,
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your body performs much worse the next
day. And same with skipping sleep.
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Right while I'm fine, I don't
need to sleep seven hours, I don't
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need to sleep eight hours a night. Well, let's look at what your
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HRV looks like when you do versus
when you don't. And then there is
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no argument anymore. That is an
objective number that tells you both that,
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yes, you actually perform better when
you have selected properly. What about the
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science of our variability? So we're
going to jump into this very quick and
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again we are going to skim the
surface of this. But what is HIV
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looking at. I've said several times
what we would define as homeostasis, right,
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and that is the maintenance of a
constant internal environment despite our ever changing
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internal and external environments that we have
around us. Okay, so we need
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to maintain that homeostasis. And how
we do that. The work that we
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put in to maintain homeostasis, well
we label at alostasis. Okay, those
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are our alostatic processes. And then
we have the concept of your allostatic load.
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And how I like to think of
this is like your load of bricks.
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So at any given time, ground
is our load of bricks. We
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have these basic things that we're around, and then when somebody hands us something
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extra so and that weighs us down
a little bit. And then we get
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something extra piled on, right,
call it finances, call it work,
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call it family stress, whatever it
is, it pushes us down a little
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bit more. So we have this
weight coming on us. And you can
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call these stressors, but I hate
the word stressors, so I like to
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call them life metrics because it makes
a lot more sense to me. We
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have all of these bricks and this
is our alostatic load, right, and
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this is what's weighing us down.
So you can imagine that somebody with a
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very large load of bricks, if
they're walking down the sidewalk, it's going
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to be difficult for them to move
from side to side. It's going to
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be difficult for them to react to
something in their environment. If somebody asks
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them a difficult question, it's going
to be harder for them to come up
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with an answer, right. It's
going to be harder for a mental task,
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even when you have a large load. If somebody says something upsetting,
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they're probably going to react in a
more emotional way. And then, of
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course, if something like a soccer
ball came flying out in front of them,
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they would probably have a very difficult
time with that physical task when you
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are carrying this big load. Now, let's look at the exact opposite,
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and somebody just walking down the street
and they just have their one little brick
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and they're walking along all jollity,
right, and somebody comes up and ask
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them a difficult mental question. They
can think about that pretty easily, and
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they can be very agile mentally,
and if something emotionally taxing happen, they
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would probably deal with it in a
very positive way. And same with that
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soccer ball comes kicking back out again, maybe that person could stop it right,
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smile, wave to whoever it was, kick it back, maybe even
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play a little bit of soccer right
and then get back to walking down the
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street. And it's the same thing
with our allostatic load that we are talking
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about with HIV. The more that
we have on our plate, the more
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it's weighing us down, the less
adaptable we are to everything in life.
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And that is what our HIV is
reflecting for us. Is that allostatic lode
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or how many stressors we have,
or how adaptable we are to everything in
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life? Here it is HRV.
This is what allows the body to be
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adaptable and maintain homeostasis in the face
of our ever changing environments. Okay,
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so we thrive with high adaptability or
high HRV. So that's what we are
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always aiming for, all right,
So what A is being measured? Why
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I already clue into this and talking
about the autonomic nervous system. That is
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what we're looking at, is the
function of our autonomic nervous system. And
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as a quick refresher for those of
you who may have been out of school
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for quite some time. We have
our two main sides of the autonomic nervous
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system. Right, we're gon we're
gonna ignore the enteric nervous system for the
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time being, but of our sympathetic
nervous system, right, And we can
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think about that as our gas pedal
or our fight flight freeze response. And
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this one often gets a bad rap, and I know for sure as as
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chiropractors, we often talk about this
in a negative way, and it's a
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lot of negative wrap in other as
well. And it's not all bad because
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if it wasn't for a sympathetic nervous
system, we wouldn't get up in the
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morning, we wouldn't move or do
anything right, we'd never go to the
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gym. And granted, if we
found ourselves to the gym, it's our
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sympathetic nervous system that makes us exercise, that actually gets us moving and doing
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these wonderful things for our body.
Right. But it gets a negative wrap
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when it is left on too long. And that's exactly it is that in
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the long term, our sympathetic nervous
system left on for a long time becomes
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problematic. That's when we start to
see a decreased immune function, we see
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decrease mental, physical, emotional.
All of that starts to ramp down when
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this gas pedal is left on too
long. And you can just imagine if
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you were stepping on the gas pedal
in your car and you were just sitting
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there revving your gas pedal for hours
on end, something's going to break.
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And it's no different with your body. Eventually something ends up breaking. And
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that's what we see. Right.
Our sympathetic nervous system was not meant for
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that. It's meant for acute,
quick processes. Let's take care of this
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and then let's go back to rest
in recovery. Okay, So that's what
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our sympathetics were meant for. So
then we have our parasympathetics the opposite side,
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or a brake pedal. So this
is our rest dies relaxed recover.
