Episode Transcript
[00:00:00] Speaker A: Welcome to the Heart Rate Variability Podcast. Each week we talk about heart rate variability and how it can be used to improve your overall health and wellness.
Please consider the information in this podcast for your informational use and not medical advice. Please see your medical provider to apply any of the strategies outlined in this episode. Heart Rate Variability Podcast is a production of Optimal LLC and Optimal HRV. Check us out at optimalhrv.com Please enjoy the show.
Welcome friends to the Heart Rate Variability Podcast. I am Matt Bennett. I am here with Friend.
I know you'll take this as a compliment, fellow HRV nerd and just somebody who is doing maybe some of the most practical work in HRV with her coaching with what she's doing with those autonomic health folks in Richmond and vcu. Just friend of the show, one of my favorite guests, Stephanie White. Welcome back.
It's been a it's been a bit since we've had you on, so if if you're not familiar with Stephanie's previous episodes, you may want to go back specifically on our YouTube channel and I'll put the if you're listening to this just by audio, I will put the link to the YouTube video in the show notes of the audio so you can quickly jump to that. If you're listening to us in a car, you might want to listen to the entire episode, but Stephanie always brings really, really good PowerPoint slides to show the data. So I would highly encourage you to look at this on YouTube as a follow up or supplement if you're just hearing our voices now. So Stephanie, just in case people haven't caught some of your past episodes, give us a quick introduction of of you and your work.
[00:01:58] Speaker B: Oh boy. Okay. I completely own HRV Nerd.
In some circles I'm known as the HRV guru.
We'll talk about FDN coaches, but you know, some of the FDN coaches call me the HRV Guru and I do own that URL by the way. Oh, nice that in case I ever want to go with it.
But yeah, I had astronomically low heart rate variability back in 2016 when I had both cancer pots and chronic fatigue and lymphedema diagnosis simultaneously. I mean, I was in a la Z boy, four hours a day, pneumatic pump, couldn't do much except for breathe. And so while I was doing my four hours a day breathing, I learned everything I could about heart rate variability. Watched everything. Dick Verts, Roland McCrady, Stephen Porges optimal HRV wasn't around around. When did you guys start?
[00:02:56] Speaker A: We're about five years old at this.
[00:02:58] Speaker B: Point, so it wasn't an option at the time. But.
[00:03:03] Speaker C: I became a manufacturer's rep for First Beat, was trained by Tim Wiles at Renovo Advantage, who was also supplied heart rate variability devices to people like Jack Ginsburg, who was doing great work at the VA in Columbia, South Carolina. When Matt stepped aside, I inherited a lot of his amazing clients. So I'm well connected in the heart rate variability biofeedback research world.
I train their clinicians to use this in their practice because doctors are now recognizing that biofeedback helps so many not only mental health issues, behavioral health issues, it is a game changer for physical health issues.
[00:03:51] Speaker B: Yes.
[00:03:51] Speaker C: I'm blessed to work with a group of doctors at VCU here in Richmond, Virginia who are, have the center for the Comprehensive Autonomic Center.
[00:04:04] Speaker B: And so, yeah, they're, they're doing great work and they're incorporated in the doctor's offices. They're, they're recommending that people do this, you know, 20 minutes a day in order to help their physical health issues. And so we're learning from that experience and I'm sharing those things with you.
[00:04:18] Speaker A: Awesome. Well, let's dive into it. I, I know when you reached out, you were. And this is. I, I love when episodes can get here because times we talk about research as one of our focuses is key, but you know, really in the field and what's unique about sort of this conversation is you're, you're training sort of an army of HRV nerds to go out into the world and spread the gospel that you and I absolutely do a long time ago. So, you know, I'm curious. You shared a little bit with me, but I just know a tiny bit of sort of what you're seeing. I know you were, you were talking about healthcare visits, interactions with providers. So set us up for what you are seeing out there in the world.
[00:05:06] Speaker B: I am seeing a common roadblock to getting the results clients want on the optimal HRV app.
And so I'd like to share it with you so that not only do.
[00:05:21] Speaker C: You know it, but clinicians know it.
[00:05:24] Speaker B: And their clients who are using the.
[00:05:26] Speaker C: App for this recommended practice know it.
[00:05:30] Speaker B: Because there's at least one scenario where for love nor money, you can't get.
[00:05:35] Speaker C: The DAG on optimal zone.
[00:05:38] Speaker A: Interesting.
[00:05:39] Speaker B: So I'd like to share that with.
[00:05:40] Speaker C: You just to give people a heads up.
[00:05:42] Speaker A: Great.
[00:05:43] Speaker C: This is what could be going on and you know, here's some things you.
[00:05:46] Speaker B: Might want to do about it.
[00:05:48] Speaker C: So just to Set the stage.
[00:05:51] Speaker B: A lot of people like Ina, for example, have a clinic, and what the client uses in the clinic to work with Ina is different than what she sends them home to practice on.
[00:06:02] Speaker A: Sure.
[00:06:04] Speaker B: And so to put this all together, you have to access to both the clinician side and the optimal HRV practice side. But I'd like to show you what can happen.
So I'm going to try to talk everything out so you can hear what's happening. But as Matt said, there are slides that go along with this.
Can you see it, Matt?
[00:06:28] Speaker A: There it is.
[00:06:30] Speaker B: Awesome. So we're going to call this Heart Rate Fragmentation and Very High Frequency because it's a combination of the two and you'll see why in just a second.
And so there is not only my past episodes because this piggybacks the most recent one I did, but your episode on heart rate fragmentation, you might want to list that one too, because she does an excellent job of talking about what heart rate fragmentation is.
So, yeah, on the Optimal HRV app, everybody wants to be in the Oz zone.
And so you feel really good. You get warm fuzzies when you're in.
[00:07:11] Speaker C: The green and you're in the optimal zone.
