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Katie: Hello, and welcome to the “Wellness Mama Podcast.” I’m Katie from wellnessmama.com and wellnesse.com, that’s wellnesse with an E on the end. And this episode is all about simple and effective ways to control stress response and improve your HRV.
And I’m here with Doctor Jay Wiles who is an international scientist, clinician, speaker, and subject matter expert on this topic of interconnectedness between the human stress response and health performance and optimization. He is a clinical health and performance psychologist with board certification in heart rate variability biofeedback and peripheral biofeedback, and he works with a team of leading consultants in psychophysiology to help professionals, athletes, and teams, executives and high performers to increase their performance. He is also the co-founder and chief scientific officer of Hanu Health. And we talk about this today, it’s a new way that they’re using HRV and respiratory training as diagnostic indicators of the dynamic nature of the human stress response, alongside therapeutic tools for regulating and conditioning this response for peak performance.
We go deep in this episode about what HRV is, and why it’s important to understand. Why this is the single greatest proxy we have for assessing the autonomic nervous system and stress levels. A lot of myths and misconceptions about HRV. The myth of low heart rate variability and how to keep this in perspective. And why HRV is not a normative comparison, but for self-comparison only. The reason males have higher HRV typically, and how height comes into play. What to understand about the autonomic nervous system. The sympathetic and parasympathetic responses and stress. The single greatest mechanism for improving HRV, and so much more. I learned a lot and I’m gonna be checking out his new tool, Hanu Health, and I know you’ll learn a lot from this one too. So let’s join Dr. Jay. Dr. Jay, Welcome. Thanks so much for being here.
Dr. Jay: Hi, Katie. Thanks so much for having me. Glad to be here.
Katie: I am excited to jump into stress and HRV with you today. I think these are huge topics, especially for moms, but briefly, before we start recording, you mentioned that your wife is also obviously a mom and into health and wellness. And I think there are a lot of listeners listening who maybe are trying to kind of gently usher their significant others into more health and wellness. I would just love to hear a little bit about your own journey into this.
Dr. Jay: Yeah. So a little bit of background. So I’m a clinical health psychologist. I guess a clinical psychologist is what most people would kind of know me as. And that means that I’ve had experience working within the clinical population and individuals with anxiety disorders, depression, PTSD, panic disorders, all the way up to like things like psychosis and schizophrenia.
However, in school, I decided to specialize in the field of health psychology, which is really looking at the intersection between mental and physical health, that bidirectional relationship. And the reason I did so was because I’ve just always been fascinated with health. And I was experiencing a lot of health concerns during graduate school. Long story short, I ended up having an unfortunate mold, a toxic mold exposure when I was a resident. And I was having a ton of brain fog, a crazy amount of stress during that time, I just couldn’t function well.
And I had just gotten married. Things were just like off to a rocky start in my own professional career. And as a psychologist, I’m like, “I feel like I should have this stuff together. Like I feel like I should be in good health. I should have my stress managed,” and I just wasn’t. And so that was a lot of my own negative cognitive play during that time. However, I came across this field of health psychology and psychophysiology, it really just kind of changed my perspective. And so, in 2018, my wife and I had our first kid Reagan, he’s four years old now. And then we had Micah, my 2-year-old who had his birthday yesterday, actually in 2020, so right at the heat of the pandemic at the start.
And my wife is an amazing individual. She’s so health and tech-savvy, and really just focused on wellbeing. But as you know, especially since you have six kids, we only have two, it still brings about a ton of stress. And so it was during kind of the time of kids really that I was like, “I need to really hone in on focusing on how can we really take practical, easy skills that anyone can implement that can inherently change our stress response and inherently change our physiology.” And the great thing is that there’s so many accessible tools that are free, easy to use, and are available at all times.
Katie: Yeah. And you’re so right. It’s very much a both/and because that physical health and mental health balances a circular thing where mental health affects how your body feels, and your actual physiology, and your physical health also can impact your mental health through all these mechanisms we’re starting to understand. But I think you hit the nail on the head that a lot of people are feeling a lot of overwhelm and stress, especially like you mentioned, after the last couple of years. And as a population, in general, moms typically feel a lot of overwhelm and stress at different phases of kids’ lives. So I think this is a super relevant topic for our listeners today.
And I wanna really go deep and tackle this topic of stress. Like you said, simple strategies we can use to actually get that into a better category. And also to go deep on the science of HRV because I think this is a newer tool that we have, that can be really, really helpful if we understand it. But until recently, I feel like there wasn’t a lot of actual information to understand it. And this is an area where you have quite a bit of expertise. So to start broad for anybody who isn’t familiar with the term, can you explain to us what HRV is?
Dr. Jay: Absolutely. Yeah, it’s really interesting because HRV has not come to the forefront of like modern consumer technology and psychology until probably, you know, the past 5 to 10 years. But really the study and research of HRV goes back decades among decades. And we’re looking at 65, 70 years’ worth of research. But just to kind of lay out kind of lay of the land of what a heart rate variability is, heart rate variability is…the easiest way to explain heart rate variability is actually by using the definition of the title, heart rate variability. So it’s the variation that occurs in between heartbeats. So the heart doesn’t operate a metronome. So a great way to think about this is that most people understand what heart rate is. So if I tell you your heart rate is beating at an average of 60 beats per minute, well, then you would say, “Okay, well that means over the course of the last 60 seconds, I had 1 heartbeat every single second.”
Now on average, that’s actually true, but it’s not the way things work. The heart isn’t pacing itself like a metronome. On average, it’s going up and down and up and down. And a lot of that is depending on your respiratory rate, your respiration cycle. There’s a process called respiratory sinus arrhythmia, which is the increasing and decreasing of heart rate across the respiration cycle. And I’ll come back to that concept here in just a minute. But the reason why the doesn’t operate like a metronome is because we have trillions, yes, trillions of processes that are occurring in the body at any given moment.
