The Crackin' Backs Podcast

Are You Paying Attention? - HRV Is the Future of Health Tracking

• Dr. Terry Weyman and Dr. Spencer Baron

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Unlocking the Power of HRV with Dr. David Hopper

Heart Rate Variability (HRV) is emerging as a critical health metric, yet many overlook its significance. Integrated into devices like the Apple Watch, Whoop, and Oura Ring, HRV can signal potential health issues before symptoms arise. In this episode of the Crackin' Backs Podcast, we welcome Dr. David Hopper, a chiropractor and HRV expert, who shares his personal journey into HRV research following his father's heart attack linked to undiagnosed sleep apnea.​

Dr. Hopper discusses the development of an HRV tracking app and clinician dashboard designed to monitor patients' HRV remotely, bridging gaps in healthcare by enabling providers to track patient health between visits. He provides real-world examples of how HRV monitoring has led to early detection of health issues, allowing for timely interventions.​

We also address common misconceptions about HRV, such as the belief that a higher HRV is always better, and offer guidance on interpreting HRV data from wearables. Dr. Hopper shares lifestyle strategies to improve HRV, emphasizing the roles of sleep quality, nutrition, hydration, stress management, and breathing practices.​

Looking ahead, Dr. Hopper offers insights into the future of wearable health technology and HRV, including the potential for continuous 24/7 monitoring and real-time health coaching based on nervous system data.​

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Tune in to learn how HRV can be a game-changer in proactive health management.

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Dr. Spencer Baron:

Welcome to the cracking backs podcast today, we're exploring Heart Rate Variability HRV, a vital health metric embedded in wearables like the Apple Watch whooping ora ring. HRV can signal illnesses day before symptoms appear. And our guest, Dr David Hopper shares how his father's heart attack due to undiagnosed sleep apnea, led him to pioneer HRV research and develop tools for remote patient monitoring. We'll discuss how HRV aids in stress management, recovery, preventative care. Stay tuned and team up to interpret how HRV can help you. Welcome to the cracking backs podcast. Dr David Hopper man, we are excited to have you because we are going to talk about a topic that has received a lot of attention, especially with all the devices that are out there that monitor heart rate variability. Meeting you has been, has already been great. How you doing, Dave? I am

Dr. David Hopper:

doing wonderful, and I'm super excited to be here and talking about one of my favorite topics. So well,

Dr. Spencer Baron:

let's jump right in. First. I'll let you know that Dr Dave is chiropractor professor at National University of Health Sciences, so he's already got that teaching mentality going on. So from from from now on, I'm gonna, we'll refer to heart rate variability as HRV, instead of me saying and Dr Terry saying it the whole time. So we'll use the lovely acronym HRV, but it's been called one of the most important health metrics these days. People aren't just, you know, aren't just tracking. I mean, this is built into all the popular wearables. Everybody's my girlfriend, she guides her whole diet and sleep on this thing. So I have to know more, Apple, watch, whoop, our ring. You know, I've heard even you know, these things are like warning signals for you and let you know when sick days are coming or potential for injuries. Dave, let's start talking about it. Man, let's hear what you got

Dr. David Hopper:

today. Yes. So exactly like You're like you're saying Dr Spencer HRV is becoming one of the most important biometrics, and in my opinion, it is the most important biometric, because it does apply to literally everything that's going on in your life. And And the surprising thing is, is that, you know, we start getting it into all these wearables, it starts becoming a household thing, and and then we learn the science behind it. And then you start to look at some of these wearables, and you go, Oh, wait, how is it possibly doing this correct? And I And, and that's where we get into a lot of, okay, we need some more education on this, and we need to understand this topic better, to be actually interpreting the data properly. So we can program our lives, program our performances program, you know, whatever it is that we want to be the best at. So, so to open with HRV, I, you know, it's, I guess I can start with a simple definition of it, right? What heart rate variability is, is we are looking at, we're looking at the space in between each heartbeat. So I know both of you guys, and I'm sure most people listening to this podcast can picture like an EKG strip, and we have is the QRS complex, which is that big spike that you see on it. We're measuring the time between one of those big spikes, so one of those big QRS complexes to the next QR to the next QRS complex. And we're looking at, what is that time, distance, and then when we look at the next one and the next one and the next one right, and then we and then we compare all those together, what is the variance? Because in a perfect system, by a biological system that is there is going to be a variance. And actually, the more variability that we have between each of those heartbeats, the more adaptable we are to literally anything that happens in our lives. So we talk about a stressor coming on, you know, and, and we can think of acute stressors in in any form, but I, but you know, the easiest one is, you know, you see a bear in the woods, right? You know an acute stressor when you when you have that high adaptability, your body can shift gears very quickly and efficiently, and you can have a really good response, and then you can shift back right, whereas, where somebody with a lower HRV may not have as efficient of a response, right and And granted, in a case of getting away from a bear, I hope that we would all be able to do do something, something appropriate, but when we get into. Things like, things like illnesses, right? Like, like, some kind of bug that our body gets introduced to that's going to be okay. Somebody with a higher HRV is actually less likely to have a negative outcome from that, whereas somebody with a lower HRV is a lot more likely to be exposed to the same thing, and their nervous system doesn't have that adaptability, and therefore we see a negative response. So sorry, I get really excited about HRV, so sorry if I jump to a few different places there. But

Dr. Spencer Baron:

I do have a question, though I want to, I would love to know, just clearly, sometimes I get confused on is the higher the number, like, you know, when I when I see the what with the results on an iPhone or a smartphone, of what the aura ring has translated to that is the higher number mean you're better, or is it or the lower number mean you're going to get sick? I'm, I'm always confused on which is, yes,

Dr. David Hopper:

the range so with heart rate variability, and that's where a lot of confusion comes in, is, is I will be talking to somebody, and I will say, I will say, Oh yeah, I do a lot of work with HRV. Are you familiar with HRV? And people will say, Yes. And then we'll start talking, and I realize that they're just talking about heart rate, and they've, you know, just, just tossed out the V So, so we're missing the variability. And when you're talking about heart rate, yes, typically, a lower heart rate is going to be better, but with HRV, it's actually the opposite. So a higher HRV is what we want, and that's what that's representing. Is not only our adaptability, but specifically our vagal tone. So how strong are, how strong our parasympathetic nervous system is, and specifically the vagus nerve, which, of course, is, you know, makes up the majority of our parasympathetic nervous system. So when we see a higher number, that's saying a higher available tone and a better outcome.

