If you thought you’d seen the last of Dr Rohin ‘Medlife Crisis’ Francis and his magnificient moustache, think again. And I’ve actually made more Medlife content since this vid so check out the smartwatches playlist for me of me and Rohin chatting wearables: ruclips.net/p/PLg0VbZ0kyCHl0yKBAQZ0NaI-Gxax6_0oX
@@MacellaioNero Thanks, glad to hear you’re enjoying these! :) For the Polar, I used this great Android app to collect all the data as massive CSVs: play.google.com/store/apps/details?id=com.j_ware.polarsensorlogger I did the analysis with some home-made R scripts which I’m planning to tidy up and share at some point…
HRV is what is used by Garmin for the stress level as I understand. I'm looking forward this video. Garmin seem to give this indicator a high value: Their "body battery " rate of descent seems based on that.
I liked what this guy does, he is measuring many kinds of smart watches and compares that with a Polar chest strap: ruclips.net/video/bEM1m7OdlyY/видео.htmlsi=xHzQUsK7Y0V8Y-uP
do you think he could fly with that thing if we go him going fast enough? I'd really like to know. Seems like it might be able to produce enough lift 😊
while not backed by any data, my theory as to why the clinical world has settled on 60-100 instead of 50-90 as their RHR range, is because of the lack of time in a clinic setting. they take your heart rate & blood pressure after having gotten up, spoken with the nurses, maybe gotten nervous, walked around, etc. they don't have time to let you sit for 10 minutes in a stress-free environment just to get your heart rate.
Is often true. My blood pressure was measured at 135/90 or something like that, then I told them “lol” that can’t be right. We sat a few minutes did it again, 105/75 or something like that. (I exercise more than a bit). The only difference was not talking for about two minutes first.
I agree. They don't have the time to let one "rest" for five minutes. I remember when I was in my 20's and the Dr took my blood pressure. I was very fit and he was surprised at how high it was. I had just quickly went up three flights of stairs to go and see him. It took a few minutes for him to see me but less than five minutes had elapsed. He presumed I had taken the elevator as most people did. We both had a good laugh over it.
You can find more clarification on Apple's RHR figure in their 'Health' app. Specifically, it says "Your resting heart rate is the average heart beats per minute measured when you've been inactive or relaxed for serval minutes." and continues with "Resting heart rate does not include your heart rate while you're asleep and is validated for users over the age of 18 years."
In that case it's just straight up inaccurate, right? His wakeful resting heart rate is far from 44 bpm, so if that's what it's supposed to be measuring, it's completely off.
@@davidbraswell1481 have you measured your actual resting heart rate and compared it to the results from the apple watch? Andrew is quite fit, which will exacerbate the issue. Maybe you're getting 52 while your actual resting heart rate is 60.
@@davidbraswell1481 Yes, this guy is lying to invalidate Apple for... reasons, rather than the notoriously inaccurate measurements from a wearable just happened to be inaccurate when he checked. Legit take, well done.
I came here to say this. But the strange thing is, I had a Garmin for a few years. When I bought my Apple Watch my resting heart-rate figure increased from around 52bpm to around 60bpm.
I've been wearing a Fitbit for over 3 years, and I believe that the Fitbit resting heart rate (RHR) feature is useful for two reasons. 1). Monitoring your RHR over the past year can indicate whether your health is improving or deteriorating. For instance, I quit consuming caffeine six months ago and noticed my RHR gradually decreasing. When I contracted COVID-19 three months ago, my RHR skyrocketed during the 10-day period, even while I was asleep. As my RHR began to decline, I started recovering from COVID-19. 2). I also check the lowest heart rate during my sleep, as I find it helpful in assessing my overall well-being. I've noticed that my lowest heart rate decreases as my body becomes healthier. In my opinion, the exact RHR number doesn't matter; what's important is observing the trend, whether it's going up or down, as it provides valuable insight into your health.
yes correct but , Apple is correct too, you just need folks to know how to use the watch......as most don't even show or talk about sleep focus ..which is very important !!!! for more metrics!!
Yep, I too have noticed that each time I get COVID, my resting and sleeping heart rate shoot way up until I begin to recover. I've seen this happen dramatically over the course of a single night, from 100 down to 70 (I'm usually in the 50s).
It would seem a bit strange for heart rate to gradually decrease from ceasing to consume caffeine. Any effect from caffeine should be gone pretty quickly.
@@loganmedia1142If you know anything about how caffeine works, yes the chemical effects go away quickly but the negative metabolic and hormonal effects stay for quite a bit after a consistent use
Amazing breakdown of all the data points, you've displayed them all fantastically. I've gotta say, I really do think the the 'cynical' reason you started with is the real reason. But yes, I accept the alternative that it's just simpler to measure overnight, however unlike the cardiac monitors we tend to use for patients, wearable devices have a major extra feature - accelerometers. Surely it would be really easy to find a 5 minute period with minimal activity and then use that for RHR. And maybe repeat several times. I think sleeping HR is a perfectly good metric to track (as you suggest), but people should be made aware of the difference. We've been focusing on the low end, but I would hate people ignoring 90bpm overnight because they think it's in the normal range of 60-100. If someone's HR is that high at night, I'd recommend getting checked for things like sleep apnoea etc.
Thanks, doc! And very good point about patients at the higher end-it’s definitely even worse at 90 bpm! And totally agree about the accelerometers, in fact that’s exactly what I did to split the heart rate data up into active, resting and asleep…I used the Fitbit step counter and found every point where no steps were registered for at least five minutes. It wasn’t rocket surgery.
Samsung watches do exactly that. And the app shows when the measurement was taken/chosen, so you can judge for yourself if the measurement was correct.
Whenever I go to the Doctor's office, my heart rate is like 20-30 BPM over what it is normally. I don't want to tell them that it's because all the nurses that work there are ridiculously attractive and I'm trying very hard not to say anything too stupid
There is something called White coat syndrome - you get nervous when seeing a doctor because you are concerned about what he/she may find. You just proposed an alternative explanation, at least for men :)
As a cardiologist I can tell you *all peripherals* (including BP monitors) under-count the true *heart rate* (i.e. the number of times the heart contracts). This is different to the *pulse rate* How can this be true? Well even fit people get ectopic beats (VPC, PVCs etc) which cause a cardiac contraction, but not a strong enough pulse wave to register peripherally. I'm sure each device has a different threshold for detecting weaker pulse waves. Furthermore, these devices use temporal smoothing - some up to 10 beats at a time. That is why you don't see an instantaneous jump from 60bpm to 100bpm like you would on an ECG. The number is smoothed over time and can result in varying heart rates at any given time.
Interesting, I knew it was smoothed during the signal processing (you might enjoy the video I made with Steve Mould about how the peripheral measurements work! ruclips.net/video/BFZxlauizx0/видео.html ) but I’d not thought of the implications of ectopic beats on that… Presumably the pulse rate is what we’ve measured for decades in studies, because you’d not feel a pulse in the ectopic case?
@@DrAndrewSteele Correct. Same with palpating a pulse rate - ectopic beats are perceived as a pause rather than a beat. That's why ECG data is the correct method to assess heart rate. For example I often get my patients to purchase an AliveCor/Kardia device online or other ECG based peripheral (Withings or even Apple watch) to assess if necessary.
In practice it doesn't matter, because the previous alternative for people measuring at home was to take their pulse. What I measure when taking my pulse matches what my watch is telling me, so I consider the watch to be accurate enough for its intended purpose.
Great clear video man! Conclusion; Don’t trust the number, trust the trend… Going up or down indicates more than the actual number. Same for body fat % on scales if you’d ask me :)
Yeah, body fat percentage scales are a bit of a scam. That's why doctors still use things like waist circumference and BMI for determining if you're obese - there isn't an easy way of accurately measuring body fat percentage.
My AW telled me 2 weeks after I stopped smoking, that my average resting heartrate was going down from 80bpm to 60bpm, since the day I stopped smoking. That was a really cool surprise. :)
Congrats, keep up the great work. I have quit it for almost 2 years now and I never feel better in my 40 now. Problem is, my breath is okay but my legs are hurting when I push too much in running and cycling lol.
As a Garmin user I know that my resting heart rate is roughly 45 BPM and when I have went into the NHS for a check up they always correlate that my resting heart rate is in the 40's and they ask me if I am an athelete, which I do fitness train, so its not any other underlying cause. I was always told that Garmin has a 10% error factor built in.
So Garmin is telling you that is your sleeping heart rate, but incorrectly labelling it your RHR. Add around 10-20bpm to get your real resting heart rate.
