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Studying Science in an Anti-Scientific Time
This Chronicle Review Deep Cut was first published in 2025. By Julianne Werlin Thanks for reading The Chronicle Review! Subscribe for free to receive new posts and support my work. Subscribe The last two decades have not been kind to science studies. Already bruised and battered by the “science wars” of the 1990s, by the 2000s sociologists of science — who had long argued that science had to be understood in its human context — were encountering the funhouse-mirror version of their own views in right-wing critiques of climate scientists. It was enough to give some prominent scholars pause. “Was I wrong to participate in the invention of this field known as science studies?” asked Bruno Latour, the most famous sociologist of science in the world, in 2003. “Should we apologize for having been wrong all along? Or should we rather bring the sword of criticism to criticism itself and do a bit of soul-searching here: What were we really after when we were so intent on showing the social construction of scientific facts?” In response, Latour proposed a change of method and attitude. Science studies, now chastened and contrite, would no longer seek to strip facts of their authority, but to enrich and enhance them. What this meant in practice was never fully clear. But his diagnosis of problems resonated, even if his solutions did not. Latour’s exercise in public hand-wringing signaled a shift in mood. By 2016, with the first election of Donald Trump, the idea that skepticism of science was a right-wing position, not a left-wing one, had become a commonplace, discussed eagerly in The New York Times. For liberals, vaccine denial during the Covid era and Trump’s second-term attacks on the funding of scientific research, covered extensively in these pages, added a new urgency to the defense of science on both practical and principled grounds. There was little appetite for a sociology or philosophy of science that emphasized the messiness and missteps of the scientific process rather than its integrity and triumphs. The distinguished historian of science Peter Dear’s new book, The World as We Know It: From Natural Philosophy to Modern Science (Princeton University Press, 2025), which seeks to tell the story of 18th- and 19th-century science for a general public, may seem comfortably remote from these bitter contests. In its 16 short chapters, Dear draws swift, sure sketches of major discoveries from Newton to Einstein, ably guiding the reader through debates on stellar nebulae, animal taxonomy, atomic chemistry, evolution, and other flashpoints in the history of science. But though a work of history, Dear’s book must still negotiate our polarized present. In a blurb on its back cover, the historian of biology Lynn K. Nyhart alludes to the “present moment, when scientific knowledge is being swamped by misinformation and its institutions are under siege.” Dear himself, in his conclusion, refers to the “yard signs” and “bumper stickers” that proclaim “Science Is Real.” One antidote to both anti-science propaganda and to reductive slogans in science’s defense is a robust history and philosophy of science: exactly what Dear’s scholarship has long offered. But his new book illustrates how difficult such work has become. Dear, an emeritus professor of history at Cornell University, is best known as a creative and philosophically minded historian of the Scientific Revolution. His edited volume The Literary Structure of Scientific Argument (1991) analyzed the rhetoric of Galileo’s thought experiments to brilliant effect. Discipline and Experience: The Mathematical Way in the Scientific Revolution (1995) was a major contribution to the analysis of scientific experiments in early modern Europe and beyond, while Revolutionizing the Sciences: European Knowledge in Transition, 1500-1700 (2001), now in its third edition, remains one of the best overviews of the profound epistemological upheavals of 16th- and 17th-century science. But Dear has also ventured into later periods. Nearly two decades ago, in The Intelligibility of Nature: How Science Makes Sense of the World (2006), he turned to the 18th and 19th centuries to sketch a history and theory of scientific knowledge. Aimed at a generalist audience, Dear’s simple prose belied serious philosophical ambitions. Science, Dear argued, has two aspects: “natural philosophy,” the quest to understand the true nature of the universe, and “instrumentality,” the applied skills and technologies that allow us to manipulate the world for human advantage. Both strands are ancient, but the innovation of the phenomenon we call “science” was to yoke them together. As Francis Bacon wrote, “Human knowledge and human power meet in one; for where the cause is not known, the effect cannot be produced,” an insight typically abridged to “knowledge is power.” Or, in Bertrand Russell’s characteristically blunt phrase, science has two functions, “1. to enable us to know things, and 2., to enable us to do things.” So far, so conventional. But Dear took issue with this familiar story in one respect. Bacon’s formula implied that theory and practice could be fused in a single method. In fact, Dear argued, the quest to understand nature and the