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Kamala Harris launches into the 2026 midterms as her 2028 decision looms
Kamala Harris is diving into the midterms, campaigning with Democrats like Senate nominee Abdul El-Sayed in Michigan
Democrats try to ride data center backlash to election victory in rural US Midwest
Mounting public anxiety about AI, cloud-computing infrastructure has transformed data center construction into a contentious midterm elections issue
New TV shows to watch this week: Tune in to 'Youth' on HBO, stream 'Slow Horses' on Apple TV and revisit 'Gilmore Girls' on Hulu
"Slow Horses" is back, "A Different World" gets a reboot and Matthew McConaughey and Woody Harrelson team up in "Brothers."
Business Group on Health taps BioRadar to boost workforce readiness for emerging threats
Biological threat intelligence is increasingly becoming a workforce and business issue, not just a public health concern. | Biological threat intelligence is increasingly becoming a workforce and business issue, not just a public health concern. Emerging threats—infectious disease outbreaks, pandemics and potential bioterrorism events—can cause workforce and operational disruptions.
Listen To Spider Sports Special With John Hardt & Bob Black Wed. Sept. 23 3-4pm On 1061. ESPN
Get caught up on all things Spider Sports and college athletics when Richmond Vice President and Director of Athletics John Hardt joins Voice of the Spiders ...
Business Group on Health taps BioRadar to boost workforce readiness for emerging threats
Biological threat intelligence is increasingly becoming a workforce and business issue, not just a public health concern. | Biological threat intelligence is increasingly becoming a workforce and business issue, not just a public health concern. Emerging threats—infectious disease outbreaks, pandemics and potential bioterrorism events—can cause workforce and operational disruptions.
CNN, MS NOW, Politico say they've notified Trump they're suing over denied White House access
The actions were a clear escalation of President Donald Trump’s long-running efforts — in the courts and through administrative action — to restrict news coverage by journalists he finds objectionable, and were the latest test of First Amendment protections in the United States.
Patrick Clancy describes Lindsay's mental health struggles in '60 Minutes' interview
Patrick Clancy described the mental health struggles he saw Lindsay face in an exclusive interview with CBS' "60 Minutes."
Presley Gerber dies at 27. What Cindy Crawford's model son said about recovery, medication and feeling 'misunderstood.'
Gerber, the son of Cindy Crawford and Rande Gerber, had spoken publicly about his mental health and experiences with addiction.
These are the Hubble Space Telescope's most spectacular images of our Solar System | BBC Sky at Night Magazine
The Hubble Space Telescope's best images of the planets, moons, comets and other celestial bodies of our Solar System.
MORNING BUSINESS REPORT: Paramount settlement, parents rely on family for money, CT foliage rank
Paramount looks to settle antitrust lawsuits, more parents are relying on family to make ends meet, and where CT ranks for foliage. Here's the Morning Business Report for Sept. 21.
Johnsonville Sausage Makes Its Case for Dinner Running in Political Parody Twist
Little Black Book, Campaign directed by Jordan Brady through True Gent puts a parody twist on the political ad blitz consuming Americans ahead of the midterms
The Battle to Turn Consumers Into Effective Health Care Shoppers
A seminar explores government efforts to encourage U.S. consumers to comparison shop for their health care needs
Hudson Regional Health cites community leaders at Secaucus University Hospital’s 50th anniversary event
Hudson Regional Health celebrated the 50th anniversary of Secaucus University Hospital with members of the HRH and local communities.
Drive-In Super Monster-Rama scares up horror heavy hitters
Drive-In Super Monster-Rama, a biannual horror movie marathon at Riverside Drive In, marks a milestone with screenings of The Shining, The Exorcist, Phantasm, and more.
Paula Poundstone on sobriety, saving democracy, and her upcoming Pittsburgh show
Paula Poundstone is looking forward to returning to Carnegie of Homestead Music Hall with a set that covers politics and practical tips.
Sen. Gary Peters, headed for academia, says he’s confident El-Sayed will win seat
The Michigan Democrat, who is retiring after this term, has accepted an offer at the University of Southern California.
