How to read your SweetBeat numbers - Heart rate variability

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This is for users who use either SweetBeat or HRV Sense. We have had a lot of questions about age specific numbers and wanted to go into detail for our users so they can get the most out of our app.

Written by CEO & co-founder, Ronda Collier.

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  • Heart Rate, Blood Pressure, Respiration, Autonomic Nervous System (ANS) is a tightly coupled systemThis system is affected by our physical actions (exercise, standing up) and our thoughts and environmentAll aspect work in concert to keep us balanced and operating “within spec”It turns out that our heart beat or rather the pattern of the heart beat is a window into this tightly coupled system.This rhythm or pattern of the heart beat is called Heart Rate Variability (HRV)HRV is: The variation between each heart beatA reflection of resilience and elasticityA true cornerstone for multilevel health monitoring An energy biomarker in an interconnected biological systemTwenty years of research validates HRV as a significant metric for measuring healthHRV is a mainstream topic of researchSome HRV metricsSDNN – Standard Deviation of RR intervalspNN50 – Percentage of RR intervals/hour in which change in normal intervals exceeds 50msecrMSSD – Root Mean Square of Successive Differences of RR intervalsSDNN, pNN50, rMSSD all have published cutoff points for risk of sudden death from MIHRV provides insight into the nature of heart-related diseasesWhile there is still a gap in awareness of HRV between researchers and doctors in the medical community, HRV is an emerging biometricInsurance reimbursement codes accept HRV as a metric for measuring ANSMonitoring HRV allows individual to modify behavior, leading to positive change throughout the body’s tightly coupled systemHRV measurements.CPT Coding 95921 and 95922Two reimbursable CPT codes allow physicians to be paid for autonomic nervous system monitoring. These two reimbursable CPT codes for autonomic nervous system monitoring (95921 and 95922) were established in 1999. These CPT codes enable health care providers to be reimbursed for monitoring the autonomic nervous systems of patients where such monitoring is indicated. The reason for two CPT codes is simple. In order for physicians to get a complete look at autonomic nervous system functioning they must read both of its branches (Sympathetic and Parasympathetic) independently. CPT code 95921 is coded for parasympathetic nervous system monitoring and 95922 is coded for sympathetic nervous system monitoring. HRV measurements. CPT Coding 95921 and 95922 357.2 Polyneuropathy in DiabetesV628.9 Psychological Stress or Physical Stress not elsewhere classified308 Stress Reactional Emotional308.1 Predominant disturbance of consciousness308.3 Other acute reactions to Stress308.4 Mixed disorders as reaction to stress308.9 Unspecified acute reaction to stress458 Orthostatic Hypotension458.1 Chronic Hypotension429.9 Heart Disease unspecified
  • Jo Beth Dow and I founded SWH in Feb, 2011While we develop apps as part of our product, we are a software technology companyOur mission is to analyze the patterns of the heart beat, known as Heart Rate Variability, AND the patterns of Heart Rate Variability to detect onset of specific conditionsThe app and mobile platform serves as a real time detection device and as a data collection platform that utilizes 3rd party sensors and heart rate monitors.Our backend database is mined and advanced analytics are utilized to detect disease specific patterns in the dataA rich and graphical tool suite brings the data to life with application specific functionality and user interfaces
  • Jo Beth Dow and I founded SWH in Feb, 2011While we develop apps as part of our product, we are a software technology companyOur mission is to analyze the patterns of the heart beat, known as Heart Rate Variability, AND the patterns of Heart Rate Variability to detect onset of specific conditionsThe app and mobile platform serves as a real time detection device and as a data collection platform that utilizes 3rd party sensors and heart rate monitors.Our backend database is mined and advanced analytics are utilized to detect disease specific patterns in the dataA rich and graphical tool suite brings the data to life with application specific functionality and user interfaces
  • How to read your SweetBeat numbers - Heart rate variability