@@sepg5084 my brand new Garmin can't even get that right!! the Garmin Epix 2 pro 51... only thing its good for is to connect it to a Polar h10 chest strap to get accurate data even the highest gps tracks are shitty. They are so bad they look like a crack head running from law and I am nowhere near builds.
The thing is, a traditional ‘taken by a doctor in an uncomfortable clinic chair’ HR is way less likely to be accurate - no-one is relaxing in that environment. So it might be more true to say “traditional medical science is lying to you about what a healthy HR is”. And it’s easy to verify smartwatch measurements. I’ve done this many times to verify that my ‘slobbed out of the sofa in the evening’ HR of 38 or something is accurate. It is. Just now I’ve just sat on the sofa and confirmed my watch’s reading of 43bpm. Which is actually 2 beats lower that it’s been showing me as my RHR this week and 2 beats higher than my overnight sleeping low. So I’d say the watch is doing a good job, and it’s the doctors who need to catch up!
My feeling is that the conventional definition is lower quality. 5 minutes of rest just in from a long run probably settles at a significantly higher number than after a short burst of exercise or a previously rested state, etc. Overnight conditions might tend to be more consistent. Maybe?
This is my feeling too…would be great to have a few more studies to back it up! Sleep seems like a much more consistent physiological state in general… (cue furore from sleep scientists haha)
I wonder how reproducible each platform is. If I'm working toward getting more fit, I could be persuaded that it doesn't really matter if my indicated RHR is 58 or 48, as long as the trend is headed downward.
This is definitely the right way to use them! Trends are reliable, even when the numbers themselves aren’t. If you’ve not seen it you might enjoy the previous video in this series where we discuss just that!
That was a great video! I subscribed. As Fitbit user for years, I found their RHR an actionable insight linked to general fitness, stress, recovery and stress. And this insight really makes sense comparing to your own values, not someone else's. Then once adding HRV it's even better as the later is really representative of recovery after exercise, getting sick and stress.
In the Apple health app, German version, I am told, that resting heart rate is validated for persons over 18 years old and is specifically not monitored during sleeping time. So, which is it?
My apple watch was warning me about low heart rate while I'm asleep. I was pretty concerned and consult with my doctor, did some measurements, wore a cardiologist device measuring me for 3 days while logging everything what happens to me. Everything was fine. Later it showed around 40 beats during the day, while I was actively talking and obviously didn't have that low numbers. I'm happy for people who got important warning in time, but for me it gave only anxiety 😢
The video is already a year old, but I know for a fact that in the past, the Apple Watch didn’t (correctly) distinguish between sleeping heart rate and daytime resting heart rate before the sleep mode launched. I used to use a third-party sleep tracking app, and once I started using that, my resting heart rate dropped significantly. When the sleep mode launched, the resting heart rate went back up to a more realistic value again.
Waking resting heart rate depends on what I've been doing. If I exercised in the past 30min, probably 80. If I've been sitting for an hour, probably 70. If I've been sitting for a few hours, probably 60. If I've been relaxing for a few days, probably min-50. My sleeping heart rate is nearly the same for every one of these situations. Low 50s.
I don't want to criticize you or alarm you but afaik heart rate shouldn't be sticky like you describe but instead more or less immediately correlate to your current level of effort.
Garmin uses RHR as the lowest 20 minute average during sleep. They do specifically call out RHR as SHR. The reason you use SHR instead of RHR is that RHR is more affected by temperature, caffeine, stress, activity, etc. But you can isolate those variables during sleep so that you can compare apples to apples and monitor recovery. RHR isn’t very useful for performance monitoring compared to SHR. I use Garmin’s health snapshot in the mornings after waking up to get an accurate RHR with HRV. My RHR sitting on the couch is 49. Sleeping varies from 44 to 50 depending on how hard my training load has been.
Resting heart and hear rate is a tough number to measure health in my mind. For someone who's numbers are in the 60s while sitting but if i try to monitor it by myself it rises in the 90s. We things called emotions (anxiety) that can alter numbers. So sleeping heart rate seems like a better metric to me.. Mine is like 48-53 while sleeping.
4:10 how funny, I had the exact same situation. My apple watch showed a heart rate of like 40 while my normal resting heartrate is around 85-90 (I know, not healthy). I got scared, went to a cardiologist and he literally did the same thing, showed me his own night time heart rate at like 35 and told me to stop worrying.
in apple health app, when you look at resting heart rate. its written that' its measured when you are at rest for a couple of minutes. and that its not a sleep measurement. so I think apple is doing a good job. my Garmin epix pro measures during the night. but in my case they provide the same resting heart rate.
I thought I have some heart disease when my Apple Watch showed me that my RHR is at 48-55 when just sitting on the computer and when it's at 40 while sleeping. Turns out I'm just fit because I work out a lot and because my maximum heart rate is at 196 bpm based on several tests which is nice for my age of 25. I also never have issues in terms of dizziness or something like that.
My Garmin doesn’t give the lowest heart rate while sleeping. While sleeping it dips down below 50 here and there, and in the morning the watch says resting is 51 or 52. When I wake up I lay in bed for a couple minutes and watch my heart rate to get an accurate resting rate, and it’s currently around 48.
Don’t wear my watch when I sleep. Easy. Not sure they are as inaccurate as you say. My Garmin if anything puts my rhr higher than what I see rested. It’s tricky to put out content on these trackers. They are regularly updated in software and tweaked to be more accurate and they take time to ‘get to know you’. Comments here suggest they are pretty good. Glad to see you finally got a Garmin.
I basically ignore the actual value my Garmin watch gives me - except the variance. I found out the hard way (Covid) that the resting heart beat value tracked very accurately the disease progress and my recovery from it.
Mine too, if anything the Fitbit I was wearing at the time _underestimated_ my covid heart rate spike because I think it does some kind of day-to-day smoothing on resting heart rate values… I was amazed how high it went though!
The bottom line is that a wrist based device only estimates all of these values and they’re not suitable for direct comparison between others, especially not between different brands which are bound to have different algorithms. They’re just for tracking your physical training progress.
My FitBit and Apple Watch returned similar resting heart rate measurements. A fun observation of my own health is that my resting heart rate is higher when I’m sleep deprived.
Another complication to consider is software updates, if you try to monitor your RHR over time is the change you observe merely due to modified algorithms. 🤔
I have a Huawei GT4 and they specifically state that their RHR is HR while at rest during the day. However, when comparing their measured value to the graphs it's obvious that I never reach that low during the day.
Very interesting results. If you use sleep tracking on the Apple Watch it specifically separates between Resting Heart Rate and Sleeping Heart Rate. And for me these are about 10 beats apart and in ranges that make sense and match my expectations (by measureing myself). So for me it does not seems to factor the time asleep into the calculations for RHR. But maybe the caveat is that you actually have to use the sleep tracking feature.
I was always told that resting heart rate should be measured first thing in the morning before getting out of bed. On that basis my Apple Watch, albeit a model from several years ago, is accurate.
Biggest question - WHO THINKS RESTING HEART RATE IS A PRIMARY FITNESS INDICATOR? Thinking resting heart rate is a better fitness indicator than trusted metrics like VO2 Max is absurd. I work in the watch world and NOBODY from the trusted reviews world ever mentions this.
I don’t know if you’d count me as being in ‘the trusted reviews world’, but Rohin and I do go into this in the first video of this series: ruclips.net/video/9H40yatCwo0/видео.html
Now I'm worried either something's seriously wrong with me or with my Garmin watch... When running - and I mean a constant pace I can maintain for 8-15 minutes - my BPM is apparently around 186-198. Idk what the "resting heart rate" is with mine, I just see heart rate that changes constantly.
Wearables are never going to be as good as a proper GE/Dynascope/etc machine you'll find in a hospital but for making you aware that your HR is high, your ECG is off etc and you need to seek medical help they've proven to be quite useful in that regard
I have an active lifestyle; I walk 3-4 km a day and try to eat healthy. My Apple Watch gave me Low HR notification while sleeping on 2 occasions which led me to goto ER and get ECG, Echocardiogram, and Holter Monitor done. They all turned out to be normal but it increased my anxiety so much that now I have to take anxiety medication and I am really wary of my heart. Apple Watch is a curse for me. I have stopped wearing it.
My smartmatch is lying to me. Damn you garmin. There is no standard for resting heartrate. Interesting. Manufacturers don't tell how their algorhitm works. That's annoying. But they do tell if they use sleeping heart rate. Ok, well they are not lying then, are they?
As long as it is consistent right? I use resting heart rate as an indicator for how my body is doing when it is trending up or down. Therefore consistency is important. I’m still looking for a video covering consistency/accuracy of wearables.