And so our autonomic nervous system has to be able, and our cardiovascular system has to be able to regulate itself and adjust to all of these processes. So a good heart rate variability is one that is adjusting to its environment. It’s adapting, it’s recovering due to any impact, both internal or external stress. So heart rate variability, as of right now is the single greatest non-invasive proxy that we have for assessing the autonomic nervous system and assessing the human stress response.
And so when we think about heart rate variability, we always wanna think of it as a data point and as a proxy. It is only giving us information. Now what we do with that information as you know, is like the next step and it’s the most important thing. But heart rate variability, again, you can think of it as a great proxy for autonomic nervous system functioning.
Katie: Yeah. And I’m glad you said the word metronome because this is something that was helpful to me in understanding is like the heart should not be a metronome in that it’s extremely regular. But in states of extreme stress, it moves more toward being metronome-like, whereas we want that variability and adaptability because that indicates we’re hopefully in parasympathetic more often, and that, like you said, our autonomic nervous system is in balance. But like you said, we actually do have research on HRV, but a lot of it hasn’t made it to the forefront of the mainstream. And I feel like some of the stuff that has, there are a lot of misconceptions still floating around out there. So I’d love to start broad and maybe kind of give us some of those common misconceptions you hear.
Dr. Jay: Yeah. This is a really great topic and one that is very close to my heart. And the reason being is because there are so many individuals that have accessibility to heart rate variability data now, and actually really good heart rate variability data. So if you look at things like Apple Watch, and Oura Ring, and Whoop, Fitbit, Garmin, all of these products and all of these consumer wearables have heart rate variability. Some of them are capturing it a little bit differently and they’re capturing it at different times. And we can talk a little bit about, you know, what that looks like. But the good thing is that most of the time, these data captures are actually pretty dang accurate. So really inexpensive…or relatively, I should say, inexpensive consumer wearables providing this data. The common misconception though that I think is probably the most prevalent, the one that people write me about, that I get emails and messages on Instagram all the time about is what does it mean for heart rate variability to be low?
I can’t tell you the number of times I’ve gotten emails of like, “I need help, my heart rate variability is low.” And what they typically mean is that it’s low when they are making a comparison to other people. So they’ll see, you know, myself or someone else that may be just has like a genetically higher HRV, or a different level of cardiorespiratory fitness, whatever it may be that’s influencing heart rate variability because there’s a lot of variables that influence heart rate variability. They’ll see pictures posted or they’ll hear someone say what their heart rate variability is, and they automatically make a comparison. They hear someone’s is 100 milliseconds on their Oura Ring, their’s is 20, “Therefore there must be something wrong with me.” And one thing that we have to clarify with heart rate variability is HRV is not a number of normative comparison, it is a number of self-comparison. We always compare with our own baseline.
So let me give the example that I always love to paint is that when we look clinically at how HRV has been used in the past, and when we say clinically, I’m gonna use the field of cardiology because that’s really the main field that has utilized HRV in the past. They don’t utilize it as much now because they have a little bit more invasive, sophisticated ways of measuring cardiac functioning. But one of the things that they used HRV for and that they could normatively compare was after someone had a myocardial infarction. So someone has a heart attack, and then we can look at 24-hour readings of HRV and utilize that as a really good predictor as to whether or not someone was at risk of having a second myocardial infarction or another heart attack.
And so there was ranges that people could look at over 24 hours, which most people are not capturing HRV over 24 hours. It’s normally when they’re tonic, or they’re asleep, or at a really solid rest. And so these numbers were thrown out there and a lot of people would look at their HRV readings and compare them, and it’s apples to oranges. We couldn’t do that. What we really know and what the research has really been firm on is that there are so many confounding variables that influence the score of heart rate variability, I mentioned some earlier. And we’re talking things like genetics and the hereditary factors. Things like gender, we know that males actually typically have a higher HRV than females do. We also know that things like height. I’m 6-foot-5, and so I actually already have more of a propensity to have a higher HRV than shorter individuals.
So there’s all of these variables that we have to take into consideration: age, you know, fitness level. So we cannot compare person to person. So when we say low HRV, I have a low HRV because you can’t have a low HRV, it’s low in comparison to your baseline. So, for instance, if we knew that kind of my upper shelf of HRV, so kind of my heightened kind of normative value was 150 and my low was 50, and then my average was 100, and I’m just using made-up numbers, by the way, then low for me is if I drop below 50. High for me is if I go over 150. So that’s kind of the biggest myth that I like to dispel is that it is always going to be a self-comparison. And when we’re comparing numbers, we have to take in consideration of context.
If you were to take your heart rate variability overnight, it’s gonna be very different than if you take your HRV after you eat lunch at 1:00 in the afternoon. So, does that mean then that we can compare those scores? Well, not really. Could you compare scores may be from day to day at the same time in the same conditions? Yes. So those are the two big ones. I wanna make sure that I don’t kind of drone on and on with kind of more misconceptions so I’ll pause here. But I think those are the two biggest ones in context. And then also knowing what you’re comparing.
Katie: That is really helpful for context because I have, for instance, a friend whose average is 180 to 200 every night on his Oura Ring. And he also isn’t an elite athlete and is over 6 feet tall and has some of those factors in play. But if someone just saw that and compared, and theirs was maybe like 40 on average, they would be like, “Oh my gosh, I’m gonna die because mine is so low.” And I think that’s really important to keep top of mind as we go through this conversation is like everything in life, it’s in comparison to yourself. And there’s not a lot of good data to be gained by comparing yourself to other people who have all of these differences. You’ve also mentioned the word autonomic nervous system multiple times, and I wanna make sure people have a baseline understanding of this before we go forward. So, for anyone who isn’t quite familiar with that, can you just kind of give us an overview and explain its role in all this?
