As A Sleep Doctor, Here's What I Really Think of Oura, Whoop, and Apple Watch Sleep Scores
A New Meta-Analysis Again Urges Caution Regarding Wearables and Sleep Data
We’re living in a golden age of health information and wearable technology. Apple Watch, Oura Ring, and Whoop band all promise lifespan and quality of life improvements. A major aspect of all three products’ claims? Sleep optimization: scores that patients strive to perfect for a perfect 100 or tracking data patients want to optimize for x hours of deep sleep, etc. It is becoming increasingly frequent to see these patients in clinic- not for snoring or unrefreshed sleep, but for ‘my device tells me my sleep is bad.’
A newly published meta-analysis in the Journal of Clinical Sleep Medicine has again urged caution for patients and providers regarding wearable sleep data.
The study analyzed how consumer wearables like Apple Watch, WHOOP, Oura, and Garmin perform when compared to polysomnography (PSG), the multi-sensor lab test sleep specialists use to evaluate brain waves, muscle tone, breathing, and more to diagnose obstructive sleep apnea.
The result? A consistent pattern:
Sleep trackers tend to misjudge total sleep time
They are poor trackers of sleep efficiency
They struggle to detect when you actually fall asleep or wake up
This piggybacks on similar data we previously reviewed and commented on for Apple Watch. That showed similar findings: mediocre ability to track total hours of sleep, and poor consistency to document sleep staging and efficiency.
Why This Matters
Patients are using sleep information to guide their actions. Even if they feel well and aren’t snoring, if their watch/ring/band tells them they’re lacking, they’re coming to see me and demanding action. This data adds to a wealth of prior information, as well as my anecdotal experience: wearables aren’t at clinical utility - sleep studies and patient history matter FAR more.
In short, just because the device says you didn’t get enough deep sleep or score 100 on their arbitrary measure doesn’t mean you have a disorder. Similarly, if your wearable says you got 8 hours of efficient sleep, but you’re dragging through the day, which signal do you trust?
The Bigger Picture: Sleep vs. Sleep Data
Here’s where we think many of these tools fall short: they provide lots of output but little insight. Knowing your score dipped last night doesn’t mean much if you don’t know what affects it or how to intervene. Even worse, obsessing over scores without context can actually increase sleep-related anxiety and worsen quality of life—a condition now so common it has a name: orthosomnia.
The data may be sleek, but the nuance is still lacking.
So Should You Toss Your Tracker?
Not necessarily. For identifying patterns and improve pre-bedtime related routines—like if you are consistently getting too few hours of rest, if your sleep schedule is irregular, or the effects of drinking alcohol—these devices can be helpful. And the technology is progressing rapidly: We foresee having clinical-level tools on our wrists and fingers within the next year or two.
So stay tuned. This is an exciting and quickly evolving area of sleep health. As a sleep physician focused on evidence based practices and the science/tech of our field, I look forward to continuing to help integrate these tools into your lifestyle.
Sleep well, Chris and Robson.
Thank you for sharing this. Wearables are often marketed as a way to give our bodies a voice, but do you think that they can potentially impair our intuition? I recently gave up my wearables for a month and tracked my sleep with good ol pen and paper, and while I found it tedious by the end, I felt more in tune to the needs of my body. I've certainly had bad sleep scores from my Oura and WHOOP set the tone for my days!
My young adult son has been on PAP therapy since the age of 4 and I have encouraged him to wear his Apple Watch to sleep, if for no other reason than to see basic patterns of his sleep sleep cycle and how many hours he's getting. He doesn't, but I look at it as a tool to look at see the basics on days when he's particulary sleepy.