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Senate tees up college sports bill aimed at regulating NIL deals
The Senate is due to vote Monday on the bill, which would create a national framework for name, image and likeness deals in college athletics.
Warriors’ Kristaps Porziņģis has ‘health issue,’ will miss start of camp
"This came as a surprise," Warriors coach Steve Kerr said. "But we'll deal with it and move forward."
Notre Dame Soccer and Volleyball get new Leprechaun logos
Notre Dame continues its rebranding efforts with more alternate leprechaun logos for its athletics programs.
Mass. launched a program to stop school sports bullying. Why are so few schools using it?
A state government initiative started four years ago specifically to prevent hate and bias in athletics, called Addressing Hate in School Sports. Yet reports of such incidents remain common across the booming school sports landscape.
Franchise-Defining Offseason Looms for A's Ownership
This will be the A's last offseason left to tinker with the roster before needing a well-oiled machine when they land in Las Vegas in 2028. Between a GM search and a wave of key players on the mend, ownership has a lot riding on getting this winter right.
The science of speed suits: Do they really make you faster?
The suits are designed to reduce 'wake drag', potentially helping save time and energy
Connections: Sports Edition today: Hints and answers for Sept. 28, 2026, puzzle No. 735
Welcome to Connections: Sports Edition Coach — a spot to gather clues and discuss (and share) scores.
Astros Are Playoff Bound after 9-0 Whitewashing of Athletics
There’s a new worst record to go to the postseason, but at least it isn’t a sub-.500 one. The Houston Astros handled business today in West Sacramento against the Athletics, 9-0. With the victory, the Astros are AL West Champions and will host the Chicago White Sox in the AL Wild Card Round beginning Tuesday […]
The CTE conversation: What science actually knows (and what we don’t)
Brain injury fears are reshaping youth athletics, but scientists say the CTE conversation is missing key facts.
A's Have One More Game to Play Spoiler Against Houston
In addition to playing spoiler on Sunday, the A's will have an achievement of their own worth chasing.
Connections: Sports Edition today: Hints and answers for Sept. 27, 2026, puzzle No. 734
Welcome to Connections: Sports Edition Coach — a spot to gather clues and discuss (and share) scores.
Some health questions answered, others arise for Dodgers with October looming
The Dodgers need a healthy Snell, even if he might not pitch until Game 3 of the NLDS.
Suns' Aggressive Offense Could Pay Off This Season
Jordan Ott’s high-octane system gains a massive athletic boost with Miles Bridges, leveraging rim-running and interior mismatches to stress defenses and create high-percentage scoring opportunities this season.
Jacob Lopez Rights Ship, Shuts Down Astros
Jacob Lopez had struggled heading into his final outing of the year, but he shut down an Astros team looking to punch its ticket to the postseason.
UConn Athletic Director Responds to Bombshell Report About Conference Change
David Benedict had a quick response to reports that UConn Football wants to join the AAC.
Real Madrid’s Midfield Woes Resurface After Atlético Loss
Real Madrid’s 2-1 defeat at Atlético Madrid on Sunday has left José Mourinho’s side fourth in La Liga after seven matches, six points behind leaders Barcelona, according to The Athletic. The res...
Alex Greenwood free-kick helps Man City defeat Charlton
There has been lots of talk about the validity of the success of Manchester City's men's team in the last 24 hours but the women put in a spirited effort to defeat away to Charlton Athletic.The Citize...
How the war in Iran is creating chaos and uncertainty in sport
Analysing the potential impact on a range of events in the coming months, including F1, golf, tennis and cycling
Connections: Sports Edition today: Hints and answers for Sept. 26, 2026, puzzle No. 733
Welcome to Connections: Sports Edition Coach — a spot to gather clues and discuss (and share) scores.
Popular Syracuse Athletics Personality Accepts New Role in Professional Ranks
Sean Dorcellus is moving on, but where to?
Flagg’s height, Irving’s return, Lively’s health and more from Mavericks media day
Kyrie Irving is back while Dereck Lively II is hoping to join him.
‘Friday Night Lights’ tops sports-themed TV shows on New York Times’ 100 ranking
What other sports-themed TV shows from the 21st century made the Times' Top 100 list?
Man City vs the Premier League: The lawyers who have been fighting sport’s ‘trial of the century’
A guide to the highly-trained - and paid - barristers who have been arguing one of English football's most significant legal cases
Spence hits first 3 homers of career, helps Astros survive Athletics 7-5
Houston (79-80) remains tied with the Texas Rangers for the AL West lead with three games left in the regular season for both teams.
