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With all the increased popularity around wearables along with increased focus on longevity, the topic of heart rate variability (HRV) can become a popular topic of conversation and discussion. As a measure of cardiovascular condition and health, nervous system regulation and balance, and overall health status, HRV is a pivotal data point in calculating health improvement and recovery status over time. Because HRV can be impacted through lifestyle factors, stress management, and training consistency, we can not only impact our aging process, but promote healthier years and longevity.
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Heart rate variability (or HRV) is the measurement of time between heart beats in milliseconds (ms), where the higher the number, the lower the stress on the system overall. Often, we see higher HRV numbers in those who exercise regularly, practice stress management, and challenge their heart with positive stressors, like community involvement, relationships, and positive emotional experiences.
HRV does change with age, generally decreasing over time, and since the two branches of the autonomic nervous system, sympathetic (“flight, fight, or freeze”) and parasympathetic (“rest and digest”), are both involved in regulating HRV status, it is a measure of the overall balance between these two systems. If someone experiences a high amount of stress on a regular basis, their HRV status will diminish due to an imbalance between the sympathetic and parasympathetic nervous systems and depletion of energy stores (Grassler et al, 2021).
The activation of the parasympathetic nervous system comes from the stimulation of the vagus nerve on the heart muscle, which can be influenced by activation of the diaphragm through breath techniques. The vagus nerve can also be inhibited through other influences, such as hormones (Schmalenberger et al, 2020).
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In today’s world, we have access to so many devices that not only provide insight into our daily lives, but allow us to better understand our exercise and recovery routines. Wearables provide a great deal of insight into our bodies and guide our routines, behaviors, and lifestyle factors when utilized properly. Devices that capture sleep data are the most vital on the market, and should be prioritized.
The Oura ring, Apple Watch, and Whoop strap are just some of the devices available, and known for their ability to track sleep statistics, including recovery, efficiency, quality, and HRV status. Understanding these numbers can be important for guiding your daily activity, sleep routines, and stress management.
Personally, I’ve thoroughly enjoyed the Oura ring. It has great sleep insights, cycle tracking, activity tracking, and readiness analysis. The readiness score uses the sleep analysis and previous days’ activity to guide you through the day, suggesting rest times and recovery activities congruent with your current status. The sleep insights, including sleep stages, heart rate, time asleep, and HRV are all great measurements for progress over time as well as outliers in normal rhythms. It even suggests when there is a minor or major strain on your system, and prioritizes rest in order to reduce strain and improve parasympathetic activation time.
Here’s an example during a high-stress time in life with little recovery time or restfulness:
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As you can see, the HRV score dropped significantly to 13 ms average for the night, which is about 50 ms shorter than normal. This is a great example of sympathetic over-drive and lack of parasympathetic activation, leaving the heart rate high overnight and showing major strain on a system.
Here’s an example during a low-stress time prioritizing sleep and recovery:
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Here, you see an incredibly restorative night of sleep with a great distribution between the sleep stages, optimal timing (timing is always important as deep sleep is achieved earlier in the night), good sleep efficiency, and high HRV of 84 ms average for the night, showing high parasympathetic activation overnight and overall low strain on the system.
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HRV can be adjusted using exercise as a vital tool. Certain types of exercise work better for improving HRV, and a combination of different exercise types seems to be best.
Though raising the heart rate is important for improving cardiac efficiency, it is more important to train the ability to lower your heart rate naturally, via parasympathetic activation, as this is the main contributor to the variability in heart rate timing. Exercise not only raises the heart rate but resets the balance between both autonomic nervous systems. Particularly, aerobic exercise has been shown to help with both cardiovascular conditioning and HRV improvement both through a positive stress exercise without the presence of excess cortisol (stress hormone) like in higher-intensity exercise (eg. Crossfit or HIIT). When aerobic exercises is combined with resistance training, like weight lifting, the heart is challenged in different capacities and therefore experiences “multi-modal recovery” (Grassler et al, 2021). This is imperative in establishing exercise as a “eustress”, or positive stressor, within the system, compared to negative stressors or “distressors”, like work meetings, traffic, relationship hiccups, and other stressful situations.
A balanced exercise plan is key to improving HRV:
Regular exercise reduces all-cause mortality, supports heart health, and strengthens recovery capacity (Grassler et al., 2021).
HRV tends to increase during deep sleep, as the body repairs and resets overnight. However, poor sleep reduces HRV over time, leading to increased stress and aging effects.
To optimize sleep HRV:
✅ Maintain a consistent sleep schedule
✅ Avoid late-night screen time and stimulants
✅ Prioritize deep sleep-enhancing strategies (e.g., magnesium, blackout curtains, wind-down routines)
Since chronic stress suppresses HRV, effective stress management is essential:
By incorporating these habits, you can train your body to recover faster and maintain nervous system balance.