Leading K-12 Schools Guide 2026
OCBJ's Leading K-12 Schools Guide profiles Orange County's top independent and faith-based schools — a trusted resource for choosing where children learn.
Holiday Event & Entertaining Guide 2026
As Orange County’s business calendar turns toward the holidays, where you gather says as much as what you serve. OCBJ’s Holiday Event & Entertaining Guide profiles the venues and culinary destinations setting the standard for the season, from client receptions to team celebrations to entertaining at home. This year’s lineup spans the county’s most distinguished […]
Trafigura to float supertanker arm in first IPO of a business
Commodities trader to take Volare Shipping public in Oslo as Gulf crisis drives tanker rates to record highs
Checking in on the mental health of construction workers
Experts say construction workers are five times more likely to die by suicide than from a jobsite injury.
Checking in on the mental health of construction workers
Experts say construction workers are five times more likely to die by suicide than from a jobsite injury.
Checking in on the mental health of construction workers
Experts say construction workers are five times more likely to die by suicide than from a jobsite injury.
Checking in on the mental health of construction workers
Experts say construction workers are five times more likely to die by suicide than from a jobsite injury.
Checking in on the mental health of construction workers
Experts say construction workers are five times more likely to die by suicide than from a jobsite injury.
Checking in on the mental health of construction workers
Experts say construction workers are five times more likely to die by suicide than from a jobsite injury.
Checking in on the mental health of construction workers
Experts say construction workers are five times more likely to die by suicide than from a jobsite injury.
Checking in on the mental health of construction workers
Experts say construction workers are five times more likely to die by suicide than from a jobsite injury.
Checking in on the mental health of construction workers
Experts say construction workers are five times more likely to die by suicide than from a jobsite injury.
Checking in on the mental health of construction workers
Experts say construction workers are five times more likely to die by suicide than from a jobsite injury.
The U.S. sent an Iranian Christian to Panama. It had no plan for what came next.
One man’s 18 months in the limbo of Trump’s third-country deportations.
CW@60: AI will change the economics of business more profoundly tha...
I have spent most of my working life watching technology change what it means to run a business.
Charles River Community Health launches $5.2M expansion to meet high patient demand
With nearly 10% of Waltham residents turning to Charles River Community Health for essential medical care, the health center is launching a major
Letter: Science fiction becomes climate change reality
From John Barnie, Aberystwyth, Ceredigion, Wales, UK
UW Health celebrates 60 years of transplant program with patients, donors and families
The UW Health Transplant Center began performing kidney transplants in 1966.
Deschutes County Health Services Host Naloxone Pop-up Sept. 24th
Deschutes County Health Services, in partnership with Almadorada coffee shop, will host a pop-up naloxone distribution event on Thursday, Sept. 24, from noon to 3 p.m. at Almadorada, 180 NW Oregon Ave., Bend. The pop-up is part
Adam Smith appointed chairman of Disney Entertainment’s Direct-to-Consumer division
Disney names Adam Smith as chairman of Direct-to-Consumer and Joe Earley as president of TV franchise and content strategy.
Bears' offense evaporates, Caleb Williams injured late in loss to Vikings
Caleb Williams left in the fourth quarter with a hamstring injury, and the Bears dropped to 1-1.
Alaskans will decide fate of ranked choice voting system after chaotic end to state's primary
The August primary revealed some of the headaches related to a major change in how Alaska voters select their candidates and was the latest example of how the real-world experience of state voting changes don't always line up neatly with expectations.
Ernie Accorsi — former Giants GM who set up team to win two Super Bowls
Ernie Accorsi was inducted into the Giants' Ring of Honor in 2016.
'The Voice' Season 30 premiere: How to watch live, new coaches, where to stream and more
'The Voice' returns for Season 30 this week. Here's how to watch live.
To Your Good Health: Word-recall difficulty causes concern in 70-year-old female
Occasional tip-of-the-tongue word-recall problems are a normal part of healthy aging.
Political Beat Preview: House District 98
Incumbent Democrat Beth Helfrich is seeking re-election and facing a challenge from former Republican representative John Rhodes in North Carolina’s 98th House district that covers the northern part of Mecklenburg County.
