{
  "registry": "KnowYourPrime Evidence Registry",
  "license": {
    "name": "CC BY 4.0",
    "url": "https://creativecommons.org/licenses/by/4.0/",
    "attribution": "Credit KnowYourPrime and link to the finding URL."
  },
  "fields": {
    "devices": "Devices this finding names, including models it says it does not cover. What was actually tested is in scope.applies_to; exclusions are in scope.does_not_cover.",
    "evidence": "Studies by role: anchor (the rating rests on it), conflicting, null_result, supporting.",
    "industry_ties": "Device-maker ties listed in Europe PMC metadata: author_affiliations names makers an author lists as an affiliation, funders names makers listed as funding. stated_ties holds ties a paper states only in its own conflict, funding or acknowledgement text, each read from that statement and worded to say only what it says. Sources are Europe PMC metadata, funding printed in the abstract, and those reviewed statements. An empty list means no tie was found there, not that the study is independent: many papers have no open full text to read. Metadata, not a judgment of the study. checked false means no Europe PMC metadata was available."
  },
  "id": "KYP-ER-0006",
  "version": "1.0",
  "reviewed": "2026-10-24",
  "url": "https://knowyourprime.com/evidence-work-stress-hrv",
  "title": "Work Stress and HRV",
  "question": "Do people under more work stress have lower heart rate variability, and can that show up on a wearable?",
  "measurement": "Heart rate variability (HRV)",
  "devices": [
    "Wearables",
    "Oura",
    "WHOOP",
    "Ultrahuman",
    "Amazfit",
    "RingConn"
  ],
  "rating": {
    "label": "Emerging",
    "code": "emerging",
    "definition": "Evidence currently favors the claim, but more confirmation is needed.",
    "rule_version": "1.6",
    "rule_reasons": [
      "Systematic-review or meta-analytic evidence affirms the core relationship.",
      "Multiple supporting studies are consistent with the core relationship.",
      "Null-result evidence bears directly on the claimed effect."
    ]
  },
  "conclusion": "Groups of workers reporting more job stress tend to have lower HRV, and HRV drops during stressful work periods compared with recovery, but the one study that followed the same people through a working day did not find job demands lowering HRV. The link supports statements about groups, not predictions about one person.",
  "reasoning": [
    "This is the evidence beneath every claim that a wearable can detect or prevent burnout. Two independent reviews affirm the link: one across job-strain studies comparing workers, one within doctors comparing their own stress and recovery periods.",
    "A null result sits against it. Teachers rating their job demands six times a day showed the effect on exhaustion and not on HRV. With two affirming anchors and a core-hitting null, the rule rates the claim Emerging rather than Established."
  ],
  "key_results": [
    {
      "text": "A systematic review of 10 studies found higher occupational stress associated with lower HRV, mainly reduced parasympathetic activity; 9 of the 10 studies were cross-sectional, so the direction is not established.",
      "source": "doi:10.2486/indhealth.2017-0190",
      "source_url": "https://doi.org/10.2486/indhealth.2017-0190",
      "source_citation": "Järvelin-Pasanen et al., Industrial Health, 2019"
    },
    {
      "text": "In a meta-analysis of continuous HRV monitoring in doctors, RMSSD was lower during stress than recovery (standardized mean difference -0.63) and SDNN lower (-1.05), in studies of 12 to 54 participants rated moderate quality at best.",
      "source": "doi:10.1093/occmed/kqaf101",
      "source_url": "https://doi.org/10.1093/occmed/kqaf101",
      "source_citation": "Kane et al., Occupational Medicine, 2026"
    },
    {
      "text": "Across 669 ambulatory measurements in teachers, job demands affected emotional exhaustion but not state HRV.",
      "source": "doi:10.1080/10615806.2020.1746286",
      "source_url": "https://doi.org/10.1080/10615806.2020.1746286",
      "source_citation": "Schmid et al., Anxiety, Stress, and Coping, 2021"
    }
  ],
  "scope": {
    "applies_to": "The association between occupational stress and HRV in working adults, measured between people and within people across work and recovery.",
    "does_not_cover": "Whether any wearable or vendor score can predict or prevent burnout in an individual, which no study scored here validates; workplace wellness program outcomes."
