Apple Watch vs Home Sleep Tests: Detection vs Diagnosis Explained

Sleep apnea affects nearly 1 billion people worldwide . Yet over 80% of these cases go undiagnosed, leaving millions to struggle with chronic fatigue, mental health, and long-term health complications. As more people are impacted, it’s encouraging to see Apple prioritize early detection, with their newest watchOS 11 update making it possible for Apple Watch to detect sleep apnea.

Recently, we spoke with our board-certified sleep medicine physician, Dr. Audrey Wells, MD , to get a doctor’s take on the Apple Watch sleep apnea detection feature. While this technology looks promising, knowing you’re at risk for sleep apnea is only part of the battle. It’s what you do with that information that truly matters.

Here's what we'll cover with Dr. Wells:

• Which Apple watches can detect sleep apnea?

• How accurate is Apple Watch sleep apnea detection?

• How does Apple Watch track sleep apnea?

• What it means if your Apple Watch says you have sleep apnea

• What to do If your Apple Watch detects sleep apnea?

• Advice for those who don’t get a sleep apnea alert but still have symptoms

Apple Watch Series 9, 10, and Ultra 2 have been FDA-approved to detect moderate to severe sleep apnea. To use the sleep apnea tracker, your watch must have downloaded the watchOS 11 update, plus your phone must be updated with the most recent software release.

Don’t have one of these Apple Watches? Check out our article on using your smartwatch to track sleep apnea.

The sleep apnea feature on Apple Watch could make early detection a whole lot easier, but Dr. Wells says the first question is accuracy, “people want to know how accurate the detection is.” The truth is, Apple Watch is great at catching some cases of sleep apnea but not all.

Apple Watch detects moderate to severe sleep apnea but misses mild cases

According to a company report, Apple’s sleep apnea feature was designed to catch moderate to severe cases of sleep apnea. The majority of people with mild sleep apnea will not receive a notification.

• 66% of people with moderate to severe sleep apnea receive a notification
• 98.5% of people who receive an alert are confirmed to have sleep apnea

Apple Watch sleep apnea detector is specific, not sensitive

Apple breaks down its report further, explaining that it focused on two main factors when determining the accuracy of its sleep apnea feature: sensitivity and specificity.

Sensitivity:

• How many cases of sleep apnea can Apple Watch catch?
• How many people with sleep apnea do not get a notification?

Specificity:

• How often does an Apple Watch alert turn out to be a false alarm?
• Do the people who receive a "Possible Sleep Apnea" notification actually have sleep apnea?

In other words, the only people getting an alert for sleep apnea are those who have moderate to severe cases.

Apple Watch is not a substitute for a sleep apnea test

If you get an alert from Apple Watch saying you may have sleep apnea, Dr. Wells says you need to “take it seriously." But it’s also important to remember that it cannot replace a diagnostic sleep apnea test, even the ones done at home.

Dr. Wells explains two reasons why Apple Watch cannot give you a sleep apnea diagnosis:

• You need to see a doctor before an official diagnosis, “Clinical evaluation of your symptoms and medical history is essential for an accurate diagnosis.”

• Diagnostic testing requiresin-depth monitoring of multiple sleep apnea signs.“Home sleep tests use multiple sensors to monitor breathing, oxygen levels, and sleep quality, providing a more comprehensive assessment.”

Apple watch vs. home sleep test: side-by-side comparison:

If Apple Watch says you have sleep apnea, you probably have a moderate to severe case.

The Apple Watch is designed to be very selective about who it sends sleep apnea notifications to. If you get an alert from Apple Watch saying you’re at risk for sleep apnea, Dr. Wells says it’s important to take these notifications to your doctor, “especially since it’s more likely to detect moderate or severe cases.”

Keep in mind that your Apple Watch may not alert you for mild sleep apnea.

Dr. Wells warns, “The Apple Watch isn’t sensitive enough to catch all cases of sleep apnea.” Because Apple prioritized “getting it right,” they went after the more obvious cases–those with more breathing disturbances. This means the current algorithm often overlooks people with mild sleep apnea and fewer breathing disturbances.

Always look for signs of sleep apnea, such as snoring, sleepiness, depression, and brain fog.

The bottom line is if your Apple Watch says you’re showing signs of sleep apnea, you probably have a moderate to severe case. But those with mild sleep apnea may not even get an alert from Apple Watch. Regardless of where you fall on the spectrum, it’s important to be on the lookout for other signs such as snoring, daytime sleepiness, brain fog, mental health changes, and more.

Dr. Wells explains that the Apple Watch detects sleep apnea via “movement monitoring technology to alert the user to abnormalities.” So, how does movement correlate to sleep apnea?

Your body moves during each sleep apnea episode.

Sleep apnea occurs when your breathing is interrupted either due to a blockage in the airway or a problem with the nervous system. Scientists have discovered that when the body experiences one of these breathing disruptions, it causes subtle movement in the wrists.

Apple Watch counts each of these movements as a Breathing Disturbance.

New generation Apple Watches include advanced accelerometer technology, which detects even slight wrist movement. When this movement occurs during sleep, your Apple Watch tallies each one as a “Breathing Disturbance”.