DIALOGUE: NAMI Albany invites community to support mental health at NAMIWalks
One in five Americans live with a mental illness. The Albany chapter of the National Alliance on Mental Illness wants to remind the community that no one has to face it alone. Ngina Mandouma and Kelly Wesselman joined Sunday’s Dialogue to discuss their involvement with NAMI and to invite the community to support mental health for all through NAMIWalks.
DIALOGUE: NAMI Albany invites community to support mental health at NAMIWalks
One in five Americans live with a mental illness. The Albany chapter of the National Alliance on Mental Illness wants to remind the community that no one has to face it alone. Ngina Mandouma and Kelly Wesselman joined Sunday’s Dialogue to discuss their involvement with NAMI and to invite the community to support mental health for all through NAMIWalks.
DIALOGUE: NAMI Albany invites community to support mental health at NAMIWalks
One in five Americans live with a mental illness. The Albany chapter of the National Alliance on Mental Illness wants to remind the community that no one has to face it alone. Ngina Mandouma and Kelly Wesselman joined Sunday’s Dialogue to discuss their involvement with NAMI and to invite the community to support mental health for all through NAMIWalks.
DIALOGUE: NAMI Albany invites community to support mental health at NAMIWalks
One in five Americans live with a mental illness. The Albany chapter of the National Alliance on Mental Illness wants to remind the community that no one has to face it alone. Ngina Mandouma and Kelly Wesselman joined Sunday’s Dialogue to discuss their involvement with NAMI and to invite the community to support mental health for all through NAMIWalks.
'I'm so, so sorry': Ed Sheeran speaks out at his first show after Macklemore controversy
Before performing in Philadelphia on Sept. 19, Ed Sheeran addressed the controversy surrounding Macklemore’s removal from the U.S. dates of his Loop Tour following pro-Palestinian remarks made onstage.
Trump says his planned arch would become a 'military complex' able to host drones and snipers
Trump has also been calling the new White House ballroom a “military complex” and arguing it is necessary for national security purposes.
Trump says planned arch will be ‘military complex’ for drones, snipers
The president’s new claims about the triumphal arch come as veterans groups, historic preservationists and others attempt to stop the project.
'They didn't want me, I didn't want them:' Florida's Jon Sumrall says he had no interest in Auburn job after Gators' win over Tigers
3 notable business takes that flew under the radar this week
Inside the latest chatter from important business leaders.
A Cloudy Climate Mystery Over Antarctica Has Scientists Rethinking Their Models
Researchers compare observations with leading climate models to identify errors and help improve future climate predictions. Some simulations put too many low clouds over the Southern Ocean, yet still underestimate how much heat reaches the surface below. Observations from an Antarctic research voyage suggest that fixing the cloud count alone will not solve the problem.
Board risky trainees at an Oglesby business?
There is a shortage of workers trained to install big solar systems, so the industry is turning to ex-convicts and other risky candidates to do the jobs. An Oglesby company is taking that to the next level.
Sunday Night Football: How to watch the Indianapolis Colts vs. Kansas City Chiefs game tonight
How to watch this week's Sunday Night Football clash between the Colts and the Chiefs.
Parental instincts are crucial. The internet is clouding them.
Parents have more access to health information than ever, but it is conflicting and erodes their confidence.
Scientists heard a knock at the door. It was a pelican in need of help.
“This is kind of just a once-in a-lifetime experience,” said marine researcher Annsli Hilton.
Minnesota Vikings vs. Chicago Bears: How to watch the NFL Week 2 game, channel, streaming info and more
How to watch the Vikings play the Bears this Sunday.
Pittsburgh Steelers vs. New England Patriots: How to watch, start time, where to stream free and more
Find out how to watch the Steelers vs. Patriots NFL game this week.
3 science-backed home remedies to ease the common cold
Rest and hydration are essential, but these other strategies may also bring relief.
Trump and sons invest heavily in AI economy as he resists calls for slowdown
Trump’s decisions as president on one of the most consequential policy debates of his administration could affect the value of his personal investments.