I recently upgraded from a Garmin Venu 2+ to a Forerunner 965 and voila! my RHR jumped from 52 to 63. So you cant even compare the results within one brand unfortunately. For reference: I am sitting here on my desk for hours now with barely any significant activity today and currently my Hr is at about 60, which aledgidly would still put me in the "excellent"" category at age 40. Nevertheless my heart rates are really high when training. Lactate threshold is at about 183 and max HR at 204. So which is it now? am I fit or unfit? its all really confusing
Some people have problems with their heart rate (too high, too low, or variable), so it is a huge disservice not to show them the rhythm as close as possible to the truth. I had a high pulse after an operation and my Xioami watch said I had 78, and I had 120. In general, the older generations had a latency in presenting the pulse variations, but they were close. Today there is no excuse for major differences. It's just a flaw.
You can check your resting heart rate during the day by stopping for a bit and checking. You can’t check your watch during the night, or during your absolute resting heart rate, so that’s why you should get that reading.
I had to wear a Holter monitor for a month to monitor my heart. I wore my Oura (gen 2 and gen 3) rings at the same time. When I would sleep at night, I would get a call every night from whoever is monitoring the Holter monitor, because my heart rate would go below 30 BPM, and it that would set off alarms. Meanwhile, Oura claimed my sleeping heart rate was in the 50s. Garbage products.
I have an Oura ring and I find the daily measurements pretty accurate after comparing it to a blood pressure cuff at multiple exercise intensity levels. I just take that resting heart rate level and use it as a minimum outlying heart rate rather than an average. I get the concern about the misleading averages though.
There is a name for slow heart rate - Bradycardia - it can be a serious medical condition and in some cases may require the fitting of a pacemaker. I’m surprised the doc didn’t add the caveat that a slow heart rate isn’t always indicative of an individuals fitness level.
Yeah, that's why I have one. But you only get a PM if your heart is irregular. Obviously an irregular HR is far more of a problem with a low HR. But then Garmin's etc don't detect an irregular HR so I'd say the readings at night may well be a result of irregular HR at night. Put simply this is only checked if you have symptoms, there are no symptoms at night so you don't know.
It makes sense that sleeping heart rate would be a better predictor. If you define resting heart rate as sitting quietly for 5 minutes, that can be anything from sitting quietly in my dark room after my pre-bedtime meditation, to the minutes they left me to wait in the doctor's office waiting to see my doctor. That's a 30 BPM difference on a good day. How can you get a good predictive value from that?
My Apple Watch is reporting a resting heart rate that is actually pretty close to what it is measuring during the day, while I am sitting at my desk, though it doesn't actually differ significantly from my sleeping heart rate (maybe 5bpm difference)
There are PLENTY of definitions that do say to use the sleep number AND I recently wore a holter monitor and THAT also recorded my resting heart rate as the lowest during the day (sleeping). So someone should tell the medical profession they are doing it wrong according to RUclips
As we explain in the video, we’re talking about the many long-term studies that have identified resting heart rate as a predictive factor for disease. Very interested if you know of any of those that use sleeping HR. :)
@@DrAndrewSteele The definition of resting heart rate was developed long before there was a smart anything to measure it 24 / 7 other than medical equipment. The definition has not kept up with the times and technology. When it was originally established people did not have a way to know their rate while sleeping because the sleep part :) so a definition was developed for people to use when they were awake that applied to everyone. Now we have the technology to know the lowest rate and to be able to trend the lowest rate over multiple days, weeks, months, and years. So I believe that if you can show over time, that nightly your lowest rate achieved is x over a period of time then THAT can be considered your true resting HR. It meets all the other definition qualifiers as far as feeling well, at rest, calm, no stress etc. There certainly are no studies either to show that we ARE being misled by using it. There are no studies of people with wearables that have sleeping HR in the 40's and 50's are at more risk of anything because their HR when they open their eyes and take it lying in bed for instance is x number of beats different as the body ramps up for activity. I think we are pretty safe to say that if the 'normal' range is 60-100 of HR then if your trend over time while sleeping is lower AND your normal while awake is 60-100 then you are on the healthier side of the equation for no other reason that EVERYTHING that does less repetitions over time takes longer to wear out.
Garmin is best as they don't charge you a monthly subscription to keep capturing and accessing all your own data. So no reason for them to 'flatter' you by trying to give a lower number. Yes, they may give a total based on night rate, but you can simply look at your own resting heart rate WHILE RESTING rather than relying on the device to give you a total figure.
Interesting. I use a Apple Watch 7 and do not wear it at night. My resting heart rate that shows on my apple watch is pretty accurate. It shows typically in the 42-47 range. When I am in (college) class, sometimes I just have it on the heart rate app and it will be exactly that. I have done some informal lab tests where I lay down or sit and it will also be in the same range. Laying down typically results in the high 30s while awake and talking.
I don't know if it is still the case but when I was comparing FitBit vs. Garmin RHR calculations several years ago it also seemed that FitBit does a decay function rather than just taking a one day value. This lead to much smoother variations compared to what Garmin would give in times where the RHR was fluctuating a lot. IIRC it was something like a one week smoothing. I'd rather have the day value directly and do the trending myself if I so choose. Again FitBit may not be doing this any longer.
Mine seems reasonably accurate. Had a hernia Op 7 weeks ago. They hooked me up to all the machines and suddenly alarms started going off. My heart rate was showing 43, about right for what my watch shows. Although it leapt to almost 50 when all the alarms started going off, until they explained why. Once I told them I was an ultra runner they were fine.
old school here... I take out my stopwatch, find my pulse, start the stopwatch as I start counting my pulse, stop the watch as the count reaches 30, and divide 1800 by seconds it took to reach 30. May not be able to monitor my heart BPM constantly, but as long as there is a watch, I can measure my BPM.. LOL
Nice to know. Oldie days measured by feel. 15 seconds try a few times see if consistent count. Not convenient but can reasonableness check HRM. Chest straps tend to be more accurate.
My Sleeping heart rate is about 8-10 beats lower than true resting heart rate ....that is well known phenomenon. It makes sense that sleep heart rate probably is a better measure .....
An interesting discussion. It wouldn’t be the first time that technology forces the well known medical gold standard to be reevaluated. One thing I would note, not mentioned in the discussion was the impact of “variable” HRV (heart rate variability) which could easily corrupt getting an accurate resting HR. Different manufacturers may well have chosen different algorithms to manage readings. While we all need to be aware of the limitations of these devices, I push back on them as being “fake”
as I sit here watching your video, I decided to look at my Fitbit Sense. It's reading about 61-62. That's pretty much exactly what it records my resting heart.
As someone that has pretty bad sleep apnea and uses a cpap I don’t think I was told about sleeping heart rate but mainly oxygen saturation which I also think is not very accurate on this type of wearables
About 10-15 years ago I measured my resting HR every day to see if I was getting enough rest between running sessions. I also measured in a few different ways just to see how different factors affected it. If I took my HR lying in bed first thing in the morning I had about 5 bpm lower compared to if I got up from bed and wa sitting in a chair. If I measured standing up it was another 5 bpm higher. If I measured later in the day the value would be a bit higher (don't remeber how much off the top of my head) and if I measured relatively close after eating the HR would also be a bit elevated. So lots of ways to get the numbers mixed up. Doesn't really matter how you do it. But you have to do it the same way every day if you want useful data.
It’s absolutely remarkable how much it varies, isn’t it?! I’ve noticed the same, eg I sometimes take my blood pressure just before going to bed and my ‘resting’ heart rate then is often in the mid-high 40s which is way lower than if I did it earlier in the day. So yeah, totally agree-whether you’re using a watch or measuring manually, the key is consistency of time/situation, and then watch the trend rather than absolutely trusting the specific number…
I’ve been using an Apple Watch since 2021, when I was about 75 lbs heavier than I am now. I looked back at the RHR trend over the last 3 years, and the graph shape looks nearly identical to my weight loss graph. In 2021 my average RHR was near 60, then dropped to below 50 after losing all the weight in 2022, when I also greatly increased my activity levels. As of this year it’s in the low 40’s. I do keep my watch on at night so I know it’s categorizing sleep HR separately. I just checked with a pulse oximeter and the number matches my watch’s real time measurement exactly (44 at the moment). So I have no reason to doubt the accuracy of my Apple Watch’s RHR numbers.
My garmin has always been pretty good when compared to traditional "lay down in bed for 5 minutes with the monitor on". I would hardly call it misleading. Taking the absolute minimum it hits during the night is silly for reliability reasons, but I find nightly average coincides very closely with the traditional definition. I am using the top of the line garmin.
