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Heart rate variability versus visual analog scale for objective and subjective mental fatigue detection: A randomized
Hiroaki Yoshikawa1,2, Yumi Adachi1,2, Ayako Baba1,2
1Health Service Center, Kanazawa University, Kanazawa, Ishikawa, Japan.
PLOS Mental Health
|February 9, 2026
Summary
Objective measurement of mental fatigue using Heart Rate Variability (HRV) shows promise. HRV indexes, like RMSSD, and subjective fatigue scores correlate with mental exertion, aiding health assessments.
Area of Science:
- Physiology
- Psychology
- Health Sciences
Background:
- Fatigue is a complex issue requiring objective assessment beyond subjective reports.
- Heart Rate Variability (HRV) is a potential objective measure for mental fatigue, but its efficacy needs validation.
- Current methods for evaluating mental fatigue lack objective, reliable indicators.
Purpose of the Study:
- To compare the efficacy and safety of Heart Rate Variability (HRV) with subjective psychological tests in evaluating mental fatigue.
- To determine if HRV can serve as an objective indicator of mental fatigue.
- To assess the relationship between objective HRV measures and subjective fatigue scales.
Main Methods:
- A single-center, randomized trial involving 140 participants aged 20-65.
- Comparison of HRV indexes (e.g., RMSSD) and subjective measures (VAS, POMS2) between a calculation task group and a resting control group.
- Wearable electrocardiography used for primary HRV outcome measurement.
Main Results:
- Participants performing the calculation task showed decreased HRV indexes (RMSSD, high-frequency power, Poincaré plot std dev).
- The calculation task group reported significantly higher subjective fatigue scores (VAS for fatigue, POMS2).
- RMSSD and VAS for fatigue emerged as significant indicators associated with the mental task.
Conclusions:
- Heart Rate Variability (HRV), specifically RMSSD, can serve as an objective indicator of mental fatigue.
- Both objective HRV measures and subjective psychological tests are related to mental fatigue.
- Further research is warranted to confirm the safety and effectiveness of HRV for fatigue assessment.
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