Dr. Jay: Yeah, absolutely. So the autonomic nervous system which comes from the word automatic is actually a part of your nervous system or a system that is within kind of your body that regulates different levels of organ functioning. And it can actually regulate nerve functioning. So the one that people are most familiar with is probably your central nervous system. That’s your brain and your spine. And then outside of your central nervous system is where all of your nerves run.
And this is your peripheral nerves that run out to all the organs of your body, to everywhere else, to supply messages, chemical messages, electrical messages to the entire body. And one system within there, the peripheral nervous system, is your autonomic nervous system. Now, the autonomic nervous system is going to regulate things like cardiac functioning, smooth muscle functioning. It’s gonna regulate lungs. It’s gonna regulate other organs. And it’s dictated by two predominant systems, but it’s actually made of three branches.
So the two that most people are most familiar with would be the parasympathetic and sympathetic nervous system. I’ll explain those two. But we also have to remember that the gut or the enteric nervous system is also another branch of the autonomic nervous system. So, there’s three. Now the two that we’ll talk about the most in regards to stress are really gonna be the parasympathetic and sympathetic, but we don’t wanna disregard the enteric nervous system or the gut. It actually plays a huge role in the stress response.
And we know that when there’s gut dysregulation, when there’s things like dysbiosis, H. pylori, gut intestinal permeability, this can cause significant concerns in the stress response. But when we talk about the sympathetic and parasympathetic nervous system, these are two not competing branches, which is often confused. A lot of people think that these are in direct tug of war. They do operate a lot of the times antagonistically so they are working against each other. However, they can also work complementary to one another as well.
So the complementary example that I give is sports performance. So when we are engaging in sports performance, we need our stress response to kick on, but we also need the mechanism for relaxation at the same time. So we can actually have them complement one another to increase our level of performance. But when we look at the branches working, antagonistically, we’re gonna consider the sympathetic nervous system, more of our fight or flight response.
So this is more of the inherent stress response that people have. So when someone encounters something acute, that’s stressful, say somebody pulls out in front of you when you’re commuting and almost hits your car, you feel that bit of shock in the body. You lock up and kind of fill that level of tension. That’s a mass engagement of the sympathetic nervous system, and that’s a removal of what we call the vagal brake or vagal outflow of the parasympathetic nervous system.
So think of the sympathetic nervous system as fight or flight, think about it as energy expenditure. So it’s a mechanism for allowing us to expend energy, gets us out of situations. It saves our lives and it is a good thing. And stress in and of itself actually, contrary to popular belief is a good thing. It’s actually from an evolutionary perspective, only there to protect us. Our modern kind of lifestyles have resulted in it working against us, but really it’s there as a protective signal mechanism. Now, when we talk about the parasympathetic nervous system, I always like to think of it as like a parachute. It brings us down it’s the rest and digest relaxation response. And what it’s predominantly there for is to decrease heart rate, allow us to feel that sense of safety, of connectedness.
Again, this is when it’s working kind of in opposition to the sympathetic nervous system, but its intention really is to help to pump the brakes. And I like to use the word “brake” a lot because the vagus nerve, which is our 10th cranial nerve and is really the predominant nerve that operates within the framework of the parasympathetic nervous system, it operates like a braking mechanism. And a lot of the times when we experience stress, it’s not nearly as much of a significant mass activation of the sympathetic nervous system, it’s actually a relinquishing of the break that is our parasympathetic nervous system. It’s pulling off of that nice gentle break that keeps us down, keeps us regulated.
But the one thing to remember here is that we need both, but we also need to learn how to exercise control over both. And I think that’s the biggest thing is that we’re not trying to just always repress the side of the nervous system that we think is bad, the “Sympathetic nervous system,” we wanna up-regulate that when we need it, but we also wanna up-regulate and down-regulate the parasympathetic nervous system when we need it. That might have been a little bit more than what you bargained for, Katie, but I figured I’d jump in there.
Katie: That was a great primer in that. I love it. You explained it so clearly. And I wanna also in a minute, jump into like tools we can use to move all of these things in a positive direction. But before we do, I also would love to talk about, do we have data on some of the factors that can impact HRV obviously with the context of, in relation to a person’s own HRV, not in comparison to others? But as examples, I wear an Oura Ring and I monitor my HRV, and I’ve noticed a correlation with things like, obviously, sleep is a big one, but hydration, sunlight, my own stress level, mobility work seems to really help HRV. Alcohol, of course, completely tanks my HRV. My body does not like it when I drink at night. But are there things that are reliably correlated with HRV that we can be aware of as we go forward in the conversation?
Dr. Jay: Yeah. Yeah. You mentioned some really great ones. I mean, the one that we see probably more significant than any is stress. So I’m gonna table that one because I’ll jump into that one last and unpack it a little bit more. So psychological or physiological stress, which is a very broad category. So I’ll jump into that in a second. You mentioned alcohol is a huge one. So we know that alcohol increases our heart rate, and when heart rate increases and there’s stress on the heart, and it beats faster that is correlated with a decrease in heart rate variability. And those effects, depending on how fast you metabolize alcohol can last a while.
So, for instance, if I consume alcohol, I will see that the first… And it depends on how much I drink. If it’s like one glass of wine or one, you know, seltzer or something, it doesn’t do nearly as much as if I do two or three, three’s about my max. But two, I’ll see it like on my Oura Ring, like my HRV will start really low and it generally will kind of go up in a nice, linear fashion throughout the night. But it takes generally, I’d say for me, around three hours or so to get back to kind of like a normal baseline, but it still creates a low average for the night.