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That's the opposite side, and this
one. Although we always talk about this
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side so highly, it's not all
good either, right. We need that
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perfect balance of the two. That's
what we are always aiming for. We
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need great function of both sides of
the nervous system. If this were only
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parasympathetic function, yeah, we'd have
a huge lack of motivation, we'd have
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poor circulation. Right, we never
do anything in life. And this picture
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is a great one. This is
actually my son and he was really sick,
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so his body was in full recovery
right break pedal, and then he
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needed to go to the bathroom,
so another big break pedal action. And
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he was so parasympathetic that he actually
fell asleep on the twiet. I like
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to say he crapped out on the
crapper. And this is a pretty fun
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way to find him. Makes me
good anyway. So this is our long
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term survival strategies, is our parasympathetic
nervous system. So these are the things
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that, yes, they do take
longer amounts of time, and it does
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take a lot of energy for this
side. So we see things like our
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digestion, our absorption, our excretion
of all that parasympathetic side, a major
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part of our immune function, our
sleep repair, recovery processes. All of
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that stuff is happening over here.
Oh and we have a higher heart rate
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variability when we have a well functioning
parasympathetic nervous system. That does go hand
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in hand, all right, And
we can't talk about our parasympathetics without talking
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about our vegus nerve. Our vagus
nerve is our tenth cranial nerve, and
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it got its name vegas because it's
the vagabond or the wandering nerve, and
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it does it wanders from our brains
so way up in our skull, and
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it makes it way all the way
down into our abdomen, making a true
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brain gut connection, and it does
parasympathetic nervous system innervation to all of the
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major organs along the way down.
That is, over eighty percent of our
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parasympathetic nervous system's function is just in
this one nerve, just in this Vegas
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nerve. And another really interesting thing
is that over eighty percent of that information
318
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from our vegas nerve is a farent
information. So a farent information is that
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information coming back towards our central nervous
system. And the reason why this is
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significant is because that means that our
parasympittic nerveous system can be stimulated. And
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if we think about anatomically where that
nerve feeds, we can easily influence this
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nerve and we can stimulate our parasympathetic
nerve system and in turn raise our HRV
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and in turn make our ability to
handle everything in life much better. Vaguel
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tone is actually what we are measuring
with HRV, and that's specifically when we
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see what most things will measure HRV
in is that URMSSD And we're going to
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get there in one second, but
that is a very strong measure of vaguel
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tone or the strength or activity level
of your vagus nerve. That is very
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much what we are looking at.
Moving on, we're going to get onto
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how to measure HRV. So the
actual process of measuring HIV. So anybody
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on this call who wants to measure
their HeartWare variability can follow these steps to
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successfully start measuring HIV. First things, First, you need to download your
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app, so you can go to
the app store on Apple or whatever you
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Android people call it, I'm not
sure, but I'm sure it has a
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weird name like Android. So then
you need to get yourself a device,
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and then once you have both of
those things, you can connect your device
336
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to your app and you can actually
start taking HIV measurements. Okay, and
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how we would do that. We
have many apps on the marketplace, so
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this is some of the better apps
out there that you could find. And
339
00:25:06.759 --> 00:25:08.960
thank you Jessday. Yes, the
Google Place or an androids, that's what
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it's called. I could not recall
it, but it wasn't Apple, so
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I wasn't very concerned. But these
apps rate here are some of the better
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ones out there at the moment for
measuring HRV, So I would highly recommend
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using any of those. Starting off
with any of those, these are some
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of the devices that you can use, and the best thing to do is
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get an open source Bluetooth device,
meaning a device that is capable of connecting
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to any app, so that way
you can try several different apps and you
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can decide which one you like.
The best things to be cautious of when
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you get these types of devices is
things like your Apple Watch, things like
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an order ring, a whoopstrap.
Those are closed. So that means that
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even though you can get a reading
from those and get an HRV reading from
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those, we can't really understand what
that information was without some higher lie level
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of software that can do investigation essentially
into those readings. So like I know
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the or ring has it or a
cloud where you can see some more of
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that information. It can be challenging
to get that information out to your provider,
355
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So especially for those of you on
this call who are providers, it's
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tough to get that information from your
patients apple measures on their Apple Watch.
357
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Their measurements are done in a very
different way than anybody else does their measurements,
358
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and they throw in a lot of
random measure measurements, which makes it
359
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quite confusing. So I encourage people
to go away from the Apple Watch they're
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looking to do HRV readings and use
it for anything with their patients or even
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just for themselves. The Polar straps
are excellent. The Polar H nine and
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H ten are excellent straps, and
those are very accurate, easy to use
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readers. So anything like that works. We have our device as well,
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the optimal device, and then there's
a couple others out there on the market.
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What are we looking at. So
when you want to actually go and
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take your heart revert ability measurement,
you want this to happen first thing in
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the morning. So in overnight reading, as we're kind of finding out here,
368
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the overnight readings aren't as good as
the morning readings. We want to
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see everybody taking their readings first thing
in the morning. And when we say
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first thing in the morning, we
literally first thing in the morning. Use
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your restroom if you need to,
but otherwise it's rolling out of bed.
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You're going to sit up and preferably
take this reading in a seated position,
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and you're going to open up your
app. You're going to connect your reader,
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and you're going to sit there and
you're going to take most apps or
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a three or five minute reading first
thing in the morning, and then that's
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it. That's all you need,
just that one simple reading. And we
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want you to breathe at a natural
pace throughout that. We want you to
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keep your mind on neutral thoughts.
