Can a Smartwatch or Ring Detect Sleep Apnea?

Smartwatches and smart rings cannot diagnose sleep apnea, but some can now give you an early warning. A few watch features are authorized by the FDA to flag signs of possible moderate to severe sleep apnea in adults. If you get an alert, or have symptoms without one, the next step is a real sleep test.^[1]

What wearables measure during sleep

Watches, rings and fitness bands use small sensors on the skin. They do not measure your breathing directly. Instead, they estimate it from other signals:

• Movement — a motion sensor (accelerometer) picks up how much you move, and some devices pick up small movements with each breath.
• Heart rate — a light sensor on the back of the device tracks your pulse. Heart rate can jump when a breathing pause ends.
• Blood oxygen (SpO2) — some devices estimate oxygen levels and look for repeated drops during the night.
• Sleep time and stages — devices guess when you are asleep and in which stage. These guesses are fair for total sleep but less reliable for stages.^[2]

The American Academy of Sleep Medicine (AASM) says consumer sleep devices can help people take an interest in their sleep, but most are not FDA-cleared to diagnose or treat sleep problems and should not replace a medical evaluation.^[3]

Wearables with FDA-authorized sleep apnea alerts

Most sleep features on wearables are "wellness" tools. A few go further and have FDA authorization as over-the-counter sleep apnea screening features. As of this writing, two well-known examples are:

• Samsung Health Monitor sleep apnea feature — granted FDA De Novo authorization in February 2024 for certain Galaxy Watch models. It uses blood oxygen readings over two nights to look for signs of moderate to severe obstructive sleep apnea in adults 22 and older.^[4]
• Apple Watch sleep apnea notifications — cleared by the FDA in September 2024 for certain Apple Watch models. It uses the motion sensor to look for breathing disturbances over many nights and sends a notification to adults 18 and older if it finds a pattern.^[5]

Both are meant only for people who have never been diagnosed with sleep apnea. The FDA labels for both say they do not diagnose sleep apnea and do not replace a sleep study.^[4][5] Mentioning these features is not an endorsement of any product.

Why no alert does not mean no sleep apnea

These features are built to avoid false alarms, so they miss some people who do have sleep apnea. In the FDA review, the Apple feature caught about two in three people with moderate to severe sleep apnea.^[5] The Samsung feature caught about 80% in its own study.^[4] The studies used different people and methods, so the numbers should not be compared head to head.

• Mild sleep apnea is not the target — the features look for moderate to severe apnea only.
• Some types are missed — the Samsung label says it cannot detect central sleep apnea, where the brain does not send the signal to breathe.^[4]
• Some health problems confuse the sensors — the Samsung label lists conditions such as atrial fibrillation, heart failure, COPD and movement disorders.^[4]
• Fit and wear matter — a loose band, a dead battery or nights without the device leave gaps in the data.

Symptoms still count. Loud snoring, pauses in breathing that someone else notices, waking up gasping, morning headaches and daytime sleepiness are all reasons to get checked, alert or not.

What to do if your wearable flags sleep apnea

• Save the alert — take a screenshot or export the report so your doctor can see it.
• Make an appointment — see your primary care doctor or a sleep specialist and mention any symptoms.
• Expect a sleep test — the AASM recommends either an in-lab sleep study or, for many adults with likely moderate to severe apnea and no major other health problems, a home sleep apnea test.^[1]
• Don't start or stop treatment on your own — the wearable result alone is not enough to choose a treatment.

Not sure which test fits you? Our guide to in-lab vs. home sleep studies explains the differences.

How a sleep study differs from a wearable

A sleep study measures what a watch can only guess. An in-lab study records brain waves, airflow, breathing effort, oxygen, heart rhythm and leg movements. A home sleep apnea test records airflow, breathing effort and oxygen. Both give an apnea-hypopnea index (AHI), the number of breathing pauses per hour, which is used to diagnose sleep apnea and choose treatment.

Sleep doctors also use a clinical wrist device called an actigraph to track sleep and wake patterns over many days. Learn how it differs from a consumer watch in actigraphy sleep testing.

Wearables and children

The FDA-authorized sleep apnea features are for adults only. Children with sleep apnea often look different from adults: snoring, restless sleep, mouth breathing, bedwetting, and trouble with attention or behavior in the day. If you notice these signs, talk with your child's pediatrician. You can read more about pediatric sleep medicine.

When to see a sleep specialist

• Your wearable flags possible sleep apnea — or keeps showing oxygen drops at night.
• You snore loudly or stop breathing in sleep — especially if someone has seen you gasp or choke.
• You are sleepy during the day — such as dozing while reading, watching TV or driving.
• You have high blood pressure or heart problems — sleep apnea is common in these conditions and worth checking.

More signs are listed in when to see a sleep specialist.

Sleep testing in Cedar Park

Dr. Minal Patel is board-certified in pediatrics and sleep medicine. Our practice offers in-lab sleep studies and home sleep apnea tests, CPAP and BiPAP therapy, and sleep care for children and adults. We are accepting new patients. Office hours are Monday through Friday, 8:30 to 5:00. We accept Medicaid and CHIP for sleep patients. We do not take walk-ins.