A proper night’s rest is absolutely essential for our well being. In light of that, it’s no wonder so many of us are keen to gain greater insight into our sleep quality. Increasingly, smartwatches and fitness trackers are kitted out with features to help us better understand our shuteye – and are offering solutions to help us detect whether we’re experiencing diagnosable disorders like sleep apnea.
I’ll be honest: as someone who lives with sleep apnea, I have a bit of a vested interest here. Given how long it took me to understand what was going on with my sleep, I’ve often wondered if I’d had access the best sleep trackers on the market, whether I could have solved the puzzle much earlier than I did.
A lot of my adult life I’ve dealt with severe fatigue. We’re not talking a little bit of tiredness – we’re talking about that feeling where you’ve not slept for 36 hours and have nothing left in the tank. At random times throughout the day, my brain will try to flick the consciousness off-switch and it takes every fiber of my being to wrench its hand away from the controls.
Naturally, as a result, I’ve always been interested in sleep tracking-wearables like the Apple Watch Ultra 2, Oura Ring 3 or Samsung Galaxy Watch 8 Classic. I remember the first time I used a fitness band with sleep cycle tracking – my sleep wasn’t so much fragmented as much as sliced into carpaccio. Even taking the accuracy of the data with a pinch of salt, I could see that I was waking countless times throughout the night without ever remembering I’d done so.
Sleep apnea is caused by the airway closing during the night and stopping you breathing; this starves your brain of oxygen and forces it to wake you up in the middle of a sleep cycle to reopen the airway. As a result, regular awakenings, broken sleep cycles interrupting deep sleep and low blood oxygen are huge warning signs for sleep apnea.
Coupled with some of the negative health implications – including increased risks of heart disease, strokes and motor vehicle collisions – these telltale signs make it pretty clear why so many of the best fitness trackers like Apple Watches have recently gone all-in on detecting sleep apnea symptoms. Given some estimates put the rates of people living with the disorder as high as 10% of the population, there’s a lot of users whose lives could be improved if they had a warning they were affected.
But how effective are they? If only we had a guinea pig who had been diagnosed with sleep apnea, had access to all of the sleep trackers mentioned above and was willing to spend several months surveilling their snoozes in the name of science… Oh wait! I know just the guy for that. Me.
Here’s what I found when I pitted the Apple Watch Ultra 2, Oura Ring Gen 3 and Samsung Galaxy Watch 8 Classic against my fragmented sleep.
Apple Watch Ultra 2
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I feel like it’s probably worth getting this out of the way: the Apple Watch Ultra 2 didn’t issue any sleep apnea alerts. In fact, spoiler alert: none of these trackers offered a clear cut warning that I suffer from a diagnosable apnea.
But, as many of them are at pains to point out, they’re not intended to be used as diagnostic tools – in fact, the Ultra 2 explicitly asked me during setup whether I’d be diagnosed with sleep apnea, presumably so it could warn me away from taking its lack of alerts as a sign my health was now hunky dory.
Which is probably a good thing. Because the Watch Ultra 2 rarely even logged that I had any breathing issues during the night. Literally the only occasion it flagged my breathing disturbances as elevated was on a night I’d been out for drinks for a co-worker’s birthday – it’s hardly a news flash to me that the booze might have suppressed my breathing. More troublingly, it also entirely missed other nights where I actively woke myself up gasping for air – so rather than a pinch of salt, I’d take its results here with the whole shaker.
That’s not to say it didn’t provide any hints something was up with my breathing though. The Ultra 2 did often log that my O2 saturation would drop during the night, regularly falling as low as 94%. That’s not a huge red flag in of itself – a healthy range is anything from 95% to 100%, so I’m not miles outside the norm – but it was my first real indication it was detecting something odd was going on here.
OK, so maybe breathing isn’t its strongest suit. But what about sleep tracking in general? Could it detect some warning signs in my general sleep patterns?