Dr. Spencer Baron:

Okay, you know, I hope you're okay with what I'm going to ask you next, and that is, and, dr, Terry, we've had so many interview, so many guests on that we've interviewed that their genius has come out of a crisis. So if you don't mind, I would I know that there was a family crisis that happened. Your father had suffered a heart attack that ultimately linked into an undiagnosed sleep apnea. Now I understand that that that pushed you to learn more. Could you share the genesis of that whole, you know, interest, yes,

Dr. David Hopper:

absolutely. So, so I've done a lot in the with airway and sleep apnea work as well. And as you said, yeah, that that started when I was, you know, geez, 1920 My father had a heart attack, and I and, and as you said, right, we found out it was undiagnosed obstructive sleep apnea, and I dove into the research about all of that, and, and that's where we got into a lot of oral exercises, a lot of fungal exercises, that kind of stuff, to help with sleep apnea in a natural way, which is actually extremely effective. But one of those things that also came out of that was HRV and and I had heard of this term before, but I never really looked at it. And what we find with something like that is that it HRV is predictive of of, really everything so, so, in fact, it's a so directly associated with nine of the top 10 killers, and the only thing being, you know, accidents. And I like to say, I really, I really like to argue that, and that's because HRV is directly associated with with reaction time. So So you're a lot less likely to have accidents with a higher reaction time, right? But anyway, with the with the obstructive sleep apnea, we were seeing that the more severe somebody's obstructive sleep apnea is diagnosed or undiagnosed. Obviously we are. We're seeing a higher HR we're seeing a lower HRV. Right as their as their sleep apnea is worse and worse. So it just ended up being a really good marker of of, Oh, wow. We can monitor this and see that the changes are actually. Being effective, right? And we see so I actually have a published study on a on a patient that I did who had severe obstructive sleep apnea and and we went through everything, and at the end of the program, not only was his sleep apnea essentially gone, but his HRV significantly increased. So we so we saw that as well as we were tracking that throughout the whole program. So that, as well as, like, really cool something, that kind of came as an aside, and then I, I just fell in love with the metric, everything that we can learn from it. So, so it's been a bit of my journey.

Dr. Spencer Baron:

So any other I, first of all, I love, love, love the idea of how an HRV can influence reaction time or a higher HRV. Because now, now we're talking, we got, you know, dr, Terry and I work with a lot of athletes, and reaction time is everything, and we can't, you know, these, some of these guys, they stay out all night, they party, they drink, they so would that influence HRV a little bit? So I hope they're all listening to this, because that if they got to compete the next day, reaction time is everything.

Dr. David Hopper:

Yes. So I so when you talk about, you know, the influencers on HRV, right? What are, what are the biggest influencers? Yeah, and sleep is going to be one of the biggest ones, right? If you have a poor night of sleep, you're going to see that your HRV is depressed the next day. And if you choose to, you know, get a short period of sleep as well, right? And alcohol is going to be one of those top influencers as well. When you take when you have just even one drink that's going to crush your HRV and then, yeah, what does that do to things like reaction time? Yeah, it obviously correlates very well too, you know? And we can see that stuff, and this is where I think the power of HRV really comes through, especially for patients, especially for athletes, is that you can, you can always say, ah, you know, that's just coincidence, right? Or, you know, okay, yeah, I had a couple drinks, but that didn't really do anything to me. Yeah, I had a poor night of sleep, but that didn't really affect me. But when there's an objective number staring you in the face, there is, there is no saying, Okay, well, obviously my nervous system isn't nearly as ready as it could have been had I not done this. Right? And for athletes, that's one of the big things too, is because I feel like athletes are better about some of those things, right? They understand the importance of sleep, they understand the importance of proper nutrition. But what athletes don't understand, or were too hard headed to understand, is is the hey, you know what? You've been training too hard, and if you don't tone that down, you're going to get injured. And so many athletes come from the mentality, and I'm guilty of it as well, is you just push, push, push. You know? Unfortunately, recovery is becoming a lot more of a topic, but again, it's when you watch your HRV trend. So if you're taking your HRV on a daily basis, which you should be, you'll see there's peaks and valleys throughout that data. And when you see consistently, consistently down data, right? So you're, you're gone down into that valley, and you're not recovering, so you're not pulling out of that valley. That is a really good sign that your body is not recovering properly. And if your body is not recovering properly, you are a lot more likely to get injured in your next training session. So that's where you have to. You have to program your your training sessions to match what you're seeing in the data. And they've done this, you know, in many of Sports Studies, just comparing your regular training programming versus versus programming based on your HRV. And of course, you know your own personal data, listening to your nervous system was always coming out way ahead. So it is, it is really cool for athletes to see that like, Okay, I need to, I need to pump the brakes here. I need to listen to my body. I need to hit the recovery and then, and then, when my body says I'm ready, I can go back to that super hard training.

Dr. Terry Weyman:

Hey, Doc, wait I gotta. I get no worries. I gotta inject some because when I first got this, I have the aura ring. And when I first got that, somebody had mentioned, you know, the alcohol can affect it. And I was like, You're HRV. And I was really curious. So of course, I had to do a diagnostic test. So he has whiskey nights at his house. Yeah. So I put I put the aura ring on, open up my AB, and I took it, took a sip of whiskey. I swear to God, within a half a second, my my app flashed at me a red warning signal that my body was under stress, and I didn't believe that it was that fast. So I had to retest it. I of course, I retested it throughout the whole night, but I had to retest it every time I took a sip, within a millisecond, the app would flash at me. Yeah. Now most people don't have their most people don't have their app open when they're drinking so but it was so fascinating that it affected that quickly and and then the next day, I looked at my HRV, and it was dramatically changed. So I think if people do have that app open while they're partying, they might stop partying, or they might be like testing. But you

Dr. Spencer Baron:

know, in the name of research,

Dr. Terry Weyman:

but it was fascinating. So I'm really liking this topic, especially with athletes and people are sick, because it was technology. It was so immediate, and it was like flashing red at your body's stress. And I was like, I was shocked.