[00:07:13] Speaker B: It tells you, keep up the good work.
[00:07:14] Speaker C: That's where we want to be. But there's actually a scenario where that might not be possible.
[00:07:19] Speaker B: Through no fault of your own, this client.
[00:07:21] Speaker C: I'd like to share that.
[00:07:22] Speaker A: Awesome.
[00:07:23] Speaker B: And so I want to caution people, don't jump to this conclusion. Your first weekend to using Optimal hrv.
It could take a couple of weeks for your results to smooth out. So don't freak out if you're. If this is happening the first week, you start using it. But if you get to two months in or three months in and you're not getting in the optimal zone, it may be worth looking into further.
So I did want to throw that out there.
But as you're using the app, optimal Optimal HRV gives you one screen that immediately is what you see when you finish with your biofeedback reading. And it's got the low frequency, your all time average, low frequency, the max min, and the max min, all time average.
If you go into the history and optimal hrv, it's going to give you a little more detail. It's going to tell you the low frequency, the high frequency, the very low frequency, the RMSD and the sdnn. So just as a teaser to my past podcast episode, what I was noticing with this folks, a lot of people and even a lot of doctors believe that RMSSD is the HRV statistic. You should be paying attention to what we're noticing. I'll go back over it real quickly, but by the very definition of a sine wave pattern, SDNN actually does better just to blow it up. On this particular reading for biofeedback, The STNM was 47.6. The RMSSD was 19.95.
So I am finding my best breathers. STNN is two times or more what their RMSSD is. So that's one public service announcement. Don't look at RMSSD when you have a beautiful sine wave pattern. STNN is going to be what shows that. And the ratio of RMSSD to sdnn, you know, is going to be important. And that's going to help you recognize if someone's starting to pick up that sine wave pattern or not.
[00:09:23] Speaker C: So that was something I shared last episode.
And so I shared why that occurs. Because RMSSD is calculated beat the beat to beat differences. And because a sine wave pattern by its very nature has more beats at the top and the bottom, RMSD gets small.
But by contrast, because SDNN is calculated the difference from the median and the sine wave pattern, you're trying to get a high max min and you want a tall sine wave pattern, the SDNM blooms and gets taller.
So SDN is going to get much better. And I think it helps to see the graphics to understand.
Yeah, statistics.
[00:10:06] Speaker A: Yeah, this is worth going to the YouTube video.
[00:10:09] Speaker C: Yeah, these two graphics are worth going to the YouTube video. Because a lot of my coaches just, they get to the end of my prior version of the eight week course and they're like, RMSSD and SDNN still don't make sense to me. And so I'll come up with an extra class where we calculate it by hand and we graph it.
[00:10:26] Speaker B: And then they're like, oh, this makes perfect sense.
[00:10:30] Speaker C: So for my people that are struggling, I do have an extra class. You know, we're gonna do this by hand and you are gonna know it when we get through with this. Awesome. And so that's made all the difference in the world for them. So I want people to understand this.
[00:10:43] Speaker B: But I want to share a different pattern.
There is a pattern called heart rate fragmentation.
And the easiest English definition is something hijacks the signal and your heart rate goes from fast to slow, fast to slow, fast to slow. Either every other beat, which is called the alternon's pattern, every other beat, it jumps up and down, fast, slow, fast, low.
So there's no sine wave pattern there's a sawtooth pattern or, you know, one step above the ultranaun's pattern is when you get every three beat pattern.
And so there's a middle beat in there somewhere. But every three beats, that cycle's repeating itself because something has hijacked the signal and you've lost the cardiopulmonary coupling that's needed to get that beautiful sine wave pattern that you see when you're doing your resonance frequency breathing. So this can happen. I'll talk about why in just a little bit. But when this happens, the statistics look completely different.
So on the SDNN side, because you're doing it from the mean, SDNN never gets to bloom because you're just oscillating around the mean.
But on the RMSD side, RMSSD gets really big because you've got the maximum difference beat to beat to beat to beat. So in this case, it's the flip. RMSSD gets big, SDNN gets smaller, almost half. It's if it's perfect.
So the reason I share that, and this is another observation from the field, I want my practitioners to know two is important.
[00:12:33] Speaker C: The number two is important in four different situations.
[00:12:37] Speaker B: When STNN divided by RMSSD is greater.
[00:12:40] Speaker C: Than two, you've got a beautiful sine wave pattern. This is when you're measuring resonance frequency breathing.
So if you can't see the trace.
[00:12:50] Speaker B: This is a statistical way to look.
[00:12:52] Speaker C: To see if you could see the trace.
[00:12:54] Speaker B: There's a beautiful sine wave pattern.
[00:12:57] Speaker C: But the flip side, if RMSSD divided by SDNN starts to approach two, you've got heart rate fragmentation. And that is the true Alternon's pattern where it switches every other beat.
So more homework needs to be done.
We talked about last time when CVNN is less than 2, it's debilitating activities. Daily living can kick people's butt.
And the other thing I want to point out, when it's a true heart rate fragmentation, Alternon's pattern that switches every two beats, that shifts the power out to what we're going to call the VHF range.
And to my knowledge, VHF isn't reported on any application or any software program currently in existence.
If you're a clinician using a robust system, you can dump your raw data out to kubios and you can manually set cobios to report it, but you do have to manually change it.
[00:13:56] Speaker B: And.
[00:13:58] Speaker C: I want to raise this awareness because if you don't look, you may not see it because your settings cut it off.
So it could be occurring, but you just don't see it because you set your settings too low.
[00:14:11] Speaker A: Got it.
[00:14:11] Speaker C: And so clinicians who are working in the physical health space, I think they.
[00:14:17] Speaker B: Need to have the awareness that when they're looking at their raw data, they need to change their settings to see power all the way out to 0.9.
