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How accurate is HRV?

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How accurate is the HRV in the health metrics?

 

 

Moderator edit: updated subject for clarity

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351 REPLIES 351

OK, this discussion has some wild misunderstandings about HRV and how it’s measured. First, HRV while sleeping and awake are two different things. If your heart rate is stable (RHR) then HRV is telling you you often your heart takes a longer break between beats. But awake and at the doctors office it’s measuring the difference in speed as your heart rate speeds up and slows down. So a doctors office or HRV measurement with a chest strap after you’ve awake will always be higher.

 

Also there’s no clear reason to think that the HRV from an optical sensor is less accurate, if it’s successfully reading your heart beat. HRV is the difference in the interval between beats. Unlike RHR it’s not a measurement of cardiovascular health, it’s more a relative measurement of stress and comparison of two different peoples HRV is meaningless.

 

if your HRV goes down it’s a sign your more stressed and if it goes up you’re less stressed. Why some people have high average HRV and some low could be genetic of neurological and have nothing to do with health of rest. 

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This post makes sense. But, the explanation of the expected ranges posted
on the Fitbit device lists ranges 3 times higher than what most people are
getting. They need a better explanation to the user. Maybe the one you
just posted. Thanks.
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Let me clarify: HRV has nothing to with heart rate.  It is a measurement of the change in timing between normal beats.  It tells you something about the health of your sympathetic and parasympathetic nervous systems.  The higher the number the more healthy interplay between the two.  You’d expect a higher HRV in waking hours because there is more stimuli for your nervous system to react to, except, maybe, if you have a series of very vivid dreams.  I suspect that nighttime HRV is typically higher during REM sleep.

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@n8vz wrote:

Let me clarify: HRV has nothing to with heart rate.  It is a measurement of the change in timing between normal beats.


That's true but I think it isn't quite complete - HRV is affected by changes in heart rate, which is why calculations like RMSSD are used in an attempt to smooth away artifacts caused by transitory changes in heart rate. At issue is the recording period being used - if you use a ultra short period like 60 seconds then the change in heart rate going from standing to laying down will swamp the actual HRV signal from the nervous system.

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Well, yes, if your HR is 160, compared to 60, the spacing between beats will be less, but this is not a measure of true HRV, which is variability induced by the parasympathetic/sympathetic nervous system interplay.  Now, how these various devices try to distinguish between real HRV and this kind of artifact is a mystery to me. I don’t think statistical tools like RMSSD really help in this regard.  They just render a more easily readable graph.  What one needs to know, and I don’t, is the actual algorithm used by these devices in collecting relevant data.  

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Not just the algorithm but the sample rate. One competitor says fitbit only
uses 1/10 the sample rate of their product. However, there may be some
benefit to knowing this value but without an accepted standard, each
product has wildly varying results that really can't carry any
significance. I just ignore this result and so do my doctors.
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@Tlinlo7don it's not only the sample rate but what the device is looking for which is R-R intervals. For the optical sensor, it's a lot more complicated to find the R-R interval than for the ECG device. The R wave is the biggest wave generated during normal conduction in your heart and simply speaking, detecting the R wave indicates a beat. An optical sensor looks at the blood flow, not the heart. If you look at the data obtained by the PolarH10 strap it detects up to 5 R-R intervals per second. This is enough to find N-N beats (for computing SDNN) and provide accuracy for R-R intervals (even during exercise). The set of R-R intervals may look like this:

time: (1.102, None, None, None, None) [s]
time: (1.006, None, None, None, None) [s]
time: (1.022, None, None, None, None) [s]
time: (1.05, None, None, None, None) [s]
time: (1.123, None, None, None, None) [s]
time: (1.12, None, None, None, None) [s]
time: (1.234, None, None, None, None) [s]

Usually, in rest lower sampling rate does the job but another example (from my 5k race) could be this:

time: (0.353, 0.354, 0.353, None, None) [s]
time: (0.357, 0.354, 0.356, None, None) [s]
time: (0.355, 0.357, 0.357, None, None) [s]
time: (0.356, 0.358, None, None, None) [s]
time: (0.36, 0.358, 0.356, None, None) [s]
time: (0.363, 0.361, 0.36, None, None) [s]

This shows that sampling 5 times per second does the job (I have never seen all the samples filled). This is enough to calculate RMSSD but here's the catch. RMSSD and SDNN are very sensitive to data artifacts and this happens to ECG devices, too. In general, it isn't simple to filter out artifacts, and sometimes despite suspecting a signal to be an artifact it's better to leave it because in the short term it won't have much of an effect on overall HRV. I usually filter it by looking at any unusual spike caused by a single beat (anything that is not falling into the N-N beat category). Simplifying, the filter checks the difference between the last and current interval looking for such sudden spikes, and applies a threshold. The point is, sometimes there is no way to know for sure that the beat is a glitch.

 

With R-R intervals I can build a beats timeline and put the HR on it so can see how it changes in time. It is true, that the higher HR than the lower intervals are but RMSSD doesn't follow that rule. Just by shifting a single beat in 1min sample, the RMSSD may jump from let's say 38ms to 120ms and a different change will change it to 8ms. This metric is very data sensitive and I usually try to run rolling RMSSD on my data using the 5-10sec domain. Each domain that is suspected to contain an artifact is verified and either filtered out or included. It's not rocket science and my results are aligned with EliteHRV, and easy to verify. I've been researching long-term HRV and for that SDNN seems to be a far better metric than RMSSD. The SDNN is the one for medical evaluation of cardiac risk and it predicts both morbidity and mortality ( so, @IronChuck, it's not just about stress levels 🙂 but in fact actual cardiovascular health including the prediction of SCD in athletes and risk of death from epilepsy - there is a lot more research going on).