Dr. Spencer Baron:

Interesting. That

Dr. David Hopper:

is so cool. And actually, actually, I didn't know that, or offers that. So I haven't, I have an aura ring, but I have to admit, I haven't used my aura ring and in a little while, and I can get into the why, but, but I didn't know that aura does that on their app, that you can, you can see the real time like that. That is, that is so cool.

Dr. Terry Weyman:

It was immediate. And I was like, and then the next day, I saw how it affected my sleep. I saw affected my readiness. I saw that. So that's really, dr,

Dr. Spencer Baron:

Terry didn't, didn't mention to you what else he does during the whiskey night, AX throwing. Wow. So I would imagine the accuracy is a little bit

Dr. Terry Weyman:

throwing first, and then we celebrate with the with the liqueur of the gods. So

Dr. David Hopper:

that sounds like a really fun night, but

Dr. Terry Weyman:

we that's a topic for another podcast.

Dr. Spencer Baron:

I think the ring is a lot safer to monitor your accuracy or potential than throwing an ax and go, Oh, I hit the target. Sorry, neighbor. No, it's

Dr. Terry Weyman:

all good. You know, it's a big target, yep.

Dr. Spencer Baron:

Oh, man, anyway, so I'm sorry, what were you saying?

Dr. David Hopper:

So yeah, I think that's awesome, because anytime that you can get an immediate feedback like that, that is just the best thing in the world. So I was, I was actually unfamiliar with that. So I said, thank you for bringing that to my attention. Doctor Terry, that is actually, I think I'm gonna have to put my n on and update my update my app, and then maybe do some testing myself, and I'm just gonna have to follow suit AX throwing and whiskey. But, um, but that, that objective number like that. There's just no denying, right? You can't, you can't argue with that. So it's, it's so cool, but, but awesome that that you get that immediate feedback, and that's where, I think, you know, just for the average person too, you know, and granted, this applies to athletes and anybody else, but just watching yourself as you are taking on stressors in life, you know, because we all get into those same trends where we go, okay, yeah, I had to stay up a little bit late, but whatever. And then, okay, this happened at work, but whatever. And you know now this is going on, and you know now I kind of got a short fuse, so now I'm fighting with my wife, but whatever, right? And you just keep stacking these things on. And I like to think of these things as, I call them life metrics. You know, I like to think of them as like individual bricks and and each of these little bricks that like you're stacking onto your pile, you're becoming less in your ability to react is becoming less and less and less right. So we can think about that stacking onto our nervous system, and then, oh my gosh, you know, the common cold, you know, you just have, the virus is introduced, right? And, and, wow, now this opportunistic bug can actually take over your system, because your ability to fend that off is significantly decreased, right? When, if you had been looking at your HRV, what you would have seen is that, okay, you lost that sleep, you were a little bit down, right? And then this happened at work, and that brought you a little bit down, and now you're arguing with your wife, and that brought you. Down a little bit further right. And then what you could have done is, well, you could have focused on rest. You could have done some extra supplementation. You could have done some extra hydration, maybe some meditation, something like that, to bring your nervous system back up to a higher function right to to help lift off some of those, some of those bricks, those life metrics, as I call them, and then maybe when that cold virus came around, your body would have been able to fend it off, right? Rather than sitting in this place where now, all of a sudden I have this here, and now I'm sick, and now I'm taking three or four days out of life because I chose to ignore what my body was trying to tell me, right? Right? So it's a, it's a very easy thing to follow. And honestly, the data is very straightforward, like once, once you teach somebody what to look at, it's very, it's very straightforward on how to follow it right? We're depressed for two, three days. We better really focus on recovery. We're we're on an uptrend. Let's push it right. Let's, let's go hard. So you know, we can look at it that simple, or we can get really complex with it, but, but yes, so let me, let me ask

Dr. Spencer Baron:

you. So we talk about athletes all the time and the importance of monitoring HRV for potential injury and reaction time. But reaction times is a cool concept, because take older folks, especially in South Florida, you know, retirement capital of the world, you got the idea of reaction time being, you know, suppressed as you go along, and that we're known for, for falls and hip fractures. So with that said, could you share a couple of perspectives that a a non athlete, let's say would look at, let's say they, they they're monitoring HRV, and they go, Ooh, it is, it's high. What would be some of the variables that they can address to help. Bring it back to a I'm sorry, it would be low.

Dr. David Hopper:

Yeah, you got it right. It would be low. Yes, yeah, what would

Dr. Spencer Baron:

be some of the variables that? What would all the variables be that they could look at to help and or what's affecting them? Yes,

Dr. David Hopper:

absolutely. So. So I always say with anything, I go back to the basics, right before we get into supplements, before we get into, you know, red light, before we get into, you know, whatever it is, always cover the basics. Always cover the basics first, because those have the biggest impact, and they're free and easy. Well, maybe not easy, right? Especially when it comes to, you know, changing, changing your diet or something like that, right? But, uh, but they're free, so things like getting more sleep is going to be the biggest positive impact, um, but breathing properly is maybe the largest impact, and that's going to affect your sleep. So, so checking on things like that, right as you know. So again, back to that sleep apnea world. Right as we age, our muscle tone starts to decrease, not yours, Spencer, but But most people, as you as your muscle tone will start to decrease a bit and, and that's everywhere, right? So that's, so, that's the airway as well. So if you start to, you know, if we start to notice that somebody is, you know, is having more breathing problems, well, that's, that's a moment to moment, something that is affecting you in a negative way. So we can look at something like that, then we can then we want to look at their sleep. Then we do want to cover simple things like, Are you moving every day? What's your diet look like, right? Are you eating a lot of foods that are that are causing inflammation for you, right? Or are you focusing on things that are only going to impact your health in a positive way? How about hydration, right? Another huge impact you can, you can have a low HRV, and you can go and chug some water and go back and retake your HRV and and it'll actually be higher, right? So, so those things are some of the biggest influencers, right? And then, yeah,

Dr. Spencer Baron:

yeah, please. I wanted to ask you, you mentioned breathing right? Yes. I'm sure our listeners don't all know what breathing right looks like. What does that mean to you? Yes, great question.