High frequency stops at 0.4.
But I think you need to go all the way out to 0.9 to be able to see what I'm calling the very high frequency, which is 0.4 to 0.9.
When I did a lit review two years ago, there were only 18 articles that talked about very high frequency. So this is a very under recognized phenomenon and you only see it in the alternates pattern. And there's very few people doing heart rate fragmentation research, so it isn't well known. But in my clients, I'm seeing it a lot. So we need to raise awareness.
[00:15:03] Speaker A: So can I, can we go back to that slide real quick? I want to make sure before we move on. So heart rate fragmentation. I know we've done a whole episode on it, but for those that may have missed that, can we get a working definition?
[00:15:17] Speaker B: Well, heart rate fragmentation is when something hijacks what's influencing the heart.
And instead of the heart being an amalgamation of circadian rhythms and hormones and parasympathetic and sympathetic, there's something else involved. And we may not know what the something else is, but there's something else involves that literally makes the heart erratic. And it, it can go from like 80 to 90. 80 to 90.
[00:15:48] Speaker C: 80 to 90.
[00:15:48] Speaker B: If you calculate the insinuating this heart rate.
[00:15:50] Speaker A: Yeah.
[00:15:51] Speaker B: If you can see the heart rate trace, instead of a sine wave or a chaotic pattern. It's a sawtooth pattern.
[00:15:58] Speaker A: Yeah.
[00:15:58] Speaker B: And so that leads me into this graphic.
[00:16:01] Speaker A: Could I also have you define cvnn because you threw that out there with the word debilitating. So. So I wonder, like, oh, I hope I don't have that, but I don't know what that might be. So can you speak? Just help our audience know what, what we're talking about with.
[00:16:19] Speaker B: Yeah, this is what we talked about on the last episode I did with you about new HRV statistics.
[00:16:25] Speaker A: Yeah.
[00:16:25] Speaker B: Because this isn't being used.
I needed a statistic that measured the severity of symptoms or allostatic load or fatigue or whatever you want to call it.
I needed a statistic that varied and could clearly say, you know, this, this is pretty extreme. But not only does it do that as people's resonance frequency breathing gets better, the number climbs.
So it can Measure continuum. When it's high, you are a rock star at resonant frequency breathing. When it's below 2, the allostatic load or the vital voids in your body, you know your body can't do something, something's broken.
When it's bad, it gets to two or below. And I haven't found a person that's two or below that can do activities of daily living and it not kick their butt and put them in the bed.
[00:17:25] Speaker A: Great. Awesome. Thank you for doing that for us.
[00:17:28] Speaker B: And so the reason I bring that up is if we can get researchers to start to recognize and use this, I think this could be a measurable way to document Social Security disability, even short term work disability.
Right now the gold test is a two day CPAT and the doctors at VCU won't even do it because they think it's unethical because it intentionally brings on a crash that could take weeks to overcome.
I think 24 hour heart rate variability with a CVNN could one day.
[00:17:59] Speaker A: Be.
[00:17:59] Speaker B: That what two day CPETs are doing.
So it stands for coefficient of variance.
[00:18:04] Speaker C: Of the normal to normal.
[00:18:06] Speaker B: It is the SDNN divided by the mean rr.
So in most packages you have the numbers you need to calculate it.
[00:18:13] Speaker C: In optimal HRV's clinician platform, it's in the download that the clinician can get who's supervising the optimal HRV practice.
[00:18:23] Speaker B: So if you're working with clinician and you're doing your practice, your clinician can calculate that for for you. Awesome.
Both at rest, your morning readiness reading and during your resonance frequency breathing because it will bloom and get better and show as your skill increases, this number will increase.
[00:18:42] Speaker C: So it's a statistics that's not being.
[00:18:44] Speaker B: Used, but I'm finding it extremely useful.
[00:18:48] Speaker A: Very cool.
[00:18:50] Speaker B: Yep, yep. Lots of potential. That's. You know, Matt keeps saying in a lot of his podcasts aren't. Don't we have any new statistics? Isn't there anything new? We're still doing the. Oh come on, there's got to be. This is new. It's, it's an old concept based on metrics we know and love already, but it does give you subtly different information. That's very helpful.
[00:19:12] Speaker A: Great.
[00:19:15] Speaker B: So yeah, it's a saw tooth pattern.
And so at, at the, at the most picture perfect textbook example, you go from high to low, high to low, every other beat.
True sawtooth. And so when it's true sawtooth pattern, the it's changing so fast.
If you plot out the power spectrum, you're going to see power past 0.4.
Because you know, these patterns can switch every half second, every second. And so it's a very fast frequency that these changes are occurring.
And so if you change your HF zone, instead of 0.15 to 0.4 in cubios, if you change it from 0.15 to 0.9, you'll be able to see that power past 0.4.
If it's at its worst and it's truly switching every other beat, the other place you can see it is on the point care plot.
I call them Easter eggs.
In a typical point care plot, you have an Easter egg that's leaning to the right, there's ellipsis that leans over to the right, which follows the SD2 line.
When you've got true alternate ends pattern, your Easter egg lays to the left and it's wide and it goes along the SD1.
[00:20:39] Speaker C: That is not normal.
[00:20:42] Speaker B: So you can clearly see it on a point care plot, if a point care plot is available.
And so every other beat is the worst form.
If it changes every third beat, that's.
[00:20:56] Speaker C: Still serious, but it's a milder form.
[00:21:00] Speaker B: And so when it changes every third.
[00:21:01] Speaker C: Beat, your point care plot has three clusters of points.
You know, one's typically high to the right along the SD2 line. One's, you know, far to the upper left along the SD1 and the others lower to the right along. Yes. So you can kind of see a tripod appear on the point care plot because you've got a three beat sequence that's taken over.
[00:21:26] Speaker A: Yeah.
