Brad Ruben isn’t your average poker player. He’s a four-time World Series of Poker champion who doesn’t just train his mind—he trains his nervous system.
In high-stakes poker, performance hinges on more than strategy. It depends on clarity, restraint, and emotional regulation in unpredictable environments. This is where metrics like Heart Rate Variability (HRV) come into play, offering measurable insights into recovery, resilience, and readiness.
We sat down with Brad to explore the exact practices he uses to stay sharp at the table. For health professionals working with executives, athletes, or patients in high-pressure environments, this conversation offers valuable insight into how data-driven recovery supports long-term performance and mental health.
Brad tracks his HRV daily. He doesn’t just glance at the number—he uses it to decide whether or not to play.
HRV, a measure of autonomic nervous system flexibility, has become a cornerstone for both elite physical performance and psychological resilience. Higher HRV is typically associated with improved parasympathetic activity, better sleep quality, faster recovery, and lower allostatic load. For someone like Brad, it’s a real-time signal of whether his system is primed to handle stress.
This same principle applies to the patients you support. Whether they’re navigating chronic illness, burnout, or high-performance careers, HRV can serve as a daily check-in to help guide behavior, activity, and recovery.
Brad’s approach to recovery is comprehensive, not complicated. His tools include:
One of the most powerful takeaways from our conversation was his discipline in not playing when the data says he’s off. In a field where emotions run high and pressure is constant, Brad sees self-regulation as a competitive edge.
For your clients or patients, this mindset shift is essential. Recovery isn’t a reward for hard work—it’s a prerequisite for high-quality output.
Read more about HBOT and cold plunge benefits:
Introduction To Hyperbaric Oxygen Therapy & Heart Rate Variability. This is a case report looking at the effect of hyperbaric oxygen therapy (HBOT) on heart rate variability (HRV) as measured by the Oura ring. While HBOT is well known for its ability to treat...
Brad also works closely with organizations supporting combat veterans recovering from PTSD. He’s deeply involved with Camp Hope and Shields and Stripes, two nonprofits focused on long-term trauma recovery.
He draws a direct connection between nervous system health and trauma healing. HRV, again, becomes a powerful metric. It helps show when a patient is progressing and when intervention may be needed.
Brad’s interest in recovery and resilience is personal. He’s seen how it transforms performance and how it supports long-term healing. This crossover between peak performance and trauma care is a space many providers are now exploring.
If you work with clients in high-demand roles—CEOs, athletes, creative professionals, or trauma survivors—Brad’s story offers three clear lessons:
As providers, your role is to support not just health, but resilience. That includes helping your clients understand when to push and when to pause.
Brad Ruben’s approach shows what that looks like in real time. He doesn’t just track recovery—he listens to it. He uses it as a compass. And in doing so, he’s staying at the top of his game.
If your patients are looking to perform at a higher level or recover from chronic stress, consider starting with HRV. It’s not just data. It’s direction.
Get started with by scheduling custom demo with one of our specialists to see the difference Heads Up can make in your practice. Schedule your demo and discovery call here.
Synchronize your clients’ medical records, labs, wearables, apps, and more into Heads Up for better outcomes. Sign Up now for a free starter account!
Heart Rate Variability (HRV) has emerged as a remarkably powerful biomarker in health and performance optimization. Unlike traditional lab tests that offer only periodic snapshots, HRV provides consistent, high-quality daily measurements, offering near real-time insights into an individual’s overall system health. This daily data is invaluable for understanding stress levels and evaluating the effectiveness of various interventions, from behavior modifications and lifestyle changes to medications and clinical protocols.
Heads Up recently hosted a masterclass focused on leveraging this powerful metric, featuring exercise physiologist Don Moxley and Heads Up Chief Medical Officer, Dr. John Limansky, hosted by Heads Up Founder & CEO, Dave Korsunsky. This session built upon previous discussions about the science of the vagal nerve and HRV.
The masterclass aimed to take a deep dive into Heart Rate Variability, with a specific focus on how clinicians can effectively utilize HRV in clinical practice.
Don Moxley made a strong case for HRV as a universal health and performance marker. He explained that HRV serves as a biomarker for health status and overall stress response, providing insights into both physical and emotional resilience. In clinical settings, lower HRV is linked to reduced adaptability and increased health risks, including morbidity and mortality. Conversely, higher values are correlated with better performance and adaptability in various contexts.
The relationship between HRV and autonomic nervous system function is critical. The balance between sympathetic and parasympathetic influences significantly impacts HRV. Various factors, including pathological, physiological, psychological, environmental, lifestyle, and genetic factors, all influence HRV. Don highlighted that HRV demands a whole-body approach to healthcare, moving away from a purely systems-based view.