We don't want you to interact with other
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people. We definitely don't want you
talking because that changes your breath pace,
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and ideally not interacting with pets or
anything like that either, and definitely not
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checking social media or emails during or
before you're reading, because we know that
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is very capable of sending our nervous
systems into a spiral. All right,
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So we want to see where you're
resting. Physiology is first thing in the
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morning, and that when taken over
time consistently, can give us great insights
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into the direction that this person's health
is going. Now we want to move
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into interpretation of ATY. We understand
the science a little bit right, and
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we understand how to take a measurement. Now, how are we going to
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actually interpret our heart rate variability reading. We can say hire is better,
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and that's a very basic way of
looking at it, but that's only true
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most of the time. So really, if we look at this and we
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just say consistent is better, that
might be the best way of looking at
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it. What we are going to
do. You can't diagnose anything with heart
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rate variability, So you can't look
at somebody's HRV and say you're having a
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heart attack right or you're going to
diabetes. We can't say that. It's
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definitely not for diagnosing anything, but
it's a marker for health, so we
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can use it as a great indication
of which direction somebody's health is going.
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And as we said, it's a
very good as a predictive metric. We
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can look at that and see that
somebody's health is drastically changing and they may
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be getting sick or they may be
setting themselves up for injury. Then we
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need to mix in these subjective data
along with that, and then we can
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make a very good call as to
what may be happening with this person.
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00:29:34.160 --> 00:29:37.799
Okay, so not for diagnosis,
but it is a monitoring tool and a
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very accurate monitoring tool. What we
are looking for is a rolling average.
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00:29:45.119 --> 00:29:48.000
So you got quickly. So we
want to establish a rolling average on our
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heart rate variability and that is going
to help us with our interpretation. So
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00:29:52.200 --> 00:29:56.119
over four to seven days, we're
going to get a good idea of where
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somebody's nervous system is sitting at and
we want them to maintain a about that
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00:30:00.680 --> 00:30:02.839
same number. If they go up
a little bit, that is great,
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00:30:02.880 --> 00:30:06.000
and especially if they go up and
they maintain that up, that is even
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better. That means that we made
a very positive change for this person and
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that they were able to maintain the
positive change for their nervous system. Okay,
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so these are good things. That's
what we want to look for,
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all right. But when we start
to look at these things, we're going
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to see these different numbers pop up. The first one is time domains.
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A time domain is looking at that
actual time difference between our to R intervals.
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So that's what we talked about way
in the beginning of this presentation,
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and those can be represented in one
of two ways, the RMSSD or the
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00:30:37.000 --> 00:30:45.119
SDNN, and we would always prefer
to see that RMSSD. That is the
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00:30:45.480 --> 00:30:49.000
more common measure, and especially when
we talk about short term measures, RMSSD
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is going to be a better measure
to use. SDNN is proving itself well,
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but it's better used over a twenty
four hour measure. So most devices,
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with the exception of Apple, will
measure an RMILD and that's what you're
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going to see. So whenever you
get your HRV on pretty much any device,
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it is actually just in RMSSD the
number, especially if it says milliseconds,
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that's what we're talking about. That's
it for today's episode. Be sure
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to tune in for part two of
this training, where doctor Hopper will discuss
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00:31:26.640 --> 00:31:32.319
HRV trends in various populations such as
athletes and individuals under high stress. We
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will also learn how to use this
data to measure visceral stress and how to
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optimize care plans based on HRV data
you've gathered. You won't want to miss
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00:31:38.720 --> 00:31:41.960
it. Episode eighty drops in two
weeks. Be sure to check out our
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00:31:42.000 --> 00:31:45.440
show note for a link to the
full webinar featured in today's episode, as
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00:31:45.480 --> 00:31:49.039
well as any links to special offers
from our sponsors. We'll see you next
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00:31:49.039 --> 00:31:55.359
time. Hey guys, if you
like what you heard today, I encourage
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00:31:55.359 --> 00:32:00.960
you to visit our website at Factor
hyphenstore dot com that's spelled a k tr
435
00:32:01.559 --> 00:32:07.279
hyphenstore dot com to find out more
information about all that we have to offer.
436
00:32:07.480 --> 00:32:09.960
We have a variety of online offerings
as well as our hands on Factor
437
00:32:10.000 --> 00:32:15.079
Rehab System course scheduled in cities around
the globe. Be sure to also check
438
00:32:15.079 --> 00:32:19.759
out our event calendar and bookmark any
of these upcoming live webinar dates coming up
439
00:32:19.759 --> 00:32:22.440
in the near future so you can
join us live. And of course,
440
00:32:22.480 --> 00:32:24.759
the biggest compliment we can receive is
for you to help us spread the word
441
00:32:24.799 --> 00:32:29.680
to your friends, colleagues, and
classmates. You'll find all the important links,
442
00:32:29.680 --> 00:32:31.519
as well as info about our sponsors
in the show notes, so be
443
00:32:31.559 --> 00:32:32.559
sure to check those out.