[00:21:27] Speaker C: The way that the heart's beating. And when you get the three beat sequence, because the timing of those three beats is a little bit longer, you're still in the traditional HF range, but you're high point twos.
[00:21:41] Speaker A: Okay.
[00:21:42] Speaker C: Low point threes. And so you start to think, I don't think the person's breathing this fast.
So if you know they're breathing at 5 in, 5 out, this is inconsistent with that. That's a 0.1 frequency.
[00:21:56] Speaker A: Yeah.
[00:21:56] Speaker C: And so just so you know, I love bcia.
I don't know that they've got a learning objective for BCI certification that you're able to use frequency math.
One of the classes I teach is frequency math. If you know one of these things, you can calculate the other three.
So if you know that the peak frequency is 0.281 divided by that peak frequency is going to give you the seconds per breath, which is 3.6.
If you take the seconds per breath divided by two, that's going to give you the inhale, exhale, which is 1.8.
And if you take 60 divided by the seconds per breath, it's going to give you the breaths per minute. So the peak frequency of 0.28 is 16.8 breasts per minute. If they were getting this when they were resonance frequency breathing, five in, five out, you know there's a disconnect, right? Something hijacked the signal.
[00:22:50] Speaker B: So for my clinicians, I want them to know how to use frequency math and determine when there's a mismatch between the respiration rate and the peak frequency, because that's a big red flag that thumbs up.
So, yeah, something's hijacked the signal. We can't tell from heart rate variability what hijacked the signal, but something has definitely hijacked the signal.
So knowing that this is happening quite a bit more frequently in the people that I'm seeing with physical health issues that are fatigue related, I'm having to dump this to an outside app to see. And if one day, when apps are upgraded and have the opportunity to add new things, it'd be nice if they would start to report vhf so that we just get a heads up that something else is in there. I keep saying my clients are extraordinary, they have something extra.
[00:23:53] Speaker A: Yeah.
[00:23:54] Speaker B: And so if we could see vhf, that would be our first clue that something needs to be looked at further.
But the other statistic that comes from heart rate fragmentation is pss.
It's the percent of time it changes directions in three beats or less.
And so if that statistic were provided, it would be another way for us to know something's hijacked in the signal.
Because if you're breathing in five and five out, there ought to be five or six beats, you know, between, you.
[00:24:27] Speaker C: Know, when you go from high to low.
[00:24:31] Speaker B: And as I've mentioned in the prior.
[00:24:32] Speaker C: One, it would be nice to have CV and then.
[00:24:35] Speaker B: But how do you calculate pss?
I've thrown this in there for anybody who really wants to geek out.
You can real quickly make an Excel spreadsheet that does this.
I'll just throw that. It's very easy to do.
And if you look, if the PSS is between 0.2 to 0.5, it's considered a smooth, coherent rhythm. If it's 0.6 to 0.8, it's transitional, mild fragmentation. But when it's above 0.9, it's a highly fragmented state.
And so if we knew this off the practice, it would just be helpful not to have to go anywhere else to Know that this is occurring.
Any questions about that, Matt?
[00:25:18] Speaker A: No. I mean. Well, are we ready for questions? Because I do have questions, but I want to make sure this is a good spot to start asking them.
[00:25:27] Speaker B: Ask and then I'll go on.
[00:25:28] Speaker A: I think so. So one of the. So, you know, one of the things is, as I think about one of those people that has an app, you know, like, with very high frequency.
Yeah, I guess what I.
Let me just throw the question that's in my head and then maybe you can help me even reframe it better. Is, you know, one of the metrics where. Well, one of the situations where high frequency seems to be a measure that's actually catching on more and more popular is with normal breathing. So when you do your morning rmssd, normal breathing, high frequency comes in there, and I'm just thinking about, like, oh, maybe we could set the high frequency scale like you did, to show that longer and include that in high frequency. But so I'm just kind of like sitting here with high frequency. You know, you've got the controlled breathing with the resonance frequency breathing. You've got the normal breathing.
Are we. Is there any.
Is very high frequency have anything to do with normal breathing rates? Would it be a good metric to track in that realm as well? Or are we just talking about the resonance frequency breathing?
[00:26:45] Speaker B: That is an excellent question, and I think Ina will back me up on this answer.
I have not only been trained in heart rate variability by feedback, I've also been trained in CO2 tolerance.
And so if a person hyperventilates, their CO2, gets out of whack and causes anxiety, causes air hunger, causes a sympathetic surge.
So typically, Hyperventilation occurs over 21 breaths per minute, maybe 30 breaths per minute.
So it is important to differentiate between high frequency and very high frequency frequency, because if the respiration were truly in the very high frequency range, they are hyperventilating, and that is not healthy.
[00:27:44] Speaker A: Okay.
[00:27:45] Speaker B: And so to answer your question, it's not satisfactory to expand HF out to 0.9.
[00:27:51] Speaker A: Gotcha.
[00:27:51] Speaker B: Because if they were truly breathing at that rate, it is not good.
[00:27:56] Speaker A: Sounds good. And if it should probably then show up in a normal breathing, I mean, because you, you do work with, you know, a specific population that we. We need to include.
You know, I want this to be usable for your folks, right? You know, as well as elite athletes and everybody else in between, you know, and so, like, is. Is there any, I guess, value to measuring that during a normal breathing reading? It sounds like, yeah, very high frequency during normal Breathing. You probably need to go to the emergency room.
[00:28:31] Speaker B: Well, not the emergency room, Matt.
[00:28:32] Speaker A: Okay.
[00:28:33] Speaker B: It.
Yeah, definitely. I want to be clear. Not the emergency room.
But it bears further evaluation. It's not an emergency. It is not a 911. Call the ambulance, go to the emergency room. But it is exhausting.
[00:28:49] Speaker A: Yeah.
