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Play'n Go partners with Ember Entertainment to expand portfolio
The renowned online casino game provider announced a new partnership to power titles in West Virginia, with two other states planned in the near future.
A bitter battle is brewing in one of Washington state’s last swing districts
Democrats are looking to scoop up more legislative seats this November in Battle Ground and other chunks of Southwestern Washington as they edge toward a supermajority in Olympia — a shift that would give them broad power to pass legislation or redraw the state’s voting maps.
Penn State Breezes Past Buffalo: Post-Game Link Dump
Koby Howard has put in the work to become the Nittany Lions’ go-to receiver. Penn State’s secondary was near perfect in the non-conference slate. The Nittany Lions defense had another strong performance, this time forcing four turnovers. Penn State’s ground game took a major step forward with a 100-yard day for Quinton Martin Jr….has Martin […]
How Tennessee QB Faizon Brandon assessed his Kennesaw State performance
Tennessee quarterback Faizon Brandon fumbled against Kennesaw State, but still hasn't thrown an interception in his first three career starts.
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.
As states crack down on sweepstakes casinos, VGW makes $351,000 play into Alabama politics
An Australian sweepstakes casino has contributed $351,000 to Alabama politicians and political groups as other states move to ban or restrict the industry.
Did Ben Shelton Return Too Soon After the US Open?
Five days after playing the biggest match of his career, Ben Shelton was back on a tennis court. This time it was nearly 4,000 miles away from New York, indoors in Prague and with the United States on his back. It did not go particularly well. Jiri Lehecka defeated Shelton 6-4 6-4 to level the …
Alaskans will decide fate of ranked choice voting system after chaotic end to state's primary
Alaska’s primary revealed some of the headaches related to a major change in how voters select their candidates | NewsRadio WILK
Alaskans will decide fate of ranked choice voting system after chaotic end to state's primary
Alaska’s primary revealed some of the headaches related to a major change in how voters select their candidates | NewsRadio 1080 KRLD
Alaskans will decide fate of ranked choice voting system after chaotic end to state's primary
Alaska’s primary revealed some of the headaches related to a major change in how voters select their candidates.
East Tennessee has more measles cases. Health officials won’t say where
East Tennessee measles cases tallied six last week, but the state’s health department isn’t disclosing which counties those with the virus live in.
Lance Leipold Admits Concern About One Kansas Position Group’s Health
After Saturday's loss to Arizona State in London, HC Lance Leipold mentioned a serious area of concern for the Kansas football team moving forward.
Gov. Braun Makes Appointments to Various Boards and Commissions
Gov. Mike Braun announced new appointments to various state boards and commissions. Appointments: Indiana Lottery Commission Brandon Clifton Appointment: Term expires …
‘Keys Unlocked’ TV series spotlights local real estate, lifestyle
CUDJOE KEY — REAL Shows Network (RSN), a national television platform for real estate and lifestyle storytelling, has added “Keys Unlocked,” a new locally hosted series serving the Florida Keys,
A new documentary traces the changing role of women in Texas Republican politics
New documentary, "Life of the Party," examines how women's roles in Texas Republican politics have changed over three decades through the experiences of Geanie Morrison, Sarah Davis and Mayra Flores.
Billionaires abound in California. Why not tax their wealth?
No state may be a more natural fit for a tax on billionaires than California. It leans left and its 250 billionaires are worth nearly $2 trillion. But a ballot initiative to impose a one-time 5% tax might not pass.
Oklahoma ranks top 10 for business bankruptcies despite startup boom
Oklahoma ranks in the top 10 for business bankruptcies as interest rates rise, yet the state remains a top spot for startups.
UH gets $3.6M grant to study health risks from state’s plantation-era contamination
A University of Hawaii at Manoa-led research team has received a five-year, $3.6 million National Institutes of Health grant to investigate whether pollutants left behind by Hawaii’s plantation era still could be affecting residents’ health — and whether wildfires and other natural disasters can bring those contaminants back into the environment.
