How To Improve Your HRV Score: 8 Ways According To Science
“Life is 10% what happens
to you and 90% how
you react to it.”
Charles R. Swindoll
I’ve written about how HRV can be used to assess the impact of daily stressors like air pollution, work, sleep, and alcohol and ways you can use it to your advantage. Today I will cover 8 evidence-based ways to increase your HRV for better adaptation to stress and recovery from stress to improve your health span.
How (And Why) To Improve Your HRV Score
We’ve all heard about the guy in his 40’s who had a heart attack or the man who died from a stroke but appeared to be “so healthy” because he wasn’t overweight and maybe he ran a few days a week. Slid in with the sentiments of how great of a person they were are utterances about “bad genes” and destiny.
More than likely though, this tipping point of health is, in part, due to the gradual accumulation of inflammation from years of low- to very high-level negative stressors that were never mitigated or addressed. It’s death by a thousand cuts.
Life is a balancing act and if we eat clean, get our 8 hours of sleep, and hit the gym 5 days a week we’re moving the needle in the right direction but if we’re simultaneously showing contempt to our significant other, we’re dehydrated, and we have a constant underlying sense of anxiety at work then we do not have true balance. If we don’t have true balance then we don’t have true health.
Humans are extremely complex organisms with millions of factors truly impacting our health. Those factors can be boiled down to six important buckets that determine our true well-being. I call these the 6 dimensions of health which are comprised of movement, nutrition, sleep, social support, mindset, and the management of stress. We have control over each of these and each of these has an impact on our lifespan and our healthspan which is shown in our HRV scores.
The Highs And Lows Of HRV
Just as using a continuous glucose monitor (CGM) can tell us when our blood sugar is too low or too high, HRV tells us if the branches of our autonomic nervous system–the parasympathetic (rest, digest, repair) and the sympathetic (fight, flight, freeze) is high or low. If our blood sugar is too high we look for the causes: not enough sleep, too many carbs at one time, food sensitivities, stress, etc. If our HRV is too high we’re able to do the same thing.
A low HRV is linked to a greater likelihood of injuries, chronic pain, cardiovascular disease, anxiety, and depression. Someone with a low HRV tends to look more tired, stressed, sick, and wears a mask of negativity. Having a consistently low HRV means that you are not adapting to or recovering from stress well and you are likely chronically stressed. This low HRV does not have to be very low either. It can just be a number that doesn’t fluctuate toward the “high” category. A low HRV is considered less than 60 on most devices.
On the other hand, a high HRV means that you are adapting and recovering well from stress. This is associated with better focus, blood pressure, pain tolerance, performance, and a calmer state of mind. Someone with a high HRV tends to have a stable mood, a positive outlook, and a plow pushing through any stress or obstacles that might weigh down others. A high HRV is considered greater than 90 on most devices.
If you’re dipping your toes in the water of HRV for the first time, there are some important things to note. First, a constantly high HRV is not optimal (see my previous post on this). Also, there is no ideal number to hit for your HRV. These numbers are very individualistic so what is ‘high” for you might be 15 points lower for me. Track your “scores” consistently and look for patterns. Many of us don’t know our weakest pillars of health (ever met someone who claims they are laid back and everyone’s eyes roll?). Stay open-minded and use HRV to zoom out and lend some insight into yourself too.
So how do we become that perfectly well-rounded human specimen? I have no idea but here are 8 scientifically-proven ways on how to improve your HRV and point you in the right direction.
How To Improve Your HRV
1. Brave The Cold
Cold water is like good alcohol. No one likes it the first time but once you do it enough and realize how it makes you feel, you come crawling back for more. In a 2018 randomized study, participants were exposed to cold water for a mere 4 bouts of 16 seconds resulting in an increased HRV and a decreased heart rate.
Cold water to the skin (particularly the head and neck) activates a built-in mechanism called the mammalian diving reflex which induces breath-holding, bradycardia (slowed heart rate), and decreases physiological distress.
