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Apple Watch sleep apnea detection gets FDA approval

464 points by brandonb 2y ago

Circlecrypto2 2y ago
This could be great for detecting it early where most people don't get help soon enough. Can't wait to get this in more devices.
- coldpie 2y ago
  Yeah I'm generally a tech skeptic, but getting FDA approval for a real, common problem is a fantastic use for this kind of device. I did an at-home sleep study a few months ago, and while it wasn't an unpleasant experience, it did involve a long wait for an appointment, two trips to & from a specialty clinic, and awkwardly strapping on this device to sleep with overnight. That's a lot of barriers. Being able to do get a useful result for a very impactful health condition, just with an affordable piece of hardware that many people already have is a game changer. Great job to the team at Apple for getting this together & getting real approval for it.
  - MBCook 2y ago
    This won’t tell you that you have sleep apnea, it will tell you you might. From there you’d probably need a real sleep study. However how many people will this catch that had no idea they should get checked? Not unlike some of the people who found out they have afib after their watches suggested they get checked? I agree this is great. It’d be interesting if we find out that a very different percentage of the population have sleep apnea than we thought simply because so many more get checked as a result of this.
- unit149 2y ago
  [dead]
- frankacter 2y ago
  >Can't wait to get this in more devices. Samsung received FDA approval back in February: https://aasm.org/samsung-galaxy-watch-sleep-apnea-feature-receives-fda-authorization/ https://aasm.org/samsung-galaxy-watch-sleep-apnea-feature-re... It works on a different monitoring method and requires 2 sleep cycles over 4 hours each in a 10 day window to start detecting. >The feature, a software-only mobile medical app, uses smartwatch built-in sensors to monitor the user’s sleep for significant breathing disruptions associated with OSA. Users may track their sleep twice for more than four hours within a 10-day period to utilize the feature.
yumraj 2y ago
Why not Apple Watch 8? Surely it’s not a technical reason, more a business one.
- MBCook 2y ago
  What makes you so sure it’s not technical?
  - yumraj 2y ago
    There are no new sensors in 9 than in 8. Different processor, battery life, etc sure.. Business reason is clear: they lost the oxygen sensor, so people hesitant to upgrade.
    - dangus 2y ago
      Different processor seems like a possible reason if they’re using new instructions. Of course I’m not saying it doesn’t line up nicely with a business reason to incentivize upgrades.
    - MichaelZuo 2y ago
      Someone else claims the 9 has a better accelerometer… what’s your source that ‘there are no new sensors’?
    - MBCook 2y ago
      > Different processor, battery life, etc sure.. So there’s no way a better processor would be needed to get acceptable all night battery life and that could be the reason? Sounds like you may have nailed exactly why they did it.
- asadm 2y ago
  atleast due to processing/battery reasons.
- brandonb 2y ago
  The Apple Watch 9 and Ultra 2 have a neural engine (GPU), which may be helpful if the sleep apnea detection algorithm uses a neural network. Those models also come with a third-generation heart rate sensor, although that part may not be required if the algorithm truly only relies on accelerometer data.
renewiltord 2y ago
This is fantastic. Breaking into medicine would be amazing. Apple’s products are generally great. M
- talldayo 2y ago
  Tim loves when you bounce on it.
nextlevelwizard 2y ago
Will this work outside of US or does it need to get approved by other orgs, like whatever is EUs FDA?
- brandonb 2y ago
  They announced they're targeting 150 countries, so there will likely be CE-mark approval coming (this is the EU equivalent of the FDA).
  - dns_snek 2y ago
    CE marks aren't an equivalent to an FDA approval process, they're self-certified with no real oversight. > By affixing the CE marking to a product, a manufacturer declares that the product meets all the legal requirements for CE marking and can be sold throughout the EEA. > Please note that a CE marking does not indicate that a product have been approved as safe by the EU or by another authority. It does not indicate the origin of a product either. https://single-market-economy.ec.europa.eu/single-market/ce-marking_en https://single-market-economy.ec.europa.eu/single-market/ce-...
    - adw 2y ago
      The equivalent is the EMA.
    - brandonb 2y ago
      I'm not an expert on European law, but the requirements listed here for a CE mark indicate that the EMA reviews the safety and performance of the device and audits the manufacturer's quality systems, similar to the FDA: https://www.ema.europa.eu/en/human-regulatory-overview/medical-devices https://www.ema.europa.eu/en/human-regulatory-overview/medic... CE marks for other categories may well be self-certified. I suppose I could have been a bit more precise in my terminology, and said the EMA (who gives the CE mark) is the equivalent of the FDA in Europe.
ortusdux 2y ago
Time to buy stock in the leading apnea machine manufacturers.
- arcticbull 2y ago
  GLP-1s significantly improve the symptoms of sleep apnea, with tirzepatide reducing incidence by 2/3. Probably just stick to Lilly and Novo for a broader exposure ;) https://www.healthline.com/health-news/glp-1-drugs-like-zepbound-and-moujaro-may-help-reduce-sleep-apnea-symptoms https://www.healthline.com/health-news/glp-1-drugs-like-zepb...
  - blackeyeblitzar 2y ago
    Is it GLP-1 or just weight loss due to it? Most sleep apnea is caused by weight issues after all.
    - outworlder 2y ago
      > Most sleep apnea is caused by weight issues after all. Citation needed here. My understanding is that being overweight just narrows part of your airways and will make any existing flow restrictions worse. But given that most sleep apnea patients don't get off treatment even when they lose weight (although the severity may decrease), I'm pretty skeptical of this claim.
      - arcticbull 2y ago
        This is not a comprehensive response to your question but 41% of patients with BMI over 28 have sleep apnea, and that number grows to 78% by the time you get referred for bariatric surgery. There is in fact a mathematical relationship. [1] > For every 7-pounds drop in weight, expect a 7% drop in [apnea severity index]. It's basically caused by tongue fat, pharyngeal/neck fat and visceral/fat in the upper belly. [2] I strongly suspect it's just a question of how much weight you lose. If you get down to 15% body fat you really won't have apnea anymore. Not for everyone, there's probably some structural issues that can also cause it, but if it's adiposity-induced, which it is for a huge number of people... For the rest with skeletal or nasal structure issues, surgery may be appropriate. [1] https://jcsm.aasm.org/doi/10.5664/jcsm.10190 https://jcsm.aasm.org/doi/10.5664/jcsm.10190 [2] https://www.pennmedicine.org/news/news-releases/2020/january/losing-tongue-fat-improves-sleep-apnea https://www.pennmedicine.org/news/news-releases/2020/january...
wincy 2y ago
I have tried for months to use my APAP machine, and failed. My wife has no problems using her. I’m not really sure what the next step even is. It’s frustrating because I can tell when I get a bad nights sleep I can’t think as well, but it feels like there’s nothing I can do about it. I can breathe through the CPAP exclusively for hours but then as soon as I try to go to sleep I feel like I’m being smothered and my heart starts racing. Does anyone have any advice?
- candiddevmike 2y ago
  Sounds like you aren't getting enough pressure. Also sounds like there could be some mechanical reasons like gerd, allergies or inflammation that cause your apnea, especially if you start fine.
  - david-gpu 2y ago
    I agree. When we fall asleep we lose muscle tone, which makes apneas more likely -- that is why we have trouble breathing when we sleep, not when we are awake. GP needs to find out how to set up the pressure in their CPAP device. YouTube has tons of videos on that subject.
- iamjackg 2y ago
  Did you try different types of masks? I found that I felt like that during the initial phases of the titration study (where they determine the right settings for you) but once they dialed in the pressure, that feeling went away and now I actually quite enjoy it, since it makes it easier to breathe through my nose. I use a nose pillow.