California Republicans walk tightrope as Trump jumps into campaigning
California Republicans running in the state's most competitive House races are appearing to keep some measure of public distance from Trump ahead of the Nov. 3 election.
Meet Kianoosh Nawai, the West Virginia eighth-grader who built a low-cost 3D-printed bionic hand and became his state’s only finalist in a national STEM contest
Kianoosh Nawai, an eighth-grader at West Virginia Virtual Academy, wanted to explore how technology could help people with disabilities. His project led him to design and build a 3D-printed prosthetic hand that aims to offer a lower-cost option for people who have lost a limb.
Fast food from the US and China catches on in both countries
China and the United States are divided on many issues, from tariffs to Taiwan.
New executive director at French Quarter theater; former state rep takes energy association job
Take a look at some of the recent promotions and new hires announced at south Louisiana businesses.
Mizzou Honors 1960 National Championship Team During Halftime
Back in August, the Missouri Tigers officially claimed the 1960 National Championship. It is the Tigers’ only claim to college football royalty in program history.The Tigers claimed the title after the United States Congress, led by Missouri Senator Eric Schmitt, awarded it to them when the Senator brought the topic to the Senate on Aug. […] The post Mizzou Honors 1960 National Championship Team During Halftime appeared first on HEAVY.
What JaMarcus Shephard said after Oregon State beat Montana
JaMarcus Shephard spoke to reporters following his first victory as a head coach, a dominant 52-17 win over Montana at Reser Stadium.
U.S.-Canada trade war further taxes small businesses as costs rise during the Iran war
NEW YORK — A trade war between the United States and Canada is making it more difficult and expensive for small businesses in the economically entwined ...
State settles infant formula contamination lawsuit, more Health Headlines
Colorado is set to receive nearly $2 million from Abbott Laboratories after settling nationwide allegations that the company misrepresented the safety of powdered infant formula purchased with state and federal
Berlin and 'Meckpomm' head to the polls in high-stakes state elections
Germany’s emptiest and most crowded states could deliver a verdict on Merz
Tri-state people in business: New hires, promotions, recognitions
Medical Associates Clinic, of Dubuque, announced the following new hires:
Gilbert Leads Irish Over MSU
Micah Gilbert had eight catches for 170 yards in a breakout performance as Notre Dame defeated Michigan State by 27-10 on Saturday. Nolan James chipped in with 121 yards rushing with one touchdown.
Texas co-DC Johnny Nansen reinstated after one-game suspension
Nansen was charged with DWI on Wednesday.
Texas high school football: Saturday's scores from Week 4
Saturday's Houston-area and statewide scores from Week 4 of the Texas high school football season.
UFC 331 Results, Bonus Winners, Highlights And Reactions
UFC 331 had statement wins and an epic upset. The UFC awarded over $500,000 in bonus money. Here's who cashed in and all of the results from Los Angeles.
Tennessee Cruises Past Kennesaw State to Stay Perfect
The Tennessee Volunteers continued their strong start to the 2026 season Saturday night, cruising past Kennesaw State 42-9 at Neyland Stadium. The No. 15 Volunteers improved to 3-0 with the victory, wrapping up their nonconference schedule undefeated and setting up a massive matchup with No. 1 Texas next weekend. Faizon Brandon Continues to Impress Freshman…
Misery Index: NC State's all-time collapse brings up questions about Dave Doeren's job security
Tennessee defeats Kennesaw State ahead of SEC play
Tennessee defeats Kennesaw State in Week 3 at Neyland Stadium.
BYU Starts Strong, Gets Road Win at Colorado State
LJ Martin and Legend Glasker showed their star power and BYU jumped out to a 38-7 lead before fluttering late in a 41-23 win at Colorado State Saturday night in Fort Collins. BYU led 31-7 at halftime, and scored a touchdown on their first drive of the second half to go up 38-7 before pulling […]
3 Takeaways From Iowa’s 55-0 Dismantling Of Northern Iowa
It was all Hawkeyes as they finished a sweep of in-state rivals There was no doubt that Saturday belonged to […]
Tulane Drops Road Contest to Kansas State, 31-20
The Green Wave couldn't find a way to keep up with the Wildcats on either side of the ball.