HRV monitoring is increasingly recognized as a crucial tool for assessing health, predicting outcomes, and guiding treatment strategies. It can serve as a reliable physiological marker of stress. For clinicians, HRV monitoring can be important in identifying cardiovascular risk and managing conditions such as hypertension, mental health disorders, and frailty in elderly populations. It is considered a valuable biomarker for assessing altered autonomic function in both health and psychiatric disease. Don noted his personal experience suggesting that lower HRV can indicate the impact of trauma.
The masterclass touched upon how different interventions and medications can affect HRV. Dr. Limansky and Don discussed the impact of blood pressure medications, noting that beta blockers and calcium channel blockers can significantly lower HRV, while ACE inhibitors may allow the heart to function more normally and even provide a slight HRV increase. They also mentioned benzodiazepines and GLP-1 medications as potentially affecting HRV.
HRV provides an indicator that practitioners can depend on to get ahead of disease, moving people from a disease state towards a performance state. Integrating HRV monitoring into routine assessments could potentially reduce the burden on the healthcare system by enabling early detection of potential issues.
In the realm of performance, athletes are increasingly using HRV metrics to optimize training and recovery protocols. HRV analytics can indicate readiness for performance, helping coaches tailor programs based on an athlete’s physiological status and stress levels. Don shared compelling examples from his time coaching college wrestling, where he could predict the team’s success based on athlete HRV scores. He detailed a case study of an athlete who was maladapting to training, showing very low HRV. By implementing training controls and focusing on intentional recovery, they were able to improve the athlete’s HRV, which correlated with a significant performance improvement at the national tournament.
Don emphasized that he prefers the term “maladaptation” over “overtraining,” highlighting that the body is either positively adapting or maladapting. HRV monitoring helps detect this maladaptation. He shared how his own HRV data clearly reflected the impact of travel, poor sleep, and lifestyle factors on his recovery, illustrating its value in identifying burnout or maladaptation in a professional context. He also noted the potential for wearable tech and HRV data to help predict injury. HRV can contribute to the decision-making process around training and recovery, and studies suggest HRV-directed training programs can improve outcomes.
While ECG is the gold standard for measuring HRV, recent advancements in wearable technology utilizing photoplethysmography (PPG) have made HRV monitoring more accessible. Devices like smartwatches and rings can effectively measure HRV in real time. However, ensuring accuracy requires using validated devices that have been compared against ECG and implementing standardized protocols for data collection, such as measuring at a consistent time, like nighttime resting data. Don expressed a preference for the Oura Ring due to its high user compliance and accurate nighttime data capture.
The masterclass reviewed different HRV metrics, including time domain metrics like RMSSD (Root Mean Square of Successive Differences), often associated with parasympathetic response, and SDNN (Standard Deviation of the Normal-to-Normal interval). Frequency domain analysis (LF, HF, LFHF ratio) was also discussed as a way to look at autonomic balance, although these metrics are less commonly available in standard wearable device software. Don mentioned using tools like those from HeartMath to explore LFHF ratios when working with clients struggling with autonomic function.
A key challenge for practitioners using HRV data is integrating measurements from various devices and tracking trends over time. The Heads Up platform is designed to address this by pulling together fragmented health data from sensors, wearables, and diagnostics into a seamless interface. This allows clinicians to easily capture data remotely, review daily metrics, track trends, set up alerts for deviations, and perform cohort analysis.
Don demonstrated how the Heads Up platform allows for visualizing HRV trends over time and correlating them with other data points, such as activity and resting heart rate. He showed how the platform helped him identify the physiological impact of life stress alongside physical activity levels. Heads Up enables practitioners to gain insights into individuals in real-time between visits and identify opportunities for improvements in behavior modification, treatment plans, and optimization strategies. The platform supports personalized care and helps validate outcomes. Case studies, such as AndHealth using HRV with autoimmune patients and Mode+Method demonstrating HRV improvements with supplements, were also referenced as examples of how Heads Up operationalizes this data in clinical practice.
The HRV Masterclass with Don Moxley and Heads Up underscored the value of Heart Rate Variability as a dynamic and accessible biomarker for understanding health, stress, recovery, and performance. By operationalizing HRV data through platforms like Heads Up, clinicians can gain deeper insights into their patients’ daily physiological status, enabling more personalized care, validating interventions, and empowering individuals to take greater ownership of their health journey.
If you’re a health professional looking to incorporate HRV monitoring into your practice or explore how to manage this data efficiently, scheduling a demo with Heads Up can provide a firsthand look at how the platform can support your goals.