In the end, Ole Miss got its revenge on Lane Kiffin in the most satisfying way possible
Kiffin's return to Oxford did not disappoint. The Rebels surged, the Tigers rallied, and then Trinidad Chambliss stole the show and Ole Miss sent its former coach home with an 'L'.
Pink Jupiter?! The science behind this psychedelic view of the gas giant is key to what makes the planet tick
Hubble Space Telescope captured an image of Jupiter in ultraviolet light as part of a study to 3D-map the gas giant's cloud system.
Valley organizations team up to provide hot food, health care
A Phoenix-based outreach organization is partnering with a mobile medical clinic to bring health services directly to neighborhoods across the city, including HIV testing and health education.
Valley organizations team up to provide hot food, health care
A Phoenix-based outreach organization is partnering with a mobile medical clinic to bring health services directly to neighborhoods across the city, including HIV testing and health education.
I tried to upgrade myself to business class without my kids. I never thought it would work
Chalk it up to a failed experiment.
Hope Harbor Speakout Through the Decades event
Guests enjoyed an evening of entertainment, games, and heavy hors d’oeuvres as they honored Hope Harbor’s history and looked ahead to its future.
Misery Index: NC State's all-time collapse brings up questions about Dave Doeren's job security
Melbourne Square held a free science event for children
Mad Science held an interactive event at Melbourne Square featuring optical illusions and detective science for kids.
Kansha grateful to serve community
Spouses recently located their business to Sandusky area
IT admins can now remotely “Sanitize” PCs and reinstall Windows 11, thanks to two new features in Cloud Rebuild
Windows 11 Build 26340 upgrades Cloud Rebuild with hardware-level drive sanitization and remote CSP deployment for IT admins. Here is how.
Tribes hit hard by wildfires face health effects, cultural losses
Neighbors across the Colville Tribes communities in Washington state knew Matilda Bob’s log home as the “rainbow house,” for its brightly painted exterior. Now it’s gone. Sparked by a lightning […]
MLT’s new family-focused indoor entertainment complex open for business
Just in time for the rainy season, Monster Mini Golf opens its doors in Mountlake Terrace, across the street from the Grocery Outlet and Cinebarre. The 18-hole, glow-in-the-dark, mini golf […]
MLT’s new family-focused indoor entertainment complex open for business
Just in time for the rainy season, Monster Mini Golf opens its doors in Mountlake Terrace, across the street from the Grocery Outlet and Cinebarre. The 18-hole, glow-in-the-dark, mini golf […]
SEED STEM Festival brings science to life for local children
From building robots to exploring neuroscience, local children got hands-on experience with science, technology, engineering and math Saturday at Aiken’s 41st annual SEED STEM Festival.
Topeka businesses go head-to-head in truck pull to support local pantry
Be Filled of South Topeka hosted its Annual Pull Event Saturday morning.
Local First Foundation advocates for community-based healthcare plan across La Plata County
Nonprofit asks city to get involved
Sunflower Troupe seeks Four Corners playwrights for 2027 short-play festival
Selected works will be performed next summer
Trump to form ‘AI Force,’ name AI czar but rejects calls for constraints
A growing chorus of lawmakers and industry leaders have called for moving more slowly on the technology.
Oktoberfest Findlay! celebrates heritage, history
Event features live German entertainment, music
Congo begins Ebola vaccinations for health workers in the epicenter of the outbreak
Health workers and other front-line workers in the Ebola response are being prioritized to receive the Ervebo vaccine that was effective in past Ebola outbreaks caused by a different, more common type of virus.
Russian election observer loses consciousness during arrest by police, opposition party says
The three-day election, which began Friday and ends Sunday, features virtually no opposition and is all but certain to secure the Kremlin’s political dominance.
Millions of funds from Rural Health Transformation program earmarked for Coast efforts
Mississippi is awarding more than $104 million to modernize and expand rural healthcare. The funding is part of the state’s Rural Health Transformation Program. George County is receiving multiple awards for hospital and healthcare upgrades, including new patient monitoring, lab and maternal health equipment, cybersecurity improvements, and other technology. Memorial Health System is also receiving millions for projects in Stone...