I’d say the Ultra 2’s sleep tracking seems a lot more robust and granular than its respiratory monitoring. Certainly, what I saw here reflects my understanding of how sleep apnea fractures your sleep. With all those micro-interruptions of my breathing, my sleep cycles look incredibly fragmented – most of my sleep data sees me ping-pong between core sleep, REM and wakefulness in quick succession, while restorative, deep sleep comes in brief fragments, if at all.
However, there are still some pretty anomalous readings dwelling in this data. I’d expect my awakenings during the night to be brief – so brief in fact, I usually don’t remember more than about a third of them – but the Apple Watch Ultra 2 sometimes would show me as being awake for an hour or sometimes two in the middle of the night. And trust me, if I’d surfaced for the length of a Lord of the Rings movie in the middle of the night, that’s the kind of thing I’d think would stick in my mind.
It’s possible this in itself is illuminating. If my core sleep is so liminal, so light and fragmentary, that distinguishing between it and true wakefulness baffles Apple’s tracker, then that could be a sign my sleep is disordered and in need of investigation. But if you’re wanting clear answers, rather than having to read the digital tea leaves in this way, I imagine you’re not going to find this kind of equivocal insight that helping.
Oura Ring (Gen 3)
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Alright, confession time: I’ll admit that the Oura Ring Gen 3 has never claimed that it’s able to detect sleep apnea. But given its newer sibling, the Oura Ring 4, is our pick for the best sleep tracker you can get with a subscription and its known for the troves of health data it can track, it seems unnecessarily obstinate to not check out how it stacks up.
Despite the lack of dedicated sleep apnea alerts, I actually found the Ring Gen 3 to be a lot more detailed and accurate than the Apple Watch. Not only does it consistently show the low levels of restorative deep sleep I get but it captures a lot of events I recognize.
One night in particular, I remember having trouble getting to sleep for several hours, after having spent the weekend entertaining guests and their toddler, as well as staying up a little too late. Not only did the Oura Ring capture this precisely, it also shows how I struggled to get into REM sleep – I remember in clear detail how shallow my sleep felt and how I was unable to enter dream sleep. That’s an impressive level of precision.
And while the Ring Gen 3 isn’t willing to suggest specific diagnoses, it definitely detects some issues with my night-time respiration. Most evenings it would register Breathing Disturbances and, while it clocked these as ‘few’ rather than the higher frequency detected by my sleep study, I’m impressed that it does at least pick up on the fact my breathing stops.
The Oura also unlocks a wealth of insights on top of sleep cycle and breathing tracking. Case in point: when my sleep has been particularly poor, it shows that my sleep debt was not only high but has brought me to the brink of sleep bankruptcy. That’s helpful to know, as a few extra naps and more time in bed will hopefully help me pay some of this back.
And it’s nice how some of these additional data points actually add further context to understanding how poor sleep impacts the rest of your life.
For example, there are some days it accurately clocked that my stress levels were spiking at work after several nights of really bad sleep, which I was definitely conscious of at the time. While these relationships aren’t necessarily causal – the week in question, I think I was self-medicating with increased caffeine intake, leading my stress levels to spike – it has been invaluable in helping me understand how my sleep relates to other elements of my physical and mental wellbeing.
On top of this, I could then use the Oura’s data to see the impact my poor sleep had on my ability to recover from this stress, or my readiness for the day ahead. Having that extra level of insight goes beyond being a warning system for sleep issues and actually starts to become a meaningful tool to help mitigate some of the ways it actually impacts your day.
Samsung Galaxy Watch 8 Classic
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I had high hopes for the Samsung Galaxy Watch 8 Classic. Looking at the list of metrics it can track, it promises a trove of data. Even if it doesn’t come with the sleep-tracking rep of a device like the Oura, at a glance it seems to offer really granular insights into your night’s rest.
Unfortunately, the more I dug into the data, the more I questioned the precision of its tracking. On some occasions, it shows me getting a tiny amount of deep sleep, while on others it shows me getting just as much deep sleep as REM. As a result, my deep sleep score often showed as being ‘good’, even on mornings I woke up shattered.