Stay tuned for future Heads Up webinars covering topics such as women’s health and perimenopause, and longevity outcomes.
Learn more about Heads Up Health: https://headsuphealth.com/
Explore Heads Up Integrations: https://headsuphealth.com/integrations/
Get started with by scheduling custom demo with one of our specialists to see the difference Heads Up can make in your practice. Schedule your demo and discovery call here.
Synchronize your clients’ medical records, labs, wearables, apps, and more into Heads Up for better outcomes. Sign Up now for a free starter account!
“We can make micro-calibrations every day. We can test, retest, and experiment every single day. We can make changes, figure out what works, and just keep stacking them up. That’s the most exciting part of Biohacking!“
What if you could wake up each day with the tools to steer your health with pinpoint precision?
Now, imagine unlocking your body’s full potential by harnessing the power of real-time data: measuring, tweaking, and optimizing every facet of your well-being.
In today’s fast-paced, information-rich world, optimizing your health isn’t a guessing game; it’s a data-driven strategy. David Korsunsky, founder of Heads Up, delivers a powerful message in his presentation “Show Me The Data!” Revealing how cutting-edge technology empowers you to do exactly that!
This isn’t about getting by, it’s about leveling up, living longer, and feeling stronger with every decision you make.
Korsunsky applies his background in optimizing high-performance IT systems to human health. Just like servers, our bodies need monitoring, fine-tuning, and optimization. This vision powers the creation of Heads Up Health—a platform built to centralize, analyze, and elevate your personal health data.
The old model of annual checkups and sporadic lab work doesn’t cut it anymore. Wearables and continuous monitors offer daily health insights, giving you the power to make micro-adjustments in real time.
You don’t need to wait months to find out if a diet, supplement, or exercise program works. With tools like the Oura Ring, Dexcom CGMs, and Apple Watch, you track your progress every day. This real-time feedback turns biohacking into a personalized, results-driven experience.
There are thousands of metrics you can track, but Korsunsky focuses on five biomarkers that consistently deliver the biggest impact:
HRV reflects the balance between your sympathetic and parasympathetic nervous systems. A higher HRV signals better stress resilience, cardiovascular health, and recovery.
Research in Frontiers in Public Health shows that higher HRV links to reduced mortality and lower risk of chronic diseases [1].
Korsunsky uses HRV daily to adjust training loads and manage stress. Since HRV is highly individualized, the goal is to improve your personal baseline—not chase someone else’s numbers.
Stable blood sugar drives energy, sleep, hormone balance, and fat metabolism. Tools like the Dexcom Stelo let you see how food and habits affect your glucose in real time.
The CDC links poor glucose control to insulin resistance, type 2 diabetes, and cardiovascular disease [2]. Korsunsky encourages using CGMs to spot trends, correct spikes, and take control of your metabolic health.
Sleep fuels everything from recovery to mental clarity. Korsunsky treats it as a skill, not a given. Tools like Oura Rings reveal your sleep efficiency, heart rate trends, and more.
The Sleep Foundation highlights that consistent quality sleep boosts immune health, emotional regulation, and cognitive performance [3].
VO2 Max measures how much oxygen your body uses during exercise. It’s a top predictor of cardiovascular endurance and long-term survival. A JAMA study shows higher VO2 Max significantly reduces mortality [4].
You can track VO2 Max with wearables or formal treadmill tests. Korsunsky recommends aiming for the fitness level of someone 10-20 years younger—and monitoring progress with every workout.
Muscle mass signals strength, hormone health, and resilience. Building muscle means you’re eating right, sleeping well, and training effectively.
NIH research shows that older adults with more muscle mass enjoy better mobility, metabolism, and cognitive performance [5]. Korsunsky uses DEXA scans and validated scales to track gains.
Korsunsky reminds us: data isn’t just physical. Emotional health matters. Practices like breathwork and mindfulness boost HRV, improve sleep, and enhance your overall well-being.
Neuroscience backs this up. Controlled breathing helps reduce anxiety by stimulating the vagus nerve, improving focus and calm [6].
Korsunsky brings a light-hearted approach to data. Don’t stress over every number. Treat your dashboard as a sandbox for self-experimentation. Try a new routine, track your response, and adapt. That’s the essence of empowered health.
With the right data, you move beyond average. You aim for optimal. Whether you’re recovering from illness or striving for peak performance, daily data fuels continuous improvement.
Heads Up Health gives you the tools.
Want deeper insights into your patients’ health and lifestyle data?
Learn how Heads Up can help provide you the data to validate your patients’ health outcomes. Schedule a discovery call.