Instant Analysis No 3 Notre Dame Handles Business Against Michigan State in 2710 Win
Irish Illustrated's Tim Prister, Tim O'Malley, and Drew Mentock gathered from Notre Dame Stadium's ninth floor to break down Notre Dame's Week 3 27-10 win over Michigan State.
Alameda County health authorities alert of possible measles exposure
State and Bay Area health officials warned of a possible measles exposure Friday after a person infected with the disease traveled by train from the Midwest through California.
Recap: Tennessee defeats Kennesaw State 42-9
Tennessee wrapped up its pre-conference slate on Saturday night in comfortable fashion, defeating Kennesaw State handily 42-9 inside Neyland Stadium. Faizon Brandon was 18/26 passing for 178 yards and a touchdown. He added 47 yards on 11 rushes and another score. Daune Morris paced the backfield with 14 carries for 116 yards and a touchdown. […]
AI 'warning shots' focus Beijing on national security risks
While AI researchers in the United States fret over out-of-control superintelligence wiping out humanity, Chinese policymakers have until now been more focused on immediate risks, from deepfakes to child safety.
UW Offense Finds Groove in 48-16 Rout of EWU
Washington advanced to 3-0 on the year by thumping in-state foe Eastern Washington to a tune of 48-16. The victory completes a turbulent, but successful, non-conference slate. There was an uneasiness sweeping over Husky Nation as the weekend approached. Fear of defeat wasn’t particularly a factor, but more so, how the victory would look. Another […]
Florida State Football Has to Get Its Momentum Back
Despite early brilliance against Alabama, costly turnovers and a fragile grip on momentum leave the 1-2 Seminoles facing coaching rumors and a desperate need for consistency.
Seminoles Succumb to No. 10 Crimson Tide in Road Loss
Florida State looked like the better team in Tuscaloosa on Saturday, at least for the first 28 minutes of the game. But the second half belonged to the Alabama Crimson Tide, scoring 24 points and running away with a 50-36 victory over the Seminoles.
Kyle Whittingham Makes Eye-Opening Tommy Carr Statement
Kyle Whittingham praised Michigan freshman QB Tommy Carr’s preparation and potential after his impressive debut against UTEP.
Saracens take command to overrun Tigers
By BEN JAYCOCK LAST season’s double winners Saracens made a devastating opening statement of intent in the PWR Cup with a 66-0 demolition of Leicester Tigers yesterday, running in 10 unanswered tries. Charlotte Wright-Haley opened the scoring for the holders after three minutes before Joia Bennett, Daisy Fitzgerald and Emma Hardy crossed to establish a […] The post Saracens take command to overrun Tigers appeared first on The Rugby Paper .
Stephen Curry Discusses Recruiting LeBron James In Free Agency
The Golden State Warriors viewed LeBron James as their only major free agent target, but they ended up losing to the Philadelphia 76ers. Stephen Curry was rumored to recruit James since they’ve been linked together for over a decade now as the faces of the NBA. Despite having a lot of respect for Curry, LeBron […] The post Stephen Curry Discusses Recruiting LeBron James In Free Agency appeared first on HEAVY.
Senior fair gives health and wellness resources for seniors in Onondaga County
New York State Senator Christopher Ryan hosted a Senior Fair on Saturday morning. It was held the North Syracuse Junior High School from 9 a.m. to 12 p.m.
Oregon State football vs. Montana live updates. Score, TV, streaming
Oregon State football hosts Montana at Reser Stadium in Corvallis. Follow along for live updates.
Wembley Crowd Brings Energy to Kansas-Arizona State Game
Wembley Crowd Brings Energy to Kansas-Arizona State Game
New York Yankees’ Aaron Judge Makes Statement Amid Diamondbacks Series
New York Yankees star Aaron Judge announced an injury update before Saturday night's game against the Arizona Diamondbacks. The post New York Yankees’ Aaron Judge Makes Statement Amid Diamondbacks Series appeared first on HEAVY.
