Heart rate variability is a powerful marker of your cardiovascular health, fitness, and the health of your nervous system.
All these aspects of your health are affected by your sleep, the amount of daily movement and exercise you get, as well as the stress levels you experience day to day and over time.
Unfortunately, sleep, general movement, and heart rate variability are difficult to monitor by your own observation alone.
Lucky for us, wearable health technology has evolved massively in the last few years, and can give us an open window onto this crucial health data.
There are plenty of tools out there that can help keep you accountable to your goals — from the Fitbit to the Whoop band — but my personal favorite is the Oura Ring.
About 50% of my clients use an Oura ring (and I’ve used one myself for the last two years).
For people who are very data-driven and use their data as motivation, having regular blood work is great, but at the most, it’s only going to be collected every quarter.
The Oura ring, on the other hand, gives you daily feedback. You can make changes and find out if your data points are moving in a healthy direction before you do your next blood test.
Personally, I feel like the Oura ring turns me into a health data collection machine.
It helps me get so much more information out of my body than I would ever be able to otherwise. For example, if I start taking a new supplement, I can see any effects happening in real time as the data changes.
The main reason I like it so much is that it gives you three scores each day: the Readiness Score, the Sleep Score, and the Activity Score.
The Readiness Score
Readiness is an overall measure of your recovery that signals your capacity to perform at your mental, emotional, and physical best. Oura monitors signals from your body and picks up on daily habits to determine how well rested you are and whether or not you’re ready for a challenge.
Ranging from 0-100, your daily Readiness Score helps you to identify the days that are ideal for challenging yourself, and those that are better for taking it easy.
This score is based on data from several key areas:
- Heart rate variability: a healthy heart has small variations in the length between beats. Your HRV level can help you to predict if you are overtraining, if you are about to get sick, as well as show the effect on your body from smoking, alcohol consumption, and dehydration.
- Respiratory rate: the number of breaths you take per minute. The typical rate for a healthy adult is 12-20 breaths per minute. A weekly or monthly average of over 18 breaths per minute may lead to low bicarbonate (CO2) levels in the blood and is a sign of stress.
- Resting heart rate: the number of times your heart beats per minute when you’re at rest. Normal RHR for adults is 40-100 beats per minute, and Oura data shows that 50% of their users are between 51-60 beats per minute.
- Body temperature: your body temperature is a powerful indicator of health status and recovery. An elevated body temperature from baseline is a sign that something needs attention.
- Previous nights’ sleep: how you slept last night, ideally a Sleep Score of > 88%
- Sleep balance for past two weeks: if the sleep you’ve been getting over the past two weeks is in balance with your needs
- Previous days’ activity and Activity balance: shows your balance between activity and rest. High inactivity and high levels of activity both lead to a drop in Readiness. This is also a measurement of overtraining.
- Recovery index: A measurement of how long it takes for your resting heart rate to stabilize during the night. Good recovery = stable heart rate in the first half of sleep (6 hours before waking). Negative impact from alcohol, heavy meal before bed, or late exercise.
Heart Rate Variability is one of the most powerful insights we have into our health. It can give us all kinds of data that helps us hone our health strategies to be more effective and to take proactive measures against disease.
The Sleep Score
To tap into the powerful effects of quality sleep, monitoring both your short-term and long-term sleep habits is key. Oura provides the resources to help you do both, giving you a personalized gauge for your sleep quality and insights to help you improve over time.
Ranging from 0-100, your Sleep Score is an overall measure of how well you slept last night. The app will recommend a bedtime based on your data after 2+ weeks.
Factors that contribute to your Sleep Score:
- Total sleep: the amount of total time you spend in light, deep, and REM sleep. Most adults need 7-9 hours to perform well and stay healthy.
- Sleep efficiency: a measurement of sleep quality, or the percentage of time you spent asleep after going to bed. An acceptable cut-off score for good sleep efficiency is 85% with 95% being optimal. Your score will be lower if it has taken you longer than 20 minutes for you to fall asleep, or if you experience one long or multiple shorter wake-ups during the night.
- Restfulness: a measure of your sleep disturbances caused by wake-ups and restless time which have a big impact on sleep quality and daytime cognitive performance.
- REM (rapid eye movement) sleep: REM is important to re-energize your mind and body. This is the sleep stage associated with dreaming, memory consolidation, learning, and creativity. REM can make up 5-50% of total sleep, but on average REM accounts for 20-25% (1.5-2 hours) of total sleep time for adults, and it decreases with age.
- Deep sleep: this is the most restorative and rejuvenating sleep stage, enabling muscle growth and repair. This is when you are most difficult to awaken. Deep sleep can make up 0-35% of total sleep, but on average adults spend 15-20% (1-1.5 hours) of their total sleep time in deep sleep. This percentage usually decreases with age.