Dr. David Hopper:

So, so if you're breathing properly, right, what we should we should only be using our nose. And I teach nasal physiology, you know, that's a part of my, part of my coursework that I teach. Did you guys know that the filtration power of our nose is pretty much the exact same as an N 95 mask?

Unknown:

No way. Isn't that

Dr. David Hopper:

crazy? See, really filter down within, within, I believe, nanometers. The particle size that we filter down to is pretty much the exact same as N 95 mask if you breathe through your nose. So that, so that's huge, right? Yes, right. I'm just so amazed with our bodies, but, but nasal breathing would be number one, right? We only want to be breathing through our nose, not through our mouth. So that's number one. Number two is the position of your tongue. So your tongue should be up in the roof of your mouth. So if this is your palate here, right, your tongue should be pressed up against the roof, up against the roof of your mouth. And then we're talking about posture, right? We're chiropractors. We have to talk about posture. But your oral posture, your lingual posture. So that's lingual posture, your tongue being up. Oral posture, that your lips should be together. And then, good job straightening up there.

Unknown:

I realized I was slouching. And then

Dr. David Hopper:

And then, and then our the position of our heads. And then we look at our posture globally as well. Right if we are broken down, if we are leaning forward, if we're slouched forward, like most people are, either on a phone or on a computer, that's going to break down how well your diaphragm can function as well. So then then you think, Okay, well, now my diaphragm can't pull all the way up and down, so instead of that, now my scalenes are going to contract, so that's the muscles up here in your neck, right? They're going to pull up so that I can breathe through this part of my lung, because I can't access the lower part of my lung. And now this becomes my habit, right? And as we all fall forward, we start to go, and that is very inflammatory for your body, versus this, which is great for your body, right? And and so many of us don't even realize that we're doing that with a with the simple thing of breathing right? Because you go, how can I be breathing wrong? But I'm sure a lot of people who just listen to that thought, oh shit, that's me. Yeah.

Dr. Terry Weyman:

So, so during the pandemic, it affected so many ways, because people were mask over their nose, which you're saying they probably shouldn't have done that, and they're bent over the computer restricting their airway. So the health pandemic was actually probably way worse, because we're now restricting airways, both at the nose, with the mask and with our posture. Yes,

Dr. David Hopper:

indeed, indeed, one of the many things that probably amplified those effects, but, but yes, and that's, that's what I always say. I'm like, man, could you imagine, what if? What if, instead of wear a mask, everybody was going around saying, breathe through your nose. Imagine the power that that would have given back to people and that and how differently we would have felt about our how in control we are of our own health, right? Because that's ultimately what, what it does come down to, right? We we are in control of our own health, and when we see how powerful our body is with this right, we're like, Oh, wow.

Dr. Terry Weyman:

So I want to get back to some HRV for, we've talked about reaction time, we've talked about sleep, but there's a lot of other things. You know, we use a lot, a lot of these devices for, you know, for recovery, for athletic performances. But can you point out some trends, or some interesting things you've seen when you see a worsening HRV that might not be people may not associate with their HIV, such as like constipation or stomach issues. Have you had cases in HIV data where you've caught in cotton? You've caught a hidden problem that otherwise somebody was just blown by

Dr. David Hopper:

So what's cool about HRV is, is it will open up a bigger conversation with a patient, right? So, so like you're saying, Dr Terry, right? You know, as a chiropractor, people are going to come into you for, for back pain for, you know, for more physical, musculoskeletal type things, right? That's what most people end up walking in our door for, right? So, so when they fill out a health history, a lot of times, they just completely omit things that they don't think is relevant for a chiropractor. No, have you guys had this happen? So, so, when you're tracking a patient's HRV, what's really cool is that you can say, Okay, this is what I expect to see happen with a patient, right? If my therapies are going, if I'm doing what I'm supposed to, you know, I'm applying the appropriate. Amount of therapy and the appropriate type of therapy to this patient, and this patient is following up and doing the other things that I'm recommending that they do at home and whatnot, then we should see this general trend of their HRV improving. And yes, it might be slight, but we should see this general trend over over weeks and especially over months. Now, if we're not seeing that, or we're seeing the opposite, where it's actually going in the other direction, then we have to ask the question, what's going wrong here? Right? What am What am I doing? And of course, you know, as we all do, what did I do wrong? Right? That's always my first question, what? What did I do? What did I mess up? And and you go, Okay, well, I'm pretty confident that I'm applying the right type of therapy. I'm pretty confident that my frequency isn't too much, that it's, you know, destroying their nervous system, right? But maybe there's something else going on, right? And then you ask the patient, hey, we're not seeing what we're expecting. So what else is happening? And then maybe they do say, Oh yeah, yeah, you know, I deal with, I deal with constipation, you know, I don't know if I've had a patient who, a patient who with constipation, specifically had almost every week they would go and get a, oh my gosh, the name is escaping me, but essentially getting another system flush out, colonic, yes, yeah, they would have to do enemas on themselves. They would get colonic. So I and, and that was, like, their process. And I was like, Really, but, but a great, a great case with, you know, with HRV is related to a TMJ payment that I've had directly where I've seen that. And I'm like, how did you not mention that to me, that this was going on, that you had this extreme jaw pain, and you thought that that wasn't related to anything that we were doing and and as soon as we started focusing on that, then we started to see, okay, now, now we're getting the resolution that we want to see in the HRV right now we're seeing The HRV trend start to come back up so it is, it is rather amazing that you can open up these conversations, and patients will start to say something. And equally, you know, I've had it as well, not only for just for them, but but we'll talk like, Hey, what's going on with this? And they'll say, Yeah, well, you know, my bed partner is a really big snore, so I end up moving to the couch a lot of nights because my sleep gets disturbed, and then go, Okay, well, that might not be you, but that's a huge health problem for your bed partner, and it's affecting your health. So we need to, we need to look at this, right? We need to really dig into this. And, you know, and again, it's a situation like, like, for my own father, where it's like, I didn't even realize that that was a problem. I thought snoring was normal. I thought it was a sign of good sleep, you know. So, so, yes, it does open up that conversation to where you can get into things that a patient might not have brought to your attention and may have seemed disconnected from what you were doing, but their nervous system is still reacting to it regardless, right? And that's what we're seeing with HRV.