 

The problem with HRV is that this metric isn't made for regular people. Yes, it is the nice selling point of the device but there are very big brains trying to understand what's the use of it and despite the general rule that high HRV = good, and HRV = bad it isn't that simple. The first thing about HRV should be making sure that the data is accurate, then verifying the methodology. We don't know the time domain for the data, we don't know how the artifacts are treated, and we don't know how RMSSD is applied through such a long set of data. Maybe what we get is a snapshot of the last 5 minutes before detecting waking up (which would make sense for morning readiness!)? Maybe not? Nobody knows so from my point of view, the data isn't relevant. I can't tell how it's obtained, how it's processed, and how it's interpreted. As well I could get a number drawn in a lottery and it would have the same meaning to me.

 

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My HRV is between 19 and 26 on my Fitbit versa 3. If my rates are the same as yours, on a HRV app that actually works, my HRV would be in the 50s. I would be very happy with that.  Where can I get the app you’re using and how do you use it?

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Mine is 12 to 18 and 70 - 80 on others. Again, I don't really pay
attention to these numbers, until the medical world begins using this in
health evaluations.
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So glad I finally came here looking for answers as to why my hrv is so low- usually 25-30. I feel so much better now😊.

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Happy to find that my 25 hrv doesn't mean I'm on the verge of keeling over. Fitbit is responsible for serious health misinformation by providing these extremely inaccurate readings. 

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Some actual data from 3 devices during my sleep on 7/15
Fitbit HRV: 23 ms

Whoop strap 4.0: 30 ms

Frontier X2 chest strap: 23 ms  (graph below)

 

And just now:
EliteHRV: 59 ms  (Garmin HRM Pro chest strap / iPhone XS, 1:24pm my time) 

I think the belief that Fitbit's HRV readings are inaccurate are more about comparing apples and oranges. As you can see from the graph, even while sleeping my HRV is bouncing around. So I think the question is more about what algorithm's being used, if you're awake, and what time period it's being smoothed over.

 

 

2022-07-15 HRV.jpg

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Yes, I agree. Your numbers are much more "in a range" of being similar,
where on my sleep number report the spread was 40 to 95 ms from fitbit,
which seems really out of whack. The algorithm and the sampling rate has
got to be an issue, that should be standardized across the industry.
However, the differences between the actual devices will never allow this
to come about. The real question is what does the HRV really mean and how
does this correlate to your heart health. Because all these devices
obviously are using different methodologies, where is the benefit of
knowing this information.
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It is ridiculously inaccurate. Mine reads 14 ms so I got a strap reader and it is 50 ms. I don’t know why fitbit includes - you have to measure the waveform with some sampling.

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I’ve said exactly the same thing!

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Please consider that mostly only English speaking people write here. Actually the amount of people having issues with a „too low HRV“ are 100-500 times higher. In addition many people dont find this forum topic.

 

My conclusion as an engineer with 30 years of expierience:

 

HRV algorithm and calculation statement from fitbit is a failure. It simply delivers wrong results. It is more than irresponsible from fitbit not to act in this regards. Sales:)

 

I strongly recommend to ignore the HRV figures from fitbit.

 

Be informed that the calculation method from fitbit combined with the duration of data storage over 48 hours are simply wrong. Add 30 points on top of it:).

Confirmed by a 48 hour supervision by my cardiologist (18 vs 54).

 

Sorry, my English is not that good to explain the false algorithm in detail. Fitbit needs to have better math experts:).

 

Greetings from Bangkok

TH, German Engineer

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Thanks for your input, and your feedback is great and I believe accurate.
This pretty much confirms what we have been saying. A plus 30 might be a
good rule if you want to use the fitbit HRV.
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Mine is 55 which is about what it should be for my age
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What chart or scale do you use to determine what is normal for your HRV?
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I’ve been researching this for a year off and on. 
I am 37 and in a healthy weight range. I am moderately active and eat fairly healthy. My resting heart rate is generally in the 60’s and I get at least 300 active minutes a week. 

When I learned what HRV was, I was shocked to find mine was in the teens to twenties via my versa 2!! I was crazy worried that I was practically dead and put a lot of effort into my health and fitness since. 
to date? My average HRV via my Fitbit versa 2 is in the 30’s, with my highest outlier being 50.

 

I discovered Wellatory, an app that measures HRV via the light and camera on your phone (not the more accurate way to measure but…) and I regularly have over 100ms HRV readings in the mornings before getting out of bed. Today, it was 124ms. Wellatory gives you tons of insights into your HRV reading if you upgrade. 

Anyway, all this is to say, the Fitbit HRV metric should be done away with until they can give you at least semi reliable data/readings. What’s the point?? There’s no way, that I logically have the HRV of a 70 year old man…. It can’t be. 

 

What I’ve learned is to take it all with a grain of salt and find a product that solely gives you HRV data. There’s a cool sleeve product and another one that you use a chest strap if you want mega reliable data. Wellatory is a good intermediate. The Fitbit HRV feature is pathetic, sadly… but I didn’t realize this until I dove way deeper into HRV metrics and products. 

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