Do this:
The effects of cold water immersion travel well beyond HRV to impacting immune function, cognition, and inflammation among a host of other benefits (as Rhonda Patrick easily organizes here). At the bare minimum, put cold water on the back of your neck. Work up to ending your cold showers with the coldest water you can tolerate for 30 seconds and then gradually increase your duration.
2. Discipline Your Kids Consistently
What does a parent-adolescent relationship have to do with your HRV? A 2017 study sought to find out. Researchers used psychological assessments, questionnaires, and HRV readings to analyze the relationship between 97 youth (11-17 years olds) and 81 parents. After crunching the data, the study concluded that “Inconsistent discipline and corporal punishment were negatively associated with adolescent resting heart rate variability, while positive parenting and parental involvement were positively associated.”
Do this:
Having a better relationship is easier said than done and can’t be taught in a paragraph but there are some easy actions you can take to help.
The first step for healthy parent-adolescent relationships is something that should go without saying; don’t use corporal punishment of any kind.
Make sure to have a united front when it comes to discipline with your significant other.
Decide on a “firm, fair, and consistent” discipline approach (although be adaptable based on the situation and the state of your child to the act).
Read. The book No Drama Discipline is a great starting resource for parenting strategies to help navigate difficult terrain as your kids' brains rapidly develop and challenge us. See my list here for more book recommendations.
Related:
3. Drop The Grudge, Maximize The Love
Strong relationships are the keys to health and happiness as the longest study on happiness recently reported. Good social support is thought to promote stress resilience in a variety of ways including through “psychosocial factors, such as fostering effective coping strategies, and through effects on multiple neurobiological factors.” According to a 2018 study, “Individuals with high HRV reported less stress in social life, but not in family life, work life or everyday life.”
Do this:
Even if you are stressed at work or in your own home, having healthy social relationships can help offset your stress. Build good relationships, stop being a part of those who do not value who you are, and be sure to curb bitterness. When you harbor grudges, jealousy, or resentment it ends up having a strong grip on you (and your health). In fact, contempt in a marriage is the “single most corrosive behavior in a relationship” and the greatest predictor of divorce. Drop these negative emotions.
Related:
4. Down That Water
Yes, everyone knows the importance of staying hydrated (as evident by the status symbol of your water bottle). But dehydration (considered a 0.6% drop in body weight) showed a negative impact on cognition, mood, and HRV, according to a 2019 study that reviewed two randomized controlled trials. They also showed a relationship between HRV and anxiety, pointing out that dehydration-associated increases in anxiety are linked to decreases in HRV.
Do this:
Practice basic hydration strategies. Make sure you drink to thirst, get enough electrolytes through your diet (including sea salt), and eat foods with high water content such as fruits and vegetables. If you tend to be a heavy sweater or an athlete, or don’t feel as if you’re getting enough electrolytes then consider adding a sugar-free electrolyte powder to your drink like LMNT packets, which I do regularly.
5. Prioritize Sleep
Track your HRV for any length of time and you’ll notice a relationship between sleep quality, sleep duration, and your HRV. A 2020 study very bluntly sums this up stating, “poor sleep quality is negatively related to HRV.” Another study, Acute Stress Affects Heart Rate Variability During Sleep, concluded that the impact of HRV during sleep may be associated with chronic stressors “which are associated with significant morbidity and increased risk for mortality.”
Do this:
Making quality sleep a priority is one of the most important things we can do for our minds and bodies. Practice good sleep hygiene habits such as going to bed at the same time each night, avoiding screens, food, alcohol, and stress 3 hours before bed, and wearing a sleep mask.
Related:
6. Yoga More
I guess there’s a reason that yoga hasn’t died after 4,000 birthdays. Yoga is “associated with improved regulation of the sympathetic nervous system and hypothalamic-pituitary-adrenal system.” according to a meta-analysis of 42 studies on the exercise. Improvements included a higher HRV as well as a reduction of cortisol, blood pressure, resting heart rate, and fasting blood glucose.