Dr. Spencer Baron:

You know, you brought

Dr. Terry Weyman:

up some you people have to understand you're you're not only a clinician, but you're a researcher, and you brought up some great things that most people have misconceptions of, HRV. I mean, I Spencer, and I will tell you, we probably see daily people wearing whoops or rings Apple watches. And when you ask them, Do you even know what those are for? They wear them either as a fashion statement or because a trainer told them to wear it, and they have no idea how to how to read it, or they look at their heart rate, or they look at how many steps they did. And so can you talk about some more and clear up some more things that the people that are wearing these devices, that one that drives you crazy, a little misconceptions and understandings. But can you get a little deeper of how people can really access and use these devices and not think of them just as a fashion statement.

Dr. David Hopper:

Yes, indeed. So pardon me, so it is becoming like a thing where it's cool to wear and it's great that there's, there's starting to become a focus on it. And I and, you know, even if a recovery score isn't really based on much great data, it's still bringing in sleep, it's still bringing in heart rate, and it's like, it's like, okay, we're. Looking at the right kind of things, right and, and that's cool that we're that we're starting to see that. But yes, like you said, most people don't even know which direction their their heart rate should be going, right and. And a big thing like my my own wife, for example, she was saying that it would benefit her to see, you know, to see all of this stuff. And she's like, do you know, do you think I should get one of those, like the whoop or the aura? And I'm like, Well, you know, there's, there's two parts to it. One is wearing it and collecting the data, and the other part is actually looking at the data. And I think that's another piece that a lot of people just don't even, do you know, they just don't even log into the app to see what it is, because they'll just go, ah, you know, I feel okay, whatever. So, so with some of that data, though, what is being collected? If it's heart rate data, it's, it's fairly accurate when it comes to HRV data, some of it is not the best, and that's where it gets a little, a little cloudy on how it's being collected. And we can get specific with that too. Um, the absolute best way to collect HRV data is first thing in the morning. You wake up, you sit up, use the restroom if needed, but you sit up and you take a three minute HRV reading quietly in that seated position, okay, that is the absolute best way, the most validated way, for short term readings to be done. Most people are using something like an aura or a whoop, where it is doing it without your knowledge, right? It's, it's doing it while you're sleeping. And here's something really funny that I find kind of ironic. The Science Advisor for aura, I actually said in his own personal blog, which, which I read all the time, he said, he said, overnight collection of HRV data is not nearly as accurate as morning readings and and then he goes, you know, he goes on to say, you know about how he told or this is the case, but, you know, I but they chose to Ignore him. And I see both sides of the coin, right? You see both sides of the coin. One is that, one is that most people aren't going to sit up first thing in the morning and and get their data, right. Um, so overnight might be the best option, because it's most realistic for most people, right. Um, but if we really want really good, really actionable data, then we should be doing that right. First thing in the morning, sit up. Three minutes of silence. Okay? Now you can go on and start your day. You have a very accurate read of where you're at. Aura is great, though, for measuring sleep, you know, whoop is okay for measuring sleep as well. I don't know that it's as good as as an aura. And then when you get into something like an apple, watch that, that's just, it doesn't really do anything with HRV correctly. So, so it measures it real quick. If we can, you know, define I there is, there's a couple different ways. There's several different ways of receiving HRV data, but the most common, especially for short term readings like this. And when I say short term reading, it's anything you know we're talking you know, our three minute or five minute readings that most devices are doing, I they're going to be in what is called rmssd or SDN n. And have you guys seen those, those labels anywhere on your on your readers? No, okay, so, um, so for or for whoop, they're both doing rmssd, which is the most validated for short term readings. And Apple does it in SDN n, which you know already starts to make it where you guys going with that, but then they also just take random readings throughout the day. So if you're wearing an apple, watch, you know, for anybody listening who's wearing one throughout the day, it'll give you brief cues, and in those moments, it's actually taking an HRV reading. So if you're wearing that and you're getting data that is collected at random times throughout the day, we have no context to what state your nervous system was in during those during those readings, and as a result, we have this jumbled data that just kind of gets average out and it doesn't, it doesn't offer any, any real actionable method with it. It's just, it just kind of meaningless data. And I know I get to, I'm very fortunate. I get to talk with some of the greatest minds in HRV. I rather. Really, and, and that's, you know, I talked to them, and I'm like, What's going on with this? And, like, I don't know. They're like, but, but all we can hope for is that the people at Apple are super smart, and maybe they're seeing something that none of us are. So, you know, I mean, that's, that's the hope, but, um, but, you know, they obviously don't, don't push that as a metric. They're obviously not doing anything major with it, but, um, but that's that's where it's at.

Dr. Terry Weyman:

I want to interject on some I think a lot of people, they buy these devices, they put it on, and that's it, and but I've noticed that I don't know if it's AI, because I'm always updating firmware, I think AI is getting smarter, but you have to teach it how you work. And so, like it will say, What did you just do? And if you're not following that on a daily basis, how's it? It almost learns how you operate. Because I'll it's now got the point where I would go skiing and go, what activity did you just do? And I go? I went snow skiing. And then what activity Jews do? I went mountain biking. When hiking, I went walking. And now it's at the point where looks like you just went skiing for 40 minutes. Looks like you just went mountain biking for 30 minutes. Now it looks like you just did this. And I think what people don't realize, you have to put in data, and then the AI can actually learn stuff. Do you see this getting better and better with updates of firmware and AI introduction into into society, that it'll get the point where, as long as you're updating things, it'll get more and more accurate.