- bloopernova 2y ago
  Do you have a slow ramp up of pressure? I have to start on low pressure when I first put the mask on each evening. Your sleep doc/clinic may be able to help.
  - Arelius 2y ago
    As an alternative, the opposite may also be true. I could never sleep when I had the slow ramp of pressure.
xnx 2y ago
This is a great "free" feature in a wearable. I wonder how many years are left before Ozempic-like drugs make sleep apnea a rarity.
- nightowl_games 2y ago
  Sleep apnea is not completely due to being overweight.
  - a_wild_dandan 2y ago
    Hence their qualifier “rarity.”
    - JohnMakin 2y ago
      But it’s not that rare in non-obese people, I think is the point. Obesity is certainly a risk factor. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5181619/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5181619/
      - david-gpu 2y ago
        When I arrived at the sleep clinic with a BMI of 22, the first thing they told me was: there are lots of people with sleep apnea who have a healthy weight, including children. The notion that sleep apnea is generally caused by weight needs to die. People also conveniently forget that being woken up multiple times every hour causes weight gain, so often times being overweight is the consequence of sleep apnea rather than the cause.
        elric 2y ago
        Thanks, I'm usually the one who has to get on their soapbox to say this. I'm glad I'm not the only one anymore :-)
        JohnMakin 2y ago
tiltowait 2y ago
I’ve completely stopped using my Apple Watch, but this is a tempting proposition. It looks like a one-off at-home sleep study is cheaper, but that doesn’t help me if the problem materializes a year after I get it.
- kylehotchkiss 2y ago
  I did one of the take home studies. It seems like there’s so many ways to get inconclusive results - they depend on a microphone that might end up underneath you, the probes could fall off, the battery could die, the “UI” is weird. I think continual testing is a very decent solve for some of those shortcomings and pushing people to the actual clinic for the real test
techwizrd 2y ago
I would be interested in knowing whether these are effective at detecting sleep apnea in flight crews to aid aeromedical certification.
- sandworm101 2y ago
  >> detecting sleep apnea in flight crews to aid aeromedical certification. 24/7 medical monitoring via a wristwatch? Monitoring that may cost you your career? I can think of nothing pilots would resist more.
  - outworlder 2y ago
    Treated sleep apnea is not a disqualifier.
  - techwizrd 2y ago
    Many pilots already use a smartwatch to track their sleep and provide evidence for fatigue callouts. Right now, pilots are grounded and face an arduous process to prove they're healthy. Most pilots eventually receive a special issuance after a fair amount of hassle. What if this could help keep them flying instead?
    - sandworm101 2y ago
      And for all the pilots that don't have sleep apnea? What will insurance companies tell the airline to do if this app each morning tells them which of their pilots didn't sleep well enough? Well enough according to their apple watches.
gijsnijholt1980 2y ago
I developed an iOS app which detects your sleeping position and starts buzzing if you’re on your back. Similar to the tennis-ball-sewn-into-pyjama’s hack. Apple kept refusing to approve stating medical reasons. Still use it myself though, works great.
- jbombadil 2y ago
  Question: were the "medical reasons" specific or a generic "no because it's medical related" reason? As in, did their refusal say "no because the way you're tracking if the user is on their back is not accurate enough?" or did they say "we don't allow people to write watch apps related to medical diagnoses / treatments / etc?"
  - deleted 2y ago
    [deleted]
- NelsonMinar 2y ago
  Interesting and frustrating story! There's an Android app I've used that does that: https://play.google.com/store/apps/details?id=com.koalative.torena&hl=en_US https://play.google.com/store/apps/details?id=com.koalative....
  - BurningFrog 2y ago
    How can a phone know which position you're sleeping in?
    - ASalazarMX 2y ago
      Obviously the user untapes the tennis ball on their back, and tapes on their iPhone instead.
      - xattt 2y ago
        I thought you were supposed to use an iPad Pro.
NelsonMinar 2y ago
I like the concept but I'm curious how it works. It sounds like it's based on detecting the movements of the wearer? Does that work? It's a shame Apple is having patent issues with their SpO2 sensor. The O2Ring was a huge help in me understanding my sleep apnea early on, in combination with a formal sleep study. Sleep apnea is a very common and harmful problem, any sort of way of helping detect it will improve a lot of lives.
- JourneyToLunar 2y ago
  It’s only turned off in the US right? Would they use the data in the rest of the world since SpO2 data is available there?
  - rootusrootus 2y ago
    The SpO2 data isn't useful for detecting sleep apnea because the sampling frequency on a smartwatch is way too coarse to pick up on it.
    - NelsonMinar 2y ago
      oh that's too bad. The O2Ring samples every 2 or 4 seconds but a lot of cheaper devices take an average reading once a minute or so which definitely obscures sleep apnea. (normal adults take a breath every 3-5 seconds when sleeping. with obstructive sleep apnea that can be more like once a minute.)
- dopylitty 2y ago
  They're tracking movements. Apple has a doc on how it works here[0] >Apple Watch tracks movement with triaxial accelerometer signals, which capture coarse motion of the body as well as fine movements including motion associated with breathing. Apple developed an algorithm that uses the accelerometer time series data to classify Breathing Disturbances that occur during sleep tracking, which are temporary interruptions in the breathing pattern. > A total of 1499 participants were enrolled, with 1448 completing the study. The sensitivity was 66.3% (95% CI: 62.2% to 70.3%), and the specificity was 98.5% (95% CI: 98.0% to 99.0%), demonstrating that the feature meets the design objectives to confidently identify sleep apnea while minimizing false positives. >It’s important to note that the specificity was 100% (95% CI: 99.7 to 100%) for the normal category, indicating that all participants with a “positive” algorithm result had at least mild sleep apnea. Also, sensitivity was higher in the severe category at 89.1% (95% CI: 83.7% to 93.2%), indicating that the large majority of severe cases were identified. 0:https://www.apple.com/health/pdf/sleep-apnea/Sleep_Apnea_Notifications_on_Apple_Watch_September_2024.pdf https://www.apple.com/health/pdf/sleep-apnea/Sleep_Apnea_Not...
alex_lav 2y ago
Can a more Apple-minded person help me understand if the Apple Watch SE counts as "Series 9"? I don't totally understand how "SE" relates to numerical versioning, but I am also not an Apple person. Apologies in advance if this question is somehow obvious to others.
- saagarjha 2y ago
  SE is a line orthogonal to their flagship models. Usually it means they took the enclosure from a previous watch and shoved some improved guts in it. Apple Watch SE is similar to Apple Watch Series 8 in terms of processing power but externally (screen, sensors) it’s like Apple Watch Series 4 or thereabouts.
- wtallis 2y ago
  "SE" denotes a cheaper, less capable model that is not part of the main sequence of product generation numbering. There have been two generations of Watch SE and three generations of iPhone SE; they're not updated as frequently as the flagship product line. The Watch SE does not have the sensors for EKG or blood oxygen, which are probably necessary for the sleep apnea detection.
- iknowstuff 2y ago
  Steve Jobs must be turning in his grave over this dogawful naming scheme.
whatnotests2 2y ago
Now we know why it's called Apple Watch. It watches you.
- FabHK 2y ago
  Yes, always has, always will. Unlike products of many other manufacturers, it keeps what it learns on your devices, and doesn't send it home to big brother.
- outworlder 2y ago
  That's precisely why I got one.
tw04 2y ago
So on paper it sounds great, in practice this feature seems almost useless to me. As someone living in the garmin watch ecosystem, every time a new apple watch comes out, I quickly hit the specs page to see if they have made any progress at all on reasonable battery life and am continually let down. With 36 hours being the absolute best-case scenario for battery life, it would seem your options are to either have two watches, or be perfectly fine only wearing your watch every other day? Otherwise, when do you charge?