Too many Breathing Disturbances are a sign of sleep apnea.

While some breathing disturbances are normal, too many can indicate sleep apnea. Apple Health reviews this metric monthly and classifies these episodes as elevated or not elevated. If your numbers remain elevated over time, your Apple Watch will notify you of signs of moderate to severe sleep apnea, plus educational materials detailing the next steps.

Wear your watch often for accurate results.

To make sure these warnings are reliable, the Apple Watch requires you to wear the device for at least 10 nights per month. Your Apple Health app reports this data for the previous month, 6 months, and one year.

Keep in mind there could be other conditions impacting your results.

Dr. Wells warns that using the Apple Watch accelerometer to track sleep apnea may not be entirely foolproof. While it’s often pretty accurate, there’s a small chance for false alarms, “If a person experiences frequent sleep disruption (not related to a breathing problem) or a sleep-related movement disorder, these circumstances should be discussed with a sleep medicine doctor.”

Knowing you’re at risk for sleep apnea is just the first step in the journey to better health. What you do after Apple Watch sends a sleep apnea notification is what matters most. Dr. Wells encourages you to start by talking to your doctor about a sleep apnea test.

As you prepare for this appointment, you’ll want to make a list of any sleep apnea symptoms you’re experiencing, along with potential risk factors. We also suggest bringing at least one month’s worth of Breathing Disturbance data from your Apple Watch.

1. Schedule a doctor's appointment

Getting an Apple Watch sleep apnea alert means it’s time to see a doctor. There are a couple of ways you can do this:

• Schedule an in-person appointment with your GP

• Request a telehealth appointment

• Order a Home Sleep Apnea Test kit and schedule a virtual consultation

Some people prefer the familiarity of going to their primary care physician, but this initial appointment can often be done virtually as well.

A few providers even offer an all-in-one option, like our Home Sleep Apnea Tests. These kits work by having you schedule a telehealth evaluation with a board-certified physician and then sending you an at-home sleep test once you’ve been approved.

2. Start a symptom diary

Some people find it helpful to create a symptom journal in the week leading up to their appointment. Things to look for include:

• Snoring

• Gasping during sleep

• Choking during sleep

• Daytime Sleepiness

• Low Energy

• Brain Fog

• Low Productivity

• Depression

• Regular Headaches

Not sure you’re experiencing symptoms of sleep apnea? Dr. Wells suggests talking to your doctor anyway, as you may still need a sleep apnea test.

“Sleep apnea often goes unnoticed, so trusting the data could be important for your long-term health. If [Apple Watch] consistently flags issues, it’s worth considering a professional evaluation. Even without classic symptoms like snoring or fatigue, untreated sleep apnea can have significant health effects.”

3. Document your health history and risk factors

You’ll also want to document potential risk factors that may indicate you have a higher likelihood of having or developing sleep apnea:

• Overweight

• Aging

• Male

• Large Neck

• High Blood Pressure

• Heart Disease

• Stroke

• Alcohol Consumption

• Smoking

• Certain Medications

• Diet

• Pregnancy

• Diabetes

4. Share your Apple Health data

Data from your Apple Watch can provide helpful insights into your risk for sleep apnea, so make sure you bring that information along. To access your Breathing Disturbance history from Apple Watch:

• Open your health app on iPhone

• Go to Browse, then Respiratory

• Select Sleep Apnea Notifications or Breathing Disturbances

• Choose to view data over the last month, 6 months, or year

• Some doctors allow you to send Apple Health data directly with the Sharing icon

5. Schedule a sleep apnea test

If your provider agrees that you are at risk for sleep apnea, it’s time for an official sleep test. Your doctor may ask you to test at an on-site clinic, but most people can test in the comfort of their own home. “If the watch data aligns with a person’s suspicion of sleep apnea, a home sleep apnea test is a good evaluation to confirm the diagnosis and assess severity.”

While the setup for a home sleep test is pretty simple, Dr. Wells reminds us that it is an essential step in this process. Your Apple Watch data is not enough to diagnose sleep apnea on its own because it only tracks one component for diagnosis compared to diagnostic tests, which track many.

6. Remember you can still have sleep apnea without an Apple Watch alert

And if you haven’t gotten a sleep apnea alert? Dr. Wells encourages you to “trust your body.” If you’re showing signs of sleep apnea, it’s important to see a doctor, even if Apple Watch hasn’t detected it. When it comes to sleep apnea, even mild breathing disturbances can impact your health and well-being, so it’s better to be safe than sorry.

If your Apple Watch detects sleep apnea, there’s a good chance that you have sleep apnea. The next step is to talk to your doctor about completing a sleep test. Still, it’s important to listen to your body! Just because your Apple Watch hasn’t detected sleep apnea doesn’t mean you don’t have it. If you are experiencing signs of sleep apnea, it’s time to talk to your doctor about a sleep test.

Although Apple Watch sleep apnea detection is no substitute for a sleep test, Dr. Wells believes it will make a difference, “I hope this technology raises awareness of the importance of healthy sleep and encourages more people to seek help, ultimately improving their long-term health and quality of life.”