[00:28:51] Speaker B: It is not efficient and it will wear your body down over time if the cause is not identified and resolved.
[00:28:59] Speaker A: Gotcha.
[00:29:00] Speaker B: But it's not an emergency.
[00:29:02] Speaker A: And then you may be about ready to answer this. And if, if you can't, if you are, that's great. So getting very high frequency during a resident's frequency breathing session.
Does that feel like hyperventilation for.
[00:29:21] Speaker B: No, it doesn't.
[00:29:21] Speaker C: No. No.
[00:29:22] Speaker A: Okay.
[00:29:23] Speaker B: Person doesn't necessarily even know what's happening.
[00:29:26] Speaker A: Okay.
[00:29:26] Speaker B: It's news to them.
And so interestingly enough, you know, I've got some people, if they do a 10 minute reading, they'll have this fragmentation all 10 minutes.
And I've got some people that do a 10 minute reading and it'll be fine for a minute. It'll do this for 20 or 30 seconds and then it'll be fine and then it'll do it for 20 or 30 seconds. I almost want to take them to Charlottesville where they do ECG and resonance frequency breathing simultaneously to see there's a brain cause or a bear, you know, if there's any costs $20,000 to have the continuous blood pressure monitors. See if the barore receptors are bouncing. Something's bouncing on and off and you need high dollar equipment to analyze that. But I.
It can, it can be intermittent.
[00:30:19] Speaker A: Yeah.
[00:30:19] Speaker B: But it can hurt.
[00:30:20] Speaker C: It can occur during your morning readiness.
[00:30:22] Speaker B: Readings, your normal resting readings, sitting in the doctor's office. It can be while you're doing your residence frequency.
It can be all 24 hours in severe cases.
So there are neurodegenerative, autoimmune and cardiac cardiovascular reasons why this could occur.
[00:30:43] Speaker C: And so further evaluation is needed. But there aren't a lot of doctors who can work it up from the heart rate variability perspective.
[00:30:53] Speaker B: They work it up from the symptom perspective.
They don't know heart rate variability.
[00:30:58] Speaker C: They don't even want to look at it.
You just start describing symptoms for them.
[00:31:03] Speaker B: To work it up their normal way.
[00:31:05] Speaker C: Working with our health coaches, we can help bridge the gap of how do you describe it in terms the doctor will understand?
Because the doctor is not going to understand it in terms of hiv, because they don't do that yet. They're going to soon, but they don't.
[00:31:17] Speaker A: Do it right now and during biofeedback then with the folks that are in that, that very high frequency range, it sounds like some people are there and stay there. Others kind of go in and out of that.
If I can use the, Should I use the word extreme or just.
It's a more.
That's too dramatic to say.
[00:31:43] Speaker B: Extreme is probably true dramatic. And you know, I'm trying to remember the other gal's name she works with Judith Anderson. You know they're doing work with police officers.
[00:31:53] Speaker A: Yes.
[00:31:54] Speaker B: So they're seeing this pattern with police officers and they're saying a certain percent of these patterns occur as you age. It's a normal part of aging.
And in the police officers, they're seeing it happen more when the police officers are stressed.
[00:32:10] Speaker C: Yeah.
[00:32:10] Speaker B: And so police officers have extreme stressful life or death situations that they face.
So I do know from their police officer work they notice it in their police officer work.
So most people would like to be as healthy as a police officer. So I don't want to call it extreme or dangerous.
[00:32:29] Speaker A: Yeah.
[00:32:30] Speaker B: There, you know, as you age or when you're experiencing extremely stressful events, this can happen as a normal part of things.
But when it starts to happen, even when you're resonant breathing all 24 hours, that's a little more serious.
[00:32:49] Speaker A: Yeah.
And so with, with these folks, if they're doing, if they're using our software and we're, we're kind of looking at percentage of time low frequency dominant. Is there like optimal zone scale just stuck at zero the whole time? Do we get any, any sort of movement in that or is it just like the break it? Like if you think about that as a car speedometer, like it's at zero. Like it, it ain't showing anything.
[00:33:19] Speaker B: It can be zero. It can be zero because it gets.
[00:33:23] Speaker C: Swept, it gets switched to the HF or vhf.
[00:33:26] Speaker A: Yes. Yeah.
[00:33:27] Speaker C: And so you know, that's another one of the heads up when, I mean, when it's just so bad.
[00:33:33] Speaker B: Yes.
That.
[00:33:34] Speaker C: That's a pretty good clue. There's something going on that needs further evaluation.
[00:33:40] Speaker B: So yes, it can truly be zero.
[00:33:42] Speaker A: Okay, great.
[00:33:44] Speaker B: Awesome.
[00:33:44] Speaker A: Those are the questions I have for now. So, so keep, keep going, my friend. I'll have more. Trust me, this is great stuff.
[00:33:52] Speaker B: Perfect.
And so remember I said RMSSD can get pretty high because it's. The difference between beats is really high because every other beat it's changing direction.
[00:34:08] Speaker A: Yeah.
[00:34:09] Speaker B: People with chronic fatigue pots long Covid have to pace.
And so depending on who you learned from how to pace. You're given different tools to make your basing decisions.
And so some people tell people to watch their RMSSD on a daily basis and they prefer, you know, some, some tools give you overnight HRV rmssd, some tools give you morning readiness readings, but they tell you based on your RMSSD overnight or first thing in the morning.
If you see this pattern, you can do the xyz, but if you see this pattern, you can't do xyz.
And so the part I want to caution people on is you need to know is it good data or bad data?
Because if heart rate fragmentation exists, you're making decisions on bad data and that's not good. It's going to get people into trouble.
And so we need to grow the awareness of this and grow the manufacturers of these different tools that we're using to know that they need to provide a couple of more numbers.
So we know if we're using good data to make that decision that day or we using questionable data to make that decision.