- Latency: sleep latency is the time that it takes you to fall asleep. Ideally, falling asleep should take no longer than 15-20 minutes. Falling asleep in under 5 minutes can indicate that you are not getting enough sleep for your needs.
- Sleep timing: when you go to bed and wake up. The midpoint of your sleep should fall between midnight and 3 AM, allowing for some variability for morning and evening chronotypes — read more here to find out if you are a morning or evening person.
Sleep is, without doubt, one of the most important indicators of our overall health. The time spent sleeping, and the quality of that time, has a profound impact on how we feel, how we perform, and how our health will evolve over time. Protecting and optimizing our sleep is one of the most powerful strategies we can deploy for our health.
The Activity Score
Oura measures your physical activity using a 3D accelerometer, an instrument used to estimate movement and activity. Combined with your profile information (e.g., age, weight, height, and gender) Oura translates these signals into units of energy expended (calories) and equivalent activity measures (steps or miles).
Ranging from 0-100, your Activity Score is an overall measure of how active you’ve been today, and over the past 7 days. I’ve written about daily activity in more depth here.
Factors that contribute to your Activity Score:
- Goal progress: your minimum daily activity goal based on your age, gender, and daily readiness. This shows as your daily activity burn in kilocalories from movement and exercise.
- Total burn: total daily energy expenditure at rest (called your basal metabolic rate, BMR) and while active. Use this information to compare with your data history to adjust your calorie intake and maintain a healthy weight.
- Walking equivalency: daily activity burn as a walking distance. Higher intensity activities like jogging increase your daily walking distance more than low intensity activities such as casual walking, even if the real distance traveled is the same.
- Steps: the optimal number of daily steps depends on your age, body size, fitness level, and readiness to perform.
- Stay active: moving around regularly and avoiding long periods of inactivity and sitting helps you to stay healthy, and keeps your metabolism active throughout the day. Oura measures the amount of time you’ve spent sitting, standing, or inactive during the past 24 hours, not including rest or sleep. 5-8 hours or less of inactive time has a positive effect on your Activity Score, while 12+ hours requires taking immediate action!
- Move every hour: this shows how well you’ve managed to avoid long periods of sitting, standing, or inactivity during a 24 hour period, not including rest and sleep. Even though inactivity increases mortality, staying active and moving for 2-3 minutes every hour helps you to avoid the harmful effects of inactivity.
- Other factors that contribute to your Activity Score:
- Meet daily goals: if you’ve reached your daily activity goals 6+ times a week
- Training frequency and training volume: if you’ve exercised for 20-30 minutes with medium to high intensity level activity 3-4 times a week
Our bodies evolved to walk, run, jump, climb, swim, carry, squat, pull, push, lift, throw and catch. We needed all these types of movement to hunt and gather food, to build homes, to work the earth, to defend ourselves and to raise kids into effective adults.
Movement has a profound impact on our sense of wellbeing, our physical capabilities, and just as importantly, our biological age.
And when we don’t practice all these innate movements on a regular basis, we slowly lose the ability to do them, and our health starts to decline in a totally preventable way.
This type of tech can help you make your dietary and lifestyle decisions with your eyes completely open and a clear sense of what’s going to happen with each action.
One of the craziest examples of this is to watch is what alcohol does to your data.
For most people, alcohol totally crashes the positive trends you’ve been seeing and it can take many days for the data to return to its pre-alcohol state. It’s kind of shocking to see, and it gives you the opportunity to decide whether or not indulging on a particular day is going to be worth it for you.
Another thing I find particularly helpful is the visual representation of the data for people who don’t suffer from any chronic disease.
When you have a chronic disease, there’s a clear causal effect between some choices and a noticeable change in your sense of wellbeing.
For example, if you have Celiac disease and you eat some bread, you know that gluten intolerance is going to flare right up and you’re going to feel horrible.
But if you don’t have a condition like that, and you don’t feel any different after doing something that might not be great for you, seeing the change in your data can help you better understand the consequences.
This might be around your food choices, around your daily levels of activity, the type of exercise you’re doing, or when you choose to go to bed at night.
Of course, the data can also show an intolerance or a problem in the making — long before you ever start experiencing noticeable symptoms.
Having this kind of data truly puts you in control of your health.
It empowers you to make informed decisions that are completely tailor-made for your body and lifestyle, and gives you the depth of insight necessary to shape your health and wellbeing over the long term.
For clients who do use an Oura ring, I work with them specifically on improving the trends in their data over time. But you don’t need to be into collecting your data or even wearable tech to work with me.
If you’re interested in understanding your blood work, transforming your diet or working movement back into your days, click here to learn more about working with me.