President Trump on why he’s banning media outlets from the White House
President Trump said he would block MS NOW, CNN and Politico from White House grounds.
Trump announces all 50 states joining Medicaid drug pricing model
The Trump administration claims that Medicaid will save billions on prescription drug costs as a result of the plan, dubbed the Medicaid “GENEROUS” model. Experts say the savings are unclear since the content of the deals isn't public.
MS NOW, CNN and Politico say their journalists were denied access to White House after Trump ban
Trump had said Friday he would ban all three outlets because of coverage he disliked.
Thousands join protest outside Kennedy Center, expressing concern that Trump might tear it down
Friday's event followed a tumultuous week in federal courts in Washington where filings and counter-filings flooded the courts as the administration continues pushing for the president’s vanity projects.
The Big Holes in Wearable Heart Rate Variability And Readiness Scores
On September 9th, Apple announced it was revamping its Apple Watch Health Sensing System, rolling out a Readiness score (0 to 10), and increasing the frequency of heart rate variability (HRV) outputs 24-fold. This can be viewed as upping its competition with various other consumer wearable sensors. These “readiness scores” as a composite of multiple metrics, with heart rate variability (HRV) being front and center for most. The majority of Americans are now using wearable sensors, which equates to well over 100 million adults. HRV and Readiness scores are increasingly being marketed as a measurement of autonomic nervous system health, a digital marker for future disease, a clock for biological age, and a holistic metric to promote healthspan and even longevity. (Apple also introduced a new longevity tab and “Health Age”.) None of this has been proven. In this edition of Ground Truths I am going to review what we know about heart rate variability and readiness scores. Heart Rate Variability HRV is the variation in normal heart cycle timing. The variability of the heart rate, the barely perceptible millisecond changes in time between consecutive heart beats (see R-R intervals in the Figure below, left panel), is due to interplay between the sympathetic and parasympathetic (vagal nerve) inputs. Distinct from heart rate, individuals with the same heart rate can have very different HRVs. It is a rough reflection of the autonomic nervous system (ANS) activity, inadequate to say whether a person’s ANS function is abnormal. For more than three decades, heart rate variability (HRV) has been measured and several studies have found an association of low HRV and clinical outcomes, particularly a link with higher all-cause and cardiovascular mortality. There have also been less well established links of low HRV to risk of early cognitive impairment, dementia, mental illness, Type 2 diabetes and substance abuse. An important reminder is that HRV is a surrogate marker without any established cause-and-effect relationship. If you increase your HRV, that doesn’t mean it will improve health outcomes. In fact, there is no hard evidence for that. All that work linking to health outcomes was done with electrocardiogram (ECG) derived HRV. Now, in the era of consumer wearables, this is getting assessed differently, by optical pulse (yes, the lights you see) plethysmography (PPG) or what is called pulse rate variability (PRV). They are not the same, as shown below (right panel) and only concordant when the delay between the ECG and pulse is kept constant, which basically means at rest. I should mention there’s also what I will call MPV, a mattress mechanical movement sensor, a derived heart rate variability, that companies like Eight Sleep use, even further away from directly measuring HRV. HRV has not one uniform measurement but many different types of quantification, such as RMSSD, the magnitude of difference between successive R-R intervals of normal sinus beats (N-N) or SDNN, the standard deviation of NN intervals, both in milliseconds. SDNN is one of the so-called frequency domain HRVs (others are LF, HF, LF/HF). Different wearable sensors use different metics; Apple has relied on SDNN and nearly all of the others use RMSSD, which is generally considered the more accurate metric. There’s also the different length of time measured, such as for a matter of minutes, all day, or an overnight’s sleep. Short measurements are especially problematic since they don’t capture enough of respiratory modulation and other factors that influence HRV. Share Ground Truths How well does HRV correlate with PRV? There are very limited studies, especially independently done. One that is commonly cited was conducted by Air Force researchers in only 13 healthy adults assessing Oura ring 3 and 4, Whoop 4.0, and Garmin Fenix 6 and showed a correlation coefficient of 0.88 to 0.97 and a mean absolute percentage error from 6 to 10%. The correlation is not a perfect 1.0, but there’s at least a fairly high level of correlation. HRV is supposed to increase during the night due