[00:35:37] Speaker A: And so would would RMSSD then, which is, you know, the typical, you know, one for a three to five minute normal breathing, you know, readiness or morning score.
Would, would this condition at, I mean obviously with the resonance frequency breathing, we're, we may not be capturing everything that's going on with just low frequency and max min.
Would RMSSD without the pace breathing still be give valuable data?
[00:36:10] Speaker B: Yeah, because this fragmentation exists at rest.
[00:36:13] Speaker A: Okay.
[00:36:14] Speaker B: It would still, it would matter of fact what you, what you might see in the beginning, if somebody truly has a degenerative condition, you'd see it in.
[00:36:26] Speaker C: The at rest reading first.
[00:36:28] Speaker A: Okay.
[00:36:29] Speaker C: When you start picking it up in the resonance frequency breathing, that's a further deterioration in the process.
[00:36:36] Speaker A: Gotcha.
[00:36:38] Speaker C: So you'll see it at rest first in the resonance breathing second. Sometimes resonance breathing will correct it, but when that won't even correct that, that's a different level of severity.
[00:36:50] Speaker A: So, so from a practical perspective, let me just make sure, because I think this is a really, really important point. I want to make sure I know it at least.
[00:36:58] Speaker B: Right.
[00:36:59] Speaker A: So with this, you know, population you work with that has, you know, probably couple co occurring things going on.
[00:37:09] Speaker B: Right.
[00:37:10] Speaker A: That's potentially wreaking havoc on the autonomic nervous system.
[00:37:15] Speaker B: Right. And their allostatic load is high as a result.
[00:37:17] Speaker A: Yes. So, so all this stuff going on, RMSSD you would, you would still say is a good useful metric for that morning reading. And if we're seeing, I think I would. If we're seeing very high frequency during that Morning reading. It is a maybe an early warning sign for folks but our messd should still be a good metric. So if we see low.
[00:37:41] Speaker B: No, it's not a good metric.
[00:37:43] Speaker A: Okay. This is where I wanted to make sure I, I was quite aligned with.
[00:37:46] Speaker B: What you were saying. It is not a usable metric because it's reporting the confusion and the chaoticness, not the typical normal variation you see in the heart.
[00:38:01] Speaker A: So sdnn, you would still see that again, normal breathing. Because I think the examples we looked at previously was during a pace breathing session and maybe I've missed that if I apologize if I did. So SDNN would be a better metric to look at for kind of either.
[00:38:20] Speaker B: One of them are good.
[00:38:20] Speaker A: None of them are good. Okay.
[00:38:22] Speaker B: All bets are off.
[00:38:24] Speaker A: Okay.
[00:38:25] Speaker B: When this is occurring because you're really.
[00:38:28] Speaker A: Hitting on and why I want to be really, really specific and I'll just be selfish that this podcast has turned into about me more than it needs to be. But like there are those. Usually there's a pacemaker involved or something like this.
There are those people that I have to question. Okay. You're.
You know, and if he's listening, he'll know who he is because we had a fun conversation about it. You're in your 80s, you're incredibly healthy, but you're still in your 80s, you have chronic heart conditions and your morning RMSSD is in the 160 range.
[00:39:00] Speaker B: Ding, ding, ding, ding, ding, ding.
[00:39:02] Speaker C: So.
[00:39:03] Speaker B: So that's you're describing my person.
[00:39:05] Speaker A: Yep. So. So there you go. Now as I joked with him, give me your heart condition up front so I don't strategize if you get pissed off at me. Before we had, we like said it was a, it was a fun time.
[00:39:18] Speaker B: I could show you some heart rate fragmentation.
[00:39:20] Speaker A: Yes, I know. So like, so, so it's like, you know, with this. And again it's. It's a very small group from, from our overall user population. But it's like how do you make this useful for somebody who's heart condition, pacemaker, whatever the, the medical things like I need to talk to your cardiologist to probably truly figure this out. If you're cardiologist is informed enough to have a conversation with me like to. What's going on here? So that's kind of what's behind my question is, is there anything that we. Is there any value of taking a three to five minute morning reading if none of these metrics are really catching it? And then yeah, I think this leads to your, your new metrics that could be Useful to folks.
[00:40:04] Speaker B: Right. And let me share you an actual example. One of my coaches came to my training and, and so I went through a six month period where when I sent out a 24 hour measurement device, I didn't send one. I sent to and I made the chronically ill and the healthy person wear them simultaneously so they could learn.
[00:40:23] Speaker A: Yeah.
[00:40:24] Speaker B: How drastic the difference is when you're in a chronically ill bottle. And they loved it. It really helped build understanding for what the chronically ill are up against.
But one of the coaches who had.
[00:40:38] Speaker C: Some health issues of her own, she.
[00:40:39] Speaker B: Came to me and we measured both.
[00:40:41] Speaker C: Her and her husband and she says.
[00:40:42] Speaker B: You need to know my husband is the HRV rock star. He has 100 plus RMSSD and by the time it was over it's like.
[00:40:51] Speaker C: It'S not for the right reasons.
[00:40:53] Speaker A: Right.
Yeah.
[00:40:56] Speaker B: Now I've got some ways we can help most people, but yeah if for him he was an HIV rock star and he, he boasts to everybody around.
[00:41:08] Speaker C: Him that his little tools are telling him this but it was not the right reason.
[00:41:12] Speaker A: Yeah, yeah.
[00:41:13] Speaker C: And when you're plus yeah.
[00:41:16] Speaker A: We don't talk about in the research nearly enough in my opinion. Like there's just not, there's not sort of that recognition. So you know, this is why I believe what you're saying is so absolutely crucial is how do we incorporate this and you know, while still providing the meaningful data for exactly the people within two deviations of the, you know.
[00:41:41] Speaker C: Right.