My heart beat and resting heart rate on my Garmin 945 LTE is almost identical to what my doctor measured every year (3 years in a row). Whatever algorithm they’re using seem to be working
I suppose the follow-up question is - do we factor this difference between resting and sleeping heart rate into our fitness thresholds on the device or has it already done so in its algorithm? How annoying.
I think sleeping resting heart rate is a better measurement for watches to report, because traditional resting heart rate doesn’t need a watch to measure. Plus since resting and sleeping heart rate both correlate it’s still a useful measure for tracking fitness. From my experience when my watch reports a higher then normal resting heart rate its because of hard training the previous day or I’m feeling ill.
The title and premise are a non sequitur; These smartwatches never advertise themselves as medical advices giving medical grade accurate measurements, they actually go out of their way to point out how they are not medical devices. If precission/accuracy is of importance then there are proper medical tests, in proper medical settings to establish that, that's not really what smartwatches should be used for. The big advantage smartwatches have is that they can consistently measure changes, even if the exact measurements ain't incredibly accurate, that still allows to surface _trends over time_ without going through a medical testing regime like a professional athlete. So it kind of doesn't matter in what specific ways these smartwatches go about calculating their data, as long as they apply the same methods of calculation consistently across all measurements.
Vital signs during sleep are misleading because medicine does not have much of a history of reconciling the numbers - heart rate, oxygen saturation, blood pressure, . . ., which can all be low enough to cause emergency medical providers to begin reaching for their drugs and devices to make the person's vital signs look more like the text book vital signs. Experienced providers will assess the person (patient) to see how the lower then considered "acceptable" vital signs are tolerated. As mentioned in this video, the text book resting heart rate range for "normal" is 60-100. That will probably change, because a range of 50-90 is more appropriate. The number is supposed to indicate when the heart rate has deviated from the norm enough to be considered an indicator of a possible problem. If your heart rate at rest is in the 90s, but is not normally in the 90s, that is not a good sign and MAY indicate stress, such as an infection or some other medical condition that should be treated. The medical definition of "normal" is often just statistically where 68.8% (2 standard deviations from the mean) of people are. Much more important is what is normal for the individual being measured. Someone with a "normal for them" resting heart rate of 48 is outside of both normal ranges for the average person. A change from that person's normal range is more important than the mean average number of 48. The range (2 standard deviations for that person over many days or longer) may be 42-52. The personal range is what matters in seeing whether something has changed with the individual, but a lower heart rate MAY also indicate a problem with the heart's conduction system and may indicate the need for treatment. We can exercise to the point where our heart is not responding appropriately to the feedback mechanisms that have evolved in our bodies, because our ancestors did not exercise as much as some people do today. .
I just look for trends. Especially if it's HRV. It seems to correlate well with how I'm feeling in regards to fatigue and training. But I'm not a doctor and probably have no idea what I'm doing.
So issue is that the algorithm for measuring isn't unified and it gives different figures depending on the provider... Hmm that sucks but you can still see the trend, which is arguably more important.
When I exercised a lot, I found my resting heart rate could be lower than my sleeping heart rate, in fact it could be 100-110 for hours while sleeping, only dropping to 60 and below just as I was to wake up. I got down to 41 BPM in the mornings, just sitting at the computer with some coffee. But stop excercising and resting hear rate goes up quickly, after a few months I can't get below 60 anymore. I was doing about 10 hours of cardio per week before, always on the edge between aerobic and anaerobic. My watch just reports the actual measured heart rate, once per hour or when I check manually.
I could have *sworn* somewhere at some point in the Fitbit app told me that RHR was calculated with the first instance of being at rest after waking up; usually the few minutes you're laying in bed awake. Oftentimes if I check my heartrate first thing after waking up (since my alarm is one my Fitbit), I find it's in the low to mid 50s. But after a few minutes on my phone, it's in the low to mid 60s - and this correlates to the number I see when I open the Fitbit app.
I used to have a Fitbit with a RHR reading 46 bpm for resting. I’m assuming that might be alright since I’m a runner in college but I have wondered the accuracy of it before.
Garmin algorithm is described on their webpage. They average the lowest 30 minutes and add some percentage to that, can’t remember exactly. It gives me the result in mid 40s, but it’s not unusual for me to see readings in the mid 30s when I drink my morning coffee. A cardiologist gives me 44, as measured at a visit some time ago. In my case the number seems reasonably accurate.
I use Garmin Fenix 7 and according to it my rhr is 45 - 50 but I know it's while sleeping. I work in a hospital and one of the nurses was scared when she saw my rhr and made me wear an ECG holter monitor for 24 hours. My minimum was 30 BPM (at 3:11 AM), maximum 202 (during a 10k run), 24 h average 62 BPM and average while asleep 49. Please don't start yapping about how low and high my HR is because the best cardiologist in my town did my report summary and told me I'm great... The point is it's hard to standardise something big corporations are so secretive about.
Just watched this video again today, and made me think about some of the different apps used to measure sleep. They very rarely guess when I'm *actually* sleeping. So the "numbers" are not really to be trusted per-se. But what I think is helpful is that the comparison is helpful! For instance, if one night is stays I slept more than the previous one, that is generally true, even if the actual number of hours are not accurate. So my question is... if we take those numbers as "arbitrary units", rather than "bpm" or "hours of sleep", is that more accurate/helpful to help people getting in better shape?
Interesting thought! I wonder if ‘arbitrary units’ might be too confusing to non-nerds, but I think emphasising the uncertainty in estimates and telling people to focus on the trend is good. It’s definitely true of sleep-my watches often get the details wrong, but the overall trend is usually instructive.
@@DrAndrewSteele By the way, I eventually stopped using those apps because instead of relying on my own internal feelings, I started relying on the app to decide if I had a good night sleep or not. 😅 "I feel refreshed, but the app says I slept 5 hours. So yeah, I kinda feel sleepy now that I think about it..."
@@AlanZucconi You are not alone! Studies show that people’s self-perceived tiredness can be affected by sleep data, even if it’s faked! twitter.com/statto/status/1635559652799791104
My Garmin Epix pro has Garmin newest heart rate sensor and seems to be pretty accurate. When I have occasional been to the hospital and had my heart rate measured I have been asked what I do as my resting heart rate is on average 50bpm or lower if I”m really relaxed. So I believe watch is about right
If you thought you’d seen the last of Dr Rohin ‘Medlife Crisis’ Francis and his magnificient moustache, think again. And I’ve actually made more Medlife content since this vid so check out the smartwatches playlist for me of me and Rohin chatting wearables: ruclips.net/p/PLg0VbZ0kyCHl0yKBAQZ0NaI-Gxax6_0oX
Really enjoying this series - could I ask, what software/apps were used in conjunction with the Polar H10 to gather the RHR data?
@@MacellaioNero Thanks, glad to hear you’re enjoying these! :) For the Polar, I used this great Android app to collect all the data as massive CSVs: play.google.com/store/apps/details?id=com.j_ware.polarsensorlogger I did the analysis with some home-made R scripts which I’m planning to tidy up and share at some point…
@@DrAndrewSteele Thanks so much!
HRV is what is used by Garmin for the stress level as I understand. I'm looking forward this video. Garmin seem to give this indicator a high value: Their "body battery " rate of descent seems based on that.
I liked what this guy does, he is measuring many kinds of smart watches and compares that with a Polar chest strap:
ruclips.net/video/bEM1m7OdlyY/видео.htmlsi=xHzQUsK7Y0V8Y-uP
That moustache has it's own resting heart rate.
do you think he could fly with that thing if we go him going fast enough?
I'd really like to know. Seems like it might be able to produce enough lift 😊
I think it's also prehensile!
Worryingly, there might be refugees hiding there…
Boom boom
😂😂
while not backed by any data, my theory as to why the clinical world has settled on 60-100 instead of 50-90 as their RHR range, is because of the lack of time in a clinic setting. they take your heart rate & blood pressure after having gotten up, spoken with the nurses, maybe gotten nervous, walked around, etc. they don't have time to let you sit for 10 minutes in a stress-free environment just to get your heart rate.
Might be true
Is often true. My blood pressure was measured at 135/90 or something like that, then I told them “lol” that can’t be right. We sat a few minutes did it again, 105/75 or something like that. (I exercise more than a bit). The only difference was not talking for about two minutes first.
I agree. They don't have the time to let one "rest" for five minutes. I remember when I was in my 20's and the Dr took my blood pressure. I was very fit and he was surprised at how high it was. I had just quickly went up three flights of stairs to go and see him. It took a few minutes for him to see me but less than five minutes had elapsed. He presumed I had taken the elevator as most people did. We both had a good laugh over it.
