Ronda Collier SweetWater HealthGlobal Tech Women

March 12, 2015

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Heart Rate Variability and the Digital Health Revolution

Evolution of the Medical TricorderScience Fiction Got it Wrong

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1966

Star Trek

1987

Star Trek Next Generation

2015

SmartPhone +

Wearables

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The Digital Health RevolutionGrowing Ecosystem

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Activity Trackers

Heart Rate Monitors

Sleep Tracking

Workout Trackers

Calories & Nutrition

Blood Pressure

Wireless Scales

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Not to Mention…..

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Personal Genotyping

24/7 Patch Blood Oxygen

Electronic Pills

Smartphone ECG

Glucose Monitors

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What Does it all Mean??Am I Healthy?

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Typical Dashboards

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The Science of HRV

What is Heart Rate Variability (HRV)?

What does a healthy HRV look like?

HRV in the mainstream

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HRV and Vagal Tone

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The vagus nerve is the 10th of 12

paired cranial nerves and controls

parasympathetic innervation of the

heart and acts to lower the heart

rate.

Vagal innervation is a mediator of

HRV and therefore HRV is an

indication of Vagal Tone

The higher the HRV, the stronger the

Vagal Tone

In the past decade, college sports

teams and world-class athletes have

been increasingly using HRV to

monitor fatigue and recovery from

workouts.

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HRV and the Autonomic Nervous System

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The Autonomic Nervous System (ANS) has two branches:

- Sympathetic

- Parasympathetic

Sympathetic “Fight or Flight” Branch speeds the heart up

Parasympathetic “Rest and Digest” Branch slows the heart down

Fractal Patterns of HRV

• Wavelet analysis is used to

analyze heart rhythm

• It turns out that the a healthy

heart rhythm exhibits a fractal

structure

• Small changes in the “input” (the

nervous system) results in larger

changes in the fractal structure.

– The Butterfly Effect

• This fractal structure will reflect

small changes in the nervous

system

– Enables early dis-ease detection

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(TOP) Color-coded wavelet analysis of a heart rate time series in health

(Bottom) Color-coded wavelet analysis of a heart rate time series of patient with OSA

Goldberger A L et al. PNAS 2002;99:2466-2472

So What Does This Mean to Me?

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HRV is an indication of your

resilience – the ability of the nervous

system to respond and recover

from physical or psychological

stressors

Sympathetic “Fight or Flight”

response, also known as Stress, can

be measured with HRV According to leading medical experts 90% of

diseases and illnesses are due to stress

Stress becomes the norm and the brain

filters the familiar so we don’t know we are

stressed

Chronic low HRV is an indication of

systemic health (psychological or

physical) issues

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Other Important Information on HRV

• HRV value is dependent on

length of measurement

• HRV taken at same time each

day• First thing in the morning while lying

in bed is recommended

• Try to keep a blank mind. Thoughts

about a busy day can effect the

reading

– In same position• Lying down

• Sitting

• Standing

– Measurement for same length

of time each day (3 minutes

typical)

HRV has a circadian rhythm

HRV is dependent on body

position

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6am 12pm 6pm 12am

Circadian Rhythm

HRV

Time of Day

Why Don’t I Know About This?HRV Legacy Products

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HRV in 2015

HRV going

mainstream with

meaningful feedback,

Mobile platforms &

consumer HRMs

Enable early

disease detection

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Increasing number

of HRV apps

While Doctors are

concerned with organ

function…

You can monitor

the system that

controls these

functions

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Circling Back AroundHRV and Digital Health

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Number of Steps

Estimated Calories

Heart RateSleep Stage

Estimates

Distance, Routes

Estimated Calories

Calories & Nutrition

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In Addition….Bio-Hacking

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Magnetic Brain Stim

……and many, many more

Which venues, # steps, calories, exercises, ….are making me healthy?

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Objective

measures

of health

Closing Comments

Digital Health, particularly personal mobile health apps and

devices, are changing the way we take care of ourselves

– We are taking charge of our health and becoming our own and our

family’s advocates

Personal health monitoring devices are give us data on our

habits, including exercise and nutrition

“Quantified Self” and “Bio-Hacking” devices and programs

provide a plethora of self-improvement venues

Because one size does not fit all, we need to monitor actual

physiological health metrics such as weight, blood pressure

and HRV

HRV has emerged as the latest “must know” physiological

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Thank You!