desire to manipulate it were coupled only loosely. They could come together, but they could also pull apart. Focusing on natural philosophy, the “knowing” half of the scientific circle, he used a series of case studies from cosmology, taxonomy, chemistry, electromagnetism, and quantum theory to show how theories changed over time, in dialogue with practice, but never reducible to it. Take the case of matter, the basic substrate of the physical world. In the 18th and 19th centuries, scientists not only disagreed about what it was, but also about how well it could be known. In 1789, the chemist Antoine Lavoisier dismissed speculation about the atomic composition of chemicals as “discussions entirely of a metaphysical nature,” as he sought to orient chemistry away from philosophical abstraction and toward laboratory results. But in the 19th century, atoms returned with a vengeance in the atomic chemistry of John Dalton, who wanted to explain the underlying structure of nature. It was not just that Dalton and Lavoisier had a different set of experimental results, or even a different theory, Dear showed. What counted as an explanation had changed. In arguing that scientific theories depended on their intelligibility to human beings with complex arrays of beliefs and commitments, Dear was in sympathy with science studies. Key figures such as the sociologist Steven Shapin emphasized the importance of psychological mechanisms like trust in the formation and acceptance of scientific ideas. But in focusing on the scientific pursuit of knowledge, not its politics or economics, Dear resisted the more cynical perspective of some of his colleagues. The Intelligibility of Nature strikes a very different note than Shapin’s collection of a few years later, Never Pure: Historical Studies of Science as If It Was Produced by People With Bodies, Situated in Time, Space, Culture, and Society, and Struggling for Credibility and Authority (2010), to name just one example. Walking a very fine line, Dear depicted science as driven at once by complex social dynamics and by the intellectual power of real discoveries. It was a testament not only to his own acumen but also to the vitality of the field that he was able to do so. Nearly two decades later, The World as We Know It returns to the questions broached in The Intelligibility of Nature. Like Dear’s earlier study, it begins with the Newtonian cosmos and ends with debates between Einstein and Bohr on quantum physics. Beyond its terminal figures, many of the same characters appear in both studies, including the naturalists John Ray and the Comte de Buffon; the chemists Étienne François Geoffroy, Antoine Lavoisier, and John Dalton; as well as Charles Darwin and Michael Faraday, among others. Its subject is nearly identical: As in The Intelligibility of Nature, The World as We Know It considers natural philosophy as opposed to instrumentality, here defined as the “desire to create a picture of what the world is really like — the world as God knows it — rather than simply having instrumental or operational control over it.” The two books also overlap in insights — and sometimes even in language. The reader who has learned in The Intelligibility of Nature that Buffon’s method of classifying animals “reflected his belief in the importance of the senses and empiricism in learning about nature (a doctrine associated with Newton and the philosopher John Locke)” will experience a sense of déjà vu on reading, in The World as We Know It, that the classification “reflects Buffon’s commitment to the epistemological stance of Newton and his philosophical underlaborer John Locke, who stressed the role of the senses in creating natural knowledge.” Later in the passage, we read that, “because of its stress on understanding the ways of life of animals in their environments, Buffon’s approach could almost be labeled (anachronistically) as ‘ecological.’” And again, “an anachronistic way of putting it would be to say that Buffon recommends an ecological mode of understanding.” Likewise, in The Intelligibility of Nature we read of Dalton that he was initially drawn to meteorology, and that: He did a bit of experimental work on these things, especially having to do with the water-holding capacity of gases, but his real interest lay in understanding what, at an underlying natural-philosophical level, was really going on physically.” Whereas, in The World as We Know It: He did experimental work on these things, especially concerning the water-holding capacity of gases — although not at a very refined level quantitatively — but he was continually trying to develop a theoretical conception of what was happening physically. The final full chapter of each book closes on the same resigned note. Intelligibility: These days, most serious work on the natural philosophical underpinnings and implications of quantum mechanics is performed not by physicists but by philosophers of science. Among scientific practitioners themselves, Bohr’s attempt to use instrumentality as sufficient grounds for a respectable science has met with a high degree of success. And again, in The World as We Know It: Bohr’s and Einstein’s concerns are now questions that are mostly discussed by philosophers of science rather than by physicists themselves. The marginalization