    1. 1. SweetWater Health August 2013 SweetWater Health LLC Confidential 1 BeatHealthy TM TM Heart Rate Variability 101 An Introduction to HRV and Interpreting SweetBeat HRV Graphs and Numbers
    2. 2. 2 SweetBeat Display Description SweetWater Health LLC Confidential
    3. 3. 3 SweetBeat “Stats for Nerds” SweetWater Health LLC Confidential
    4. 4. HRV Interpretation  HRV can vary greatly from person to person depending on health and fitness  HRV can vary greatly for an individual from day to day and even hour to hour  While there are “average HRV values” determined through clinical research, HRV is dynamic and individuals will tend to have their own range – Scroll down to see charts of “average HRV values” from some research papers  Some athletes have HRV values that are magnitudes higher than average persons  SweetBeat is about understanding and managing the nervous system and not intended to diagnose anything. If you feel your HRV is “low” see your doctor  Athletes use HRV to guide training – As seen on the next 2 charts, HRV power levels vary quite a bit – The elite athlete has LF and HF power that are orders of magnitude higher than average – Don’t be alarmed if your HRV values are closer to average
    5. 5. 5 HRV for Training Example Elite Athlete SweetWater Health LLC Confidential 0 2000 4000 6000 8000 10000 12000 14000 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 LF HF Day of first race high cortisol measure day before Tuesday after race high cortisol measured LF vs. HF Elite Athlete
    6. 6. 6 HRV for Training Example Fitness Enthusiast SweetWater Health LLC Confidential 0.00 1000.00 2000.00 3000.00 4000.00 5000.00 6000.00 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 LF HF LF vs. HF Fitness Enthusiast
    7. 7. Average HRV Ranges  Source: http://www.sciencedirect.com/science/article/pii/S0735109797005548  Values based on 24 hour measurements  HRV represents rMSSD scaled to a value between 0 – 100 and is SweetBeat specific  Source:  http://www.anti-aging.gr.jp/english/pdf/2010/7_94.pdf  Values based on 5 minute measurements 20's 30's 40+ Average LF Male 1480 678 212 Female 804 336 330 Average HF Male 925 314 131 Female 528 311 156 Gender Age Average SweetBeat HRV Male 10-29 72.29827 Female 67.68875 Male 30-49 62.51162 Female 60.47521 Male 50-69 52.91486 Female 55.733 Male 70-99 52.91486 Female 52.91486
    8. 8. 8 Coherence  Many SweetBeat customers use HeartMath coherence training techniques – excellent!  Coherence is associated with a “spike” at 0.1hz frequency  There are industry standards for LF and HF frequency ranges – LF = 0.04hz - 0.15Hz – HF = 0.15hz – 0.4hz  Stress is associated with a high LF with respect to HF (high LF/HF ratio). Because coherence is associated with a high power spike at 0.1hz, which falls into the HRV definition of LF, coherence shows as high stress in SweetBeat. SweetWater Health LLC Confidential
    9. 9. Coherence Visualized 9  Coherence spike at 0.1hz  Note very high power in the LF range (0.04hz – 0.15hz) and little to no power in the HF range (0.15hz – 0.4hz) SweetWater Health LLC Confidential  SweetBeat Heart Rate Graph during Coherence
    10. 10. SweetWater Health Tidbits  SWH was founded in Feb. 2011 by Ronda Collier and Jo Beth Dow  Idea came from the realization that in order to improve the world, individuals must improve themselves  Much of what needs improvement is subconscious thoughts and behaviors  SWH created an app to alert an individual in real time when their nervous system enters fight or flight, bringing subconscious reactions to the conscious mind  An unexpected realization about how to identify good stress from bad stress – Power levels of nervous system are high during good stress even if sympathetic dominates – HRV increases when one is “in the zone” and highly creative – Fight or flight response accompanied by low HRV and low power levels  SweetBeat is about understanding and managing the nervous system – Nervous system activity is the result of the coupling of biological oscillators – This coupling (when healthy) results in a signal that is complex (fractals, chaos, self-organizing)  Athletes use HRV to guide training – HRV is the reflection of vagal tone which is affected by overtraining
    11. 11. The Science of HRV • What is Heart Rate Variability (HRV)? • HRV is a result of this tightly coupled system trying to keep your body system in equilibrium • HRV in the mainstream SweetWater Health LLC Confidential 11
    12. 12. SweetWater Health HRV and Vagal Tone 12  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 the mediator of HRV and therefore HRV is an indication of Vagal Tone  The higher the HRV, the stronger the Vagal Tone  Higher HRV is an indication of an individuals ability to “put the brakes on stress” by mediating the sympathetic control over the nervous system and heart rate. SweetWater Health LLC Confidential
    13. 13. 13 Benefits of SweetBeat Continuous real-time generative feedback SweetWater Health LLC Confidential
    14. 14. 14 SweetWater Health HRV and Vagal Tone  HRV is an indication of your resilience – the ability of the nervous system to respond and recover from physical or psychological stressors  HRV has a circadian rhythm  IMPORTANT: HRV measured values depend on length of measurement  3-5 minutes  24 hour  IMPORTANT: HRV is age and gender dependent  HRV may change day to day with your biorhythm or due to emotional or physical stress  HRV associated with willpower in several studies  Chronic low HRV is an indication of systemic health (psychological or physical) issues  There are over 5,000 papers on HRV in the NIH database alone  There are CPT reimbursement codes for HRV measurements SweetWater Health LLC Confidential
    15. 15. 15 SweetWater Health HRV Parameters  Heart Rate Variability is measured by several parameters:  Time domain – These are standard statistical analysis of the heart beat time series  Standard Deviation (SDNN)  Root Mean Square of Successive Differences, (rMSSD)  Heart Rate (HR)  pNN50, TINN, Triangular index  Frequency Domain:  Very Low Frequency (VLF)  Low Frequency (LF, associated with sympathetic activation)  High Frequency (HF, associated with parasympathetic activation)  Non-Linear:  SD1/SD2, ApEn, SampEN  SweetBeat calculates rMSSD, LF and HF  The SweetBeat HRV value is a value from 0 – 100 and based on rMSSD SweetWater Health LLC Confidential
    16. 16. 16 rMSSD,LF, HF  rMSSD is a reflection of Vagal Tone  rMSSD is non-stationary and varies +/- 10 ms at rest  Average rMSSD ranges from ~20ms to ~80ms depending on age and state of health  Generally calculated on 3-5 minute window  LF is associated with sympathetic nervous system  Some contribution from parasympathetic  HF is associated with parasympathetic nervous system  LF/HF is ratio of sympathetic and parasympathetic  So a high HRV means  High rMSSD which means strong Vagal Tone or total variability  LF, HF total power in optimal range for age and gender  LF/HF < 2 is indication healthy stress levels SweetWater Health LLC Confidential

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