And again, that’s gonna depend on a lot of factors, and it’s gonna depend on metabolism and the genetics around metabolism. So alcohol is one. We also know that a sedentary lifestyle is very much correlated with a lowered self-reported…sorry, self-quantified HRV, self-compared HRV is the best way to put it. So when I say a sedentary lifestyle, there’s been studies done that demonstrates that people who walk under 6,000 steps a day, generally have a lower cardiorespiratory fitness and correspondingly we see a higher heart rate and we see a lower heart rate variability.
So active movement, generally in between 7,000 to 8,000 steps is where I typically like people to hit. We know that 10,000 is kind of like that, you know, set standard that was set, you know, a long time ago by the Japanese who were developing pedometers, and they thought this would be a good number. So they set 10,000 as kind of the number, they called it the 10K. But we know that actually, over 10,000 steps won’t improve kind of overall the autonomic response, we know that it won’t hurt it, but it won’t necessarily improve it. So I’d tell people generally around 7,000 to 8,000 steps is what the research has demonstrated to be effective. Go for 10,000 if you can do it, but anything over that, it’s really not gonna be super effective from an autonomic perspective. It’s not gonna hinder it though. So you might as well do it if you wanna do it. And it feels good and helps in other ways.
We also see things, like you mentioned as well, is overall lighting and mood especially as it sets circadian rhythm. So we know that limited light exposure, especially throughout the day, and especially in the morning, if you’re not getting direct sunlight can indeed impact it. There’s been some really interesting studies that have been done on the effects of sunlight and also grounding. So, actually getting out in nature and grounding to nature. The studies that have been published on this, looking at HRV have demonstrated an increase in overall power of HRV. And they’ve looked at a lot more nuance metrics, and that’s one thing to consider too. A lot of these products and consumer wearables only provide one metric. There’s actually about 15 to 20 HRV metrics that can be used that provides us a much better high fidelity snapshot and microscopic snapshot of HRV.
So this study that I’m talking about actually looked at what we call frequency domains which are very much analogous to like EEG brain waves, but for the heart. So we look at the different wavelength components and the power behind those just like we would for EEG brain waves. So this study looked at that and found that when people were grounded and out in the sun, that they had increased HF or high-frequency power. And high-frequency power is mostly associated with parasympathetic functioning, and we know that if we actually put a block on the vagus nerve, then the power within the HF domain or high-frequency domain goes to zero. So we actually know that it’s directly controlled by the vagus nerve, and directly controlled by our parasympathetic nervous system. And they seen increases.
Now these studies, I always put kind of like the asterisk there, because this was a study that was published and probably not saw blue ribbon journal. So I take it, you know, for what it is, it was peer-reviewed. It was interesting. But I like to throw it out there. I tend to be a little bit more…I mean, you know, I co-host the “Ben Greenfield Fitness Podcast” and work within that group. So tend to be a little bit more of the biohacker and a little more fringy than most. So I take it and I run with it, and I’ve seen that anecdotally if you will, with my own anecdata and I like it. So I go for it and I have a lot of people engaging in practices like that.
The other thing that we know really significantly impacts it would be stress. And so that’s encountering stressful situations throughout the day, but especially compounding stress. One of the things that I always hone in on when we think about the human stress response is that we know that the more larger stressors that we experience acutely, so I made kind of the…for instance, if someone’s cutting you off in traffic, which is a very jolting, really quick, but strong, acute response. Those exposures that we have every once in a while, aren’t nearly as damaging to our autonomic nervous system and our human stress response as the “smaller” compounding stressors.
So you as a mom, my wife as a mom, me as a dad, like when the kids are screaming or yelling, you know, at night during dinner, you know, you’re trying to focus on something, those little things, it could be an email that you get, all these little build-up stressors that we experience on a day-to-day basis, they compound. And when they start to compound, and our ability to be resilient to those and adaptive to those aren’t there, or we’re not introducing things to help us with that, that’s where we start to see the most damage, if you will. And so that’s much more concerning to me than those kinds of like larger, more acute.
Now there is an extreme there, right? I mean, if you’re somebody who’s in war, or you’re somebody who gets in a major car accident, or, you know, you have some major catastrophic life event, like that’s gonna affect you in a different way. But, you know, it’s really the one that we focus on and most people experience are the small compounding things, relationships, finances, work, all of the above. We know that those are the biggest ones. And then the next thing that I’ll mention too, that we know has a very large impact on heart rate variability and can tank it, if you will, and also improve it is exercise.
But not exercise in the moment. It’s more like when you start to overreach and when you overtrain. And we utilize HRV as a great proxy for recovery because we know that when we start to see a downward trend of HRV, if we have one down day, ah, not that big of a deal, but if we start to see a downward trend, then that can actually give us a good indication as to, okay, “Is something stressful in life going on that’s tanking HRV, or is it that you’re overtraining or overreaching within, you know, your workouts or your gym life?
So those are things to always kind of consider, and always consider them within their context. And the great thing, again, about a lot of the wearables and why we built Hanu was well, which is my company, is experiment with them. See what impacts it, see what doesn’t. And you know, you’re gonna have sometimes where you know it’s gonna impact it. Like for you, you mentioned alcohol for me, it’s for alcohol as well. For most people, it’s alcohol that will do it. You just have to know, like, if you are going to, you know, engage in the pleasures of those things that you like in life that bring you joy, like you might suffer a little bit on your data, but you pick things back up the next day, and you get back at it, and you recover, and you repair.
Katie: Yeah. I think that’s important context as well is that I will always…I often choose people and experiences even over knowing some of my health data. So I’m not gonna drink wine every night and I’m not gonna stay up late every night, but if there’s a chance for bonding with people and social connection and relationships, I will choose that sometimes even knowing my data. And I love that you use the word anecdata as well because I realize we have to separate this, of course, from the scientific literature that we have. But also I say a lot, we are each our own primary healthcare provider and our own data can very informative, especially if we know what to do with it. And it sounds like there’s a lot of crossover here, obviously with stress and HRV and that improving our resilience to stress is gonna have a big impact on all of these things happening within our body. So let’s talk a little bit about that, and maybe also line up a little bit with sleep and how we can improve that.