of these sorts of questions amounts to the demise of natural philosophy, at least in physics, in the 20th century. Quantum mechanics “works,” and that’s good enough for most scientists who encounter it. Examples could be multiplied. When handling the same subject matter, some echoes are inevitable. Scholars should not feel that because they have written “Isaac Newton died in 1727” in one book, in the next they must describe him as perishing, expiring, or meeting his maker. But the repetitions of language and arguments (not to mention six reproduced images) threaded throughout The World as We Know It are more extensive than that. They should have been caught by Princeton University Press or its reviewers, and revised. Because the two books have so much in common, it is easy to see where they diverge. The World as We Know It is a less theoretical work than its predecessor. The sociology of knowledge that organized The Intelligibility of Nature has been reduced in scale and folded into readings and examples. The taut interplay between history and theory, which gave the earlier study so much interest, is there, but it is subtle. In the earlier book, the case studies demonstrated theoretical claims about the character and development of science. In the later work, each narrative of discovery is an end in itself. Insights emerge from the history, but they do not control the organization of the study. With the theory muted, it can be hard to understand the logic uniting Dear’s sprawling history of more than two centuries of scientific knowledge. The 16 brisk chapters cover an enormous amount of material. But the closer the volume edges to comprehensiveness, the more obvious the missing elements become. A chapter on “Institutions and Pedagogy,” describing the birth of the research university, illustrates the problem. Inserted roughly halfway through the book, the unnumbered chapter is designed as an “entr’acte,” in acknowledgement that it does not fit the study’s organization around scientific discoveries. Yet as Dear is well aware, no general history of the development of modern science can bracket its 19th-century institutionalization and professionalization. It was the 19th-century university, after all, that gave us the “scientist,” a term coined by the Cambridge philosopher William Whewell. Dear’s history of scientific discoveries implies a wider social and institutional history, but it remains largely subterranean, only occasionally extruded under the pressure of the narrative. It must be said that the balance is not all on the side of the earlier study. There are some advantages to the more historical, less theoretical organization of The World as We Know It. Dear’s accounts of paradigm shifts are remarkably lucid, no small accomplishment given that they span fields and centuries. He makes excellent use of the wealth of new scholarship on Darwin and his influences, to which he has himself contributed. It is satisfying to see puzzle pieces from Buffon’s natural history, Georges Cuvier’s animal taxonomy, Thomas Robert Malthus’s demography, and Charles Lyell’s geology recombined seamlessly in the Darwinian jigsaw. Likewise, Dear’s discussion of stellar nebulae, divided between chapters two and 15, shows vividly how Newton, Kant, Herschel, and Hubble reimagined insights and observations as they sought to discover whether the diffuse light that filtered through early telescopes was a glowing, gaseous substance or discrete but distant stars. Yet despite such pleasures, the book remains a more modest work than The Intelligibility of Nature. Dear has clearly not changed his views about the history of science. But in the two decades that have elapsed, the discipline and the world around it have changed, making it harder to write a sociologically and philosophically ambitious history of science for the general reader. That is a shame, because in the age of Silicon Valley and biotechnology, both the reciprocity and the tensions Dear identified between the epistemological and instrumental ambitions of science are more evident than ever. In recent years, some of the most exciting new books on the history of science in early modernity have focused precisely on this pressure point. Important studies such as Pamela H. Smith’s From Lived Experience to the Written Word (2022), James Poskett’s Horizons: The Global Origins of Modern Science (2022), and Vera Keller’s The Interlopers: Early Stuart Projects and the Undisciplining of Knowledge (2023) all shed new light on how early modern science negotiated the relationship between its instrumental and epistemological ambitions, or in Russell’s phrase, knowing and doing. There is every opportunity for a philosophically informed approach to draw new insights from this wealth of material. Dear, unfortunately, has not done so in The World as We Know It. But for future scholars of the history of science, his body of work over nearly four decades may provide just the model. Julianne Werlin is an associate professor of English at Duke University. Thanks for reading The Chronicle Review! Subscribe for free to receive new posts and support my work. Subscribe
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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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