to takeover of the parasympathetic nervous system, and higher during deep sleep. A recent example of my 1 week, all day “HRV,” and one during sleep is shown below. As you can see, the N of 1 data are inconsistent for the same days from different sensors (Oura, AppleWatch, Fitbit Air, and Eight Sleep) by patterns, absolute numbers, and comparison with prior days and weeks. The largest study in over 8 million Fitbit users (the old version, not Google Fitbit Air, introduced in May 2026) gives you a sense of the effect of age, sex, and the 2 different main HRV (here PRV) metrics, with RMSSD on the left and SDRR (=SDNN) on the right below. That study, from data collected in 2018, is a major outlier, since all the more recent ones are tiny with respect to sample size. Many of the companies have not had independent evaluation of their HRV, such as Eight Sleep, but have published a low standard error on their website. There are some other published studies on the correlation between HRV and PRV, but they are all small and only in healthy adults. A scoping review emphasized the lack of study in underrepresented individuals, including the aged, people of color (which affects the PPG signal), and individuals who are underweight or obese. Add the typical adult age 60 plus with one or more chronic diseases. For example, one study in over 900 adults found poor correlation of HRV and PRV, non-uniformly underestimated across many chronic diseases (cardiovascular, endocrine, neurological, respiratory, and others), concluding PRV is “an invalid surrogate for HRV.” A recent systematic review of 43 studies comparing HRV and PRV found reasonable pooled absolute standardized error (HRV as gold standard) but only 10 of the studies provided quantitative synthesis in ideal conditions. Their main conclusion was similarly cautious: “PPG-derived HRV [PRV] should not be regarded as universally interchangeable with ECG-derived HRV across all devices, populations, and recording contexts.” Factors Affecting HRV and PRV That gets me to the long list of factors that affect HRV (and PRV) besides the device, the type of measurement (RMSSD, SDNN or others), the person’s signal, the sensor site, the duration of data capture, if weighting by sleep stage is used, how artifact is processed and corrected. And this list is not complete!: Oura puts out data from their community of users (who input data) on what affects their overnight HRV. The factors currently provided are: no alcohol (increase 8%), melatonin (increase 2%, float tank (increase 2%), wine (decrease 4%), and party (decrease 14%) in overnight HRV. Must be some big parties! Subscribe What is a PRV measurement good for? It has been falsely characterized as an index of “autonomic balance” and a specific indicator of stress. A 2018 review of the studies available for HRV and its relationship to stress, not using any of the current wearables, found that stress can lower HRV. But so can many other factors. The non-specificity of the signal, indexed to the table above, is striking. Evidence from a UK Biobank study of over 46,000 participants with actual HRV looked at genetically predicted HRV, a genetic risk score, that failed to show the expected HRV-mortality link, indicating that _HRV is likely not causa_l, but rather a reflection of person’s physiologic state. A review of consumer wearable HRV data from 5 longitudinal studies showed that nighttime PRV was not associated with perceived stress, and surprisingly higher HRV, in the largest cohort (N=717 participants), was correlated with higher stress. An Oura ring cohort of 525 first-year college students found a link between overnight PRV and perceived stress, but that was also seen with resting heart rate, sleep, and respiratory rate. Several very small studies have examined the relationship of HRV and athletic injuries or guiding training with mixed, and predominantly negative results. HRV biofeedback training with paced breathing had no significant effect on reducing stress or raising HRV, as demonstrated with sham controlled trials. When HRV for multiple days showed a decline in conjunction with body temperature, the Oura ring published data for prediction of Covid. The WHOOP company sponsored an observational study, published in 2026, of 30,000 users for 72 weeks, without a control group, that reported reduced alcohol intake (5.8 % points) by self-report. That doesn’t tell us much, and particularly about the merits of HRV for behavioral change. If you use the same device and conditions as longitudinal trends for multiple (at least 2-3) weeks that may be the one way to get something useful from the measurements. Data for overnight sleep with minimal motion and using RMSSD is the best proxy for real HRV. The reason to look at trends rather than any given night is that it more likely represents something, even though you won’t know with certainty what the “it” is. Keep in mind there are no data, no peer-reviewed evidence, to show that HRV fluctuation in-person has any correlation with health outcomes. Share Readiness Scores These are proprietary scores