Sources:
Get started with by scheduling custom demo with one of our specialists to see the difference Heads Up can make in your practice. Schedule your demo and discovery call here.
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In an era where holistic health and biohacking converge, clinical professionals and wellness experts alike are turning to the powerful intersection of Vagus Nerve Activation and Heart Rate Variability (HRV) tracking. In a robust and information-packed webinar, Sachin Patel, Dr. Navas, and Dave Korsunsky demystify these cutting-edge tools and explain their practical applications in health monitoring and optimization.
In 2020, data surpassed the value of oil. If you’re not collecting data from your clients, whatever you’re claiming, isn’t happening… This underscores the shift toward outcomes-based care, where real-time metrics replace guesswork. For health professionals, tracking data isn’t optional—it’s the only way to prove efficacy, personalize treatment, and scale trust in a results-driven market.
The vagus nerve, the longest cranial nerve in the body, plays a pivotal role in autonomic nervous system regulation. Emerging from the brainstem, it extends through the neck into the thorax and abdomen, interfacing with the heart, lungs, digestive tract, and more. According to Dr. Navas, approximately 80% of the vagus nerve’s fibers are afferent, meaning they transmit information from the body to the brain. This makes the vagus nerve an essential sensor of internal bodily conditions.
In his detailed anatomical breakdown, Dr. Navas demonstrates how the vagus nerve’s influence spans from modulating inflammatory responses to affecting mood, digestion, heart rate, and respiratory rate. The nerve also activates the parasympathetic nervous system—often referred to as the “rest and digest” system—which counters the stress-induced fight-or-flight response.
Heart Rate Variability (HRV) measures the variation in time between successive heartbeats, a crucial marker of autonomic nervous system flexibility and overall resilience. HRV is no longer just for elite athletes—it’s a clinical goldmine. Patel and Korsunsky explain that HRV reflects the balance between sympathetic (stress) and parasympathetic (recovery) states.
Low HRV may indicate stress, inflammation, or fatigue, while higher HRV is typically a marker of good recovery and adaptive capacity. HRV is sensitive enough to predict illness onset before symptoms occur, making it a preemptive tool in both general wellness and chronic disease management.
Dave Korsunsky introduces the Heads Up Health platform, which aggregates real-time biometric data from wearables like the Oura Ring, CGMs, smart scales, blood pressure cuffs, and other digital health technologies. It enables clinicians to monitor HRV, respiratory rate, blood sugar, sleep quality, and other metrics from a single dashboard.
Korsunsky shares how practitioners can set thresholds for various metrics to trigger alerts, enabling early interventions. In autoimmune patients, for instance, a consistent drop in HRV can signal an impending flare-up. These insights allow for preemptive care strategies rather than reactive treatment.
A standout theme of the webinar is empowering patients to take charge of their own health. Patel’s philosophy—”The doctor of the future is the patient”—emphasizes the growing role of self-monitoring and experimentation. Patients can assess how lifestyle changes such as late-night meals, alcohol consumption, or breathwork practices affect their physiological markers.
This empowerment extends beyond anecdotal evidence to objective metrics. For example, an Oura Ring can show how a client’s HRV changes after improving sleep hygiene or implementing breathing techniques, leading to higher engagement and compliance with wellness programs.
1. Breathwork and Diaphragmatic Training
Sachin Patel emphasizes that many clients suffer from dysfunctional breathing patterns rooted in trauma or stress. These patterns contribute to chronic sympathetic activation. He introduces tools such as coherence breathing, the BOLT test (Body Oxygen Level Test), and breath-focused therapies to help recalibrate the autonomic nervous system.
2. Mouth Taping and Nasal Breathing
Mouth taping during sleep is discussed as a powerful intervention to promote nasal breathing, which enhances nitric oxide production, improves cardiovascular function, and supports better sleep architecture.
3. Vagus Nerve Stimulation (VNS)
Dr. Navas discusses non-invasive VNS methods, including auricular stimulation and neck-based techniques, which activate specific brain regions associated with calm, cognition, and pain reduction. These interventions are backed by fMRI studies showing thalamus activation and reduced inflammation via IL-6 suppression.
4. Technology-Based Monitoring
Wearables now allow real-time tracking of not just HRV but also respiratory rate and sleep apnea markers. These tools make it possible to monitor subtle shifts that could signify metabolic dysregulation or chronic stress.
In one compelling case, an autoimmune patient showed declining HRV following a series of intense bike rides. The Heads Up dashboard allowed clinicians to correlate HRV data with training logs and intervene early, potentially preventing a flare-up. In another case, patients using CPAP therapy were found to have chronically lower nocturnal HRV—a useful marker when optimizing treatment plans.