  },
  "limitations": [
    "Most studies compare groups at one point in time, which cannot show that stress causes lower HRV.",
    "Studies used different HRV devices and stress questionnaires.",
    "Much of the within-person evidence comes from doctors and surgeons, not general workforces."
  ],
  "evidence": {
    "anchor": [
      {
        "key": "doi:10.1093/occmed/kqaf101",
        "title": "Continuous heart rate variability monitoring, stress and recovery in doctors: a systematic review and meta-analysis.",
        "first_author": "Kane",
        "journal": "Occupational medicine (Oxford, England)",
        "year": 2026,
        "url": "https://doi.org/10.1093/occmed/kqaf101",
        "industry_ties": {
          "checked": true,
          "author_affiliations": [],
          "funders": [],
          "stated_ties": []
        }
      },
      {
        "key": "doi:10.2486/indhealth.2017-0190",
        "title": "Heart rate variability and occupational stress-systematic review.",
        "first_author": "Järvelin-Pasanen",
        "journal": "Industrial health",
        "year": 2019,
        "url": "https://doi.org/10.2486/indhealth.2017-0190",
        "industry_ties": {
          "checked": true,
          "author_affiliations": [],
          "funders": [],
          "stated_ties": []
        }
      }
    ],
    "null_result": [
      {
        "key": "doi:10.1080/10615806.2020.1746286",
        "title": "Teachers' ambulatory heart rate variability as an outcome and moderating variable in the job demands-resources model.",
        "first_author": "Schmid",
        "journal": "Anxiety, stress, and coping",
        "year": 2021,
        "url": "https://doi.org/10.1080/10615806.2020.1746286",
        "industry_ties": {
          "checked": true,
          "author_affiliations": [],
          "funders": [],
          "stated_ties": []
        }
      }
    ],
    "supporting": [
      {
        "key": "doi:10.1080/00140139.2025.2543518",
        "title": "Work-related mental stress in confined tunnel construction environments: a field study with heart rate variability (HRV).",
        "first_author": "Wu",
        "journal": "Ergonomics",
        "year": 2026,
        "url": "https://doi.org/10.1080/00140139.2025.2543518",
        "industry_ties": {
          "checked": true,
          "author_affiliations": [],
          "funders": [],
          "stated_ties": []
        }
      },
      {
        "key": "doi:10.1093/bjsopen/zrae097",
        "title": "Heart rate variability as a dynamic marker of surgeons' stress during vascular surgery.",
        "first_author": "De Louche",
        "journal": "BJS open",
        "year": 2024,
        "url": "https://doi.org/10.1093/bjsopen/zrae097",
        "industry_ties": {
          "checked": true,
          "author_affiliations": [],
          "funders": [],
          "stated_ties": []
        }
      },
      {
        "key": "doi:10.1007/s00420-020-01525-6",
        "title": "Heart rate variability as a measure of mental stress in surgery: a systematic review.",
        "first_author": "The",
        "journal": "International archives of occupational and environmental health",
        "year": 2021,
        "url": "https://doi.org/10.1007/s00420-020-01525-6",
        "industry_ties": {
          "checked": true,
          "author_affiliations": [],
          "funders": [],
          "stated_ties": []
        }
      }
    ]
  },
  "evidence_last_evaluated": "Oct 24, 2026",
  "rating_history": [
    {
      "date": "2026-09-30",
      "rating": "Emerging",
      "from": null,
      "rule_version": "1.6"
    }
  ],
  "versions": [
    {
      "version": "1.0",
      "date": "2026-10-24",
      "rating": "Emerging",
      "change": "First published."
    }
  ],
  "research_desk": "https://knowyourprime.com/research-desk-hrv#occupational-stress",
  "related_findings": [
    "https://knowyourprime.com/evidence-readiness-recovery-score-validity",
    "https://knowyourprime.com/evidence-do-activity-trackers-increase-activity"
  ],
  "related_articles": [
    "https://knowyourprime.com/do-workplace-wellness-programs-work",
    "https://knowyourprime.com/does-your-wearables-stress-score-actually-measure-stress",
    "https://knowyourprime.com/does-high-hrv-protect-against-stress"
  ],
  "methodology": "https://knowyourprime.com/methodology",
  "citation": "KnowYourPrime Evidence Registry, Finding KYP-ER-0006, version 1.0, reviewed 2026-10-24. https://knowyourprime.com/evidence-work-stress-hrv"
}