that integrate different metrics for each of the wearables: no algorithms have been disclosed. They are unvalidated against health outcomes. In a review of 14 composite health scores of readiness and recovery, HRV contributed 86% to the scores, followed by reading heart rate (79%), physical activity and sleep duration (both at 71%). That review noted the substantial variability in measurement protools and lack of standardization. Sleep staging is notoriously inconsistent and inaccurate by these sensors, which adds further to the HRV uncertainties for what the scores, which use sleep stage data, mean. Only resting heart rate has been shown consistently across devices to be extremely accurate. I’ve made a Table to summarize what we know about which metrics are included, the scores, any peer-reviewed studies that compared the readiness score with health outcomes, and the corresponding (if any, NA-not available) citation. You will note that some companies do not use the term “readiness," such as WHOOP for recovery, and Garmin, which has 2 different scores, one of which is Body Battery. Eight Sleep uses the term “Fitness Score.” They all include HRV; Apple includes a new metric they call “Recovery HRV” which among other components uses 7-days of sleep, but it is unclear what this means or how it is differentiated from other scores (there are clearly no data for outcomes). We have no knowledge of how the different components are weighted or whether any of these scores are better than resting heart rate, HRV alone, physical activity, or any other single metric. Since none of these are standardized, they are not interchangeable, so if you get a 90 for Oura that has no relationship to a 90 on a Google Fitbit Air. Notably, the company can update its algorithm for readiness score at any point without notification to device users. Without any useful evidence of actionability for these scores or established relationship with health outcomes, it is hard to make a case for their value. At the Apple recent announcement they showed their Readiness score (0-10) on the watch (Figure below) but there are no published data on this score, not even on their website. It’s available only on their new Watch Series 12 or Ultra 4 [of course, ;-)]. That exemplifies the problems with these scores, lack of data and evidence for being meaningful to promote health. Perhaps the best study (which isn’t saying much) is the WHOOP Recovery for golfer performance, because it did correlate with an objective outcome, even though there was no control group and the authors were all from the company. Among the 389 pro golfers, an absolute 10-per cent point increase in Recovery score was associated with about 0.5 fewer strokes per round. But that’s hardly a health outcome! WHOOP is also conducting a study in over 2,700 runners to see if their recovery score will be linked to less injuries and improved performance, but that is not yet published and has no control group or randomization. Putting This in Context For two decades I’ve been enthusiastic about the potential for digital health and particularly wearable biosensors. Over the years, we’ve seen some great progress for their ability to promote physical activity and accurately detect atrial fibrillation (the first FDA cleared deep learning AI for consumers). That work was the subject of rigorous research. But there are holes in the data and evidence for other metrics. One notable one is the “VO2 max” story that I wrote about earlier this year. At that time many subscribers asked me to cover heart rate variability, which I finally got to here. When I dived into the research and publication for HRV and readiness scores, I expected to find at least some that were of high quality and demonstrated their utility by linkage to health outcomes. To my surprise, I found none. The wearable sensor measurements for HRV (PRV) are, for the most part, accurate, but that validation work has only been done in small studies of healthy adults and does not take into account the long list of factors, from the device, software side, and the user side, that affect HRV measurements. Moreover, this metric chiefly relies on optical sensing and, as we have learned for heart rate PPG sensing, may be less accurate in people of color. Keep in mind that all of the health outcome association evidence comes from ECG-derived HRV; none are from wearable sensor data. I will repeat the key point: there's no peer-reviewed evidence to show that in-person HRV fluctuation—or efforts to raise your HRV— has any correlation with health outcomes. For those of you who look at your HRV on awakening, or even 2+ week trends of it being low, I hope this context helps to relieve any anxiety. Yes, low HRV (not PRV) has been shown to increase risk of some diseases as summarized above. But efforts to raise your HRV—a surrogate metric— has not been established for improving any health outcomes. HRV does not have any evidence of causality (the genetic evidence actually goes against this possibility). In this summary, I have not included data for other wearable sensors such