Dr. David Hopper:

I would, I would hope so. And yes, things like that are just so amazing. Where it can, it can actually predict, and I'm guessing, Dr Terry, that it is correct most of the time when it when it says, did you just do okay, yeah, yeah. And without a doubt, as it learns your body, your routine, you know, each day, yes, it can get, I would hope that it will continue to go in a positive direction to where it can say, all right. Dr Terry, is, you know, is off to do his workout at this time of the day. And maybe it can even get into a queue where it would say, you know, Hey, Dr Terry, you know, you're going to lift weights today based on your based on your health data, we'd recommend X, Y and Z. And I know that some of the health scores are, you know, are already doing that, but it could possibly do it a lot more accurate as it learns your body and what you do each day. So yes, without a doubt, I would hope that that only gets better and better. Well,

Dr. Terry Weyman:

I think people have to understand that they have to use and enter their data and not just expect it to learn without their input,

Dr. David Hopper:

yes, yes, and that's yeah. So going back to just like what I said about, you know, my wife, who hopefully doesn't listen to this after I, but I, but that's, you know, if you're not even looking at the data, it's useless. And as you're saying, too, if you're not telling it what you're doing, in addition, it really will never get that great. And in addition to that, right, we like to say with HRV readings, context is absolutely everything. So, so like we said, I you know when you do a reading, morning time is best. And the reason why morning time is best is because that is about the only time where your nervous system will be in the exact same place every single day, right? Because once you go ahead and start your day, you look at social media, you check your emails, you interact with your spouse, your kids, your dog, you go to work, you drive, interact with other drivers on the on the highway, whatever it is, you interact with co workers. All of this stuff is pushing your nervous system up and down, up and down, right? It's charging you. It's taking from you. It's charging from you. It's taking from you. Each of these events throughout the day, the only time where you are you know, where your battery is fully reset, right where you're at, where you're at, your true spot is first thing in the morning, right when you wake up, because from there, everything is going to play into a change in your HRV. So that's why we want to see that. And unfortunately, you know, during the night, sleep is is just not accurate enough. At this point, we want to you actually, ironically, you actually need a bit of a sympathetic stressor, which is just waking up and actually sitting upright is enough of a stressor, to actually give you a more accurate read of your nervous system,

Dr. Spencer Baron:

I have a very elementary question, and that is something that I've always contended with as being an issue, how does how does a device like an aura ring or. Apple Watch. Pick up such vital information from your finger and or if you're not wearing the Apple Watch correctly, how is it like? What is it seeing in your skin that's determining your heart rate?

Dr. David Hopper:

So that is so it's measuring what is called a pulse wave. So it's not actually measuring your heart rate. So if you have something strapped to your chest, you know, like, like, if you have an EKG on right, or if you have, like, a Polar heart rate monitor, right, that's measuring true electrical activity from your heart, right? But, yeah, when you get out to an extremity and you have something on your finger, you have something on your wrist, your forearm, whatever it may be that is using what is called a PPG. So it's photoplasmography. And those sensors, what they do is they are going to shoot light into your skin. So if you look at you know your if you look at your aura ring, if you look at you know, any of your watches or your bands, they're always shining a green light, typically, into your into your skin. And what we're looking at is that light is shining in and how quickly that light is reflected back. So we're looking at how much light is getting absorbed versus how much light is reflecting back and, and that will determine that pulse wave, right? Because once we get down here, it's no longer truly your heart rate, but it's the it's the pulse wave that's going through, you know, that arterial bed, whatever it may be, and, and then from that, it is giving a very accurate prediction of what your heart rate is. And I, and then if we go backwards from there, right, I, we can assume that most people, their heart rate is, is being derived from their sino atrial node. And if that is the case, right, you don't have ectopic beats or anything like that. Then we can assume that that is all vagal inputs, because, because sinal control of your heart rate is 100% from your vagus nerve. So, so from there, we can make very accurate predictions about how well your vagus nerve is doing on influencing your heart rate, and hence we're getting vagal tone out of that. So we just dove really deep down there and came up. No,

Dr. Terry Weyman:

it's cool. We have another elementary question. If you're in South Florida and it's hot out, you're gonna have more if this is registering at your extremities, and then you go to the polar ice caps, you go to the snow, and now you're really cold. Won't that affect this HRV or and what about people that have circulation like diabetes, that have cold hands and cold feet? Are they going to get accuracy readings on this as well?

Dr. David Hopper:

Great question. Um, so yes, I you, you are 100% right. If we have, if you have something going on in the extremities where blood flow may be poor to the extremities, then that invalidates those measurements. You can't use a PPG sensor at, you know, at your fingers, for example, you know, and even your wrist, maybe, maybe questionable, if you're within normal temperatures, and, you know, and I say normal, right? Are, you know, normal, normal, for most of us, temperatures, or at least something that your body has adapted to, well, then you're probably fine, right? It's a but, but, yes, if you do have some kind of ailment that affects the blood flow. Or you go from, you know, where Dr Spencer is to a polar ice cap, right? It's gonna look really different for him, while his body adjusts. But, but yeah, for people like that, you know, like you're saying with with diabetes, for example, it may be the most accurate place might be they need to use a polar sensor to to do that, you know, directly from their chest. That might be the only way to get a proper measurement. They do earlobe sensors as well, which are fairly accurate to even forum people like that.

Dr. Spencer Baron:

Fascinating. That is cool. Thank you, because I didn't realize that was had such a deeper answer to the question, I appreciate that. So we've talked about things that can positively impact your HRV, and that would be you look at sleep, look at your diet, over exercise could have a negative effect. What are some other things that maybe other than obviously drinking shots of tequila or whiskey? What are some other things that would have an effect, positive and negative that you might look for when a patient comes in with a series of. Readings,

Dr. David Hopper:

yeah, absolutely, so. So supplementation, you know, it's, it's really, you can, you can test a lot of supplements with HRV, which is really cool, but, but things like, you know, things like fish oils, we know, I you can see a positive impact when, you know, over, you know, I forget the exact time period, but, but we can see a positive impact on HRV just from, you know, something like a fish oil I've had, the same with nitric oxide supplements and, and these are things that you know there's actually data on and, and you can go crazy with that, with with testing these kinds of things. And equally, you can go in the opposite direction with, with, you know, hey, you know, is sugar really all that bad for me, right? Well, let's see what happens to your body, you know, and, and, and you can do it with, you can do it with a workout session too, right? Just based on how quickly your HRV recovers after and what it looks like the next day. So I so we can capture and test almost anything by doing that. Where's your HRV? You know, where's your HRV trending? What's it look like. What if we take it right before whatever event, and then we take it immediately after, and then we then we start looking at it 30 minutes, 60 minutes, 90 minutes, and we see how that HRV recovery actually is that can give us a lot of information on on just about anything that we want. But, but, yeah, that's a that's, that's a very easy way to go