Dr. Jay: Yeah, indeed. When we look at the literature and this is strong literature, by the way, this has been published in thousands among thousands of peer-reviewed blue ribbon journals. When we look at the single greatest mechanism for raising HRV, and I wanna put this…like a huge disclaimer before I say what I’m about to say. At the beginning of the podcast, remember I recall that I said HRV is a proxy. It is data. It is information. And we have to remember that that’s what it is. It is data and it is information. But what is it a proxy for? What does it mean? Because we don’t wanna get into this sport of like gamifying it, like, “Oh, how high can I raise my HRV?” Well, for what? Like, what does that actually mean? “Oh, my HRV is low.” Well, okay. But what does that actually mean?
In a minute I also wanna talk about why we need to also marry our subjective experience with objective data, and why our subjective experience is actually more important than our data. And, you know, I should be the fox guarding the hen house in that I own a health tech company that is a daytime, you know, monitor of stress and HRV, but the subjective experience, in my opinion, and as a psychologist, is way more important than the data. We just use the data as, again, a proxy. It gives us insight, it gives us information. So with that said, when we look at the literature, the single greatest mechanism for raising HRV baseline is really increasing cardiorespiratory fitness. And by increasing cardiorespiratory fitness, I’m really talking about exercise. And I’m talking about doing two forms that have been found in the literature to be quite helpful.
One would be endurance training, and the second would be resistance or weight training. So resistance training is highly effective in building overall strength and muscular endurance. And so we see that as being effective. We also know that it’s extremely effective in increasing overall mood state and reducing depression, regardless of whether or not you’re doing endurance-type training. So this is resistance training.
Now, when we look at endurance training some of the greatest research that I’ve seen is looking at kind of moderate level exercise or so-called zone two exercise. So zone two exercise is a lower heart rate level. It’s a lower lactate threshold level. Really the best to know whether or not you’re in zone two is you actually see whether or not you can hold a conversation. That’s a little bit strainful, might be a little bit difficult, but you can still hold a conversation. And if you get past that point, then you’re probably in an upper threshold zone three or maybe entering into zone four. Zone five would be like high-intensity interval training, like really intensive heart rate, like almost max heart rate type exercise.
And these can be extremely effective in increasing cardiorespiratory fitness. So when we say cardiorespiratory fitness, we’re really just talking about how fit is your heart, and how fit is your cardiovascular system, how fit is your respiratory system? So that is one way of doing it. So if people are not engaging in exercise, then it’s always my pitch for why exercise is extremely important for stress resiliency, but also too for autonomic nervous system functioning.
The next thing that I really focus in on, and the research really focuses in on is the utilization of direct tools for changing autonomic nervous system, and autonomic control and regulation in the moment. And what that is is breathwork and HRV biofeedback. So there’s this whole field of study referred to as HRV biofeedback, which is a very tech-savvy way of calculating or quantifying the effectiveness of breathing, of breathwork. And so, you know, I’m board-certified in HRV biofeedback. There’s a lot of probably individuals within that domain who would think that’s heresy for saying that, but that’s really what it is. It’s a way of looking at the physiological changes, utilizing your biology as a feedback mechanism when you’re engaging in breathwork practices. So HRV biofeedback is a well-established field. This is one that has been published tens of thousands of times, HRV biofeedback efficacy that is, but it’s been demonstrated to be extremely helpful. And yes, raising baseline HRV but the most important thing, and this is the tool that I tell people is the most important, is it teaches people good autonomic control.
So what does that mean? And here’s the example I always give, if someone had an HRV of, let’s say, 100 and another person had an HRV of 50, a lot of the modern-day individuals, again, and we’ve already dispelled this myth, but I’ll say it again, a lot of people would say, “Oh, it’s probably the person with the 100 HRV, they’re the healthier individual. They’re the less stressed individual. They’re the,” you know, you fill in the blank. And if somebody were to tell me that, I would say, “No, absolutely not the case.” What would be the case is looking to see how much control they have over their autonomic nervous system. Well, you would then say, “Okay, well, how would you know that? Like, what would you do to do that?” Well, you would do HRV biofeedback and you would see when someone engages in paste breathing, they increase respiratory sinus arrhythmia, which is the peak-to-trough differences in heart rate across the respiratory cycle.
So the way to think about it is that when we inhale, the heart is gonna speed up and that’s because the vagal brake is coming off. And this makes sense, right? There’s more oxygen that needs to be delivered to the brain, to the body, to vital organs. And so when it senses that it’s present because you’ve inhaled, time to speed the heart, to pump it out to all the organs. And then as you exhale, the vagal brake is put back on. And if you extend your exhalation out, the vagal brake is applied even more. So we can think about that. Inhale as relinquishing the vagal brake, heart rate goes up, exhale, heart rate goes down.
The longer that we extend that cycle, to an extent, that breath cycle and slow it down, the more we’re gonna increase heart rate variability because if we increase those peak-to-trough differences across the respiratory cycle by slowing our breathing down, we’re gonna inherently increase the variability across the cycle. So when people ask, what is the major influencer of heart rate variability? It’s respiratory sinus arrhythmia. It’s the peak-to-trough differences in heart rate across the breathing cycle. So that’s my pitch for everybody now, as they’re listening to the podcast to slow breathing down.
So back to heart rate variability biofeedback. What we will do within this type of training is that we have people find what we call their resonance rate, a resonance frequency. And we built this into our app here at Hanu. What it does is it looks at your optimal breathing rate and from research, we know that everybody has…and this is adults, by the way, has an optimal breathing rate somewhere between as high as 6.5 breaths per minute down to 4 breaths per minute. And we can actually run a test called a resonance frequency assessment that will find that optimal rate for the individual.