Two BYU football starters ruled out against Colorado State
Injuries to key offensive playmakers force the Cougars to test their depth in Fort Collins as the Rams aim to snap a decades-long losing streak against ranked opponents.
UCF Names Jenkins as Starting QB Against Georgia State
Jenkins takes the reins, facing a high-stakes debut to stabilize the Knights before Big 12 play.
TCU Gets Positive, Negative Injury Updates Before Arkansas State
TCU is set to face off with Arkansas State on Saturday night and the Horned Frogs are ready to welcome back one of their biggest threats. Meanwhile, an offensive powerhouse will wait at least another week to suit up for the team.
Notre Dame releases injury report for Michigan State matchup
Notre Dame has released its injury report for tonight's game versus Michigan State.
Annual rally at Boston Common draws thousands of marijuana advocates ahead of historic repeal vote
This year’s event billed itself as the “first overtly political” Freedom Rally since recreational marijuana was legalized across the state in 2016.
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 […]
BYU football vs Colorado State in a pregame weather delay
BYU and Colorado State football game has entered a weather delay pregame ahead of the Sept. 19 game, which will be broadcast on CBS.
Rockies reinstate José Quintana, make other roster moves
Quintana will provide a fresh arm for a struggling rotation.
Vanderbilt stuns N.C. State with fumble recovery, improbable 35-31 win
N.C. State quarterback CJ Bailey was trying to run out the clock in the end zone and fumbled as he was tackled.
Michigan State vs Notre Dame live updates: Score, highlights, analysis
Follow along live as Michigan State gears up for a rivalry matchup with Notre Dame
Nurses sound alarm on proposed healthcare cuts during Bangor bus tour stop
On Saturday, National Nurses United (NNU) made a stop at Bangor’s Cascade Park as they travel the country on its “Red Alert” bus tour, joined by the Maine State Nurses Association (MSNA).
Arkansas volleyball drops final nonconference match before SEC play
The Arkansas volleyball team saw its five-match win streak end Saturday, losing to Illinois in straight sets in the Arkansas State Invitational in Jonesboro.
Massachusetts labor union endorses nearly all incumbents as businesses, workers flee
The Massachusetts AFL-CIO is endorsing 14 of 15 incumbents in major state and federal races in the general election as a massive outmigration of businesses and working-aged residents continues.
Health officials warning people about measles exposure across 6 counties in CA: Here's what we know
Health officials are warning about a possible measles exposure across California including in the Bay Area. A person with measles who was unvaccinated traveled around the state in trains and buses, ac...
What is Dave Doeren’s buyout as NC State football coach
Following N.C. State football's stunning loss at Vanderbilt, here's contract info on coach Dave Doeren, including his buyout.
Health officials warning people about measles exposure across 6 counties in CA: Here's what we know
Health officials are warning about a possible measles exposure across California including in the Bay Area. A person with measles who was unvaccinated traveled around the state in trains and buses, according to health officials.
Concerning Penn State stats emerge despite lopsided win over Buffalo
Penn State blew out the Buffalo Bulls 55-13, but there were still some areas of concern as they head into Big Ten play.
Flora’s all-around day leads Iowa State over Bowling Green
For the first time in school history, Iowa State returned a kickoff and a punt for a touchdown. Jaylen Raynor threw for 133 yards and one touchdown to true freshman Jamal Polite Jr. and Iowa State defeated Bowling Green 55-7 on Saturday. Cam Pettaway, a Bowling Green transfer, had three receptions for 47 yards and […]
Czechs beat USA to qualify for Davis Cup finals
Jiri Lehecka downed Learner Tien in a deciding rubber as the Czech Republic stunned the United States 3-2 in Davis Cup qualifying for a second straight year, while South Korea
EB-2 NIW Green Card Case Study: Approval for Business and Wellness Professional from Venezuela
Business Executive and Wellness Professional Colombo & Hurd secured an EB-2 National Interest Waiver (NIW) green card for a business and wellness professional from Venezuela focused on mental wellness education, early awareness, and prevention. USCIS approved the EB-2 NIW petition without a Request for Evidence, and after the Adjustment of Status (AOS) process, the client received her green card and is now a permanent resident of the United States.