That's not mentioning the fact that most watches test your resting heart rate when you're actually asleep versus just sitting or laying down
You can find more clarification on Apple's RHR figure in their 'Health' app. Specifically, it says "Your resting heart rate is the average heart beats per minute measured when you've been inactive or relaxed for serval minutes." and continues with "Resting heart rate does not include your heart rate while you're asleep and is validated for users over the age of 18 years."
In that case it's just straight up inaccurate, right? His wakeful resting heart rate is far from 44 bpm, so if that's what it's supposed to be measuring, it's completely off.
@@MrAwawe my apple watch has never said mine was that low this dude is doing something fishy
@@davidbraswell1481 have you measured your actual resting heart rate and compared it to the results from the apple watch? Andrew is quite fit, which will exacerbate the issue. Maybe you're getting 52 while your actual resting heart rate is 60.
@@davidbraswell1481 Yes, this guy is lying to invalidate Apple for... reasons, rather than the notoriously inaccurate measurements from a wearable just happened to be inaccurate when he checked. Legit take, well done.
I came here to say this. But the strange thing is, I had a Garmin for a few years. When I bought my Apple Watch my resting heart-rate figure increased from around 52bpm to around 60bpm.
I've been wearing a Fitbit for over 3 years, and I believe that the Fitbit resting heart rate (RHR) feature is useful for two reasons. 1). Monitoring your RHR over the past year can indicate whether your health is improving or deteriorating. For instance, I quit consuming caffeine six months ago and noticed my RHR gradually decreasing. When I contracted COVID-19 three months ago, my RHR skyrocketed during the 10-day period, even while I was asleep. As my RHR began to decline, I started recovering from COVID-19. 2). I also check the lowest heart rate during my sleep, as I find it helpful in assessing my overall well-being. I've noticed that my lowest heart rate decreases as my body becomes healthier. In my opinion, the exact RHR number doesn't matter; what's important is observing the trend, whether it's going up or down, as it provides valuable insight into your health.
yes correct but , Apple is correct too, you just need folks to know how to use the watch......as most don't even show or talk about sleep focus ..which is very important !!!! for more metrics!!
Yep, I too have noticed that each time I get COVID, my resting and sleeping heart rate shoot way up until I begin to recover. I've seen this happen dramatically over the course of a single night, from 100 down to 70 (I'm usually in the 50s).
It would seem a bit strange for heart rate to gradually decrease from ceasing to consume caffeine. Any effect from caffeine should be gone pretty quickly.
@@loganmedia1142If you know anything about how caffeine works, yes the chemical effects go away quickly but the negative metabolic and hormonal effects stay for quite a bit after a consistent use
Amazing breakdown of all the data points, you've displayed them all fantastically. I've gotta say, I really do think the the 'cynical' reason you started with is the real reason. But yes, I accept the alternative that it's just simpler to measure overnight, however unlike the cardiac monitors we tend to use for patients, wearable devices have a major extra feature - accelerometers. Surely it would be really easy to find a 5 minute period with minimal activity and then use that for RHR. And maybe repeat several times.
I think sleeping HR is a perfectly good metric to track (as you suggest), but people should be made aware of the difference. We've been focusing on the low end, but I would hate people ignoring 90bpm overnight because they think it's in the normal range of 60-100. If someone's HR is that high at night, I'd recommend getting checked for things like sleep apnoea etc.
Thanks, doc! And very good point about patients at the higher end-it’s definitely even worse at 90 bpm! And totally agree about the accelerometers, in fact that’s exactly what I did to split the heart rate data up into active, resting and asleep…I used the Fitbit step counter and found every point where no steps were registered for at least five minutes. It wasn’t rocket surgery.
UwU doctoru-san
Samsung watches do exactly that. And the app shows when the measurement was taken/chosen, so you can judge for yourself if the measurement was correct.
That is what apple
Does, it has resting and sleeping heart rate en even walking heart rate.
Doctor, that mustache is glorious
Whenever I go to the Doctor's office, my heart rate is like 20-30 BPM over what it is normally. I don't want to tell them that it's because all the nurses that work there are ridiculously attractive and I'm trying very hard not to say anything too stupid
They aren’t there to date you and giving them bad information will only hurt you.
There is something called White coat syndrome - you get nervous when seeing a doctor because you are concerned about what he/she may find. You just proposed an alternative explanation, at least for men :)
everyone’s a little nervous getting their vitals taken.. i have tachycardia (fast heart rate) so mine’s always faster. You might just also have rhat
Might also be because of walking, or the simple act of going to a place.
How the fuck is someone getting nervous giving bad information. Grow up.
As a cardiologist I can tell you *all peripherals* (including BP monitors) under-count the true *heart rate* (i.e. the number of times the heart contracts). This is different to the *pulse rate* How can this be true? Well even fit people get ectopic beats (VPC, PVCs etc) which cause a cardiac contraction, but not a strong enough pulse wave to register peripherally. I'm sure each device has a different threshold for detecting weaker pulse waves. Furthermore, these devices use temporal smoothing - some up to 10 beats at a time. That is why you don't see an instantaneous jump from 60bpm to 100bpm like you would on an ECG. The number is smoothed over time and can result in varying heart rates at any given time.
Interesting, I knew it was smoothed during the signal processing (you might enjoy the video I made with Steve Mould about how the peripheral measurements work! ruclips.net/video/BFZxlauizx0/видео.html ) but I’d not thought of the implications of ectopic beats on that… Presumably the pulse rate is what we’ve measured for decades in studies, because you’d not feel a pulse in the ectopic case?
@@DrAndrewSteele Correct. Same with palpating a pulse rate - ectopic beats are perceived as a pause rather than a beat. That's why ECG data is the correct method to assess heart rate. For example I often get my patients to purchase an AliveCor/Kardia device online or other ECG based peripheral (Withings or even Apple watch) to assess if necessary.
In practice it doesn't matter, because the previous alternative for people measuring at home was to take their pulse. What I measure when taking my pulse matches what my watch is telling me, so I consider the watch to be accurate enough for its intended purpose.
you tryna tell me when my watch says my hr is 180 it’s actually 190?? 😰
Great clear video man! Conclusion; Don’t trust the number, trust the trend… Going up or down indicates more than the actual number. Same for body fat % on scales if you’d ask me :)
Ja thinking the same going up indicates less fitness ore some infektion ? - going down ore staying down : everything ok ?
Yeah, body fat percentage scales are a bit of a scam. That's why doctors still use things like waist circumference and BMI for determining if you're obese - there isn't an easy way of accurately measuring body fat percentage.
How do we know YOU are not lying to us?
Because we can cross-check what he says…
My AW telled me 2 weeks after I stopped smoking, that my average resting heartrate was going down from 80bpm to 60bpm, since the day I stopped smoking. That was a really cool surprise. :)
Congrats, keep up the great work. I have quit it for almost 2 years now and I never feel better in my 40 now. Problem is, my breath is okay but my legs are hurting when I push too much in running and cycling lol.
As a Garmin user I know that my resting heart rate is roughly 45 BPM and when I have went into the NHS for a check up they always correlate that my resting heart rate is in the 40's and they ask me if I am an athelete, which I do fitness train, so its not any other underlying cause. I was always told that Garmin has a 10% error factor built in.
So Garmin is telling you that is your sleeping heart rate, but incorrectly labelling it your RHR. Add around 10-20bpm to get your real resting heart rate.
@@KindredBrujah did you even read the part that he went to the doctor and the numbers were similar? 🤦
@@sepg5084 no they are NOT
@@sepg5084 my brand new Garmin can't even get that right!! the Garmin Epix 2 pro 51... only thing its good for is to connect it to a Polar h10 chest strap to get accurate data even the highest gps tracks are shitty. They are so bad they look like a crack head running from law and I am nowhere near builds.
@@sepg5084 Wasn't how I interpreted it, but it could be that, yeah.
The thing is, a traditional ‘taken by a doctor in an uncomfortable clinic chair’ HR is way less likely to be accurate - no-one is relaxing in that environment. So it might be more true to say “traditional medical science is lying to you about what a healthy HR is”. And it’s easy to verify smartwatch measurements. I’ve done this many times to verify that my ‘slobbed out of the sofa in the evening’ HR of 38 or something is accurate. It is. Just now I’ve just sat on the sofa and confirmed my watch’s reading of 43bpm. Which is actually 2 beats lower that it’s been showing me as my RHR this week and 2 beats higher than my overnight sleeping low.
So I’d say the watch is doing a good job, and it’s the doctors who need to catch up!