- hardwaregeek 2y ago
  It takes like 20 minutes to charge the watch. Just don’t wear it for that time
  - tw04 2y ago
    The manual says 45 minutes to 80%, 90 minutes to 100%. If I'm only charging to 80% that's roughly 14 hours of battery life on a Series 9 or 10 (18 hours on full charge). So not even a full day? I just don't get how the math works if I'm trying to wear it all night every night and wear it for workouts during the day.
    - halostatue 2y ago
      There is a material difference between the older Apple Watch (where the charging puck uses USB A) and the newer Apple Watch and/or the Ultra (where the charging puck uses USB C). Plugged into an appropriate source, the USB C puck gets much faster charging and is usually sufficient for a day's wear after about 10 minutes (depending, of course, on what the day includes). Charging to 80% is likely to be more than enough for most uses, and topping it up with another 15% just before bed is enough for overnight (probably). I had the Series 4 previously and the Ultra 2 now; with the older watch, I would charge it for about an hour while watching TV in the evening. With the Ultra 2, I charge it for about 20 minutes here and there depending on what I’m doing and whether I remember. I’m currently at 39% which will be just fine for my hourlong exercise ride (with GPS), and then I can toss it on the charger while I shower and it’ll probably be at 70% which is good enough for another full day.
efsavage 2y ago
Does this mean that you could be prescribed an Apple Watch if you were at risk of apnea? Or even use an HSA?
- tantalor 2y ago
  I can see it now: it's December and my FSA still has a balance, must be time to buy 12 Apple Watches and sell them on eBay.
  - 39896880 2y ago
    Out of curiosity, does your health plan have an HSA? After learning about these I decided that FSAs are a total rip off. Why would my money expire?
    - kstrauser 2y ago
      If you know you're going to have certain recurring expenses, they can be great. That money's untaxed so you're basically getting a 25% or whatever discount on whatever you buy with FSA money. But yes, the expiration bit is insane. That's how I ended up buying a pair of prescription Ray-Bans in late December several years ago.
      - 39896880 2y ago
        > That money's untaxed so you're basically getting a 25% or whatever discount on whatever you buy with FSA money This is the same with an HSA. The difference is that you can invest funds from an HSA and the growth is tax free.
        kstrauser 2y ago
        That's not the difference. The difference is that you have to have an HDHP to use an HSA. My employer pays for me to have a very good low-deductible policy. I did the math and it would almost certainly cost me more out of pocket to have an HDHP than what I have now. If you are young, single, and healthy, the equation may look different. If you're older and have a spouse and kids, it's shockingly easy to hit the deductible and OOP max year after year. I could imagine a case where I'd start an FSA. An HSA did not work out well for me a few years ago when I tried it, and would be even less likely to be a win for me now.
blackeyeblitzar 2y ago
The problem is that these at home tests aren’t good enough to eliminate the costly and time consuming and inconvenient step of a sleep study in the lab. At least near me, to get a CPAP you first do a take home study with a wrist based (watch like) recorder. Then they make you go into the lab for an overnight sleep study (or multiple of them) anyways, for a study that costs your insurance several thousand dollars per night (and you have some copay potentially) and it is of course a massive hassle and barrier to getting CPAP treatment. They claim it is so they know your air pressure numbers but it is all just regulatory capture, because CPAP machines can auto adjust your pressure and people like to tweak numbers manually to their comfort level anyways. Can Apple do something about eliminating all these bureaucratic barriers that hurt the health of so many?
- outworlder 2y ago
  The largest barrier by far is actually starting the process to get a diagnosis. It's often a family member that notices and raises the alarm. Note that you can be diagnosed with sleep apnea based on the home study alone, you don't always have to go to a sleep clinic. If you are really sure you have sleep apnea (and you can be pretty certain with a home sleep study + symptoms) you can just go online and get a prescription for free by talking to a doctor at one of the companies that resell CPAP machines. At least in the US, other countries can be more bureaucratic.
- Bluecobra 2y ago
  > Can Apple do something about eliminating all these bureaucratic barriers that hurt the health of so many? I sure hope so, because my experiences with sleep apnea made it seemed very quack-ish. I keep on hearing ads on the radio by a company called ADVENT with a catchy jingle promising that surgery is the solution to snoring. At the time I had my study (2013) I did not have an in-home test and had a sleep test (which was an awful experience). I was prescribed a Phillips CPAP machine and was very good about adhering to it and keeping up with regular doctor visits. During the 3 years I had it, I lost a significant amount of weight and each time my doctor re-programmed my CPAP SD card so it was a lower and lower setting. I always had very little face time with the doctor, I wish I knew about Sleepyhead earlier as I could have done this myself. The practice I was referred to would always try to sell me stuff like new masks, tubes, etc. when everything I had was in good condition and frequently cleaned. I even used distilled water in the CPAP itself. Eventually I went on a long vacation and didn't bring my machine and been off it since. I'm glad I did, it turns out Phillips was negligent about foam breaking down in their CPAP machines and even the replacement devices have this issue as well. At this point I don't know who to trust, and with something with Apple's name on it would give to some more legitimacy.
swyx 2y ago
> The feature, announced at last week’s iPhone 16 event, will arrive as part of the imminent watchOS 11 release. how exactly was Apple able to preannounce approval for this before the, yknow, approval? like exactly no other agencies work this way, precommiting them to a decision they havent formally taken, even if informally it was already taken they would frown very strongly on leaking their stuff
- dgarrett 2y ago
  The announcement said that the feature was pending FDA approval.
- nobrains 2y ago
  Most likely the decision was taken internally, but sometimes to make it official requires some procedural paperwork. Apple probably got the green light that the approval was approved on the way.
  - larkost 2y ago
    Having been next to the people working with the FDA at one point, they do tend to give a lot of feedback, especially when they don't like something. And there were a lot of hoops to jump though where the feedback was "you are on track" for a while before the actual official approval of that step came through. Very likely all of the core approvals were done, and they were just waiting on things like approval of software testing methodology (yes, they have to approve your software testing system), or something of the like.
Beijinger 2y ago
Is any VC guy here that is interested in medical devices? I would have something for you.
nox101 2y ago
It going to be great fun as Apple and Google add more and more medical features and then when they ban your account you lose them all. Maybe this will be more of the door to break their control on mobile computing.
- argsnd 2y ago
  I understand the argument that it's quite annoying that so much of the hardware you own relies on Apple permitting you to keep using it, but on the other hand what are you even doing to make them ban you? Their terms and conditions make it fairly clear that the only thing that would cause this is if you upload illegal content to their platform or attempt to chargeback purchases.
  - dvngnt_ 2y ago
    or you get hacked and your account is used for spam or you email an innocent picture of your naked baby in their first bath and the ML gets your banned
  - fsflover 2y ago
