29 Apr Understanding Heart Rate Variability (HRV) and Why This Health Metric Matters with Dr. Molly Maloof
Heart rate variability (HRV) has become a popular metric on fitness trackers and health wearables, but what exactly is it – what does it measure, and why should midlife women pay attention to it? Should we worry about if it’s low? High? Jumps around? What impacts it? What do we need to know…and what do we do about it?! Recent insights from health optimization expert Dr. Molly Maloof shed light on this overlooked and often misunderstood health marker that could be key to understanding your body’s resilience, stress levels, and overall health.
What is HRV and Why Should You Care?
HRV is connected to your cardio health. HRV measures the variation in time between consecutive heartbeats – how long it takes to beat again between beats. This seemingly simple metric actually reveals your body’s ability to adapt to stress and demands. A healthy heart doesn’t beat in a perfectly consistent rhythm – it shows flexibility, with varying intervals between beats.
HRV is essentially a major marker of resilience and adaptation. When your heart rate is consistently high, there’s typically less variability between beats (lower HRV), indicating your body might be stuck in a chronic stress state and lower cardiovascular health. Conversely, a person with a lower resting heart rate (and higher HRV) has more capacity to adapt to stressors, indicating better cardiovascular health.
HRV acts as a window into your overall health: as we age, our blood vessels naturally stiffen, our heart function may weaken, and our HRV tends to decrease. This makes HRV optimization a key target for improving health, especially for midlife women navigating hormonal changes.
Understanding Your HRV Markers
If you’ve been concerned about the HRV number on your fitness ring or watch, Dr. Maloof offers reassurance. The specific number isn’t as important as understanding your personal baseline and the variations from it. While chest strap monitors provide the most accurate HRV readings, wrist and finger wearables can still offer valuable insights when used consistently.
Rather than fixating on having a “good” or “bad” number, what matters MOST is how your HRV changes in response to your lifestyle choices. If your typical HRV suddenly drops, it’s worth examining what might have triggered this decline – perhaps poor sleep, alcohol consumption, emotional stress, or overtraining.
It’s also important to remember that not all wearables are 100% accurate. The MOST accurate way to measure your HRV is a chest strap, but the rings and watches can still give you a general idea and are a decent visual of your pattern. If it says your HRV is 25, it might not be 25 (because it’s not a definitive, reliable number). BUT, if it shows that you trend one way or another based on things you’re doing, that is probably accurate.
What If HRV is Not Consistent?
An important way you can use your HRV is to determine how well you are recovering from your lifestyle. If your HRV is jumping around day to day – one day it’s really high and the next day it’s really low, it’s best to identify what in your life is causing the jumps. What did you do on the day it was low? What did you do on the day it was high? What happened? What is the difference? Did you drink? Did you have a fight with your spouse? Did you have a really hard workout the day before? Chronic stress can really tank your body’s ability to adapt.
Improve HRV with Sleep and Nighttime Routine
For midlife women (or anyone really) looking to improve their HRV, quality sleep stands as the cornerstone. Undiagnosed sleep issues, from sleep apnea to disordered breathing, significantly impact HRV readings and overall health.
Several sleep-related factors can dramatically affect your HRV:
- Late-night eating disrupts both digestion and sleep quality
- Alcohol consumption, even a single glass of wine with dinner
- Poor circadian rhythm management, including blue light exposure
- Inadequate recovery periods during daily activities
Prioritizing sleep means creating boundaries around evening habits. Avoiding food at least 2-3 hours before bedtime and reconsidering that “harmless” evening glass of wine could make a significant difference in your overnight recovery.
Improve HRV with Stress Management
If you use wearables, pay attention to your Stress Response. Where is your stress throughout the day? Is it consistently high? Are you getting periods of recovery during the day? Many of us in today’s world are NOT getting recovery during the day – we are in a chronic stress/stimulated state. It’s really important to make time to “recover” and decrease stress throughout the day. While meditation benefits HRV, it’s not the only solution – finding personalized stress management tools is crucial.
Effective alternatives include:
- Breathwork practices, particularly box breathing (in for 4, hold for 4, out for 4, hold for 4, and repeat) and alternate nostril breathing
- Supplements like magnesium, CBD, and lavender (oil or as a supplement)
- PEMF (Pulsed Electromagnetic Field) therapy mats
- Acupressure mats
- Relaxing workouts like yoga
- Consistent time in nature and sunlight exposure improving circadian rhythm
- Gargling, singing, and face dunking in cold water to activate the vagus nerve
- Hugging, getting affection
- Keeping a gratitude journal
Dr. Maloof also points to the powerful impact of disconnecting from technology. Creating even a 20-minute phone-free window before bed can help recalibrate your nervous system and improve sleep quality.
The Vagus Nerve, Stress, and Impact on HRV
The vagus nerve is a powerful cranial nerve and is perhaps the most significant influencer of your HRV measurements. The vagus nerve emerges from your brain stem, traveling down both sides of your body into your gut. This nerve creates a bidirectional highway of information, with 85-90% of its fibers actually sending sensory information from your body back to your brain.