The Watch 8 Classic also makes some odd assumptions about restfulness. According to the Samsung Health app, my restfulness score is usually ‘fair’ to ‘good’ – despite the fact it’s showed I’ve woken up more than 20 times and spent a cumulative 90 minutes of the night awake. That’s because it classifies waking events as unproblematic as long as you quickly return to sleep – an assumption that doesn’t concur with the medical literature around sleep disorders like sleep apnea.
And unlike the other two wearables I tested, even its sleep times didn’t seem all that reliable. Several times it logged me as taking a nap during the working day – at times I can see I’ve sent colleagues Slack messages and can see time-coded edits I’ve made to articles. Either I’m being ‘Severanced’ by my innie while I sleep or the Samsung sometimes struggles to differentiate between sleep and focused productive time.
That’s a real shame as the level of detail the Watch 8 Classic records elsewhere is genuinely very decent. For instance, rather than the simple nightly range for blood oxygen the Watch Ultra 2 offers, the Samsung Health app offers a very granular blood oxygen graph with precise peaks and troughs throughout the night.
This makes it far easier to see if there’s correlation between your O2 saturation and awakenings. One night where I had a particularly broken sleep in the early morning, it showed my blood oxygen dropped multiple times down to 79% – a definite warning sign for apnea events.
Similarly detailed movement and snoring graphs open up even more opportunities for this kind of comparison and insight, to the degree that I wish the Watch 8 Classic’s rivals above would offer similar levels of insight.
If scrutinizing hard data isn’t your bag, Samsung does offer some fluffier ways to understand your sleep data. Honestly, its Sleep Animal feature – where you’re assigned a critter based on your sleep habits – felt a little like astrology to me, with the categories broad enough that they felt mere millimeters deep. I’m a Deer sleeper apparently because, like the skittish ruminant, I wake up easily. Insightful.
Samsung’s sleep coaching habits feel a lot more practical to me. While a lot of them are common knowledge – like avoiding caffeine after 5pm or getting out of bed quickly – I can see why having a checklist to run through each night would be helpful. Being able to compare how many you completed to how well you slept is a great way to see how these healthy habits work for you.
Honestly, the Samsung Galaxy Watch 8 Classic is the wearable I found least helpful with my sleep apnea. While some of its features are top tier for things like tracking blood oxygen and how much you move during the night, its sleep stage and total sleep time tracking aren’t accurate enough that I’d ever totally trust it was giving me the full picture.
Verdict
OK, so first thing’s first: none of these devices alerted me to the fact I was experiencing sleep apnea. I’m not totally surprised by this – while the Oura Ring Gen 3 doesn’t offer this functionality, the manufacturers of the other devices could not be clearer that they’re not to be considered of diagnostic standard. They may flag sleep apnea events if you’re experiencing them but the lack of notifications does not mean you aren’t suffering from disturbed night time breathing.
However, all three devices offered enough info that I could tell something wasn’t quite right with my sleep. Out of the three of them, the most reliable and insightful for me was the Oura Ring Gen 3 – its sleep phase tracking always seemed to align with my recollections of my night’s sleep. Moreover, it provides the most insights into what your poor sleep actually means for you. Certainly, it’s the tracker I’ll continue to use to give me insight into how my sleep apnea impacts upon my sleep.
Fundamentally, though, this might be the most important advice I’ve ever offered: if you’re worried you might be suffering from sleep apnea, don’t rely on a sleep tracker to guide you. Speak to your doctor about your fatigue.
A sleep study is the gold-standard when it comes to diagnosing disordered sleep – mine cleared up the mystery of my fatigue in a single night and has allowed me to tackle my sleep apnea head on. Sleep trackers are a great tool for gaining a little extra insight but, if you have concerns about something that might be negatively impacting your health, only a doctor can truly help you be sure.
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