    > Their terms and conditions make it fairly clear that the only thing that would cause this is if you upload illegal content This is false: https://news.ycombinator.com/item?id=32547912 https://news.ycombinator.com/item?id=32547912 https://news.ycombinator.com/item?id=33737577 https://news.ycombinator.com/item?id=33737577 https://news.ycombinator.com/item?id=35133917 https://news.ycombinator.com/item?id=35133917 https://news.ycombinator.com/item?id=22146082 https://news.ycombinator.com/item?id=22146082 https://news.ycombinator.com/item?id=22705122 https://news.ycombinator.com/item?id=22705122 https://news.ycombinator.com/item?id=4013799 https://news.ycombinator.com/item?id=4013799
    - yreg 2y ago
      Those are all Google, argsnd is talking about Apple. But I'm sure one can get randomly banned by Apple as well.
godelmachine 2y ago
This is groundbreaking
- makeitdouble 2y ago
  The product isn't even on people's hands, and FDA approval only means it's not actively harmful and has a fighting chance of being somewhat beneficial. Is there anything objectively groundbreaking at this point ?
- billfor 2y ago
  For Apple. Samsung Galaxy has sleep apnea and blood pressure as well.
  - deleted 2y ago
    [deleted]
  - hombre_fatal 2y ago
    Apple leads the whole market in wrist wearable heart rate and sleep accuracy. So I wouldn't be surprised if its sleep apnea detection is also much better. Here's a chart: https://youtu.be/Jr4p66vSmLY?si=Ry3g80lh3kiDD12D&t=1100 https://youtu.be/Jr4p66vSmLY?si=Ry3g80lh3kiDD12D&t=1100
nakedneuron 2y ago
Main reason for sleep apnea - in my opinion - is deformed/degenerated fascia in the neck aka head forward posture. It's the disease of our modern (sedentary) age. SA is only one symptom. If you heard this the first time please feel free to ask. I'm always astounded at how common these CPAP devices are. Truly frightening.
- DEF14A 2y ago
  That is definitely one cause of OSA as is micrognathia and other craniofacial abnormalities, but it remains that the most common cause is fat mass constricting the upper airway - even if that person has completely normal craniofacial development and proper posture.
quyleanh 2y ago
In term of tracking sleep, is there any alternative with better battery life? I don’t mind other sport tracking functions.
- fragmede 2y ago
  There's Whoop, but it's pricey.
- MoonYard 2y ago
  Withings sells a sleep mat that connects to a wall socket. Disclosure: I work there.
- vbarrielle 2y ago
  I find Garmin's sleep tracking on my forerunner 255 quite good. I have no idea how it compares to an Apple Watch though.
rootedbox 2y ago
I have sleep apnea and I have an implant to stop my apnea / snoring. 1. if your watch tells you that you might have apnea go get a sleep study! 2. apnea and snoring do tend to happen together but not necessarily. you can have apnea without snoring(sometimes the other way but not as common) 3. apnea is like high blood pressure it's slowly killing you. 4. there are a lot of options now to help you. one might be losing weight. one might be sleeping on a side or stomach.. you won't know until you do a sleep study! get it done. After I got my apnea fixed I feel like a new person. I did not even know how tired I was or what being "awake" was like anymore. My body adjusted to a new normal. Please look into treatment!
- OptionOfT 2y ago
  Tell me more about this implant. Is that the electric one that basically tenses up your tongue as you breathe in? How long until you got it? Did you have to 'fail' CPAP & the mandibular device?
  - hackernewds 2y ago
    It is probably "Inspire is an implantable device that treats obstructive sleep apnea by stimulating the tongue nerve to keep airways open during sleep. It's an option for people who have moderate or severe sleep apnea and can't use or don't benefit from a CPAP machine. Here's how Inspire works: Components: The device consists of a generator, sensing lead, and stimulation lead, all implanted under the skin. It also includes a handheld remote that patients use to turn the device on and off, adjust stimulation strength, and pause it during the night. How it works: When the sensing lead detects breathing, the generator sends a signal to the stimulation lead, which then stimulates the hypoglossal nerve. This causes the tongue to move slightly forward, which helps keep the airways open. FDA approval: The FDA approved Inspire in 2014. Some potential side effects of Inspire include: Damage to blood vessels near the implant, Excessive bleeding, and Nerve trauma or damage" There's a reason it hasn't taken off in 10 years.
  - rootedbox 2y ago
    I did fail at CPAP.. it really is hard to do; but I have friends who swear by it. mandibular devices.. rarely work. I am using inspire. It's great. Turn it on when I go to sleep after 15 minutes it turns on and it moves my tongue depending on my breathing. It is basically a pacemaker but connected to tongue instead of the heart. And if you look at pictures of an inspire and a pacemaker they look exactly the same. So the reason everyone isn't getting it.. is not really for the side effects. But cost. My bill was 150k.. luckily I only paid a few thousand. So in order for your insurance to approve it you have to meet certain criteria. (talk to your doctor for an exact list) 1. Can't have a high BMI. Snoring and Apnea are closely related to weight. Your doctor should get you on semaglutides first. 2. You must have failed at using CPAP. It failed for me for multiple reasons. But like I said I have friends who love CPAP and get the same relief as me. 3. You have to get a type endoscopy to see if the procedure will work. I'm sure there are some other things they check but those are the main ones.. Now once you get the surgery.. recovery isn't tons of fun. When they are programming it while you are in surgery they are moving your tongue in all sorts of ways.. It took about a month to get to the ability to eat a sandwich again; and I was still sore for some time after that. They also have to do some craziness to get the wiring from your chest to throat(where the nerve for the tongue is actually stimulated. So my chest was sore and my arm was unable to pick up anything heavy for a couple months.. Also it takes a few months for everything to heal and for them to first turn it on. Then 3 months of programming to be stronger and stronger without waking you up. But one day it clicked and I was sleeping like a baby!
kylehotchkiss 2y ago
I’ve always dealt with snoring and a take home test was inconclusive (so my doctors weren’t super pushy about me doing an in person test). I still worry a little and my dentist used their 3d head XRay to show me my airway is so slightly constricted and I will certainly have it one day if not now. All to say I am elated to have my watch helping me just monitor and understand the issue and help give me more actionable data if I need to pursue the doctors again. I just wish we could solve this with something other than needs-AC-plug machine. I’d like to be able to travel without needing to think about that
wodenokoto 2y ago
What does that approval mean for the rest of the world? Do they still need a new approval in Europe before adding the feature in the EU? And if so, is the feature geofenced? E.g., you lose it when traveling or how do they prevent Europeans and people living in markets that are pending approval from using it?
sitzkrieg 2y ago
this is pretty funny considering taking a nap w apple watch will completely break the health app sleep tracking for that day
- malthaus 2y ago
  what a coincidence that they've added nap detection just in time then: https://www.macrumors.com/2024/06/17/watchos-11-supports-automatic-nap-detection/ https://www.macrumors.com/2024/06/17/watchos-11-supports-aut...
bamboozled 2y ago
Such a shame that my 2 year old, ultra high end watch can't use this feature. Apparently Apple Ultra is too dated to have this functionality, what a joke.
- consf 2y ago
  It’s always disappointing when high-end tech doesn’t support features that seem like they should be standard.
  - bamboozled 2y ago
    Especially when you pay a premium for the "ultra" which turns out to be the not so ultra 9 months after release and now, doesn't support one of the most enticing features. I get it, Apple is a business, I love their products, but I can see why people hate the company.
- deleted 2y ago
  [deleted]
Nesco 2y ago
Reminder that sleep apnea is mostly caused by something hindering the normal airflow. It might require a jaw/orthognathic surgery or a nasal obstruction surgery, depending on the cause being a jaw or nasal dysmorphia + muscular rehabilitation