The vagus nerve serves as command central for your parasympathetic nervous system—the “rest and digest” response that counters your sympathetic “fight or flight” mode. When your vagus nerve is functioning optimally, your heart rate lowers, digestion improves, and perhaps most importantly, your HRV increases.
Modern life, however, creates the perfect storm for poor vagal function. Chronic stress, constant smartphone use, poor sleep, and inflammatory diets all suppress vagal tone.
Improving vagal tone represents one of the most direct paths to better HRV. When your vagus nerve functions optimally, you’re not just improving a number on your fitness tracker—you’re enhancing your body’s fundamental ability to recover from stress, regulate inflammation, and maintain overall health.
The relationship between vagal tone (the activity of your vagus nerve) and HRV is direct and powerful. During relaxed states when vagal tone is high:
- Your breathing naturally becomes slow and deep
- Your heart rate decreases
- The time between heartbeats lengthens
- Your body can more easily adapt to stressors
To improve your HRV through vagal activation, consider these simple techniques:
Quick Daily Practices:
- Gargling water (which Dr. Maloof calls “phenomenal” for vagal nerve activation)
- Chewing gum
- Singing
- Face dunking in cold water
- Diaphragmatic breathing (lying down and watching your belly rise and fall)
- Yin yoga, which combines long-held poses with deep breathing
- Alternate nostril breathing
The vagus nerve might be invisible to the naked eye, but its effects on your HRV—and by extension, your entire wellbeing—are profound and measurable. By incorporating simple vagal stimulation techniques into your daily routine, you can potentially transform your body’s resilience and recovery capacity from the inside out.
How to Improve HRV with Workouts
Physical activity significantly influences HRV, but the right type and intensity matter greatly. For optimal HRV, consider combining:
- Zone 5 high-intensity interval training 1-2x weekly for 5-10 minutes (to calculate your zone 5, take 222 and subtract your age)
- To optimize your metabolic health, pair these days with eating under 40 carbs
- Zone 2 cardio (approximately 70% of your maximum heart rate) 3x weekly for 30 minutes (to calculate this, take your zone 5 and multiply that by 0.7 to get your zone 2)
- Regular strength training to preserve muscle mass and metabolic health
For midlife women especially, strength training becomes crucial during perimenopause and beyond, not just for HRV but for overall metabolic health and aging well.
How Technology Affects HRV
Our relationship with technology significantly impacts HRV. Constant phone use, social media scrolling, and news consumption can keep our bodies in heightened stress states without recovery periods.
Dr. Maloof suggests examining how you feel after extended phone use and implementing boundaries around technology. Even adding a 20-minute phone-free period before bed can improve sleep quality and HRV over time.
Alcohol and Your HRV
While many midlife women have normalized a daily glass of wine for “stress relief,” Dr. Maloof presents the uncomfortable truth – alcohol consistently tanks HRV measurements. Even moderate consumption significantly impacts sleep quality and recovery.
Rather than viewing alcohol elimination as deprivation, Dr. Maloof encourages women to experiment with tracking their HRV with and without alcohol to see the difference personally. Most discover that the supposed relaxation benefits are outweighed by poorer sleep quality and reduced recovery.
Small, Easy Steps Toward Better HRV
Improving your HRV doesn’t require overhauling your entire lifestyle overnight. Dr. Maloof recommends starting with:
- Tracking your personal HRV baseline and noticing patterns
- Implementing a consistent sleep and wake schedule, ensuring enough sleep
- Leaving alcohol consumption in the dust
- Not eating late at night
- Adding breathwork practices to your daily routine
- Creating technology boundaries, especially before bed
- Incorporating appropriate exercise based on your fitness level
- Considering the impact of evening alcohol consumption
- Prioritizing meaningful social connections
Perhaps most surprisingly, human connection plays a vital role in HRV health. Our modern disconnection crisis affects physical health metrics, including HRV. Regular physical touch, meaningful social interaction, and community involvement all improve vagal tone and HRV.
For midlife women who often prioritize caring for others, creating intentional connection opportunities should be viewed not as self-indulgence but as a health necessity.
By viewing HRV as a helpful biofeedback tool rather than another metric to stress about, midlife women can gain valuable insights into their body’s needs and resilience capacity.
For those looking to dive deeper, Dr. Maloof’s book “The Spark Factor” offers comprehensive guidance on metabolic health optimization, which closely connects to HRV improvements.
Understanding and improving your HRV represents an opportunity to take control of your health trajectory during midlife. Rather than accepting declining resilience as inevitable, this powerful biomarker offers a window into how lifestyle choices directly impact your body’s capacity to thrive through life’s challenges.
The contents of the Midlife Conversations podcast is for educational and informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider. Some episodes of Midlife Conversations may be sponsored by products or services discussed during the show. The host may receive compensation for such advertisements or if you purchase products through affiliate links mentioned on this podcast.
