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Heart rate variability (HRV) measurements provide information on the autonomic nervous system and the balance between parasympathetic and sympathetic activity. A high HRV can be advantageous, reflecting the ability of the autonomic nervous system to adapt, whereas a low HRV can be indicative of fatigue, overtraining or health issues. There has been a surge in wearable devices that claim to measure HRV. Some of these include spot measurements, whilst others only record during periods of rest and/or sleep. Few are capable of continuously measuring HRV (≥24 h). We undertook a narrative review of the literature with the aim to determine which currently available wearable devices are capable of measuring continuous, precise HRV measures. The review also aims to evaluate which devices would be suitable in a field setting specific to military populations. The Polar H10 appears to be the most accurate wearable device when compared to criterion measures and even appears to supersede traditional methods during exercise. However, currently, the H10 must be paired with a watch to enable the raw data to be extracted for HRV analysis if users need to avoid using an app (for security or data ownership reasons) which incurs additional cost.

Wearable Devices Suitable for Monitoring Twenty Four Hour Heart Rate Variability in Military Populations