464 points by brandonb 2y ago

This could be great for detecting it early where most people don't get help soon enough. Can't wait to get this in more devices.

coldpie 2y ago
Yeah I'm generally a tech skeptic, but getting FDA approval for a real, common problem is a fantastic use for this kind of device. I did an at-home sleep study a few months ago, and while it wasn't an unpleasant experience, it did involve a long wait for an appointment, two trips to & from a specialty clinic, and awkwardly strapping on this device to sleep with overnight. That's a lot of barriers. Being able to do get a useful result for a very impactful health condition, just with an affordable piece of hardware that many people already have is a game changer. Great job to the team at Apple for getting this together & getting real approval for it.
- MBCook 2y ago
  This won’t tell you that you have sleep apnea, it will tell you you might. From there you’d probably need a real sleep study. However how many people will this catch that had no idea they should get checked? Not unlike some of the people who found out they have afib after their watches suggested they get checked? I agree this is great. It’d be interesting if we find out that a very different percentage of the population have sleep apnea than we thought simply because so many more get checked as a result of this.
unit149 2y ago
[dead]
frankacter 2y ago
>Can't wait to get this in more devices. Samsung received FDA approval back in February: https://aasm.org/samsung-galaxy-watch-sleep-apnea-feature-receives-fda-authorization/ https://aasm.org/samsung-galaxy-watch-sleep-apnea-feature-re... It works on a different monitoring method and requires 2 sleep cycles over 4 hours each in a 10 day window to start detecting. >The feature, a software-only mobile medical app, uses smartwatch built-in sensors to monitor the user’s sleep for significant breathing disruptions associated with OSA. Users may track their sleep twice for more than four hours within a 10-day period to utilize the feature.

yumraj 2y ago

Why not Apple Watch 8? Surely it’s not a technical reason, more a business one.

MBCook 2y ago
What makes you so sure it’s not technical?
- yumraj 2y ago
  There are no new sensors in 9 than in 8. Different processor, battery life, etc sure.. Business reason is clear: they lost the oxygen sensor, so people hesitant to upgrade.
  - dangus 2y ago
    Different processor seems like a possible reason if they’re using new instructions. Of course I’m not saying it doesn’t line up nicely with a business reason to incentivize upgrades.
  - MichaelZuo 2y ago
    Someone else claims the 9 has a better accelerometer… what’s your source that ‘there are no new sensors’?
  - MBCook 2y ago
    > Different processor, battery life, etc sure.. So there’s no way a better processor would be needed to get acceptable all night battery life and that could be the reason? Sounds like you may have nailed exactly why they did it.
asadm 2y ago
atleast due to processing/battery reasons.
brandonb 2y ago
The Apple Watch 9 and Ultra 2 have a neural engine (GPU), which may be helpful if the sleep apnea detection algorithm uses a neural network. Those models also come with a third-generation heart rate sensor, although that part may not be required if the algorithm truly only relies on accelerometer data.

renewiltord 2y ago

This is fantastic. Breaking into medicine would be amazing. Apple’s products are generally great. M

talldayo 2y ago
Tim loves when you bounce on it.

nextlevelwizard 2y ago

Will this work outside of US or does it need to get approved by other orgs, like whatever is EUs FDA?

brandonb 2y ago
They announced they're targeting 150 countries, so there will likely be CE-mark approval coming (this is the EU equivalent of the FDA).
- dns_snek 2y ago
  CE marks aren't an equivalent to an FDA approval process, they're self-certified with no real oversight. > By affixing the CE marking to a product, a manufacturer declares that the product meets all the legal requirements for CE marking and can be sold throughout the EEA. > Please note that a CE marking does not indicate that a product have been approved as safe by the EU or by another authority. It does not indicate the origin of a product either. https://single-market-economy.ec.europa.eu/single-market/ce-marking_en https://single-market-economy.ec.europa.eu/single-market/ce-...
  - adw 2y ago
    The equivalent is the EMA.
  - brandonb 2y ago
    I'm not an expert on European law, but the requirements listed here for a CE mark indicate that the EMA reviews the safety and performance of the device and audits the manufacturer's quality systems, similar to the FDA: https://www.ema.europa.eu/en/human-regulatory-overview/medical-devices https://www.ema.europa.eu/en/human-regulatory-overview/medic... CE marks for other categories may well be self-certified. I suppose I could have been a bit more precise in my terminology, and said the EMA (who gives the CE mark) is the equivalent of the FDA in Europe.

ortusdux 2y ago

Time to buy stock in the leading apnea machine manufacturers.

arcticbull 2y ago
GLP-1s significantly improve the symptoms of sleep apnea, with tirzepatide reducing incidence by 2/3. Probably just stick to Lilly and Novo for a broader exposure ;) https://www.healthline.com/health-news/glp-1-drugs-like-zepbound-and-moujaro-may-help-reduce-sleep-apnea-symptoms https://www.healthline.com/health-news/glp-1-drugs-like-zepb...
- blackeyeblitzar 2y ago
  Is it GLP-1 or just weight loss due to it? Most sleep apnea is caused by weight issues after all.
  - outworlder 2y ago
    > Most sleep apnea is caused by weight issues after all. Citation needed here. My understanding is that being overweight just narrows part of your airways and will make any existing flow restrictions worse. But given that most sleep apnea patients don't get off treatment even when they lose weight (although the severity may decrease), I'm pretty skeptical of this claim.
    - arcticbull 2y ago
      This is not a comprehensive response to your question but 41% of patients with BMI over 28 have sleep apnea, and that number grows to 78% by the time you get referred for bariatric surgery. There is in fact a mathematical relationship. [1] > For every 7-pounds drop in weight, expect a 7% drop in [apnea severity index]. It's basically caused by tongue fat, pharyngeal/neck fat and visceral/fat in the upper belly. [2] I strongly suspect it's just a question of how much weight you lose. If you get down to 15% body fat you really won't have apnea anymore. Not for everyone, there's probably some structural issues that can also cause it, but if it's adiposity-induced, which it is for a huge number of people... For the rest with skeletal or nasal structure issues, surgery may be appropriate. [1] https://jcsm.aasm.org/doi/10.5664/jcsm.10190 https://jcsm.aasm.org/doi/10.5664/jcsm.10190 [2] https://www.pennmedicine.org/news/news-releases/2020/january/losing-tongue-fat-improves-sleep-apnea https://www.pennmedicine.org/news/news-releases/2020/january...

wincy 2y ago

I have tried for months to use my APAP machine, and failed. My wife has no problems using her. I’m not really sure what the next step even is. It’s frustrating because I can tell when I get a bad nights sleep I can’t think as well, but it feels like there’s nothing I can do about it. I can breathe through the CPAP exclusively for hours but then as soon as I try to go to sleep I feel like I’m being smothered and my heart starts racing. Does anyone have any advice?

