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Your Newer Smartwatch Can Alert You to Symptoms of Sleep Apnea

FDA gives its blessing to software update that measures interruptions in breathing


spinner image a smartphone and a smartwatch
Courtesy of Apple

The Food and Drug Administration (FDA) approved a feature Monday that may be able to detect signs of moderate to severe sleep apnea in people who wear their Apple Watch to bed.

The feature, which became available via a software update to some Apple Watch models, leverages the accelerometers on the new Apple Watch Series 10 (starting at $399), the new Apple Watch Ultra 2, (starting at $799) and last year’s Apple Watch Ultra 2 and Apple Watch Series 9. An accelerometer measures the vibration of motion, and in a smartwatch it can track a wearer’s movements and activity levels.

The OK is the agency’s second of a sleep apnea detection feature in a smartwatch. The first came in February for the Samsung Galaxy Watch Ultra (starting at $649.99) and its Samsung Health Monitor app for Galaxy Android smartphones.

While the FDA cleared the Apple Watch as a medical grade device, the watches are not certified to diagnose sleep apnea, which affects more than 1 billion people worldwide. Experts estimate that 4 out of 5 people who have sleep apnea — characterized as repeated stopping and starting of breathing that can disrupt sleep — have not been diagnosed, either because they don’t recognize the symptoms or don’t believe they have anything to worry about.

The potential consequences are more serious than the fatigue or irritability you might feel the next day. Left untreated, sleep apnea can increase the risk of cancer, type 2 diabetes, chronic kidney disease, cardiac issues and dementia.

spinner image a smartphone screen
The Apple Watch monitors your breathing disturbances for 30 days to look for patterns that could be a symptom of sleep apnea. It notifies you, but you have to talk to your doctor.
Courtesy of Apple

Smartwatch traces your breathing

Apple is basing its sleep apnea feature around a metric it refers to as Breathing Disturbances, described as interruptions in your regular respiratory patterns. Each night, Apple classifies your Breathing Disturbances as “elevated” or “not elevated.”

Some elevated disturbances might relate to medications you take or alcohol you ingest and not have anything to do with sleep apnea.

Every 30 days, Apple will analyze the data, and if more than half the nights have been determined to be elevated, you’ll be notified of potential moderate to severe sleep apnea. Such notifications will include the time frame when the possible sleep apnea was detected.

If you receive a notification, you’ll be encouraged to contact your doctor. The feature is designed for people 18 and older who have not previously had a sleep apnea diagnosis.

Keep in mind the battery life on Apple Watch Series 9 and Series 10 is rated to last around 18 hours, so if you intend to wear the watches to bed, you'll have to find time to charge them. The Ultra2 model has double the battery life..

Other devices approved this year

Users of the comparable features in a Samsung Galaxy Watch must be older than 22 and not previously diagnosed with sleep apnea. Samsung cautions users not to use the sleep apnea feature to replace traditional methods of diagnosis and treatment from a qualified clinician, adding that the data provided is also not intended to assist health care providers in making such diagnoses.

Meanwhile, on Sept. 9, the FDA cleared the way for sales of the Withings Sleep Rx Mat, which you place under your regular mattress. You won’t need to wear any sensors while you sleep.

Sleep apnea and other sleep data shows up on Withing’s companion Health Mate smartphone app. For now, you’ll need a prescription to buy it.

Take a sleep apnea questionnaire

The sleep field in general is in favor of anything that would increase the ability to detect patients who’ve got obstructive sleep apnea and to get them screened,” says James K. Wyatt, professor and director of sleep disorders and sleep-wake research at Rush University Medical Center in Chicago.

But Wyatt is not ready to make any clinical decisions based on what he knows now about Apple’s research. He wants to learn more about potential biases in the study design.

And he wants to see whether the results will outperform a University of Toronto STOP-Bang questionnaire. That free online questionnaire allows people to assess their sleep apnea risk.

The eight-question mnemonic:

  • S stands for snoring
  • T for tired
  • O for observed
  • P for pressure, as in blood pressure
  • B for body mass index
  • A for age over 50
  • N for neck size 16 inches or larger
  • G for Gender

The collective answers are meant to determine your risk for obstructive sleep apnea.

In the past several years, Apple has gone all in on health with its Apple Watch. Models can detect falls and the irregular heartbeat known as atrial fibrillation, A-fib for short.

Because of a patent dispute, in 2023 Apple had to remove a blood oxygen sensor on Apple Watches sold in the U.S.

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