as Polar, Samsung, Withings, Suunto, Amazfit, Coros, Ultrahuman, or additional mattress sensors. These are beyond my first-hand experience, and as far as I know from my in-depth review none have any peer-reviewed published data that differ from the 6 sensors I’ve reviewed here. From the points I’ve gone over above, we’re not ready for readiness scores. Besides being proprietary, they are predominantly based on metrics that have their own issues. It’s compounding the problem, like building a house without a solid foundation that has never undergone a rigorous inspection, and then selling it. Like I mentioned for PRV, you can look at trends over weeks rather than any single day, to get a handle, but even that may not be helpful. There’s simply no evidence that these scores meaningfully relate to health outcomes. I’d emphasize they might, but that requires doing prospective or randomized studies to prove it. None exist. There’s great promise for HRV/PRV utility_. For example**,**_ Prof Maiken Nedergaard, who discovered the brain glymphatics that are essential in eliminating metabolic waste products from the brain during sleep, has posited that HRV could be a non-invasive marker for neuromodulator oscillations, brain-body regulatory circuits, and brain clearance. That would be extremely useful, but like everything else on HRV and readiness scores it requires solid research and validation. The lay media isn’t helping much to get the story straight. Earlier this year The Economist published a piece entitled “The most useful indicator of your overall health” which ordained HRV as an “accumulated stress score.” That’s akin to the false assertion about VO2max: “V02 max is the singular most powerful marker for longevity.” As I’ve summarized here, that is not established. The fact is that so many things can lower HRV, including physical exercise (especially an intense workout), reduced sleep quality, stress, the list above, no less the device, signal, and software. Whatever fluctuations observed have not been correlated with any health outcome. Sadly, “datamaxxers” are widely using HRV and readiness scores that have never been validated to mean anything. We already know that for some people using the sensors for sleep metrics, it can induce “orthosomnia,” an obsession to get high sleep quality, with associated high levels of anxiety. In an experiment done by a company to promote sleep quality for its employees, “For those employees who did use the trackers, many reported feeling perfectly rested until their tracker told them they had had a terrible night. Others were told that they had slept like a baby when they had actually been lying awake worrying about the quality of their sleep. “ The same problem can result from preoccupation with HRV or readiness scores, with anxiety that would lead to further reduction in both. It you are using a wearable like >100 million American adults, it’s OK to look at these data, but contextualized with the major caveats reviewed here. If you are one to require evidence that HRV or readiness scores are linked to health outcomes, you may not even want to look. The companies make it hard to turn them off! Let me end with the companies that make and sell wearables. Apple’s doubling down on HRV (24-fold more reporting and heart rate very 5 seconds) and introduction of a Readiness score tells us that consumers have bought into these metrics and they are joining the club. However, all of this is occurring with a backdrop of tens millions of users, claims about the data that are not backed up by adequate evidence, marketing way out in front of whatever limited data exists, and not being transparent about their readiness score algorithms. The companies can well afford to do the research that is needed to connect these metrics with health outcomes show, once and for all, that increasing HRV or using readiness scores promotes our health. If they believed and invested in the products they are selling, we’d not be in this position of not knowing. That’s essentially where we are with HRV and readiness scores. Perhaps someday this will change and we’ll have good reason to embrace them. NB: I wrote this post. No AI. I have no conflicts of interest with any of its content. Loading... Ground Truths has 215,000 subscribers from every US state and 214 countries. There are over 300,000 followers of Ground Truths so more than 90,000 folks who can easily convert to be free subscribers. Your subscription to these free essays and podcasts makes my work in putting them together worthwhile. If you’re not a subscriber, please join! If you found this interesting PLEASE share it! Share Ground Truths The proceeds from all voluntary paid subscriptions go to support our summer internship program. It enabled us to accept and support a record number of 62 summer interns that joined us in 2026! These are high school, college and medical students selected from thousands of applicants. We couldn’t do this expanded program without the funds coming in through Ground Truths. Thank you!
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