candiddevmike 2y ago
Sounds like you aren't getting enough pressure. Also sounds like there could be some mechanical reasons like gerd, allergies or inflammation that cause your apnea, especially if you start fine.
- david-gpu 2y ago
  I agree. When we fall asleep we lose muscle tone, which makes apneas more likely -- that is why we have trouble breathing when we sleep, not when we are awake. GP needs to find out how to set up the pressure in their CPAP device. YouTube has tons of videos on that subject.
iamjackg 2y ago
Did you try different types of masks? I found that I felt like that during the initial phases of the titration study (where they determine the right settings for you) but once they dialed in the pressure, that feeling went away and now I actually quite enjoy it, since it makes it easier to breathe through my nose. I use a nose pillow.
bloopernova 2y ago
Do you have a slow ramp up of pressure? I have to start on low pressure when I first put the mask on each evening. Your sleep doc/clinic may be able to help.
- Arelius 2y ago
  As an alternative, the opposite may also be true. I could never sleep when I had the slow ramp of pressure.

xnx 2y ago

This is a great "free" feature in a wearable. I wonder how many years are left before Ozempic-like drugs make sleep apnea a rarity.

nightowl_games 2y ago
Sleep apnea is not completely due to being overweight.
- a_wild_dandan 2y ago
  Hence their qualifier “rarity.”
  - JohnMakin 2y ago
    But it’s not that rare in non-obese people, I think is the point. Obesity is certainly a risk factor. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5181619/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5181619/
    - david-gpu 2y ago
      When I arrived at the sleep clinic with a BMI of 22, the first thing they told me was: there are lots of people with sleep apnea who have a healthy weight, including children. The notion that sleep apnea is generally caused by weight needs to die. People also conveniently forget that being woken up multiple times every hour causes weight gain, so often times being overweight is the consequence of sleep apnea rather than the cause.
      - elric 2y ago
        Thanks, I'm usually the one who has to get on their soapbox to say this. I'm glad I'm not the only one anymore :-)
        JohnMakin 2y ago

tiltowait 2y ago

I’ve completely stopped using my Apple Watch, but this is a tempting proposition. It looks like a one-off at-home sleep study is cheaper, but that doesn’t help me if the problem materializes a year after I get it.

kylehotchkiss 2y ago
I did one of the take home studies. It seems like there’s so many ways to get inconclusive results - they depend on a microphone that might end up underneath you, the probes could fall off, the battery could die, the “UI” is weird. I think continual testing is a very decent solve for some of those shortcomings and pushing people to the actual clinic for the real test

techwizrd 2y ago

I would be interested in knowing whether these are effective at detecting sleep apnea in flight crews to aid aeromedical certification.

sandworm101 2y ago
>> detecting sleep apnea in flight crews to aid aeromedical certification. 24/7 medical monitoring via a wristwatch? Monitoring that may cost you your career? I can think of nothing pilots would resist more.
- outworlder 2y ago
  Treated sleep apnea is not a disqualifier.
- techwizrd 2y ago
  Many pilots already use a smartwatch to track their sleep and provide evidence for fatigue callouts. Right now, pilots are grounded and face an arduous process to prove they're healthy. Most pilots eventually receive a special issuance after a fair amount of hassle. What if this could help keep them flying instead?
  - sandworm101 2y ago
    And for all the pilots that don't have sleep apnea? What will insurance companies tell the airline to do if this app each morning tells them which of their pilots didn't sleep well enough? Well enough according to their apple watches.

gijsnijholt1980 2y ago

I developed an iOS app which detects your sleeping position and starts buzzing if you’re on your back. Similar to the tennis-ball-sewn-into-pyjama’s hack. Apple kept refusing to approve stating medical reasons. Still use it myself though, works great.

jbombadil 2y ago
Question: were the "medical reasons" specific or a generic "no because it's medical related" reason? As in, did their refusal say "no because the way you're tracking if the user is on their back is not accurate enough?" or did they say "we don't allow people to write watch apps related to medical diagnoses / treatments / etc?"
- deleted 2y ago
  [deleted]
NelsonMinar 2y ago
Interesting and frustrating story! There's an Android app I've used that does that: https://play.google.com/store/apps/details?id=com.koalative.torena&hl=en_US https://play.google.com/store/apps/details?id=com.koalative....
- BurningFrog 2y ago
  How can a phone know which position you're sleeping in?
  - ASalazarMX 2y ago
    Obviously the user untapes the tennis ball on their back, and tapes on their iPhone instead.
    - xattt 2y ago
      I thought you were supposed to use an iPad Pro.

NelsonMinar 2y ago

I like the concept but I'm curious how it works. It sounds like it's based on detecting the movements of the wearer? Does that work? It's a shame Apple is having patent issues with their SpO2 sensor. The O2Ring was a huge help in me understanding my sleep apnea early on, in combination with a formal sleep study. Sleep apnea is a very common and harmful problem, any sort of way of helping detect it will improve a lot of lives.

JourneyToLunar 2y ago
It’s only turned off in the US right? Would they use the data in the rest of the world since SpO2 data is available there?
- rootusrootus 2y ago
  The SpO2 data isn't useful for detecting sleep apnea because the sampling frequency on a smartwatch is way too coarse to pick up on it.
  - NelsonMinar 2y ago
    oh that's too bad. The O2Ring samples every 2 or 4 seconds but a lot of cheaper devices take an average reading once a minute or so which definitely obscures sleep apnea. (normal adults take a breath every 3-5 seconds when sleeping. with obstructive sleep apnea that can be more like once a minute.)
dopylitty 2y ago
They're tracking movements. Apple has a doc on how it works here[0] >Apple Watch tracks movement with triaxial accelerometer signals, which capture coarse motion of the body as well as fine movements including motion associated with breathing. Apple developed an algorithm that uses the accelerometer time series data to classify Breathing Disturbances that occur during sleep tracking, which are temporary interruptions in the breathing pattern. > A total of 1499 participants were enrolled, with 1448 completing the study. The sensitivity was 66.3% (95% CI: 62.2% to 70.3%), and the specificity was 98.5% (95% CI: 98.0% to 99.0%), demonstrating that the feature meets the design objectives to confidently identify sleep apnea while minimizing false positives. >It’s important to note that the specificity was 100% (95% CI: 99.7 to 100%) for the normal category, indicating that all participants with a “positive” algorithm result had at least mild sleep apnea. Also, sensitivity was higher in the severe category at 89.1% (95% CI: 83.7% to 93.2%), indicating that the large majority of severe cases were identified. 0:https://www.apple.com/health/pdf/sleep-apnea/Sleep_Apnea_Notifications_on_Apple_Watch_September_2024.pdf https://www.apple.com/health/pdf/sleep-apnea/Sleep_Apnea_Not...

alex_lav 2y ago

Can a more Apple-minded person help me understand if the Apple Watch SE counts as "Series 9"? I don't totally understand how "SE" relates to numerical versioning, but I am also not an Apple person. Apologies in advance if this question is somehow obvious to others.

saagarjha 2y ago
SE is a line orthogonal to their flagship models. Usually it means they took the enclosure from a previous watch and shoved some improved guts in it. Apple Watch SE is similar to Apple Watch Series 8 in terms of processing power but externally (screen, sensors) it’s like Apple Watch Series 4 or thereabouts.
wtallis 2y ago
"SE" denotes a cheaper, less capable model that is not part of the main sequence of product generation numbering. There have been two generations of Watch SE and three generations of iPhone SE; they're not updated as frequently as the flagship product line. The Watch SE does not have the sensors for EKG or blood oxygen, which are probably necessary for the sleep apnea detection.
iknowstuff 2y ago
Steve Jobs must be turning in his grave over this dogawful naming scheme.

whatnotests2 2y ago

Now we know why it's called Apple Watch. It watches you.