My feeling is that the conventional definition is lower quality. 5 minutes of rest just in from a long run probably settles at a significantly higher number than after a short burst of exercise or a previously rested state, etc. Overnight conditions might tend to be more consistent. Maybe?
This is my feeling too…would be great to have a few more studies to back it up! Sleep seems like a much more consistent physiological state in general… (cue furore from sleep scientists haha)
That's probably why we were always told to check our heart rate immediately after waking in the morning.
I wonder how reproducible each platform is. If I'm working toward getting more fit, I could be persuaded that it doesn't really matter if my indicated RHR is 58 or 48, as long as the trend is headed downward.
This is definitely the right way to use them! Trends are reliable, even when the numbers themselves aren’t. If you’ve not seen it you might enjoy the previous video in this series where we discuss just that!
Imagine just having a normal conversation while sporting that mustache, as though you're just a real person.
That was a great video! I subscribed.
As Fitbit user for years, I found their RHR an actionable insight linked to general fitness, stress, recovery and stress.
And this insight really makes sense comparing to your own values, not someone else's.
Then once adding HRV it's even better as the later is really representative of recovery after exercise, getting sick and stress.
In the Apple health app, German version, I am told, that resting heart rate is validated for persons over 18 years old and is specifically not monitored during sleeping time. So, which is it?
As a data scientist I appreciate the discussion on validation metrics R square!
My apple watch was warning me about low heart rate while I'm asleep. I was pretty concerned and consult with my doctor, did some measurements, wore a cardiologist device measuring me for 3 days while logging everything what happens to me. Everything was fine.
Later it showed around 40 beats during the day, while I was actively talking and obviously didn't have that low numbers.
I'm happy for people who got important warning in time, but for me it gave only anxiety 😢
The video is already a year old, but I know for a fact that in the past, the Apple Watch didn’t (correctly) distinguish between sleeping heart rate and daytime resting heart rate before the sleep mode launched. I used to use a third-party sleep tracking app, and once I started using that, my resting heart rate dropped significantly. When the sleep mode launched, the resting heart rate went back up to a more realistic value again.
Yup, at least now when using sleep tracking, the Apple Watch doesn't include the sleeping heart rate in the resting heart rate for sure.
Waking resting heart rate depends on what I've been doing. If I exercised in the past 30min, probably 80. If I've been sitting for an hour, probably 70. If I've been sitting for a few hours, probably 60. If I've been relaxing for a few days, probably min-50. My sleeping heart rate is nearly the same for every one of these situations. Low 50s.
How would you exercise before you wake up? Waking resting heart rate would be taken immediately after waking in the morning.
I don't want to criticize you or alarm you but afaik heart rate shouldn't be sticky like you describe but instead more or less immediately correlate to your current level of effort.
My SE 2. gen Apple Watch doesn't seem to include sleeping data. I'm averaging around from 50 - 60 resting but I have below 50 when i'm sleeping.
I own none of these devices…now I’m not worried that I haven’t.
Haha
Garmin uses RHR as the lowest 20 minute average during sleep. They do specifically call out RHR as SHR. The reason you use SHR instead of RHR is that RHR is more affected by temperature, caffeine, stress, activity, etc. But you can isolate those variables during sleep so that you can compare apples to apples and monitor recovery. RHR isn’t very useful for performance monitoring compared to SHR. I use Garmin’s health snapshot in the mornings after waking up to get an accurate RHR with HRV. My RHR sitting on the couch is 49. Sleeping varies from 44 to 50 depending on how hard my training load has been.
Resting heart and hear rate is a tough number to measure health in my mind. For someone who's numbers are in the 60s while sitting but if i try to monitor it by myself it rises in the 90s. We things called emotions (anxiety) that can alter numbers. So sleeping heart rate seems like a better metric to me.. Mine is like 48-53 while sleeping.
4:10 how funny, I had the exact same situation. My apple watch showed a heart rate of like 40 while my normal resting heartrate is around 85-90 (I know, not healthy). I got scared, went to a cardiologist and he literally did the same thing, showed me his own night time heart rate at like 35 and told me to stop worrying.
Good to know! My Garmin gives me a RHR in the low 50s, but during the day I rarely see it below 60.
have you been resting (meaning "doing nothing for ~5 minutes as stated in the video) during the day when you read out the HR?
Very nice video mate, helps a lot, thank you. These watches are often giving people so much anxiety.
in apple health app, when you look at resting heart rate. its written that' its measured when you are at rest for a couple of minutes. and that its not a sleep measurement. so I think apple is doing a good job. my Garmin epix pro measures during the night. but in my case they provide the same resting heart rate.
As a determiner of cardiopulmonary health, recovery rate from stress to rest is far more instructive.
Wow, this title didn't come up to be clickbait. Respect for you.
Thanks gentlemen. Very illuminating. Rohin, is that a stick-on moustache? Whatever, I love it! From Australia 😊
Knowing how and what your watch is measuring your RHR, your ECG, etc. is just as important as your readings.
Can you do the Samsung 4 Classic?
Thanks!
I thought I have some heart disease when my Apple Watch showed me that my RHR is at 48-55 when just sitting on the computer and when it's at 40 while sleeping. Turns out I'm just fit because I work out a lot and because my maximum heart rate is at 196 bpm based on several tests which is nice for my age of 25. I also never have issues in terms of dizziness or something like that.
My Garmin doesn’t give the lowest heart rate while sleeping. While sleeping it dips down below 50 here and there, and in the morning the watch says resting is 51 or 52. When I wake up I lay in bed for a couple minutes and watch my heart rate to get an accurate resting rate, and it’s currently around 48.
Don’t wear my watch when I sleep. Easy. Not sure they are as inaccurate as you say. My Garmin if anything puts my rhr higher than what I see rested. It’s tricky to put out content on these trackers. They are regularly updated in software and tweaked to be more accurate and they take time to ‘get to know you’. Comments here suggest they are pretty good. Glad to see you finally got a Garmin.
I basically ignore the actual value my Garmin watch gives me - except the variance. I found out the hard way (Covid) that the resting heart beat value tracked very accurately the disease progress and my recovery from it.
Mine too, if anything the Fitbit I was wearing at the time _underestimated_ my covid heart rate spike because I think it does some kind of day-to-day smoothing on resting heart rate values… I was amazed how high it went though!
The bottom line is that a wrist based device only estimates all of these values and they’re not suitable for direct comparison between others, especially not between different brands which are bound to have different algorithms. They’re just for tracking your physical training progress.
My FitBit and Apple Watch returned similar resting heart rate measurements. A fun observation of my own health is that my resting heart rate is higher when I’m sleep deprived.
I'm still wanting to know how Samsung Galaxy Watch compares to these. Would be nice to get a followup video on that one.
When I was in the height of cross-country season, my Garmin watch said my heart rate was in the 60s while sleeping, but low 40s when awake
Another complication to consider is software updates, if you try to monitor your RHR over time is the change you observe merely due to modified algorithms. 🤔
I have a Huawei GT4 and they specifically state that their RHR is HR while at rest during the day.
However, when comparing their measured value to the graphs it's obvious that I never reach that low during the day.
I use Samsung's Gear S3. It shows me around 54 BPM when I first wake up then usually in the upper 70s and 80s when I'm resting during the day.
If my RHR was 35-48 even while awake I'd probably think "hey, that's neat" while also making a doctor's appointment
Very interesting results. If you use sleep tracking on the Apple Watch it specifically separates between Resting Heart Rate and Sleeping Heart Rate. And for me these are about 10 beats apart and in ranges that make sense and match my expectations (by measureing myself). So for me it does not seems to factor the time asleep into the calculations for RHR. But maybe the caveat is that you actually have to use the sleep tracking feature.
Exactly, my findings are the same. I think it suggests the video was made without full understanding of the product perhaps.
I was always told that resting heart rate should be measured first thing in the morning before getting out of bed. On that basis my Apple Watch, albeit a model from several years ago, is accurate.
Biggest question - WHO THINKS RESTING HEART RATE IS A PRIMARY FITNESS INDICATOR?
Thinking resting heart rate is a better fitness indicator than trusted metrics like VO2 Max is absurd. I work in the watch world and NOBODY from the trusted reviews world ever mentions this.
I don’t know if you’d count me as being in ‘the trusted reviews world’, but Rohin and I do go into this in the first video of this series: ruclips.net/video/9H40yatCwo0/видео.html
@@DrAndrewSteele Fair enough, thanks for the reply! I'll take a look.