Once we find that rate, we know that that rate actually is going to do a couple of things. It’s gonna be the rate that increases that respiratory sinus arrhythmia the most. It’s going to increase heart rate variability the most. And it’s also gonna help with blood pressure regulation. The reason we know this is because when we find that resonance rate, the reason it’s called resonance is because it resonates with what’s called our baroreflex mechanism. The baroreflex mechanism is a homeostatic mechanism that regulates blood pressure. And what I mean by regulates blood pressure is that it makes sure that it’s stable. When we’re stressed, we can actually change our blood pressure thermostat. If it experiences it over and over and over again, then blood pressure will actually go in that direction. And so it can become kind of like baseline or normal at that point, but be way too high for medical standards and where we need to make change.
So if we influence the baroreflex mechanism, that actually means that we make it more sensitive and more adaptive. In other words, we make it listen to us more. And the great tool behind this, Katie, is that we just have to use our breathing. Breathing is the best way to regulate that baroreflex mechanism and increase HRV. And so we do so through biofeedback. Now, do you need fancy-schmancy biofeedback equipment and to use devices? You don’t, and that’s the cool thing. You just need to pace your breathing. What I like about biofeedback and what the research demonstrates in biofeedback is it helps with conditioning.
So, conditioning mean that we can change our breathing pattern, and subjectively we can say, “Oh, man, yeah, I feel it. Like, that was really nice. Like I feel a lot less stressed.” And that’s well and good. But if we also see, “Oh, my goodness, there’s objective data here that also coincides with what just happened. It’s not me just subjectively thinking I feel better, but I also see the data that demonstrates I feel better,” then people are much more likely to make it a habit and come back for more, and experience that dopamine release and want it over and over and over again.
So I love it as a great tool. I tell people, you don’t have to use technology and wearables in order to do something like heart rate variability biofeedback, but it’s a great way to keep you motivated because you’ll see that change. So that’s my pitch. Now, if you wanna know kind of like what is kind of like the established research standard for how often someone should be doing something like heart rate variability biofeedback, there really is no standard. However, most clinical biofeedback that’s done with people with clinical anxiety, depression, PTSD, they’ll do it typically 25 minutes, twice a day. So it’s a lot. Fifty minutes a day. I tell people, if you can do it 5 to 10 minutes a day, you will see significant results.
And there’s research to also demonstrate that as well. Most people aren’t necessarily experiencing clinical disorders, like clinical anxiety and depression or PTSD, there are many individuals like that, obviously. And I think it would be good to try 25 minutes, twice a day. But for most people, they could benefit from 5 to 10 minutes a day. So again, I know I can go on and be verbose, but those are a couple of ways. There’s other ways too. If you want me to mention, there’s some other things that have been demonstrated in the research to also be highly effective, and I can get into those as well.
Katie: Yeah. Let’s touch on those briefly. And then we’ll circle back a little bit more about the training and biofeedback side.
Dr. Jay: Sure. Yeah. So the other ones that are really effective that I use daily, and this also have been found in research to be highly effective in modulating HRV, but let’s go ahead and replace that with strengthening resiliency to stress, would be elemental stress exposure. And what I mean by that is heat exposure, hot exposure, and cold exposure. So what we know in the literature, and this is fascinating research. I mean, I’ll have to send you the study via email because it’s one of the most fascinating sauna studies that I’ve ever seen. Is that when individuals engage in sauna sessions, we know that if you take a baseline HRV before session, and then you take an HRV baseline about an hour after your sauna session, you will see significant improvement after sauna sessions. Now, during a session, your HRV is gonna tank, your heart rate’s gonna increase like crazy.
And as it should, these are hormesis, this is hormetic stressors, but it’s made to build you back bigger, faster, stronger. So there’s a lot of things that’s occurring within the sauna session that are extremely helpful. I mean, we have the activation of heat shock proteins, the activation of sirtuins. But we also have the ability to mimic exercise. Now, I’m not saying to dump exercise for sauna sessions, but in conjunction with exercise, it can be really great. I mean, you wanna exercise because you want muscle protein and synthesis. I mean, you want a lot of the other growth factors from a muscular standpoint, but we can influence or mimic some of the cardiovascular benefits of exercise via sauna.
So sauna is one of those. I typically like to recommend about 19 to 20 minutes, 3 to 5 times a week for this, but the research has demonstrated, and it’s so cool that you can increase just within a time period of one hour the baseline HRV from start to finish after a sauna session. So I love heat exposure, but I also love cold exposure.
Now, cold exposure can take…it can look like many different things. So I think there’s kind of like a tiered system. And I like the way that Andrew Huberman puts it. Like at the top tier would be like cold plunging. So it’s actually getting into a cold plunge for anywhere from two to three minutes. It doesn’t have to be long. Long enough to really kickstart noradrenaline, to kickstart epinephrine, and to kickstart dopamine. All three of them happen when we get into the chronic heat…or I should say acute heat exposure and acute cold exposure. So a good cold plunge is really effective in HRV. And there’s great studies on that as well, that was sent over by the guys who own a company Morozko Forge, Tom Seager. Dr. Tom Seager sent me some amazing research on HRV and the effectiveness of cold exposure.
The other thing is like cold shower, something we could do, like a three-minute cold shower can be highly effective as well, or even filling up a tub with cool water that’s cold as it will go, and sitting in it so that you don’t have to buy, you know, 20 pounds…you know, 20 bags, I should say, of ice and fill up the tub. So those are two you that I really like. The last one that I’ll mention for HRV, which is really important as well, and I talk about it a lot on my podcast, is nutrition and inflammation reduction. So we know that individuals who are eating really poor quality diets, standard American diets, it’s high in, you know, linoleic acid and refined processed seed oils, refined processed sugars.