Dr. Spencer Baron:

with it. That's great. I didn't realize that, like what Dr Terry was saying, that you could get an immediate response if you have the app up. I've always witnessed, you know, you know a series of readings and what you look at after a poor night's sleep or what have you. But my gosh, how we had a podcast where we interviewed the guy who, Dr Terry, did he create nitric oxide or, I mean, he researched it for many, many years and brought a product I have something like, I would love to see if that nitric oxide has an effect on HRV like that almost immediately that would be because I've always wondered supplements, are they helping or without doing a whole blood test and everything that would be really super cool. So, oh, go ahead. Go ahead. What were

Dr. David Hopper:

you saying? Oh, yes, I've had, I've had several patients who, you know, obviously they get in, they get very into HRV as a result of being around me and and they've gone, and, you know, they've said, they said, Oh my gosh, I started taking this supplement two weeks ago, and look what happened. It's the only change that I've made, right, you know? And they'll go No way, like, That's really amazing. So, you know, we can, we can easily say that's, that's, that's a simple yes, that was HRV, or, I'm sorry, yes, it was that supplement. And really quick to I so similar, similar thread from there is a guy that I work with. And, and he said he's an optimal HRV, I and he, him and I were talking, and he does, he does work in the psychology realm, right? And, and he and him and I were talking, he's like, he's like, you know, for years, I was so jealous of orthodos and of orthopedic doctors, and he goes, he goes because they knew when their patients were getting better. I never knew. He's like, Yeah, we have a lot of subjective stuff that can tell us, but I never knew for sure, right? And he'd be like, you know, an orthopedic you take an x ray of the bone, and it's broken, you do whatever to it, right? And six weeks later, you take another x ray, and it's healed, and it's very obvious that there was a change, right? And he goes, HRV became my X ray, right? HRV became that for me, for mental health, in that, in that I no longer had to guess if a patient was actually getting better, because, because we could look at their HRV, we could look at that trend, and we could see through therapy and using things like biofeedback, whatever it may be that, oh my gosh, they actually are better, right? Not just are they telling me that they're better, right? But this person actually did recover. So so that's that's a really cool use of it as well. And I love the way that he framed that, right for things, for things that you can't really see, all of a sudden, we have this tool that makes it visible.

Dr. Terry Weyman:

That's fantastic,

Dr. Spencer Baron:

because I. I hate asking patients how you feeling today. I go let me see your HRV. That'd be great, or better yet, I would love to know how spinal manipulation effect could affect HRV. I'm

Dr. David Hopper:

glad that you brought that up. So for for a long time in my office, I was collecting data on that exactly. I would have patients come in. I would have I would take their HRV immediately before so they'd sit in the waiting room, take HRV. I would adjust them, then they'd go back to the waiting room, retake their HRV. And this is no joke. Almost every single patient, their HRV would nearly double, um, and it was just so cool to see. And, and you go, okay, like, you know how you feel so good after you get adjusted. You're kind of in that state. And I'm like, That's it. We are just cranking up their parasympathetics so, so no wonder why you feel so good after it, right? And that was, that was so cool to see. And granted, there is other studies out there on like blood pressure, you know, and and chiropractic adjustments, where it shows, where it shows, essentially the same thing, right? The same thing, where we're affecting the autonomic nervous system. But, you know, it's not looking directly at this, so, so it was, it was really cool to see. And I maybe one day I'll actually do something with that and with that data, and publish it or something, but I

Dr. Spencer Baron:

will harass you until you do, because I think that is huge information. That would be cool. What a great way to objectively monitor. So what you're doing is effective. Thanks. So with the excitement that we have here, what would be some of the things that you foresee in the future with HRV? You know, I understand that, you know, with wearables and all that you're on the board of a major biofeedback Association, and you know, what do you see as emerging trends?

Dr. David Hopper:

So I think as we, as we touched on earlier, with, with AI, you know, I think that that is going to become more and more of a of an influencer with, with HRV, in that, you know, hopefully it will make the collection of data easier and more accurate that would be, that would be one major thing. But I think also I, you know, opening people's eyes to to the power of not only tracking HRV on a regular basis, but the power of HRV as a health metric. You know, there's a there's studies and beginning to be a push out there that your primary care physician shouldn't be collecting things like like cholesterol, like blood pressure, like any of those, as much as they should be paying attention to HRV, because it is so much more accurate of a Health predictor for longevity than is these other biometrics that we've been collecting. So, so I would hope that healthcare as a whole is moving in that direction. And you know, unfortunately, I think pharmaceutical industry has a bit of an influence on what metrics your PCP is going to measure, right? But, but that's, you know, the that would be really cool to see that start to change and look at that as a power. The other thing would be, the other thing would be with biofeedback in itself, so using HRV and HRV biofeedback as a recovery tool, and that is one that is deeply in psychology, and not really in too many other places. There is it's getting into sports with sports psychologists, but but using that, a particular breathing pattern, a particular breathing method, to influence recovery, you know, to influence reaction time, to influence all of these things that we know about HRV, that you can change that just simply by doing a particular breathing pattern, following a metronome. The power that that has because that's it's not talked about enough.

Dr. Terry Weyman:

I have one quick question, if people listening don't have a Apple Watch, I mean, some of these are very expensive. Some are cheaper. Can you give us just a really quick way for somebody they can get some get into this HRV, where it's somewhat inexpensive that they can start listening,

Dr. David Hopper:

yes, yes, absolutely. So. So most devices are rather expensive, and even, like the you know, not so great ones are still pretty expensive. I I work with a group. Are you guys okay if I mentioned names? Yeah. Yeah, okay, so I work with a company, optimal HRV and, and that was the whole push, was, how can we make this more affordable for people and and the initial device that we came out with was under $50 it was the first really high quality device that was not all that expensive, that was realistic for the average person. And we just upgraded to a to a higher quality device, and I want to say that one's like $60 you know, so again, not, not a huge ask, but I but you know what it came down to is we're a group of people who are concerned about, concerned about helping people more than we were about profits, you know, and so, so we're like, well, if, if we can get them at this cost, why don't we just turn around and sell them to people at so much cheaper, right? We don't, we don't have to make a killing on these things. So, uh, so, yeah. So that was so, that device I can highly recommend. It is a PPG device like, like would be used for for most other devices, and you can use it with any app. That's the other awesome thing is, I is that most devices like an aura, like a whoop, like Apple, you can only use it with their app, right? They don't share data with anything else. Polar, actually, they do theirs is what's called an open source device, so they can share data to any application that can read it as as can ours. So so we're very grateful that we're able to provide that.