Now I'm worried either something's seriously wrong with me or with my Garmin watch... When running - and I mean a constant pace I can maintain for 8-15 minutes - my BPM is apparently around 186-198. Idk what the "resting heart rate" is with mine, I just see heart rate that changes constantly.
Wearables are never going to be as good as a proper GE/Dynascope/etc machine you'll find in a hospital but for making you aware that your HR is high, your ECG is off etc and you need to seek medical help they've proven to be quite useful in that regard
I have an active lifestyle; I walk 3-4 km a day and try to eat healthy. My Apple Watch gave me Low HR notification while sleeping on 2 occasions which led me to goto ER and get ECG, Echocardiogram, and Holter Monitor done. They all turned out to be normal but it increased my anxiety so much that now I have to take anxiety medication and I am really wary of my heart.
Apple Watch is a curse for me. I have stopped wearing it.
My smartmatch is lying to me. Damn you garmin.
There is no standard for resting heartrate. Interesting.
Manufacturers don't tell how their algorhitm works. That's annoying.
But they do tell if they use sleeping heart rate. Ok, well they are not lying then, are they?
Take phone, Place over heart, record audio for 20sec, trim video to 20sec exact, count beats, multiply by 3, bpm calculated, mine was 57
As long as it is consistent right? I use resting heart rate as an indicator for how my body is doing when it is trending up or down. Therefore consistency is important.
I’m still looking for a video covering consistency/accuracy of wearables.
I recently upgraded from a Garmin Venu 2+ to a Forerunner 965 and voila! my RHR jumped from 52 to 63. So you cant even compare the results within one brand unfortunately.
For reference: I am sitting here on my desk for hours now with barely any significant activity today and currently my Hr is at about 60, which aledgidly would still put me in the "excellent"" category at age 40.
Nevertheless my heart rates are really high when training. Lactate threshold is at about 183 and max HR at 204.
So which is it now? am I fit or unfit? its all really confusing
Some people have problems with their heart rate (too high, too low, or variable), so it is a huge disservice not to show them the rhythm as close as possible to the truth.
I had a high pulse after an operation and my Xioami watch said I had 78, and I had 120.
In general, the older generations had a latency in presenting the pulse variations, but they were close. Today there is no excuse for major differences. It's just a flaw.
You can check your resting heart rate during the day by stopping for a bit and checking. You can’t check your watch during the night, or during your absolute resting heart rate, so that’s why you should get that reading.
Why do only a few persons refer to taking pulse rate with your fingers on the artery and a watch? Is this not the most accurate method?
I had to wear a Holter monitor for a month to monitor my heart. I wore my Oura (gen 2 and gen 3) rings at the same time. When I would sleep at night, I would get a call every night from whoever is monitoring the Holter monitor, because my heart rate would go below 30 BPM, and it that would set off alarms. Meanwhile, Oura claimed my sleeping heart rate was in the 50s. Garbage products.
I’m not sure if you intended it to be funny or not, but that “while you’re awake….“ echo made me laugh out loud😂
I have an Oura ring and I find the daily measurements pretty accurate after comparing it to a blood pressure cuff at multiple exercise intensity levels. I just take that resting heart rate level and use it as a minimum outlying heart rate rather than an average. I get the concern about the misleading averages though.
There is a name for slow heart rate - Bradycardia - it can be a serious medical condition and in some cases may require the fitting of a pacemaker. I’m surprised the doc didn’t add the caveat that a slow heart rate isn’t always indicative of an individuals fitness level.
Yeah, that's why I have one. But you only get a PM if your heart is irregular. Obviously an irregular HR is far more of a problem with a low HR. But then Garmin's etc don't detect an irregular HR so I'd say the readings at night may well be a result of irregular HR at night. Put simply this is only checked if you have symptoms, there are no symptoms at night so you don't know.
It makes sense that sleeping heart rate would be a better predictor. If you define resting heart rate as sitting quietly for 5 minutes, that can be anything from sitting quietly in my dark room after my pre-bedtime meditation, to the minutes they left me to wait in the doctor's office waiting to see my doctor. That's a 30 BPM difference on a good day. How can you get a good predictive value from that?
To me personally the relevance to a real value doesn’t matter. As long as it is specific between day to day, to track my training status.
I find the anatomy of that skeleton a bit disturbing!
My Apple Watch is reporting a resting heart rate that is actually pretty close to what it is measuring during the day, while I am sitting at my desk, though it doesn't actually differ significantly from my sleeping heart rate (maybe 5bpm difference)
There are PLENTY of definitions that do say to use the sleep number AND I recently wore a holter monitor and THAT also recorded my resting heart rate as the lowest during the day (sleeping). So someone should tell the medical profession they are doing it wrong according to RUclips
As we explain in the video, we’re talking about the many long-term studies that have identified resting heart rate as a predictive factor for disease. Very interested if you know of any of those that use sleeping HR. :)
@@DrAndrewSteele The definition of resting heart rate was developed long before there was a smart anything to measure it 24 / 7 other than medical equipment. The definition has not kept up with the times and technology. When it was originally established people did not have a way to know their rate while sleeping because the sleep part :) so a definition was developed for people to use when they were awake that applied to everyone. Now we have the technology to know the lowest rate and to be able to trend the lowest rate over multiple days, weeks, months, and years. So I believe that if you can show over time, that nightly your lowest rate achieved is x over a period of time then THAT can be considered your true resting HR. It meets all the other definition qualifiers as far as feeling well, at rest, calm, no stress etc. There certainly are no studies either to show that we ARE being misled by using it. There are no studies of people with wearables that have sleeping HR in the 40's and 50's are at more risk of anything because their HR when they open their eyes and take it lying in bed for instance is x number of beats different as the body ramps up for activity. I think we are pretty safe to say that if the 'normal' range is 60-100 of HR then if your trend over time while sleeping is lower AND your normal while awake is 60-100 then you are on the healthier side of the equation for no other reason that EVERYTHING that does less repetitions over time takes longer to wear out.
Garmin is best as they don't charge you a monthly subscription to keep capturing and accessing all your own data. So no reason for them to 'flatter' you by trying to give a lower number. Yes, they may give a total based on night rate, but you can simply look at your own resting heart rate WHILE RESTING rather than relying on the device to give you a total figure.
Interesting. I use a Apple Watch 7 and do not wear it at night. My resting heart rate that shows on my apple watch is pretty accurate. It shows typically in the 42-47 range. When I am in (college) class, sometimes I just have it on the heart rate app and it will be exactly that. I have done some informal lab tests where I lay down or sit and it will also be in the same range. Laying down typically results in the high 30s while awake and talking.
I don't know if it is still the case but when I was comparing FitBit vs. Garmin RHR calculations several years ago it also seemed that FitBit does a decay function rather than just taking a one day value. This lead to much smoother variations compared to what Garmin would give in times where the RHR was fluctuating a lot. IIRC it was something like a one week smoothing. I'd rather have the day value directly and do the trending myself if I so choose. Again FitBit may not be doing this any longer.
Mine seems reasonably accurate. Had a hernia Op 7 weeks ago. They hooked me up to all the machines and suddenly alarms started going off. My heart rate was showing 43, about right for what my watch shows. Although it leapt to almost 50 when all the alarms started going off, until they explained why. Once I told them I was an ultra runner they were fine.
The absolute does not really matter, right? I use it to measure changes.
old school here... I take out my stopwatch, find my pulse, start the stopwatch as I start counting my pulse, stop the watch as the count reaches 30, and divide 1800 by seconds it took to reach 30. May not be able to monitor my heart BPM constantly, but as long as there is a watch, I can measure my BPM.. LOL
Nice to know. Oldie days measured by feel. 15 seconds try a few times see if consistent count. Not convenient but can reasonableness check HRM. Chest straps tend to be more accurate.
My Sleeping heart rate is about 8-10 beats lower than true resting heart rate ....that is well known phenomenon. It makes sense that sleep heart rate probably is a better measure .....
An interesting discussion. It wouldn’t be the first time that technology forces the well known medical gold standard to be reevaluated. One thing I would note, not mentioned in the discussion was the impact of “variable” HRV (heart rate variability) which could easily corrupt getting an accurate resting HR. Different manufacturers may well have chosen different algorithms to manage readings.
While we all need to be aware of the limitations of these devices, I push back on them as being “fake”
as I sit here watching your video, I decided to look at my Fitbit Sense. It's reading about 61-62. That's pretty much exactly what it records my resting heart.