Spence hits first 3 homers of career, helps Astros survive Athletics 7-5
Houston (79-80) remains tied with the Texas Rangers for the AL West lead with three games left in the regular season for both teams.
Syracuse athletics announces new sports performance director
Syracuse athletics announced a new sports performance director on Thursday.
America’s newest soccer star, plus a bad night for Green Bay
The Pulse Newsletter 📣 | This is The Athletic’s daily sports newsletter. Sign up here to receive The Pulse directly in your inbox. Good morning! Don’t get fined today. Coming up: 😮 A Falcons blowout win? ✅ The latest MLB playoff clinches 👋 Say hello to Cavan Sullivan Geoff Stellfox / Getty Images It’s a busy day, so this will be short. Important stuff from last night: The Falcons routed the Packers on the road, 35-14, in one of the more surprising results of the early NFL season. A lesson learned: Having a competent quarterback to go with Atlanta’s...
Can the WNBA’s biggest star just play basketball? Let’s ask Caitlin Clark
"“Everybody wants her to be something." But what does Clark want to be?
Spence Powers Astros with Three-Homer Night Against A's
The Athletics are looking to play spoiler this weekend, but rookie Lucas Spence decided to put Houston on his back in Game 1.
Connections: Sports Edition today: Hints and answers for Sept. 25, 2026, puzzle No. 732
Welcome to Connections: Sports Edition Coach — a spot to gather clues and discuss (and share) scores.
Houston Astros shortstop Jeremy Peña back in lineup against Athletics
Houston Astros shortstop Jeremy Peña returns after missing one game from being hit by a pitch on his arm.
'I'm in a pretty good place.' Why Terry Francona's health key for Reds
Reds manager Terry Francona said his regular swimming regimen has kept him sharp and healthy through a rough season, Thursday's 7-6 victory over Atlanta notwithstanding..
Astros at Athletics Game Discussion 9/24/2026
TONIGHT’S GAME: The Houston Astros will continue their final road trip of the regular season with the first game of a four -game series against the Athletics at Sutter Health Park in West Sacramento, CA…RHP Peter Lambert (8-10) will be on the mound for the Astros, opposite RHP Mason Barnett (1-4) and the Athletics. THE […]
Senate bill on college athletics won’t ‘save’ NCAA sports, Sam Acho says
ESPN analyst Sam Acho discusses his perspective on the Senate bill aimed at restructuring college sports.
Rangers finish home slate with 3-1 win over Mets
Texas (79-80) stopped a three-game losing streak and moved a half-game ahead of Houston, which played Thursday night at the Athletics.
Ex-NC State sports medicine director arrested after accusations of sexual abuse
More than 30 former NC State athletes have accused Robert Michael Murphy Jr. of sexual abuse.
Capitol agenda: Democrats fracture over college sports - Live Updates
Despite bipartisan backing of a college athletics bill, Black Democratic lawmakers are warning their own party that supporting the measure risks exploiting Black athletes.
Why are trading cards surging again? Average collectors, wealthy investors seeing value
Trading cards likely generated well over $1 billion in sales in August alone, pushing the once sleepy hobby into uncharted waters.
UNC, Michigan followed the college sports investigations’ playbook: No paper trail
More and more, if a university needs an external investigation, it will retain a law firm that delivers the findings verbally.
How Roger Federer became a global sports brand, on the tennis court and off it
The 20-time Grand Slam champion's off-court identity is tied to — and bolstered by — his commercial moves.
How the Laver Cup works: Its tennis status, match format, who is playing and why
The tournament is somewhere between a glitzy pageant and a serious sporting endeavor. The players seem to like it that way.
Los Angeles Angels edge closer to franchise rock bottom
The Oakland Athletics defeated the Los Angeles Angels 7-3 on Wednesday night, powered by a three-run blast from Donovan Walton and a career-first four-hit game by rookie Henry Bolte.
Manchester United announce seventh annual loss in latest financial record
Manchester United finished third in the 2025/26 Premier League season while recording their lowest wage bill in six years, The Athletic reports.United spent £302 million on wages during the year, dow...
For Lewis Moody, motor neurone disease is not the end. It’s a beginning
England's former rugby union captain is attacking his MND diagnosis with the same fervour in which he played
Three big issues Julian Ward would need to resolve as Liverpool’s new sporting director
Ward is in advanced talks to be appointed Liverpool sporting director. Here are the things that need to be sorted over the coming year
Connections: Sports Edition today: Hints and answers for Sept. 24, 2026, puzzle No. 731
Welcome to Connections: Sports Edition Coach — a spot to gather clues and discuss (and share) scores.