FabHK 2y ago
Yes, always has, always will. Unlike products of many other manufacturers, it keeps what it learns on your devices, and doesn't send it home to big brother.
outworlder 2y ago
That's precisely why I got one.

tw04 2y ago

So on paper it sounds great, in practice this feature seems almost useless to me. As someone living in the garmin watch ecosystem, every time a new apple watch comes out, I quickly hit the specs page to see if they have made any progress at all on reasonable battery life and am continually let down. With 36 hours being the absolute best-case scenario for battery life, it would seem your options are to either have two watches, or be perfectly fine only wearing your watch every other day? Otherwise, when do you charge?

hardwaregeek 2y ago
It takes like 20 minutes to charge the watch. Just don’t wear it for that time
- tw04 2y ago
  The manual says 45 minutes to 80%, 90 minutes to 100%. If I'm only charging to 80% that's roughly 14 hours of battery life on a Series 9 or 10 (18 hours on full charge). So not even a full day? I just don't get how the math works if I'm trying to wear it all night every night and wear it for workouts during the day.
  - halostatue 2y ago
    There is a material difference between the older Apple Watch (where the charging puck uses USB A) and the newer Apple Watch and/or the Ultra (where the charging puck uses USB C). Plugged into an appropriate source, the USB C puck gets much faster charging and is usually sufficient for a day's wear after about 10 minutes (depending, of course, on what the day includes). Charging to 80% is likely to be more than enough for most uses, and topping it up with another 15% just before bed is enough for overnight (probably). I had the Series 4 previously and the Ultra 2 now; with the older watch, I would charge it for about an hour while watching TV in the evening. With the Ultra 2, I charge it for about 20 minutes here and there depending on what I’m doing and whether I remember. I’m currently at 39% which will be just fine for my hourlong exercise ride (with GPS), and then I can toss it on the charger while I shower and it’ll probably be at 70% which is good enough for another full day.

efsavage 2y ago

Does this mean that you could be prescribed an Apple Watch if you were at risk of apnea? Or even use an HSA?

tantalor 2y ago
I can see it now: it's December and my FSA still has a balance, must be time to buy 12 Apple Watches and sell them on eBay.
- 39896880 2y ago
  Out of curiosity, does your health plan have an HSA? After learning about these I decided that FSAs are a total rip off. Why would my money expire?
  - kstrauser 2y ago
    If you know you're going to have certain recurring expenses, they can be great. That money's untaxed so you're basically getting a 25% or whatever discount on whatever you buy with FSA money. But yes, the expiration bit is insane. That's how I ended up buying a pair of prescription Ray-Bans in late December several years ago.
    - 39896880 2y ago
      > That money's untaxed so you're basically getting a 25% or whatever discount on whatever you buy with FSA money This is the same with an HSA. The difference is that you can invest funds from an HSA and the growth is tax free.
      - kstrauser 2y ago
        That's not the difference. The difference is that you have to have an HDHP to use an HSA. My employer pays for me to have a very good low-deductible policy. I did the math and it would almost certainly cost me more out of pocket to have an HDHP than what I have now. If you are young, single, and healthy, the equation may look different. If you're older and have a spouse and kids, it's shockingly easy to hit the deductible and OOP max year after year. I could imagine a case where I'd start an FSA. An HSA did not work out well for me a few years ago when I tried it, and would be even less likely to be a win for me now.

blackeyeblitzar 2y ago

The problem is that these at home tests aren’t good enough to eliminate the costly and time consuming and inconvenient step of a sleep study in the lab. At least near me, to get a CPAP you first do a take home study with a wrist based (watch like) recorder. Then they make you go into the lab for an overnight sleep study (or multiple of them) anyways, for a study that costs your insurance several thousand dollars per night (and you have some copay potentially) and it is of course a massive hassle and barrier to getting CPAP treatment. They claim it is so they know your air pressure numbers but it is all just regulatory capture, because CPAP machines can auto adjust your pressure and people like to tweak numbers manually to their comfort level anyways. Can Apple do something about eliminating all these bureaucratic barriers that hurt the health of so many?

outworlder 2y ago
The largest barrier by far is actually starting the process to get a diagnosis. It's often a family member that notices and raises the alarm. Note that you can be diagnosed with sleep apnea based on the home study alone, you don't always have to go to a sleep clinic. If you are really sure you have sleep apnea (and you can be pretty certain with a home sleep study + symptoms) you can just go online and get a prescription for free by talking to a doctor at one of the companies that resell CPAP machines. At least in the US, other countries can be more bureaucratic.
Bluecobra 2y ago
> Can Apple do something about eliminating all these bureaucratic barriers that hurt the health of so many? I sure hope so, because my experiences with sleep apnea made it seemed very quack-ish. I keep on hearing ads on the radio by a company called ADVENT with a catchy jingle promising that surgery is the solution to snoring. At the time I had my study (2013) I did not have an in-home test and had a sleep test (which was an awful experience). I was prescribed a Phillips CPAP machine and was very good about adhering to it and keeping up with regular doctor visits. During the 3 years I had it, I lost a significant amount of weight and each time my doctor re-programmed my CPAP SD card so it was a lower and lower setting. I always had very little face time with the doctor, I wish I knew about Sleepyhead earlier as I could have done this myself. The practice I was referred to would always try to sell me stuff like new masks, tubes, etc. when everything I had was in good condition and frequently cleaned. I even used distilled water in the CPAP itself. Eventually I went on a long vacation and didn't bring my machine and been off it since. I'm glad I did, it turns out Phillips was negligent about foam breaking down in their CPAP machines and even the replacement devices have this issue as well. At this point I don't know who to trust, and with something with Apple's name on it would give to some more legitimacy.

swyx 2y ago

> The feature, announced at last week’s iPhone 16 event, will arrive as part of the imminent watchOS 11 release. how exactly was Apple able to preannounce approval for this before the, yknow, approval? like exactly no other agencies work this way, precommiting them to a decision they havent formally taken, even if informally it was already taken they would frown very strongly on leaking their stuff

dgarrett 2y ago
The announcement said that the feature was pending FDA approval.
nobrains 2y ago
Most likely the decision was taken internally, but sometimes to make it official requires some procedural paperwork. Apple probably got the green light that the approval was approved on the way.
- larkost 2y ago
  Having been next to the people working with the FDA at one point, they do tend to give a lot of feedback, especially when they don't like something. And there were a lot of hoops to jump though where the feedback was "you are on track" for a while before the actual official approval of that step came through. Very likely all of the core approvals were done, and they were just waiting on things like approval of software testing methodology (yes, they have to approve your software testing system), or something of the like.

