Wearables Play Pivotal Role in Diagnosing, Identifying OSA

Wearables, such as smart watches, have become more commonplace over the years, with nearly 1 in 3 adults in the US using a wearable device to track their health and fitness.¹ With the prevalence of wearables in the country, turning those wearables into tools for maintaining sleep health can benefit a wide range of patients. A session held during the Sleep 2026 Annual Meeting, which is taking place in Baltimore, Maryland, between June 14 and June 17, 2026, focused on how wearables could benefit sleep health, particular when used in obstructive sleep apnea (OSA).

Why Wearables Are Promising Tools in Addressing OSA

Robson Capasso, MD, a professor of otolaryngology at Stanford Medicine, began the session by emphasizing the progress that has been made in the past decade in the perception of using wearable technology for use in sleep medicine. In 2014, Capasso tried to publish a manuscript on the use of smartphone apps in measuring snoring and met some resistance.

“The reason I’m telling you this is because it took us forever to publish that article because the reviewers were so funny. ‘This is not the gold standard; this is a race to the bottom.’ Those are some of the comments my reviewers liked to leave,” said Capasso. Ultimately, the study was published in 2015 and was the most downloaded paper for that journal in Europe, which Capasso said was evidence of the public interest in the topic.

Right now, the process of getting diagnosed with a sleep disorder can take a long time, with Capasso estimating that it can take anywhere from less than 2 months to up to a year between getting a primary care referral, seeing a sleep medicine consult, performing a sleep test, and finally getting a prescription for continuous positive airway pressure (CPAP) machines. Wearables could potentially close parts of this gap by allowing for sleep apnea assessment on a quicker timeline, as sleep specialists are looking for a way to reduce the delayed diagnosis of moderate-to-severe OSA.

But wearable technology needs to be in the right hands in order to get the most benefit. Individuals in the US are more likely to have wearable technology if they have an advanced degree or have an income of $200,000 or more, with those aged 65 years or older, uninsured individuals, rural residents, and those on Medicaid having lower odds of owning this technology.²

Wearable technology data can be used as a basis for prescribing CPAP if there are signs of OSA, said Capasso, as he emphasized that there are no major adverse risks tied to CPAP if the patient ultimately does not need it. When it comes to performing surgeries to fix OSA, though, he emphasized that these are major surgeries that will need more data to back up these decisions.

Capasso concluded by emphasizing that wearables are becoming more commonplace among Americans in particular. “There is already a significant change about the culture of sleep among our patients. Some of [us] get resistant to this, and there is a delay in adopting those changes,” he said. “…We should not be that resistant that long.”

Developing an anticipatory strategy to incorporate wearables into practice and shorten the cultural lag in applying this technology is important to integrating wearable technology into sleep medicine.

Implementing Wearables in Clinical Practice

Cathy Goldstein, MD, professor of neurology at the University of Michigan Sleep Disorders Center, built on the reason why wearables should be considered in sleep medicine by speaking about how they could be, particularly focusing on the Apple Watch and the Samsung Galaxy Watch, which were both approved by the FDA in 2024 to be used in monitoring risk of moderate to severe OSA. Although the sensitivity for detection of OSA risk in the Apple Watch was lower at 66.3%, Goldstein said that this was intentional.

“The reason they have this performance breakdown is they wanted to minimize false positives; they wanted to minimize false alarms so everyone wasn’t running to their primary care doctor saying, ‘My watch told me I have [OSA],” she said. The specificity of the Apple Watch in detecting OSA was 98.5%.³

Goldstein said that knowing what clinicians want to screen for when using these wearables can help to maximize wearable technologies in this space. For example, breathing disturbances while off and on CPAP, blood oxygen levels both on and off CPAP, and sleep scores are some of the areas she said may be beneficial to monitor through wearable technology.

However, these wearable technologies are made for consumers rather than through a medical lens. “There are things on our end that we are failing to standardize. We don’t have a standard terminology for wearable tracked sleep, we don’t have a common data model, and we don’t have standard data visualization,” said Goldstein.

Goldstein emphasized that coming up with standard terminology that could live within the LOINC common language could be beneficial alongside a common data model that represents the data. A study published in April 2026 found that patients that received a weekly report of their nightly pulse oximetry data increased the use of CPAP, indicating that logging the information at all is beneficial for patients overall.⁴

Wearable technology has not been part of the conversation in sleep medicine in the past, Goldstein concluded. “I hope we can all move this forward and we can use these devices to help our patients with their OSA management.”

References

1. Study reveals wearable device trends among U.S. adults. News release. National Heart, Lung, and Blood Institute. June 15, 2023. Accessed June 15, 2026. https://www.nhlbi.nih.gov/news/2023/study-reveals-wearable-device-trends-among-us-adults
2. Nagappan A, Krasniansky A, Knowles M. Patterns of ownership and usage of wearable devices in the United States, 2020-2022: survey study. J Med Internet Res. 2024;26:e56504. doi:10.2196/56504
3. Aguilar M. Sleep apnea alert on Apple Watch: what does it mean, and how does it work? STAT. September 26, 2024. Accessed June 15, 2026. https://www.statnews.com/2024/09/26/sleep-apnea-apple-watch-expert-evaluation-clinical-data/
4. Fung CH, Mak S, Ash G, et al. Augmenting management of obstructive sleep apnea with consumer wearable devices to increase use of positive airway pressure therapy: a pilot randomized trial. Sleep. 2026;49(4):zsaf342. doi:10.1093/sleep/zsaf342