Details as Milan prepare to renew Christian Pulisic’s contract
Serie A side Milan are yet to tie down Christian Pulisic to a new deal, with the player’s current contract running out in 2027. While the Athletic have reported that no talks have taken place, some ...
How ‘One Piece’ became sports’ biggest crossover sensation: MoneyCall
This week's free sports business newsletter from The Athletic name-checks everyone from Monkey D. Luffy to Howard Schultz.
England captain Harry Kane eyes combining MLS stint with NFL kicker role
Kane is "fairly close" to agreeing a new contract with Bayern Munich but is still considering a change of sports at the end of his career.
Debut Patches are everywhere, and the cards they’re going into are selling for big money
More and more sports leagues are utilizing Topps' Debut Patches on player uniforms and the response from collectors illustrates why.
ICYMI: Protect College Sports Act Earns Support from Students, Coaches, ADs, Professors, University Presidents - U.S. Senate Committee on Commerce, Science, & Transportation
WASHINGTON, D.C. – Student athletes, coaches, professors, and presidents from universities and colleges from across the country have rallied behind the bipartisan Protect College Sports Act. The American Football Coaches Association (AFCA), the National Association of Basketball Coaches (NABC), and FBS Athletics Directors Association have all offered their support. Ruben Rojas Betanzos, a student athlete […]
Riverhounds to host Pittsburgh Spirit Reunion at F.N.B Stadium
The Pittsburgh Riverhounds will host a Pittsburgh Spirit Reunion during their match against Hartford Athletic at 7 p.m. on Oct. 10 at F.N.B. Stadium.
Arkansas athletic director Hunter Yurachek feels mounting pressure
Amid calls for boycotts, resolutions from the Board of Trustees and fans wearing bags on their heads, Arkansas AD Hunter Yurachek feels the pressure.
Roma Reportedly Eyeing Frosinone Winger Giorgi Kvernadze
Roma’s search for an athletic left winger could lead to Frosinone’s Giorgi Kvernadze, who could make a midseason switch.
Matthew Berry expanding beyond ‘Fantasy’ with new daily talk show on Roku Channel
Arguably the most well-known fantasy football personality, Berry is shifting from NBC Sports to hub Roku Channel's daily sports lineup.
Many coaches negelct their health. After Shawn Clark’s death, his widow wants to change that
Jonelle Clark founded the Shawn Clark Legacy Foundation and the 61 Initiative to convince coaches to get checkups and monitor their health.
Connections: Sports Edition today: Hints and answers for Sept. 23, 2026, puzzle No. 730
Welcome to Connections: Sports Edition Coach — a spot to gather clues and discuss (and share) scores.
New Xavier Athletics partnership promoting mental health with uniform patch
A new number appeared above Xavier men’s soccer players’ jersey numbers Tuesday night: 1N5.
Without Olivia Miles, Lynx lose to Fever, need rematch win to clinch No. 1 seed
Indiana can't slide lower than the sixth seed in the postseason with Tuesday's win.
A's Notes: Kuroda-Grauer Returns, Muncy to IL
The Athletics are getting back one infielder, but losing another to begin the final week of the season.
Syracuse athletic department hires Cleveland Cavaliers exec to boost business
Chris Presson will run the business side of the Syracuse athletic department for Bryan Blair.
The Athletic Gives Red Wings Just 26% Playoff Odds
The Athletic put a hard number on Detroit's playoff chances, with and without Dylan Larkin. #RedWings
A's Have Looming Roster Decisions to Make
With 10 players on the 60-day IL, the A's will have to add them back to the 40-man roster this offseason. Those decisions will have an impact on the team's offseason approach.
Julian Ward expected to be named Liverpool sporting director
Richard Hughes officially left the role at the beginning of September ahead of joining Saudi Pro League side Al Hilal.
University of Tennessee breaks ground on 865 Neyland entertainment district
A new era for the University of Tennessee campus and Big Orange athletics is officially underway.
Why are Florida senators against the Protect College Sports Act?
A procedural vote last week placed the bill seeking to regulate collegiate athletics on the verge of U. S.
Cardiff pain must lead to progress for Charlton
Charlton Athletic fan Paul Sullivan hopes the club can use the extended international break wisely
The Giants’ season is already in danger, plus an early NHL preview
The Pulse Newsletter 📣 | This is The Athletic’s daily sports newsletter. Sign up here to receive The Pulse directly in your inbox. Good morning! Talk to your friends about EPA today. Coming up: 🔀 Vibe shift in L.A. 🤓 The WNBA’s spectacle 📕 We’re all football nerds Football season can be so fickle. Vibes can turn on a dime. Last week, we marveled at how the new-look Giants dominated the Cowboys in primetime. We wondered if New York’s ceiling could be higher than previously thought under coaching legend John Harbaugh. And we wondered if the Rams’ dream season...
