Defining, Measuring, and Monitoring Resilience for the Tactical Professional: Part 3—Heart Rate Variability Application Guide for Tactical Professionals

by Colin Tomes, CSCS, TSAC-F, Ben Schram, TSAC-F, and Robin Orr, PhD, TSAC-F,*D
TSAC Report October 2022
Vol 65, Issue 1

Available to:
Members only
TSAC Facilitators

The third and final article in this series will introduce the practical and technical elements of heart rate variability (HRV) monitoring in greater depth and detail.

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This article originally appeared in TSAC Report, the NSCA’s quarterly, online-only publication geared toward the training of tactical athletes, operators, and facilitators. It provides research-based articles, performance drills, and conditioning techniques for operational, tactical athletes. The TSAC Report is only available for NSCA Members. Read more articles from TSAC Report 



1. Akintola, AA, Van de Pol, V, Bimmel, D, Maan, AC, and Van Heemst, D. Comparative analysis of the equivital EQ02 lifemonitor with Holter ambulatory ECG device for continuous measurement of ECG, heart rate, and heart rate variability: A validation study for precision and accuracy. Frontiers in Physiology 391, 2016.

2. Armour, JA. Potential clinical relevance of the ‘little brain’ on the mammalian heart. Experimental Physiology 93(2): 165-176, 2008.

3. Belding, JN, Koenig, HG, McAnany, J, Del Re, A, Bonkowski, JF, and Thomsen, CJ. In the trenches of military epidemiological research: Lessons learned from large-scale archival data projects. SAGE Research Methods, 2020.

4. Bellenger, CR, Fuller, JT, Thomson, RL, Davison, K, Robertson, EY, and Buckley, JD. Monitoring athletic training status through autonomic heart rate regulation: A systematic review and metaanalysis. Sports Medicine 46(10): 1461-1486, 2016.

5. Benowitz, NL. Pharmacology of nicotine: Addiction, smoking-induced disease, and therapeutics. Annual Review of Pharmacology and Toxicology 49: 57-71, 2009.

6. Bigger, JT, Fleiss, JL, Rolnitzky, LM, and Steinman, RC. The ability of several short-term measures of RR variability to predict mortality after myocardial infarction. Circulation 88(3): 927-934, 1993.

7. Billman, GE, Huikuri, HV, Sacha, J, and Trimmel, K. An introduction to heart rate variability: Methodological considerations and clinical applications. Frontiers in Physiology 6: 55, 2015.

8. Burma, JS, Graver, S, Miutz, LN, Macaulay, A, Copeland, PV, and Smirl, JD. The validity and reliability of ultra-short-term heart rate variability parameters and the influence of physiological covariates. Journal of Applied Physiology 130(6): 1848-1867, 2021.

9. Camm, AJ, Malik, M, Bigger, JT, Breithardt, G, Cerutti, S, Cohen, RJ, et al. Heart rate variability: Standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. 1043-1065, 1996.

10. Chaudhary, NS, Taylor, B, Grandner, MA, Troxel, WM, and Chakravorty, S. The effects of caffeinated products on sleep and functioning in the military population: A focused review. Pharmacology Biochemistry and Behavior 173206, 2021.

11. Corrigan, SL, Roberts, S, Warmington, S, Drain, J, and Main, LC. Monitoring stress and allostatic load in first responders and tactical operators using heart rate variability: A systematic review. BMC Public Health 21(1): 1-16, 2021.

12. Costardi, JVV, Nampo, RAT, Silva, GL, Ribeiro, MAF, Stella, HJ, Stella, MB, et al. A review on alcohol: From the central action mechanism to chemical dependency. Revista da Associação Médica Brasileira 61: 381-387, 2015.

13. Ding, M, Bhupathiraju, SN, Satija, A, van Dam, RM, and Hu, FB. Long-term coffee consumption and risk of cardiovascular disease: A systematic review and a dose–response meta-analysis of prospective cohort studies. Circulation 129(6): 643-659, 2014.

14. Duchan, E, Patel, ND, and Feucht, C. Energy drinks: A review of use and safety for athletes. The Physician and Sports Medicine 38(2): 171-179, 2010.

15. Fullagar, HH, Skorski, S, Duffield, R, Hammes, D, Coutts, AJ, and Meyer, T. Sleep and athletic performance: the effects of sleep loss on exercise performance, and physiological and cognitive responses to exercise. Sports Medicine 45(2): 161-186, 2015.

16. Goldberger, JJ, Challapalli, S, Tung, R, Parker, MA, and Kadish, AH. Relationship of heart rate variability to parasympathetic effect. Circulation 103(15): 1977-1983, 2001.

