Sleep Trackers and Smart Rings: What the Numbers Can and Can't Tell You

Rings, watches and bedside devices now give you a sleep score each morning, with charts of deep sleep, REM and restlessness. Some add a monthly membership on top of the device price. When hot flashes, bathroom trips or 3 a.m. wake-ups break up your nights, a number can feel like an answer. Here is what sleep specialists say these devices can do.

They can’t diagnose a sleep disorder

The American Academy of Sleep Medicine (AASM)¹ says consumer sleep technology can’t be used to diagnose or treat sleep disorders. It points to a lack of validation against polysomnography, the full overnight sleep study, and to a lack of FDA clearance for those purposes.¹

That includes the sleep stage breakdown. A deep sleep or REM figure from a ring or watch is the device’s estimate, not the result of a sleep study.

They can help the conversation

The AASM also says these devices may improve the conversation between you and your clinician, when the data is looked at as part of a proper evaluation.¹ Patterns can help: bedtimes drifting later, nights with long awake stretches, or changes after a new medicine.

The score can become the problem

Sleep researchers have described “orthosomnia,” a preoccupation with getting perfect tracker data. In a 2017 report, clinicians described patients seeking treatment for problems they had diagnosed from tracker data, such as periods of “light” or “restless” sleep. For some, the search for the ideal score became perfectionistic, and patients trusted the tracker over validated tests.²

If you check the score before you check how you feel, or a low number makes you anxious all day, take a break from looking at it.

Signs to get checked, whatever the score says

The AASM lists snoring with choking, gasping or pauses in breathing, and daytime sleepiness, among warning signs of sleep apnea, and advises talking to a medical provider if you’ve been told you snore.³ A good sleep score doesn’t rule these out.

Before you buy

1. Decide what you want to learn. Bedtime and wake time patterns are something a paper diary can record for free.
2. Check what’s behind a paywall. Some features need a monthly membership. Note the yearly total.
3. Read the health claims. The AASM says products meant to diagnose or treat sleep disorders need FDA clearance and testing.¹ If a device claims to detect a condition, check what clearance it has.
4. Check the privacy settings for where your sleep and heart data goes.

Try: “My tracker says I’m getting very little deep sleep and I wake up tired. Could something like sleep apnea, hot flashes or a medicine be affecting my sleep, and do I need a sleep study?”

Did I Do That in My Sleep? includes a 14-Night Lights-Out Record and a Visit Brief. Use them alongside or instead of a tracker to record bedtimes, wake-ups and what woke you, then bring them to your visit. See the book.