NC State Alumnus Establishes Full Scholarship for Undergraduate Students in Agriculture Majors
A $10 million gift from NC State alumnus David Peele will give students from eastern North Carolina the opportunity to attend NC State’s College of Agriculture and Life Sciences with the full cost of attendance covered – and spend four years immersed in the research, mentorship and experiences preparing them to lead the future of agriculture.
Questions Remain After Ohio State Thrashes Kent State
Ohio State demolished Kent State, 59-3. Despite that, there are a few questions that remain which need answered as Big Ten play looms.
A 35-Year-Old Is Facing A $19M Business Exit — But 70% Of The Value Is Tied To Real Estate
Selling a business for an estimated $19 million sounds like the hard part is already over. For one 35-year-old, though, figuring out what to do with the money may be just as complicated. About 70% of the value they expect...
Buckeyes Roll Over Kent State while Jeremiah Smith Makes History
Ohio State rolls over the Kent State Golden Flashes while Jeremiah Smith makes history.
Saturday afternoon Orioles game thread: vs. Brewers, 4:05
Where the Birds keep coming close to mathematical elimination from the playoffs, and Félix Bautista is reinstated.
Gophers take care of business, beating Akron 41-7
It was a gloomy day in the Twin Cities and a lethargic crowd supported a Gopher team that moved to 2-1 as they head into Big Ten play. After a deflating loss to Mississippi State last week, the Gophers came out and did exactly what they were supposed to do, beating the Akron Zips 41-7. […]
BSD YouTube Postgame Show: Penn State Blasts Buffalo
Penn State takes care of business against Buffalo in their final tune-up before Big Ten play begins next Saturday against Wisconsin. Tim, Jared, and Bennett will be going live around 3:20 PM EST to break it all down for you.
State/Local Health Officials Warn Public Measles Visitor Traveled State
It is related to a passenger who traveled by train and bus and was hospitalized.
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...
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.
Power & Politics: Dangers of AI; 'Pay The People!' author John Driscoll; Former Budget Deputy Kosta Diamantis flees the country
State Sen. James Maroney and author and University of Connecticut Health's Board of Directors Chairman John Driscoll join the show this week.
Premier League issue statement after Everton vs Ipswich Town controversy
Everton boss David Moyes and Premier League badge in inset
Inside Vanderbilt football vs NC State, Jared Curtis' first start
Here are our best Vanderbilt football vs NC State photos from Saturday, Sept. 19.
TST Best Bets: September 19, 2026
Lane Kiffin’s return to Oxford was always going to be loud. After leaving Ole Miss for LSU last season, he’ll walk back into Vaught-Hemingway Stadium on Saturday as the coach of one of the Rebels’ biggest rivals. With both teams ranked in the top 10, there’s plenty at stake beyond the reception Kiffin gets.Earlier in the day, No. 16 SMU visits No. 23 Louisville in a ranked ACC matchup. The Mustangs have opened 2-0, while the Cardinals have a chance to make an early statement at home after a 1-1
Tropical disease spread by mosquitoes claims first recorded death in southern US state
Gay Small died on her 80th birthday from dengue after a mosquito bite near her Tampa home, the Florida Department of Health confirmed Friday.
How to watch Memphis’ home game against UT Martin
Memphis returns to action at Simmons Bank Liberty Stadium for its final non-conference game against UT-Martin. The Tigers will look to bounce back following a 38-20 loss against Boise State.
Kansas State vs Tulane: 2026 Game 3
A big test is out of the way. Can the Wildcats avoid stumbling again against the Green Wave?
Democratic Gov. Katie Hobbs leans into a GOP-friendly message in battleground Arizona
Even as the political environment favors her party, Hobbs is focused on the middle as she seeks a second term in a state Trump won in 2024.
Latest impressive defensive performance helps undefeated Cedar Ridge stuff Rouse
After allowing nearly 40 points per game last year, Cedar Ridge's defense has dominated so far this season. The Raiders are 4-0 for the first time since 2017.
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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