Another clinical pearl discussed is using HRV to guide fasting regimens and glucose monitoring. Patel shares examples where patients could self-adjust based on CGM and HRV data, improving outcomes significantly.
Heads Up doesn’t stop at wearables—it also integrates functional lab data (stool tests, blood panels, organic acid tests), creating a unified view of the patient’s health. This holistic view allows practitioners to pinpoint the root causes of symptoms rather than simply treating surface-level issues.
Korsunsky notes that practitioners with large client bases need automation. The platform’s alert systems highlight patients who fall outside their HRV baseline or exhibit early signs of distress. This triage approach helps clinics operate efficiently while maintaining personalized care.
Furthermore, Patel stresses the marketing value of these tools. Clients can visually track progress, share results, and become brand advocates, effectively increasing referrals and practice growth.
This video masterfully illustrates how the intersection of HRV and vagus nerve activation is ushering in a new era of precision wellness. With patient empowerment, technological integration, and clinically validated interventions, practitioners are now equipped to offer deeper, more effective care.
By transforming subjective wellness into measurable outcomes, HRV and vagus nerve tools are becoming non-negotiables in progressive health practices.
Use HRV as an early warning signal for stress and inflammation.
Encourage patients to self-monitor using wearables.
Employ breathwork and vagal stimulation to improve recovery and resilience.
Integrate biometric and lab data for a 360-degree view of client health.
Leverage platforms like Heads Up for efficient and scalable client management.
As the healthcare industry shifts from episodic treatment to proactive wellness, tools like HRV tracking and vagus nerve stimulation will lead the charge. Backed by research and enabled by technology, these modalities empower both clinicians and patients to make informed, impactful decisions.
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“You can’t sit on your ass eight hours a day and think that working out for one hour is going to make up for it—it doesn’t work that way.”
In the ever-evolving landscape of health optimization, clinicians and wellness professionals are increasingly faced with a common challenge: how to empower patients with practical, data-driven strategies that genuinely move the needle on their healthspan.
In a concise but potent 4-minute video, physiologist and performance coach Don Moxley distills years of applied science into four foundational biohacks that clinicians can integrate into patient care plans starting today. These are not trendy quick fixes—they are time-tested principles grounded in physiology, behavioral science, and wearable data.
Moxley’s framework, known as the “Four Rocks in the Jar,” is an elegant metaphor for prioritization in health. Each “rock” represents a key lifestyle area that, when addressed, contributes to not just longevity—but quality longevity.
The first pillar is movement, and Moxley is clear: sedentary lifestyles are among the most underestimated threats to modern health. As clinicians, this reframes the conversation around physical activity—not merely prescribing workouts, but coaching patients to build movement into the architecture of their daily lives.
Clinical Tip: Use wearables and step counters to prescribe movement goals, and integrate behavior-change models to sustain activity over time.
Moxley emphasizes nutrient-dense eating, urging health pros to move beyond fad diets and instead help patients assess what their bodies truly need. The use of HRV (Heart Rate Variability) as a tool to measure the impact of dietary changes offers a bridge between subjective experience and objective biofeedback.
Clinical Tip: Encourage food journaling alongside HRV tracking using platforms like Heads Up Health to visualize correlations and identify the most nourishing dietary patterns for each individual.
While sleep hygiene is widely discussed, Moxley makes a critical distinction—you can’t hack sleep, but you can hack your sleep environment. This reframing encourages deeper investigation into light exposure, magnesium supplementation, and even cannabinoid use when appropriate.
Clinical Tip: Audit the sleep environment and introduce sleep tracking wearables to fine-tune both quality and quantity. Avoid melatonin as a first-line intervention unless clinically indicated.
Moxley introduces a game-changing perspective: light is both nutrient and toxin. Early-morning sunlight exposure is essential for resetting circadian rhythms, while blue light exposure after dark can disrupt metabolic and neurological health.
Clinical Tip: Educate patients on light hygiene. Recommend blue-light blocking glasses, dim lighting in the evening, and prioritizing morning sunlight.
This isn’t just biohacking—it’s applied health science. Moxley’s video is a tool clinicians can use to open conversations, initiate behavior change, and personalize care. When paired with platforms like Heads Up Health, professionals can turn subjective lifestyle advice into quantifiable, trackable outcomes.
Get started with by scheduling custom demo with one of our specialists to see the difference Heads Up can make in your practice. Schedule your demo and discovery call here.
Synchronize your clients’ medical records, labs, wearables, apps, and more into Heads Up for better outcomes. Sign Up now for a free starter account!