[00:41:41] Speaker A: Most people, RMSSD is, you know, high frequency SDNN are going to be those good measurements of this three to five minute reading. But then how do we assess or help those individuals who are 80 and thinking that they're, you know, then the next incarceration of whatever because they got a 200 RMSSD and you know what wants you to, you know, kind of recognize their greatness. Which I, which I did because it's amazing how healthy this person is. But yeah, yep, yep, yep, yep.
[00:42:15] Speaker B: Absolutely.
And by the way, so when I download your data as a clinician and I, I look for the problem spots, another one is PNN50. When PNF M50 gets close to 100, there might be something going on.
So I, I didn't share that in the slides but in some people it gets that bad.
So that's another thing that can, can be thrown off.
[00:42:43] Speaker A: Yeah.
[00:42:44] Speaker B: But yeah, I just want to people be aware that. And so like for the research that's going on, you know, when you write your research grant you have to put.
[00:42:56] Speaker C: Who'S Going to be included in the.
[00:42:57] Speaker B: Study and who's going to be excluded? Yeah, people need to, as part of the initial workup of who's going to be included in the study, they need to get a baseline reading and they need to exclude people who have this happening or it's going to screw the results.
[00:43:13] Speaker A: Yeah.
[00:43:14] Speaker B: And so for researchers, I'm also training them, you need to write your inclusion exclusion very specifically to exclude people who had this from day one because your research isn't going to get, it's not going to be usable. It could be skewed for reasons that are beyond their control.
So please test for this before you.
[00:43:37] Speaker C: Start the research project. So these people aren't included in the study.
[00:43:40] Speaker A: Yeah.
[00:43:43] Speaker B: That'S really important from a research perspective.
And so HRF can increase RMSSD for the wrong reasons. Exactly what we've been talking about.
So for future research opportunities, I think it's important to know when is HRF occurring, which is kind of what we talked about. Is it all the time?
Is it only at rest? Is it during the resonant frequency frequency breathing? Is it only under stress?
We know it increases as you age. I could have put that, but that could, that could be helpful. And also is it getting worse over time? Because as I said before, there's cardiovascular, there's autoimmune, and there's neurodegenerative processes that could cause this to occur over time. And in people who, you know, have a documented history, it's worth it to check those things out.
[00:44:36] Speaker A: Yeah.
[00:44:38] Speaker B: So this has some opportunities for research, but it also has some coaching opportunities. So as you know, I'm growing a network of coaches, army of coaches who can help people with a variety of physical health issues.
Because we do know that resonance frequency breathing can help manage those symptoms, if not improve the symptoms.
And so a first line of defense, when someone comes to us and has that pattern, we have a software package called Cronometer. We can plug in what they eat, you know, for a day or for a week. And we can, we can also plug in their supplements and we can see if there's any holes.
Because if there's any holes in your nutrition, your body doesn't have the ingredients, like not putting gas in your car, your body doesn't have the ingredients to do its job and that could be causing the problem.
And so what we found is minerals in particular are essential. And they're bulky. Most people aren't getting enough minerals.
[00:45:46] Speaker C: And if you are a high performance individual or a highly stressed individual, you may be burning through minerals two to three times the recommended daily allowance. Because stress increases the need and utilization of these.
The sinoatrial node, which is the pacemaker in the heart that sets the beat rhythm, is completely contingent on having enough calcium, sodium and potassium.
[00:46:12] Speaker A: Okay, I was going to ask you which minerals we were. We were speaking of here.
[00:46:17] Speaker B: Yeah. So it is completely dependent on calcium, sodium and potassium to do its job.
But those three can't stay in balance without enough magnesium. Magnesium is the smart plug of the cells.
[00:46:29] Speaker A: Yeah.
[00:46:30] Speaker B: So all of my coaches, except for one, are FDNs, Functional Diagnostic Nutritional Practitioners. We've been certified by FDN and air certification allows us to use functional tests to help our clients solve their health mysteries. We're all health detectives.
And so one of our functional test is the htma, which is a hair tissue mineral analysis, which will let you know where you stand on these four based on a hair sample.
Because often what you see in a blood test does not mean it could have been utilized adequately.
Your hair actually gives you a better indication of the utilization and the sufficiency, you know, based on the stress and the other things that you're experiencing in your life. So based on your hair tissue mineral analysis, we can see, you know, are you using them well? Are you getting enough? Are you out of balance?
You're getting enough of one, but not the other. We have functional tests that we can run.
And I can tell you that over half the people that have these patterns, initially, when we dial that in, it disappears.
[00:47:44] Speaker A: That's great. Yeah.
[00:47:45] Speaker B: Yes.
So for the majority of people, there is an easy fix. And minerals are cheap. This is not expensive supplementation or it's not expensive at all.
[00:47:56] Speaker A: But I mean, we're talking kind of multi. I mean, multivitamins can get a bad rap, you know, are we talking.
[00:48:02] Speaker B: Here's the funny. Here's the funny thing. I challenge you to read the contents of your multivitamin. Minerals are so bulky, they're not included in the multi environment.
[00:48:11] Speaker A: Oh, interesting.
[00:48:14] Speaker B: And so, for example, for my regimen that is based off the recommendations of the POTS treatments that are in Dallas, my multivitamin, which is a whole food multivitamin, I have to take six tablets a day. I split it across. They don't have the minerals in them.
[00:48:29] Speaker A: Yeah.
[00:48:30] Speaker B: I have to take a separate eight tablets to get the minerals. Plus, because I'm in a highly stressed body, because of my health conditions, I have to take another four on top of that based on my heritage mineral analysis.
[00:48:42] Speaker A: Okay.
[00:48:43] Speaker B: So if you're taking my significant other takes one Multivitamin a day? Yeah, one pill. It's dark green. He's been taking them all his life, that one. If you're taking one multivitamin a day, you're not getting all I get. Yeah, they are bulky. We're talking a lot of capsules.