Do this:
Incorporate some sort of yoga into your day. Start with a sun-salutation routine in the morning using the Down Dog app or do Yoga with Adriene before bed.
7. Breathe Slow
It’s said that the quality of your breath is the quality of your mind. That sounds like an exaggeration but in truth, your breath is the most impactful tool we have for regulating our autonomic nervous system.
I am always surprised at how difficult it is for many of my patients to slow their breath to be able to do resonance breathing for any period of time. After many, many observations of people trying this breathing pattern, I believe that the more healthy you are the more difficult it is to truly slow your breath down. (The participants in this study couldn’t even do it.)
Do this:
Get better at breathing by practicing a form of guided breathing in quiet environments. Choose a breathwork guide through your media du jour (apps, YouTube videos, podcasts, etc.). Once you feel comfortable doing this intentional breathing, use your HRV monitor as a biofeedback tool. Then, most importantly, integrate these patterns into your day. Take long, slow, and deep (think “LSD”) breaths frequently. The more you do this the more interoception (self-perception of sensations) you will have and the easier it will be to incorporate this breathwork into lower-HRV moments.
There is no shortage of intentional breathing strategies that can elevate your HRV. The most basic of these is simply breathing slower (source, source). The structured version of this is resonance frequency breathing (aka resonance breathing, coherence breathing) which is supported by research, including one aptly titled “How Breath-Control Can Change Your Life: A Systematic Review on Psycho-Physiological Correlates of Slow Breathing.” Simply take 5.5 breaths per minute by inhaling for 5.5 seconds and exhaling for 5.5 seconds per breath for a higher HRV. See my articles below for more simple, but effective, breathwork techniques.
Related:
8. Green Leafy Veggies Are King
In addition to weight loss and eating a Mediterranean diet, research has found that the foods that increase our HRV are “omega-3 fatty acids, B-vitamins, probiotics, [and] polyphenols.” That same study, published in Behavioural Pharmacology in 2018, also concludes that high intakes of foods with saturated fat, trans fat, and high glycemic carbs decrease HRV.
In another study, 586 older men were tracked over a 7-year period in the Normative Aging Study. Researchers concluded that green leafy vegetables have a positive impact on HRV (although no effects were shown for the other foods tested such as fruits and fish).
Do this:
It should be no surprise that eating a variety of nutrient-dense foods plays an important role in your health (which would then be reflected in your HRV). Make these foods stapes in your diet and limit the processed foods which often contain trans fats and glucose-spiking carbs.
Related:
How I Increase My HRV
For me, the key to stress management and a high HRV is routine. That which I do consistently is that which I do.
For cold, I end each of my showers with at least 30 seconds of the coldest water possible (except in the summer when the water doesn’t get cold enough). For breathwork, I incorporate box breathing during the showers to help me handle the chill and I also meditate daily before bed, practice breathwork (such as resonance breathing or extended exhales) at times of stress for me (long lines, hitting a standstill on the highway, a tantruming kid).
My wife and I practice a consistent approach to discipline and have open conversations about how we can handle situations better next time. I eat a nutrient-dense diet with a huge, colorful salad with at least one of my meals and I make sure I drink enough that my pee is a light beer color.
Takeaway
When thinking about how to improve your HRV score, what you’re really thinking is how do I improve my body’s adaptability to stress for better health?
Looking at it one way, constantly having slight dehydration, getting to bed an hour late, mind-wandering for much of the day, and not being on the same page as your partner when disciplining your kid can each wreak havoc on your health. When they’re put together over a lifetime, the underlying health issues will come to fruition but not always the cause (who attributes inconsistent discipline with longevity?).
Looking at it with a more glass-half-full approach, the incorporation of good daily habits can be life-changing. HRV is a proxy for the state of your nervous system which is the state of your health. None of these points, taken individually, will likely drastically improve your health but each holds a significance that often goes unrecognized until you become aware of it.
Start by incorporating one of the above strategies at a time. Maybe begin with the cold exposure each morning then add in the breathwork next week.
Start small, get better.
What are you going to do to improve your HRV score today?