17. Goodman, LS. Goodman and Gilman’s the Pharmacological Basis of Therapeutics. New York, NY: McGraw-Hill; 1996.

18. Grandou, C, Wallace, L, Fullagar, HH, Duffield, R, and Burley, S. The effects of sleep loss on military physical performance. Sports Medicine 49(8): 1159-1172, 2019.

19. Halson, SL. Monitoring training load to understand fatigue in athletes. Sports Medicine 44(2): 139-147, 2014.

20. Hausswirth, C, Louis, J, Aubry, A, Bonnet, G, Duffield, R, and Le Meur, Y. Evidence of disturbed sleep and increased illness in overreached endurance athletes. Medicine and Science in Sports and Exercise, 2014.

21. Hayano, J, Yamada, M, Sakakibara, Y, Fujinami, T, Yokoyama, K, Watanabe, Y, et al. Short-and long-term effects of cigarette smoking on heart rate variability. The American Journal of Cardiology 65(1): 84-88, 1990.

22. Hibino, G, Moritani, T, Kawada, T, and Fushiki, T. Caffeine enhances modulation of parasympathetic nerve activity in humans: Quantification using power spectral analysis. The Journal of Nutrition 127(7): 1422-1427, 1997.

23. Hinde, K, White, G, and Armstrong, N. Wearable devices suitable for monitoring twenty four hour heart rate variability in military populations. Sensors 21(4): 1061, 2021.

24. Javaloyes, A, Sarabia, JM, Lamberts, RP, and Moya-Ramon, M. Training prescription guided by heart-rate variability in cycling. International Journal of Sports Physiology and Performance 14(1): 23-32, 2019.

25. Jitnarin, N, Poston, WS, Haddock, CK, Jahnke, SA, and Day, RS. Tobacco use pattern among a national firefighter cohort. Nicotine and Tobacco Research 17(1): 66-73, 2015.

26. Karakaya, O, Barutcu, I, Kaya, D, Esen, AM, Saglam, M, Melek, M, et al. Acute effect of cigarette smoking on heart rate variability. Angiology 58(5): 620-624, 2007.

27. LaHood, AJ, and Kok, SJ. Ethanol toxicity. StatPearls, 2020.

28. Makivić, B, Nikić Djordjević, M, and Willis, MS. Heart rate variability (HRV) as a tool for diagnostic and monitoring performance in sport and physical activities. Journal of Exercise Physiology Online 16(3): 2013.

29. Malpas, SC, Robinson, BJ, and Maling, T. Mechanism of ethanol-induced vasodilation. Journal of Applied Physiology 68(2): 731-734, 1990.

30. Mancia, G, Bousquet, P, Elghozi, JL, Esler, M, Grassi, G, Julius, S, et al. The sympathetic nervous system and the metabolic syndrome. Journal of Hypertension 25(5): 909-920, 2007.

31. Mansvelder, HD, and McGehee, DS. Cellular and synaptic mechanisms of nicotine addiction. Journal of Neurobiology 53(4): 606-617, 2002.

32. McEwen, BS, and Wingfield, JC. The concept of allostasis in biology and biomedicine. Hormones and Behavior 43(1): 2-15, 2003.

33. Mietus, J, Peng, C, Henry, I, Goldsmith, R, and Goldberger, A. The pNNx files: Re-examining a widely used heart rate variability measure. Heart 88(4): 378-380, 2002.

34. Moak, JP, Goldstein, DS, Eldadah, BA, Saleem, A, Holmes, C, Pechnik, S, et al. Supine low-frequency power of heart rate variability reflects baroreflex function, not cardiac sympathetic innervation. Heart Rhythm 4(12): 1523-1529, 2007.

35. Motie-Nasrabadi, A, Behbahani, S, and Dabanloo, NJ. Ictal heart rate variability assessment with focus on secondary generalized and complex partial epileptic seizures. Advances in Bioresearch 4(1): 2013.

36. Ralevski, E, Petrakis, I, and Altemus, M. Heart rate variability in alcohol use: A review. Pharmacology Biochemistry and Behavior 176: 83-92, 2019.

37. Randin, D, Vollenweider, P, Tappy, L, Jéquier, E, Nicod, P, and Scherrer, U. Suppression of alcohol-induced hypertension by dexamethasone. New England Journal of Medicine 332(26): 1733-1738, 1995.

38. Rodrigues, S, Paiva, JS, Dias, D, and Cunha, JPS. Stress among on-duty firefighters: An ambulatory assessment study. PeerJ 12: 2018.

39. Romanowicz, M, Schmidt, JE, Bostwick, JM, Mrazek, DA, and Karpyak, VM. Changes in heart rate variability associated with acute alcohol consumption: current knowledge and implications for practice and research. Alcoholism: Clinical and Experimental Research 35(6): 1092-1105, 2011.