Beijinger 2y ago

Is any VC guy here that is interested in medical devices? I would have something for you.

nox101 2y ago

It going to be great fun as Apple and Google add more and more medical features and then when they ban your account you lose them all. Maybe this will be more of the door to break their control on mobile computing.

argsnd 2y ago
I understand the argument that it's quite annoying that so much of the hardware you own relies on Apple permitting you to keep using it, but on the other hand what are you even doing to make them ban you? Their terms and conditions make it fairly clear that the only thing that would cause this is if you upload illegal content to their platform or attempt to chargeback purchases.
- dvngnt_ 2y ago
  or you get hacked and your account is used for spam or you email an innocent picture of your naked baby in their first bath and the ML gets your banned
- fsflover 2y ago
  > Their terms and conditions make it fairly clear that the only thing that would cause this is if you upload illegal content This is false: https://news.ycombinator.com/item?id=32547912 https://news.ycombinator.com/item?id=32547912 https://news.ycombinator.com/item?id=33737577 https://news.ycombinator.com/item?id=33737577 https://news.ycombinator.com/item?id=35133917 https://news.ycombinator.com/item?id=35133917 https://news.ycombinator.com/item?id=22146082 https://news.ycombinator.com/item?id=22146082 https://news.ycombinator.com/item?id=22705122 https://news.ycombinator.com/item?id=22705122 https://news.ycombinator.com/item?id=4013799 https://news.ycombinator.com/item?id=4013799
  - yreg 2y ago
    Those are all Google, argsnd is talking about Apple. But I'm sure one can get randomly banned by Apple as well.

godelmachine 2y ago

This is groundbreaking

makeitdouble 2y ago
The product isn't even on people's hands, and FDA approval only means it's not actively harmful and has a fighting chance of being somewhat beneficial. Is there anything objectively groundbreaking at this point ?
billfor 2y ago
For Apple. Samsung Galaxy has sleep apnea and blood pressure as well.
- deleted 2y ago
  [deleted]
- hombre_fatal 2y ago
  Apple leads the whole market in wrist wearable heart rate and sleep accuracy. So I wouldn't be surprised if its sleep apnea detection is also much better. Here's a chart: https://youtu.be/Jr4p66vSmLY?si=Ry3g80lh3kiDD12D&t=1100 https://youtu.be/Jr4p66vSmLY?si=Ry3g80lh3kiDD12D&t=1100

nakedneuron 2y ago

Main reason for sleep apnea - in my opinion - is deformed/degenerated fascia in the neck aka head forward posture. It's the disease of our modern (sedentary) age. SA is only one symptom. If you heard this the first time please feel free to ask. I'm always astounded at how common these CPAP devices are. Truly frightening.

DEF14A 2y ago
That is definitely one cause of OSA as is micrognathia and other craniofacial abnormalities, but it remains that the most common cause is fat mass constricting the upper airway - even if that person has completely normal craniofacial development and proper posture.

quyleanh 2y ago

In term of tracking sleep, is there any alternative with better battery life? I don’t mind other sport tracking functions.

fragmede 2y ago
There's Whoop, but it's pricey.
MoonYard 2y ago
Withings sells a sleep mat that connects to a wall socket. Disclosure: I work there.
vbarrielle 2y ago
I find Garmin's sleep tracking on my forerunner 255 quite good. I have no idea how it compares to an Apple Watch though.

rootedbox 2y ago

I have sleep apnea and I have an implant to stop my apnea / snoring. 1. if your watch tells you that you might have apnea go get a sleep study! 2. apnea and snoring do tend to happen together but not necessarily. you can have apnea without snoring(sometimes the other way but not as common) 3. apnea is like high blood pressure it's slowly killing you. 4. there are a lot of options now to help you. one might be losing weight. one might be sleeping on a side or stomach.. you won't know until you do a sleep study! get it done. After I got my apnea fixed I feel like a new person. I did not even know how tired I was or what being "awake" was like anymore. My body adjusted to a new normal. Please look into treatment!

OptionOfT 2y ago
Tell me more about this implant. Is that the electric one that basically tenses up your tongue as you breathe in? How long until you got it? Did you have to 'fail' CPAP & the mandibular device?
- hackernewds 2y ago
  It is probably "Inspire is an implantable device that treats obstructive sleep apnea by stimulating the tongue nerve to keep airways open during sleep. It's an option for people who have moderate or severe sleep apnea and can't use or don't benefit from a CPAP machine. Here's how Inspire works: Components: The device consists of a generator, sensing lead, and stimulation lead, all implanted under the skin. It also includes a handheld remote that patients use to turn the device on and off, adjust stimulation strength, and pause it during the night. How it works: When the sensing lead detects breathing, the generator sends a signal to the stimulation lead, which then stimulates the hypoglossal nerve. This causes the tongue to move slightly forward, which helps keep the airways open. FDA approval: The FDA approved Inspire in 2014. Some potential side effects of Inspire include: Damage to blood vessels near the implant, Excessive bleeding, and Nerve trauma or damage" There's a reason it hasn't taken off in 10 years.
- rootedbox 2y ago
  I did fail at CPAP.. it really is hard to do; but I have friends who swear by it. mandibular devices.. rarely work. I am using inspire. It's great. Turn it on when I go to sleep after 15 minutes it turns on and it moves my tongue depending on my breathing. It is basically a pacemaker but connected to tongue instead of the heart. And if you look at pictures of an inspire and a pacemaker they look exactly the same. So the reason everyone isn't getting it.. is not really for the side effects. But cost. My bill was 150k.. luckily I only paid a few thousand. So in order for your insurance to approve it you have to meet certain criteria. (talk to your doctor for an exact list) 1. Can't have a high BMI. Snoring and Apnea are closely related to weight. Your doctor should get you on semaglutides first. 2. You must have failed at using CPAP. It failed for me for multiple reasons. But like I said I have friends who love CPAP and get the same relief as me. 3. You have to get a type endoscopy to see if the procedure will work. I'm sure there are some other things they check but those are the main ones.. Now once you get the surgery.. recovery isn't tons of fun. When they are programming it while you are in surgery they are moving your tongue in all sorts of ways.. It took about a month to get to the ability to eat a sandwich again; and I was still sore for some time after that. They also have to do some craziness to get the wiring from your chest to throat(where the nerve for the tongue is actually stimulated. So my chest was sore and my arm was unable to pick up anything heavy for a couple months.. Also it takes a few months for everything to heal and for them to first turn it on. Then 3 months of programming to be stronger and stronger without waking you up. But one day it clicked and I was sleeping like a baby!

kylehotchkiss 2y ago

I’ve always dealt with snoring and a take home test was inconclusive (so my doctors weren’t super pushy about me doing an in person test). I still worry a little and my dentist used their 3d head XRay to show me my airway is so slightly constricted and I will certainly have it one day if not now. All to say I am elated to have my watch helping me just monitor and understand the issue and help give me more actionable data if I need to pursue the doctors again. I just wish we could solve this with something other than needs-AC-plug machine. I’d like to be able to travel without needing to think about that

wodenokoto 2y ago

What does that approval mean for the rest of the world? Do they still need a new approval in Europe before adding the feature in the EU? And if so, is the feature geofenced? E.g., you lose it when traveling or how do they prevent Europeans and people living in markets that are pending approval from using it?

sitzkrieg 2y ago

this is pretty funny considering taking a nap w apple watch will completely break the health app sleep tracking for that day

malthaus 2y ago
what a coincidence that they've added nap detection just in time then: https://www.macrumors.com/2024/06/17/watchos-11-supports-automatic-nap-detection/ https://www.macrumors.com/2024/06/17/watchos-11-supports-aut...

bamboozled 2y ago

Such a shame that my 2 year old, ultra high end watch can't use this feature. Apparently Apple Ultra is too dated to have this functionality, what a joke.

consf 2y ago
It’s always disappointing when high-end tech doesn’t support features that seem like they should be standard.
- bamboozled 2y ago
  Especially when you pay a premium for the "ultra" which turns out to be the not so ultra 9 months after release and now, doesn't support one of the most enticing features. I get it, Apple is a business, I love their products, but I can see why people hate the company.
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Nesco 2y ago

Reminder that sleep apnea is mostly caused by something hindering the normal airflow. It might require a jaw/orthognathic surgery or a nasal obstruction surgery, depending on the cause being a jaw or nasal dysmorphia + muscular rehabilitation