How to measure Stress for optimal wellness and health?

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In wellness services across spas and retreats, stress management services long been the mainstay of service provision, with a focus on massage, meditation sessions and yoga being readily accepted by guests as helping with their stress.

The subjective assessment of ‘stress relief’ is often mixed and subtly influenced by the relaxing environment, the vibe and location of the spa / retreat. So determining exactly what has been the most influential experience for guests is hard to pinpoint and it can vary between guest to guest. Just by travelling and being in different comforting destination can make all the difference to relaxing and calming a persons stress response.

But in a world of medi-tech and wearable can we do more to provide better guest experiences in terms of assessing and managing stress responses to every day life? IWC believe we can go much further, to the point of actually providing some clinical data for guests, which they can take away and work on at improving on a daily / weekly / monthly basis.

When assessing stress clinically there are two widely accepted methods to people understand how they’re doing. Firstly Heart Rate Variability (HRV) has be utilised to varying success in gyms, wellness spaces. HRV helps to determine the variation between heart beats, which in turn determines whether one is in a parasympathetic (relaxed) or sympathetic (stressed, fight-or-flight) state. Studies have shown that many people are predominantly in a stress sympathetic state, throughout their daily lives, with demands of work, family, partners and colleagues and so this negatively impacts many aspects of ones health. It can impact the cardiovascular system, immune system, hormonal regulation, cognitive function. So its important to assess and get a handle on it.

Next question is what device to use and whats the best intervention? There are many devices out there on the market, some basic, some quite technical, ultimately it’s the measured improvement of ones stress response which is important to track. Most fitness and wellness professionals just address the lifestyle which includes drinking less alcohol, coffee, management of sleep routines, eating and exercising correctly. But does this go far enough?

In clinical practice what we find is HRV should be used consistently at precise times in the day to obtain a pattern of behaviour, then to deep dive into other areas lifestyle and physiology which can impact the sympathetic response. 

Beyond lifestyle, we know insulin regulation, gut health, nutrient status, low-grade infections and relationship dynamics all impact the stress response. Understanding the complete dynamic which contributes to HRV adaption is the best approach to improve it. In addition, measuring the 24hr cortisol/ DHEA/ melatonin levels can be helpful in determining the adrenal stress response. Cortisol, a stress hormone is produced in response to stress, and typically follows a pattern over 24 hrs of peaking in the morning and declining during the day. When cortisol patterns become deranged either being elevated at inappropriate times, or depleted, mal-adaption to stress occurs and additional symptoms start to present themselves.

When we combine an appropriate HRV assessment with a 24 hr cortisol measurement we are really becoming more precise and clinical in our approach to helping people determine what exactly is

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