40. Ruxton, CH. The impact of caffeine on mood, cognitive function, performance and hydration: A review of benefits and risks. Nutrition Bulletin 33(1): 15-25, 2008.

41. Sanchez-Molina, J, Robles-Perez, JJ, and Clemente- Suarez, VJ. Effect of parachute jump in the psychophysiological response of soldiers in urban combat. Journal of Medical Systems 41(6): 99, 2017.

42. Sánchez-Molina, J, Robles-Pérez, JJ, and Clemente-Suárez, VJ. Psychophysiological and specific fine motor skill modifications in a checkpoint action. Journal of Medical Systems 43(4): 90, 2019.

43. Shaffer, F, and Ginsberg, JP. An overview of heart rate variability metrics and norms. Frontiers Public Health 5: 258, 2017.

44. Shaffer, F, Meehan, ZM, and Zerr, CL. A critical review of ultra-short-term heart rate variability norms research. Frontiers in Neuroscience 14, 2022.

45. Sjoberg, N, and Saint, DA. A single 4 mg dose of nicotine decreases heart rate variability in healthy nonsmokers: implications for smoking cessation programs. Nicotine and Tobacco Research 13(5): 369-372, 2011.

46. Smith, DR. Alcohol and tobacco consumption among Australian police officers: 1989 to 2005. International Journal of Police Science and Management 9(3): 274-286, 2007.

47. Smolander, J, Juuti, T, Kinnunen, M-L, Laine, K, Louhevaara, V, Männikkö, K, et al. A new heart rate variability-based method for the estimation of oxygen consumption without individual laboratory calibration: Application example on postal workers. Applied Ergonomics 39(3): 325-331, 2008.

48. Spaak, J, Tomlinson, G, McGowan, CL, Soleas, GJ, Morris, BL, Picton, P, et al. Dose-related effects of red wine and alcohol on heart rate variability. American Journal of Physiology-Heart and Circulatory Physiology, 2010.

49. Stephenson, MD, Thompson, AG, Merrigan, JJ, Stone, JD, and Hagen, JA. Applying heart rate variability to monitor health and performance in tactical personnel: A narrative review. International Journal of Environmental Research and Public Health 18(15): 8143, 2021.

50. Thayer, JF, Ahs, F, Fredrikson, M, Sollers, JJ, 3rd, and Wager, TD. A meta-analysis of heart rate variability and neuroimaging studies: Implications for heart rate variability as a marker of stress and health. Neuroscience and Biobehavioral Reviews 36(2): 747-756, 2012.

51. Thayer, JF, Yamamoto, SS, and Brosschot, JF. The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors. International Journal of Cardiology 141(2): 122-131, 2010.

52. Tomes, C, Schram, B, and Orr, R. Field monitoring the effects of overnight shift work on specialist tactical police training with heart rate variability analysis. Sustainability 13(14): 7895, 2021.

53. Tomes, C, Schram, B, and Orr, R. Relationships between heart rate variability, occupational performance, and fitness for tactical personnel: A systematic review. Frontiers in Public Health 8(729): 2020.

54. Vincent, GE, Aisbett, B, Larsen, B, Ridgers, ND, Snow, R, and Ferguson, SA. The impact of heat exposure and sleep restriction on firefighters’ work performance and physiology during simulated wildfire suppression. International Journal of Environmental Research and Public Health 14(2): 180, 2017.

55. Voss, A, Schroeder, R, Heitmann, A, Peters, A, and Perz, S. Short-term heart rate variability—Influence of gender and age in healthy subjects. PloS One 10(3): e0118308, 2015.

56. Williams, S, Booton, T, Watson, M, Rowland, D, and Altini, M. Heart rate variability is a moderating factor in the workload-injury relationship of competitive CrossFit™ athletes. Journal of Sports Science and Medicine 16(4): 443-449, 2017.

57. Ziegler, D, Laux, G, Dannehl, K, Spüler, M, Mühlen, H, Mayer, P, et al. Assessment of cardiovascular autonomic function: Agerelated normal ranges and reproducibility of spectral analysis, vector analysis, and standard tests of heart rate variation and blood pressure responses. Diabetic Medicine 9(2): 166-175, 1992.

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Colin Tomes, CSCS, TSAC-F

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Colin Tomes is a professor, PhD candidate, and physical therapist. He enlisted in the United States Air Force with the objective of training to join ...

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Ben Schram, TSAC-F

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Ben Schram has experience in officer training with the Army reserve to complement his exercise science, doctor of physiotherapy, and PhD degrees. He ...

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Robin M. Orr, PhD, TSAC-F,*D

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Rob Orr is an Associate Professor of Physiotherapy at Bond University in Australia. He is the director of the Tactical Research Unit, a multidiscipl ...

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