Regular exercise geared towards HRV improvement shows marked decreases in all-cause mortality, cardiovascular diseases, and premature mortality, while also strengthening the heart in order to remain active in later years (Grassler et al, 2021). Specific training guidelines and individualized approach to training can be just what one needs to not only address age-related changes, but better address subjective training needs towards the client’s goals. This ensures the training load is adequate for each individual, and does not overwork or overextend the body - using training and physiological parameters allows for clients to be monitored and for training to be adjusted to their perceived ability (Manser et al, 2021). For example, let’s say a client comes in for a training session and is not feeling at their best, and when HRV is checked for the previous night, it is abnormally low compared to their previous measurements. This can help in tailoring training to the state of their body currently, and better understand how their body responds to particular stimuli.
Here’s a great article on training for longevity and healthspan, and the important factors to consider when training (link).
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Both are a measure of time between beats, and because exercise generally raises heart rate (thereby decreasing HRV acutely) and sleep generally lowers heart rate (thereby increasing HRV), they measure nervous system regulation in different ways. With exercise, heart rate recovery is an additional important measure of conditioning and nervous system regulation following a stressor on the system (Grassler et al, 2021).
Sleep patterns and circadian rhythms can affect overall HRV status over time, as proper sleep and recovery promotes a higher HRV score. When properly rested and recovered, the heart can return to homeostasis, and if sleep disturbances occur on a regular basis, HRV will decrease over time. Prioritizing sleep hygiene and stress management can improve sleep HRV measurements with consistent practice (Voss et al, 2015).
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HRV fluctuates with hormonal changes—especially in women.
Understanding these patterns can help women adjust their exercise and recovery strategies accordingly.
HRV can be influenced by hormones and will change throughout the menstrual cycle. The influence on heart rate variability comes from the presence of progesterone, and affects the heart rate rhythm in the latter half of the cycle. Overall, there is a change in HRV in the last two weeks before the cycle, which correlates with higher-than-normal feelings of stress and reduced recovery during this time (Schmalenberger et al, 2020).
For women, it is normal to experience a dip in HRV status after ovulation, and can show that they need additional rest and recovery during this time. This aligns well with the hormonal rhythm and exercise output associated with the latter half of the cycle, where intensity should drop, and endurance should be prioritized, reducing overall strain and allowing for metabolic support. In later years of life, HRV is relatively predictable and stable regardless of gender, which is after the hormonal influence has diminished through the menopausal transition (Geovanini, et al; 2020; Schmalenberger et al, 2020; Voss et al, 2015). One consideration, particularly hormone replacement therapy (HRT), can cause HRV fluctuations compared to non-HRV females of the same age, and may even help with recovery and athletic performance (Voss et al, 2015).
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Next Steps:
By prioritizing HRV, you’re investing in a longer, healthier, and more resilient life.
Conclusion
HRV is a pivotal tool for understanding physiology at a deeper level, promoting wellness and stress management within the body, and managing exercise intensity for the best balance of strain and recovery. Through training for HRV improvement, we not only address our cardiovascular conditioning, but affect the aging process overall by supporting healthy habits and mitigating strain on the body. Using wearables is recommended for better understanding your own HRV measurements and how they translate to day-to-day life, and even more understanding the influence of hormones on your body over time.
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References
Geovanini, G., Vasques, E., De Oliveira Alvim, R., Mill, J., Andreão, R., Vasques, B., Pereira, A., & Krieger, J. (2020). Age and Sex Differences in Heart Rate Variability and Vagal Specific Patterns – Baependi Heart Study. Global Heart, 15. https://doi.org/10.5334/gh.873.
Grässler, B., Thielmann, B., Böckelmann, I., & Hökelmann, A. (2021). Effects of Different Training Interventions on Heart Rate Variability and Cardiovascular Health and Risk Factors in Young and Middle-Aged Adults: A Systematic Review. Frontiers in Physiology, 12. https://doi.org/10.3389/fphys.2021.657274.
Manser, P., Thalmann, M., Adcock, M., Knols, R., & De Bruin, E. (2021). Can Reactivity of Heart Rate Variability Be a Potential Biomarker and Monitoring Tool to Promote Healthy Aging? A Systematic Review With Meta-Analyses. Frontiers in Physiology, 12. https://doi.org/10.3389/fphys.2021.686129.
Schmalenberger, K., Eisenlohr-Moul, T., Jarczok, M., Eckstein, M., Schneider, E., Brenner, I., Duffy, K., Schweizer, S., Kiesner, J., Thayer, J., & Ditzen, B. (2020). Menstrual Cycle Changes in Vagally-Mediated Heart Rate Variability Are Associated with Progesterone: Evidence from Two Within-Person Studies. Journal of Clinical Medicine, 9. https://doi.org/10.3390/jcm9030617.
Voss, A., Schroeder, R., Heitmann, A., Peters, A., & Perz, S. (2015). Short-Term Heart Rate Variability—Influence of Gender and Age in Healthy Subjects. PLoS ONE, 10. https://doi.org/10.1371/journal.pone.0118308.
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