[00:49:04] Speaker A: Gotcha.
[00:49:06] Speaker B: But we're having success. You know, when we solve that problem, this disappears.
[00:49:11] Speaker A: That's great.
[00:49:12] Speaker B: So I want to know people there, there might be an easy fix. And I want, you know, executives and small business owners and competing athletes to know you need to dial in your mineral intake to your body's mineral utilization.
If you don't, your cardiovascular and cardiopulmonary system, I mean, all these things can get misaligned and that is inefficient. You cannot play your A game and not dial that in.
[00:49:41] Speaker A: Excellent.
[00:49:42] Speaker B: That's really important.
So we've got that.
And to give a plug when people ask me for advice, we're all but one. And the one that's not an fdn, she's a licensed physical therapist.
So Reed Davis started the FDM program.
[00:50:02] Speaker C: He's got a dress for success.
[00:50:06] Speaker B: Plan.
[00:50:06] Speaker C: That'S diet, rest, exercise, stress and supplementation.
His plan could almost identically be covered in your book the Heartbeat of Business.
[00:50:16] Speaker B: When you guys are interviewed about what.
[00:50:19] Speaker C: You do to improve your heart rate variability, which is identical to the recommendations that are in the AFIB cure book, all three of these sources are telling the same thing. There are basic lifestyle things that you can do that make a difference.
[00:50:35] Speaker A: Yeah.
[00:50:36] Speaker C: And unfortunately we live in a culture where people want to go to the doctor and get a pill. Yeah, you can't get a pill to fix what your behavior screwing up. The only way you can fix it is to change your behavior.
So because of that, I want to create.
By the way, I went to BCIA last year before they met and said, would you create a certification for health coaches?
They came back and said, thanks, but no thanks. All of our certified individuals have to have a health related degree.
I am going to have to create a different track for health coaches.
[00:51:13] Speaker B: I want to create a board certification for HRV behavioral health coaches.
There's a level one coach that can use a tool like optimal HRV and do the basic coaching with an individual and if they run into problems, kick it to a level two coach.
Level two coaches are going to be master behavioral coaches that can use raw data and other tools to analyze what the problem might be.
And in that they'll also be able to be able to use capnography for CO2 tolerance training because it's an important piece of the puzzle.
And then our third tier coaches will be licensed master behavioral health coaches that can bill insurance for these services.
Because some of the doctors that treat the chronic fatigue, the pots, the long Covid and the other things, they need a licensed medical professional that they can refer to that can bill insurance because not everybody can pay out of pocket.
So the first two health coaches are definitely out of pocket. Insurance is not going to cover.
There is a health coach organization that's trying to get health coaches covered by insurance and they are making inroads and we will dovetail that if it ever becomes available.
But right now, only the third tier of coaches could bill insurance for their services.
And so my two coaches that have doctorates of physical therapy, one chooses not to work with insurance, the other works with insurance. So those people will have the option to provide these services and be billed by insurance.
So I absolutely see the need for this. Yes, we're doing it and we're, we're tackling physical health issues as well as emotional, mental, traditional mental health issues. Because at some point people will begin to understand you can't separate the two.
[00:53:09] Speaker A: Right, Exactly.
[00:53:10] Speaker B: It's the body, the body, the mind, body connection.
[00:53:14] Speaker C: It's integrated.
[00:53:15] Speaker B: This is integration.
[00:53:17] Speaker C: And so we can deal with both. And I think that's my. Oh.
Because I use 24 hour HRV. That's why it says HRV. Behavioral Health Coach. We can measure success.
[00:53:30] Speaker B: We can do a 24 hour pre.
[00:53:32] Speaker C: We can do a 24 hour post and we can get measurable differences to prove you're moving in the right direction.
[00:53:39] Speaker B: And you're getting the results that you're paying the health coach to achieve.
[00:53:42] Speaker C: So people go to health coaches for a transformation. We can measure the transformation.
[00:53:47] Speaker A: That's awesome.
[00:53:48] Speaker C: And so that's really important and that's going to ultimately be what builds doctors competence and our ability to get results is the fact that we can provide measurable success.
[00:54:01] Speaker A: Love it.
Well my friend, it is always a master class.
[00:54:08] Speaker B: I appreciate you.
[00:54:10] Speaker A: Yeah.
[00:54:10] Speaker C: So.
[00:54:11] Speaker A: So obviously we're gonna put this in the show notes as well. But I mean I, I gotta assume knowing our audience, how do I join Stephanie's army? So. Well, just, just give a little plug for your, your, your coaching training with that because I don't think we've talked a ton about.
[00:54:31] Speaker B: We haven't. My website is measurable resilience.com.
if you go to the promotions, the starting place is my eight week course which will be the beginning stages of the behavioral health coaching program. It can be taken by the client or the practitioner, either one and then the education progresses from there depending on what the person's interested in. But the entree to learn all of this, there is a starting eight week course that can be purchased directly off of the website.
It will be an online course with live office hours, two hours every week. Right now we meet Wednesdays 10 to noon. As we get more participants we might expand the options to have like a nighttime office option or a weekend option. But right now it's a self paced course with live office hours to help you implement what you learn.
[00:55:28] Speaker A: And we'll put that information, those links in the show notes.
Stephanie, always a pleasure my friend. When I saw you popped up on my calendar I'm like oh, I get a nerd out with Stephanie this week which always puts a huge smile on my face.
You always push me in a good way and get me thinking in a good know. So I just appreciate you my friend. I appreciate your work in this area. It's just always a pleasure to talk to you.
[00:55:56] Speaker B: Thanks Matt.
[00:55:57] Speaker A: And as always you can find show notes, resources and everything else at optimalhrv. Com. Thank you everybody and we'll see you next week.