As someone that has pretty bad sleep apnea and uses a cpap I don’t think I was told about sleeping heart rate but mainly oxygen saturation which I also think is not very accurate on this type of wearables
About 10-15 years ago I measured my resting HR every day to see if I was getting enough rest between running sessions. I also measured in a few different ways just to see how different factors affected it. If I took my HR lying in bed first thing in the morning I had about 5 bpm lower compared to if I got up from bed and wa sitting in a chair. If I measured standing up it was another 5 bpm higher. If I measured later in the day the value would be a bit higher (don't remeber how much off the top of my head) and if I measured relatively close after eating the HR would also be a bit elevated. So lots of ways to get the numbers mixed up. Doesn't really matter how you do it. But you have to do it the same way every day if you want useful data.
It’s absolutely remarkable how much it varies, isn’t it?! I’ve noticed the same, eg I sometimes take my blood pressure just before going to bed and my ‘resting’ heart rate then is often in the mid-high 40s which is way lower than if I did it earlier in the day.
So yeah, totally agree-whether you’re using a watch or measuring manually, the key is consistency of time/situation, and then watch the trend rather than absolutely trusting the specific number…
I’ve been using an Apple Watch since 2021, when I was about 75 lbs heavier than I am now. I looked back at the RHR trend over the last 3 years, and the graph shape looks nearly identical to my weight loss graph. In 2021 my average RHR was near 60, then dropped to below 50 after losing all the weight in 2022, when I also greatly increased my activity levels. As of this year it’s in the low 40’s. I do keep my watch on at night so I know it’s categorizing sleep HR separately. I just checked with a pulse oximeter and the number matches my watch’s real time measurement exactly (44 at the moment). So I have no reason to doubt the accuracy of my Apple Watch’s RHR numbers.
My garmin has always been pretty good when compared to traditional "lay down in bed for 5 minutes with the monitor on". I would hardly call it misleading. Taking the absolute minimum it hits during the night is silly for reliability reasons, but I find nightly average coincides very closely with the traditional definition. I am using the top of the line garmin.
My heart beat and resting heart rate on my Garmin 945 LTE is almost identical to what my doctor measured every year (3 years in a row). Whatever algorithm they’re using seem to be working
I suppose the follow-up question is - do we factor this difference between resting and sleeping heart rate into our fitness thresholds on the device or has it already done so in its algorithm? How annoying.
I think sleeping resting heart rate is a better measurement for watches to report, because traditional resting heart rate doesn’t need a watch to measure. Plus since resting and sleeping heart rate both correlate it’s still a useful measure for tracking fitness. From my experience when my watch reports a higher then normal resting heart rate its because of hard training the previous day or I’m feeling ill.
I have a Garmin Forerunner 55. I've tested it against taking my pulse upon waking for 60 seconds and it's spot on.
The title and premise are a non sequitur; These smartwatches never advertise themselves as medical advices giving medical grade accurate measurements, they actually go out of their way to point out how they are not medical devices.
If precission/accuracy is of importance then there are proper medical tests, in proper medical settings to establish that, that's not really what smartwatches should be used for.
The big advantage smartwatches have is that they can consistently measure changes, even if the exact measurements ain't incredibly accurate, that still allows to surface _trends over time_ without going through a medical testing regime like a professional athlete.
So it kind of doesn't matter in what specific ways these smartwatches go about calculating their data, as long as they apply the same methods of calculation consistently across all measurements.
Vital signs during sleep are misleading because medicine does not have much of a history of reconciling the numbers - heart rate, oxygen saturation, blood pressure, . . ., which can all be low enough to cause emergency medical providers to begin reaching for their drugs and devices to make the person's vital signs look more like the text book vital signs. Experienced providers will assess the person (patient) to see how the lower then considered "acceptable" vital signs are tolerated. As mentioned in this video, the text book resting heart rate range for "normal" is 60-100. That will probably change, because a range of 50-90 is more appropriate. The number is supposed to indicate when the heart rate has deviated from the norm enough to be considered an indicator of a possible problem. If your heart rate at rest is in the 90s, but is not normally in the 90s, that is not a good sign and MAY indicate stress, such as an infection or some other medical condition that should be treated.
The medical definition of "normal" is often just statistically where 68.8% (2 standard deviations from the mean) of people are. Much more important is what is normal for the individual being measured. Someone with a "normal for them" resting heart rate of 48 is outside of both normal ranges for the average person. A change from that person's normal range is more important than the mean average number of 48. The range (2 standard deviations for that person over many days or longer) may be 42-52. The personal range is what matters in seeing whether something has changed with the individual, but a lower heart rate MAY also indicate a problem with the heart's conduction system and may indicate the need for treatment. We can exercise to the point where our heart is not responding appropriately to the feedback mechanisms that have evolved in our bodies, because our ancestors did not exercise as much as some people do today.
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I just look for trends. Especially if it's HRV. It seems to correlate well with how I'm feeling in regards to fatigue and training. But I'm not a doctor and probably have no idea what I'm doing.
So issue is that the algorithm for measuring isn't unified and it gives different figures depending on the provider... Hmm that sucks but you can still see the trend, which is arguably more important.
When I exercised a lot, I found my resting heart rate could be lower than my sleeping heart rate, in fact it could be 100-110 for hours while sleeping, only dropping to 60 and below just as I was to wake up. I got down to 41 BPM in the mornings, just sitting at the computer with some coffee. But stop excercising and resting hear rate goes up quickly, after a few months I can't get below 60 anymore. I was doing about 10 hours of cardio per week before, always on the edge between aerobic and anaerobic. My watch just reports the actual measured heart rate, once per hour or when I check manually.
rates that high during sleep is concerning, might want to get that checked
I could have *sworn* somewhere at some point in the Fitbit app told me that RHR was calculated with the first instance of being at rest after waking up; usually the few minutes you're laying in bed awake. Oftentimes if I check my heartrate first thing after waking up (since my alarm is one my Fitbit), I find it's in the low to mid 50s. But after a few minutes on my phone, it's in the low to mid 60s - and this correlates to the number I see when I open the Fitbit app.
Then the watch is doing it correctly. Immediately after waking, before getting out of bed, is the best time to check.
Doesn't matter what the number is. It's for tracking trends.
You should do a collaboration with the Quantified Scientist on this topic. He rigorously tests the smart watches.
Definitely on the to-do list, I love his videos :)
I used to have a Fitbit with a RHR reading 46 bpm for resting. I’m assuming that might be alright since I’m a runner in college but I have wondered the accuracy of it before.
Garmin algorithm is described on their webpage. They average the lowest 30 minutes and add some percentage to that, can’t remember exactly. It gives me the result in mid 40s, but it’s not unusual for me to see readings in the mid 30s when I drink my morning coffee. A cardiologist gives me 44, as measured at a visit some time ago. In my case the number seems reasonably accurate.
I use Garmin Fenix 7 and according to it my rhr is 45 - 50 but I know it's while sleeping. I work in a hospital and one of the nurses was scared when she saw my rhr and made me wear an ECG holter monitor for 24 hours.
My minimum was 30 BPM (at 3:11 AM), maximum 202 (during a 10k run), 24 h average 62 BPM and average while asleep 49. Please don't start yapping about how low and high my HR is because the best cardiologist in my town did my report summary and told me I'm great...
The point is it's hard to standardise something big corporations are so secretive about.
Just watched this video again today, and made me think about some of the different apps used to measure sleep.
They very rarely guess when I'm *actually* sleeping. So the "numbers" are not really to be trusted per-se.
But what I think is helpful is that the comparison is helpful! For instance, if one night is stays I slept more than the previous one, that is generally true, even if the actual number of hours are not accurate. So my question is... if we take those numbers as "arbitrary units", rather than "bpm" or "hours of sleep", is that more accurate/helpful to help people getting in better shape?
Interesting thought! I wonder if ‘arbitrary units’ might be too confusing to non-nerds, but I think emphasising the uncertainty in estimates and telling people to focus on the trend is good. It’s definitely true of sleep-my watches often get the details wrong, but the overall trend is usually instructive.
@@DrAndrewSteele By the way, I eventually stopped using those apps because instead of relying on my own internal feelings, I started relying on the app to decide if I had a good night sleep or not. 😅 "I feel refreshed, but the app says I slept 5 hours. So yeah, I kinda feel sleepy now that I think about it..."
@@AlanZucconi You are not alone! Studies show that people’s self-perceived tiredness can be affected by sleep data, even if it’s faked! twitter.com/statto/status/1635559652799791104
My Garmin Epix pro has Garmin newest heart rate sensor and seems to be pretty accurate.
When I have occasional been to the hospital and had my heart rate measured I have been asked what I do as my resting heart rate is on average 50bpm or lower if I”m really relaxed. So I believe watch is about right
Surely you could just look at what your heart rate was when your alarm went off in the morning on your wearables corresponding heart rate?