When inflammation markers go up, we always see a one-to-one correlation of these autonomic nervous system markers go down. So we know that as C-reactive protein or homocysteine go up, we see HRV markers go down, we see heart rate go up. We even see respiratory rate go up in comparison and correlation with those markers. So I always like to hone in on nutrition and ensuring that people are eating a really high-quality whole foods diet, they’re being tested for these inflammatory biomarkers. And they’re looking at them in comparison to these other markers that we’re taking that are great direct measurements of the autonomic nervous system. So this is just the few I wanted to add in outside of biofeedback.
Katie: I love it. That was super comprehensive. And to echo what you said, I’ve noticed the biggest difference personally for myself, when I do HIIT strength training workouts every week. I’m also a big fan of sprinting a couple of times a week for the effects that has. And then just supplementing that with that low-level zone two stuff, which might be just walking, might be jumping on a trampoline with my kids, just moving around, even like organizing my house, like pretty quickly can get in that zone too. And then same with sauna. I think if sauna were a pill, everyone would take it because the studies are absolutely phenomenal. And I know it’s not inexpensive or easily available, but it’s definitely something that I prioritized in our budget because of how profoundly it can impact health.
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But I do think, really to echo your point, is breath might be the most underused tool that we have. And it’s something that we’re all doing obviously all the time, but we don’t necessarily think about. And when you said that four to six breaths per minute range, I know from Oura Ring data, most people’s respiration rate is much higher than that on average. So I’m really curious if we start training breathing through some of these feedback mechanisms, can we actually create a lasting change in that, even in the times when we’re not training?
Dr. Jay: Yeah. Phenomenal question, because I’m asked this one all the time, right? They’re like, “Okay. So you talk about breathing at this rate of, you know, you resonance rate 4 to 6.5 breaths per minute. But my Oura Ring says I’m at 16 breaths, or I’m at 17 breaths. Like what’s going on here? Like, am I able to significantly change that?” The one good clarification that I wanna make here is that when you are practicing this breathwork, this HRV biofeedback resonance type breathing, you are doing something and making changes to your physiology that are not normal. They’re not hormetic stressors. And they’re not stressors at all. They actually are engaging parasympathetic and vagal outflow and output. But they’re not normal. So if I were to see somebody breathing at that slow of rate, when they had like Oura Ring scores, I would think, “Uh-oh, like, this person has apnea. This is not good.” Because they’re, like, cutting off breathing.
So we can see that as you increase cardiorespiratory fitness, as you increase biofeedback or breathwork training, that that will indeed go down. So respiratory rate will go down, but we’re not talking about to the rate of like 4 to 6 breaths per minute. We might see it go down from 16 to 14, or maybe even 13 or 12 at times, which would be a lot lower than what the person was breathing at. But we won’t see it go down to like six or so. So really that type of breathing pattern is going to be a very conscious way of us manipulating respiratory rate to condition the nervous system. What we are intending to do with biofeedback is to train that so that it…train that response so that it becomes reflexive. It becomes a response that we go to immediately without conscious thought when we experience a stressor.
So initially you have to practice over and over and over again, but the end goal or the end result would be for you to get through a stressor and look back and be like, “Whoa, did I just get through that? Like what was I doing? Oh man, my breathing was slow. We want it to become reflexive.” So I tell people the more and more you train it, just like you would in exercise. Like for a marathon, you wouldn’t train one day, and then just go out and try to run a marathon, right? You’d train over and over and over. The same thing happens within our cardiovascular system, and our autonomic nervous system, is that if we train it over and over and over again, and we say, “This is what I want you to do when, you know, the going gets tough,” then it does it.
And if we can have that goal accomplished, then that’s a huge success, right? Because now we’ve gotten to where we have a tool that initially, yeah, we might have to consciously think about using it, but it’s always readily available. It’s accessible. It’s easy. No one has to know that you’re doing it, right? And it works every single time. Now, it may not cause a significant reduction in HRV or even in stress reduction. But we know that changing breath regardless of whether or not we see movements in HRV or reduction in subjective stress has immense physiological benefits elsewhere, especially baroreflex change and in other avenues. So yes, you can indeed shift respiratory rate, but not to six or four breaths per minute.
Katie: Really important distinction. I’m glad we talked about that. And I’ve noticed that…I listened to the Huberman podcast episode with Dr. Andy Galpin as well, and I’ve been trying to be more conscious of how I’m using my breath, especially in between sets of workouts, and then post-workout, and then also pre-bed. And that seems to have like a cumulative good effect the more we do it. But I’m really excited for technology like yours that lets us actually see that data in real-time, and kind of train it more consciously. So let’s talk about that understanding now this foundation we’ve put in place for all the things that come into play here and only tracking in relation to yourself, not other people. What are some of the tangible ways we can use, tools like HRV in our training and improving other areas of our life, our stress resiliency, and talk about your platform as well?
Dr. Jay: Yeah, absolutely. So, one of the things that I did is I noticed, and myself and the other co-founders of Hanu, which is my company, we saw that there was a gap in the marketplace of wearable technology. A lot of wearable technology does a couple of things well, and then a couple of things wrong. The things that it does well is that it provides you with pretty good data. The one problem though, is that it provides you with data information, but it doesn’t help you to close the loop. It doesn’t tell you exactly what to do about it. It doesn’t tailor the data to you. And that can be problematic because, again, if you’re just checking your Oura Ring or your Whoop or whatever in the morning, you’re just seeing the score, but you don’t have anything tangible to do with it, well then, I’m not sure how useful that data is.
