Sleep Apnoea and the Rise of Smart Technology

How consumer wearables are transforming early detection and awareness:

Sleep apnoea has long been called a silent killer. It may sound loud when someone snores, but it is silent in the way it damages the body over years. Many people wake feeling tired, groggy, or irritable despite a full night’s sleep, without realising that their airway may be repeatedly collapsing during the night. This condition, known as Obstructive Sleep Apnoea (OSA), affects millions of adults. Yet most people who have it remain undiagnosed.

Today, direct to consumer health technology, including the Apple Watch, Withings sleep devices and FDA-cleared home tests such as WatchPAT, is changing how people recognise symptoms and seek help. These tools cannot replace a full diagnostic sleep study, but they can play a powerful role in screening, increasing awareness and encouraging people to take action sooner.

What is Obstructive Sleep Apnoea?

OSA occurs when the muscles in the throat relax too much during sleep, causing the airway to narrow or collapse. Breathing stops for short periods, often many times each hour. Each pause reduces oxygen levels and disrupts the natural structure of sleep.

Key symptoms include:

• Loud snoring

• Choking or gasping during sleep

• Daytime tiredness

• Irritability or poor concentration

• Waking with a dry mouth

• Headaches on waking

• Obesity or a large neck circumference
  

Because these symptoms are familiar and easy to dismiss, OSA often goes unnoticed. Many people simply assume they are “bad sleepers”.

How common is it?

Studies estimate that around 5 to 20 per cent of adults have some degree of OSA, with higher rates in older adults and people who are overweight. A large proportion have never been diagnosed. It is very likely that you know someone affected by it.

Why does it matter?

Untreated OSA is linked to serious long-term health risks, including:

• High blood pressure

• Coronary artery disease

• Stroke

• Abnormal heart rhythms

• Heart failure

• Diabetes

• Increased risk of cancer

• Motor vehicle accidents due to sleepiness
  

OSA severity is measured using the Apnoea Hypopnoea Index (AHI), which counts the number of breathing interruptions per hour of sleep:

• Normal: fewer than 5 events per hour

• Mild: 5 to 15 events per hour

• Moderate: 15 to 30 events per hour

• Severe: more than 30 events per hour
  

The STOP-BANG screening tool:

A simple questionnaire such as STOP-BANG can help you assess your risk. A score of 0 to 2 makes OSA less likely. A score of 3 or more suggests a higher chance of OSA and is a strong reason to speak to your GP.

STOP-BANG has high sensitivity. This means it is good at identifying people who truly have OSA. Its specificity is lower, so a higher score does not confirm the condition, but it is a valuable first step.

How technology is changing early detection

Until recently, the path to diagnosis involved seeing a GP, being referred to a sleep clinic and undergoing a formal home or hospital sleep study. This remains the gold standard. However, consumer technology is now providing accessible ways to detect early signs of problems.

Polysomnography, or PSG, is the full sleep study done in a clinic and is considered the gold standard for diagnosing sleep apnoea. Unlike home or wearable devices, PSG records brain activity (EEG), eye movements (EOG), and muscle activity (EMG) in addition to breathing and oxygen levels. 

Apple Watch Sleep Apnoea Notifications

In 2024, Apple introduced Sleep Apnoea Notifications for Apple Watch, which uses motion sensors and photoplethysmography (PPG) to analyse breathing patterns during sleep. The system identifies signs consistent with OSA and alerts users who may need further assessment. According to Apple’s published documentation, the feature is designed as a population-level screening tool. It does not diagnose the condition but signals when users should seek medical evaluation.

Recent research suggests that smartwatches can be helpful for spotting signs of sleep apnoea. Studies using Apple Watch data show that its measurements of breathing interruptions during sleep closely match results from formal sleep studies. In some studies, the watch was able to correctly identify almost all cases of moderate to severe sleep apnoea, and correctly rule out the condition in many people who did not have it. These watches cannot diagnose sleep apnoea, but they can give useful early warnings and encourage people to get checked by a doctor.

Withings Sleep Analyzer

The Withings Sleep Analyzer is placed under the mattress and tracks breathing patterns, heart rate and snoring. It uses a clinically validated algorithm to detect possible OSA. While it cannot diagnose the condition, it provides detailed sleep reports that can prompt users to seek a formal assessment. 

Studies show that the Withings Sleep Analyzer is good at spotting moderate to severe sleep apnoea when compared with the gold standard sleep test done in a clinic. The device does not measure airflow or oxygen levels directly. Instead, it detects breathing problems by picking up movements and sounds while you sleep. This means it can be used at home, automatically, without any wires or a sleep technician. It is a convenient way to screen large numbers of people or keep track of sleep over time.

WatchPAT: A Clinically Validated Home Test

WatchPAT is a home sleep test that can estimate how often your breathing stops or becomes very shallow during the night. It does this using a combination of sensors that measure changes in your blood vessels, oxygen levels, and movement. Unlike the Withings Sleep Analyzer, which sits under your mattress and detects breathing and sound patterns (piezoelectric sensors), or the Apple Watch, which uses light-based sensors on your wrist (photoplethysmography) and motion tracking, WatchPAT uses a wrist device and a finger sensor to track subtle changes in your circulation and body signals while you sleep.

Research shows that WatchPAT gives results that are very similar to a full in-lab sleep study, especially for moderate to severe sleep apnoea. It may sometimes slightly over- or underestimate the number of breathing interruptions, but overall it is highly accurate. Its main advantage is that it provides a clinically validated, automated way to screen for sleep apnoea at home without the need for wires, electrodes, or a sleep technician.

What to do if you suspect OSA:

1. Have an open conversation: Talk to your partner or family. Ask whether they have noticed snoring, pauses in breathing or gasping during sleep.

2. Complete the STOP-BANG questionnaire: A score of 3 or more suggests an increased risk.

3. Speak to your GP: If your symptoms or STOP-BANG score suggest a risk, your GP can refer you for a sleep study at home or in a specialist clinic.

4. Consider supportive home technology: Devices such as Apple Watch, Withings Sleep Analyzer or clinically validated tools like WatchPAT can provide valuable insights while you wait for assessment.

5. Make lifestyle changes: Weight loss of more than ten kilograms can significantly improve mild OSA. Regular exercise, reducing alcohol intake and improving sleep routines are helpful for everyone, whether or not OSA is confirmed.

6. Adopt better sleep hygiene and consider sleep position changes: A regular sleep schedule, going to bed and waking up at roughly the same times every day, helps regulate your body’s sleep-wake cycle, which is good for overall sleep quality.Also, many people with OSA breathe better when they sleep on their side rather than their back. Sleeping on your back can allow soft tissues (like the tongue) to fall back and block the airway. Using a supportive pillow or positional aids can help encourage side‑sleeping (see https://www.iwantgreatsleep.com/ for more sleep hygiene and positional suggestions). 
   

The future of sleep health:

As technology becomes more advanced, OSA screening will continue to shift towards the home. Wearables now offer early warning signs that were simply not possible a decade ago. They empower people to take control of their health, improve awareness and seek support earlier.

While a diagnosis must still come from a formal sleep study, direct to consumer health technology is closing the gap between symptoms and action. For a condition that is so common and so often missed, this shift could save lives.

If you snore loudly, wake feeling unrefreshed or suspect that your breathing is interrupted at night, consider exploring these tools and speaking to your GP. Early recognition is the first step towards better sleep, better energy and better long-term health.

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