Dr. Spencer Baron:

Can we add a? Dr Terry, we had a contact to get one of those at the in our

Dr. Terry Weyman:

description. Yeah, great.

Dr. Spencer Baron:

All right. Dr, Dave, we're entering more favorite part of our podcast. It might be a little scary for you. You're gonna have to think on your feet quick. It's the rapid fire questions. It tends to have nothing to do with what we just talked about, but it's all about you.

Dr. David Hopper:

Okay, all right, let's do it. You gotta.

Dr. Spencer Baron:

There's five questions you gotta answer fast and furiously. Okay, but we never do that anyway. So here we go. All right, question number one, dr, Dave, your mom ran marathons in all 50 states, and your dad was a bodybuilder. You literally had no choice but to exercise every day as a kid. So what's a funny childhood fitness moment your parents put you through that still makes you smile now that it's all over.

Dr. David Hopper:

Oh, geez. You know, I do have to say it was a lot of it was a was more of a choice. It was just like, You're not welcome here unless you're working out. But, but my mom didn't have me. Yes, my mom did have me run a, you know, a smaller race with her one time. I think it was like a 10 mile race and and it was very important to me that I won first place. Because, you know, that was that I literally, as I crossed the finish line in that race, I puked everywhere. And, I mean, it was, it was uncontrollable, but I knew that if I pushed really hard, I couldn't, I could cross the finish line first and and that last, you know, whatever it was, eighth of a mile. I killed me in every single way but, but I knew that I would never live that down with the way that I was brought up. If I, if I let somebody else win.

Dr. Spencer Baron:

Great story, and your mom probably said, Get up, shake it off. You'll be fine. Wait, that garbage off your face.

Dr. David Hopper:

She laughed at me a lot, as did everybody else.

Dr. Spencer Baron:

Great answer. Question number two, you're you were a pro MMA fighter in your 20s, and you're still an avid jujitsu guy. Dr Terry, if you saw this guy, he's jack man. I love it. So do you do any of those martial arts habit or mindsets sneak into your life as a doctor or teacher, hopefully without putting anyone in a chokehold anything in particular.

Dr. David Hopper:

Yes, well, well, I will say, I, I enjoy the sport of fighting a lot. I've never actually been in a real fight. I've never, I've never hit anybody out of anger. So I think that's, you know, but yes, indeed, I'm actually, I talk about this all the time with my students and and with adjusting. I think, I think every chiropractor should do some form of martial arts to be the best they can be as an adjuster, because there is. So much crossover in understanding and understanding where the end play is for joints, how a patient feels when they're relaxed versus not right, and when they're just holding on just a little bit, and how to distract somebody just right, right? And so understanding your own body to to the highest level is what martial arts teaches you, but also it teaches you how you interact with other people's bodies, right at that, at that highest level. So, um, so I think martial arts is crucial for for you know, as healthcare practitioners that are putting our hands on our patients all the time, I think there's so much crossover there. And just the mindset of it all, that

Dr. Spencer Baron:

may be the coolest answer I've ever heard in three years, because as everything I do, right, right, you need to be a black 10th degree at adjusting. That's what I tell all my interns. I don't care what you do, but that's cool. Yeah. Cool. Question of riches, Yeah, question number three outside the clinic here also a husband and a dad. What's something your family sees every day? You know, quirky habit, a hobby, a hidden town that you that would totally surprise your patients or students if they knew?

Dr. David Hopper:

Oh, there's so many. I'm trying to come up with one that's appropriate to share. That's awesome. I have a really weird habit of popping a headstand just about all the time in interesting places a lot, because it just makes my kids giggle.

Dr. Spencer Baron:

Head stance. All right. I'm sure you have photographs of odd locations that you do a headstand in.

Dr. David Hopper:

Yes, yeah, yes.

Unknown:

I love it.

Dr. Spencer Baron:

All right. Question number four, you were you once wrote that you were thankful for my simple miracles every day. Even tagged chickens and eggs in that post, what's one little everyday miracle in your life that never fails to brighten your mood no matter how busy that day gets? Honestly,

Dr. David Hopper:

you know, that's, that's simple, as a father, your your kids, you know, it's one of those, it's one of those things that you see every day. You're, holy shit. How did, how did I create that, and how did that thing become what it is, right? So that's just, that's just the coolest thing that I get to see every day. Yeah, it's

Dr. Spencer Baron:

awesome. Thanks. That's fantastic. That means a lot. I appreciate that number five and the last question. As an inventor with multiple gadgets to your name, I appreciate that. What's one everyday problem or pet peeve you haven't quite solved yet, but really wish you could invent a solution for

Dr. David Hopper:

anything I look at. I wish there was a gadget that could help me figure out what I should and shouldn't say to my wife, oh, my God. Because I want clueless.

Dr. Terry Weyman:

I want to open a restaurant called I don't know.

Dr. David Hopper:

I Yes, oh, my God, that's the best acceptable answer. Doctor,

Unknown:

that's the best care. Is another great. Yeah.

Dr. Spencer Baron:

So Oh, Dr. David Hopper, I'll tell you, man, this has been a fantastic this has been a pleasure. I was so glad to meet you that day that this evolved into a program like this. Thank you so much for imparting such fantastic, usable, practical knowledge to our listeners. Yes, yes,

Dr. David Hopper:

yes, absolutely. And thank you guys so much. I appreciate everybody listening. I greatly appreciate you guys inviting

Dr. Spencer Baron:

me on Great, great. Thank you for listening to today's episode of The cracking backs podcast. We hope you enjoyed it. Make sure you follow us on Instagram at cracking backs podcast, catch new episodes every Monday. See you next time you.