It was just information. What we need is to really close the loop. What we saw is that on the market right now, there’s really nothing out there that really hones in on stress and stress resiliency. But we know that it’s something that is a huge market because almost everybody, I would say everybody, you can try to fool me and tell me you don’t experience stress, but you’re not gonna fool me. Everybody experiences stress, right? This device that we’ve created is a continuous daytime stress monitor and a stress radar. So it’s looking at continuous HRV, continuous heart rate, continuous respiratory rate. And it’s making sure that you’re not deviating away from what is normal for you. But when you do, we’re gonna alert you. So it actually will vibrate on you to say, “Hey, it’s time to check in. Like your metrics look like they’re a little off.”
You wanna do some training and we give you the action, the call to action right away to get you into biofeedback immediately. And so with that, the biofeedback will start, you pace your breathing, and then we can see the effective change. And then you can rate it and say, “Yeah, you know what? This really helped me out today. This really took my stress level down.” And we created this proprietary algorithm and composite score that we call the stress resiliency score. And what the stress resiliency score is, is it’s kind of like a really good composite score that indicates kind of your 0 to 100 scale. Like this is kind of where you are. And it modulates throughout the day, depending on your data, depending on your training. It also allows you to log life events.
So when we give you an alert and we say, “Okay, it looks like something’s a little bit off with your nervous system right now.” You can tell it, “Yeah. You know what? It is, I’m stressed. Like I was just, you know, writing an email or reading an email, like to my boss.” Or like, “Yeah. You know, my kids were just screaming and yelling while I was cooking dinner.” Or, you know, whatever the event happened, you were able to log that and then look back over time. Like, “Oh, man, over the last like month, the thing that’s stressing me out the most is finances.” Or, “The thing that’s stressing me out the most is work.” Or, “It’s, you know, kids.” Or, “It’s my spouse,” or whatever it may be. So that allows you to track, you know, throughout the day.
So this is really meant to be worn all throughout the day to monitor you, to help you out. But we say too that, yes, we are tracking data, but we don’t wanna overemphasize data. Like the intention behind this is really for you to focus and become more self-aware of when you’re stressed, and then better self-regulate your stress response. Because self-awareness which you get from a lot of wearables is great, but self-awareness without self-regulation is totally incomplete. So we really want to give you the tools to close the loop, have really good data, use the data for what it’s intended to do, and then close the loop to really help you to see the effectiveness of it, and continue to draw upon that.
Katie: Well, I’m very excited to try it and I will definitely report back on what I learned. And I always love having actionable data, not just data. And this is really exciting that we have this much understanding and now tangible tools to be able to use it for positive change. I love that it gives feedback throughout the day. So it pays attention when you may not even be paying attention and can give you feedback. As we get close to the end of our time, a couple of last questions I wanna ask. The first being, if there’s a book or number of books that have profoundly influenced your life, and if so, what they are and why?
Dr. Jay: Yeah, there are. There are three books that come to mind. The first one would be Viktor Frankl’s “Man’s Search for Meaning.” So any good psychologist is probably gonna say that. It’s just a phenomenal book, especially in looking at trials, tribulations, and how someone who can go through something as egregious, as atrocious, and traumatic as being in a concentration camp, and can find meaning and value from that situation. It’s like, I need to be able to do that in my own life if someone can do that. So that book has really shaped my view of existentialism, of really making sure that what I’m doing, my behaviors are in line and they’re congruent with my value system. And they’re congruent with my sense of meaning and purpose. So, Viktor Frankl’s “Man’s Search for Meaning,” if you haven’t read that, that’s one.
The other two, one would be a book called “Radical Candor” by Kim Scott. And it is one of the most phenomenal leadership books that’s all about clear messaging and providing kind of everybody, even in regular relationships, not just work relationships, with clear compassionate messaging, but one that allows for a challenge, one that allows for criticism, but isn’t you being obnoxiously aggressive. So “Radical Candor” is a phenomenal book for, especially for people who are looking for, “How can I be more assertive, but still, provide compassionate value within my relationships and within my workplace?”
And then the last one is a good buddy of mine, Patrick McKeown wrote a book called the “Oxygen Advantage,” which is hands down, my favorite breathwork book that really focuses on how we can change the biochemistry, cadence, and mechanics of breathing to affect systematic change, improve performance and wellbeing, and enhance overall mental acuity and mental performance. So, those are my favorite. I got plenty of others too. I’m a big reader, but those are three great ones.
Katie: I love it. I will make sure those are linked in the show notes for anyone listening. And I will order those. I’ve read “Man’s Search for Meaning,” but I’m gonna order the other two. And I will also, of course, make sure that there are links to Hanu so people can check that out. I’m gonna pre-order because I’m really excited to get a picture into that. Thank you so much for your time and being here today. Do you have any parting advice for the listeners today?
Dr. Jay: Self-Awareness and self-regulation. Just check in throughout the day. Don’t try to convince yourself that you’re the stress superstar. Stress impacts everybody and it’s okay if it beats you down every once in a while, because it’s going to. It’s not about how much it beats you down, it’s how much you recover from it and you become adaptive and you become resilient. So, being self-aware, being mindful of our stress, and then self-regulating with the easiest mechanism that we can, breathing.
Katie: I love it. Super grateful for your time today. I learned a lot and I’m really excited to keep learning more. Thank you for being here.
Dr. Jay: Thanks so much, Katie.
Katie: And thanks, as always, to all of you for listening and sharing your most valuable resources, your time, your energy, and your attention with us today. We’re both so grateful that you did. And I hope that you will join me again on the next episode of the “Wellness Mama Podcast.”
If you’re enjoying these interviews, would you please take two minutes to leave a rating or review on iTunes for me? Doing this helps more people to find the podcast, which means even more moms and families could benefit from the information. I really appreciate your time, and thanks as always for listening.
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