Connections: Sports Edition today: Hints and answers for Sept. 22, 2026, puzzle No. 729
Welcome to Connections: Sports Edition Coach — a spot to gather clues and discuss (and share) scores.
Doc Rivers, retired from coaching, steps back into TV booth for NBC Sports
Rivers last worked in the booth for ESPN/ABC before leaving to coach the Milwaukee Bucks in 2022.
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 ...
Jack Perkins' Adjustments By the Numbers
A's right-hander Jack Perkins is thriving as the season winds down. After talking with him about his approach to the final month early in September, we take a look at how that approach has worked by the numbers.
Connections: Sports Edition today: Hints and answers for Sept. 21, 2026, puzzle No. 728
Welcome to Connections: Sports Edition Coach — a spot to gather clues and discuss (and share) scores.
This One Yankees’ Brent Headrick Concern
It’s no secret that Yankees left-handed relief pitcher Brent Headrick has been one of, if not their most dominant relief pitcher this season in 2026. However, concerns are growing about Brent Headrick as we approach the final week of the regular season before the postseason.Yankees beat writer Brendan Kuty of The Athletic posted earlier this […] The post This One Yankees’ Brent Headrick Concern appeared first on HEAVY.
Troy Melton Suffers Potential Injury vs. White Sox
Tigers starter Troy Melton left Sunday’s game against the White Sox with an athletic trainer during the fourth inning.
Road Sweep Comes with Bright Spot For A's Future
Jack Perkins provided an on-the-field positive for the franchise, while another losing season has provided them the odds to land the No. 1 pick in next year's draft.
Inter Miami’s Nu Stadium to host 2027 Women’s Champions Cup
Inter Miami’s Nu Stadium will stage the 2027 Women’s Champions Cup. Miami had been announced as the hosts for the final phase of the competition, contested by the reigning continental champions from each confederation (UEFA, CAF, CONCACAF, CONMEBOL, OFC and AFC) in a calendar year, by the FIFA Council in April. World football’s governing body and Inter Miami confirmed on Saturday that the MLS side’s newly-opened stadium would hold the semi-finals, bronze medal match and final in January 2027. Th
Manchester City 5-3 Sunderland: What Le Bris said
This is the reality of the Premier League and we have to learn. Brobbey for Sunderland today was the sixth instance of a player scoring a Premier League hat-trick but ending the match on the losing side, and the first since Roque Santa Cruz for Blackburn Rovers against Wigan Athletic in December 2007.
Guardians News: One More Game Against the Athletics
News and Notes for Sunday, September 20th, 2026
Chicago Athletic Association: Inside the private club turned hotel
I stayed at the Chicago Athletic Association, a historic gentlemen's club turned luxury hotel with Gilded Age charm and whimsical designs.
Arizona State athletics events, Sept. 20-26
The Arizona State football team is enjoying a week off but there will be plenty of other Sun Devil squads in action this week.
Connections: Sports Edition today: Hints and answers for Sept. 20, 2026, puzzle No. 727
Welcome to Connections: Sports Edition Coach — a spot to gather clues and discuss (and share) scores.
Latest on Brayan Rocchio After Early Exit in Guardians’ Win
Brayan Rocchio left with an injury during the Cleveland Guardians' win over the Athletics.
Patriots DC calls Darnell Washington a ‘big challenge’
The New England Patriots have plenty to prepare for as they get set to face the Pittsburgh Steelers, and tight end Darnell Washington presents a particularly difficult matchup. Patriots defensive coordinator Zak Kuhr singled out Washington as a “big challenge,” pointing to the fourth-year tight end’s rare combination of size, strength and athleticism. Washington has […]
Five 'connected' cases of mumps reported on SDSU athletic team
"Importantly, the students are no longer considered contagious," the school's Student Health Services medical director said.
Heidelberg vs Mount Union college football live updates, highlights
Heidelberg and Mount Union kicked off Ohio Athletic Conference play in college football action Saturday. Click here for live scoring and updates
White Sox See 307-2 Scenario Go Against Them
The Chicago White Sox looked comfortably on their way to tying the AL Central Division at the top again with the Cleveland Guardians. The Guardians were finishing off a Friday night win over the Athletics, but the White Sox were also in control, leading 8-2 against the Detroit Tigers. That’s when everything went wrong. And […] The post White Sox See 307-2 Scenario Go Against Them appeared first on HEAVY.
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. 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