[HN Gopher] Apple Watch sleep apnea detection gets FDA approval
       ___________________________________________________________________
        
       Apple Watch sleep apnea detection gets FDA approval
        
       Author : brandonb
       Score  : 278 points
       Date   : 2024-09-16 16:35 UTC (6 hours ago)
        
 (HTM) web link (techcrunch.com)
 (TXT) w3m dump (techcrunch.com)
        
       | yumraj wrote:
       | Why not Apple Watch 8?
       | 
       | Surely it's not a technical reason, more a business one.
        
         | MBCook wrote:
         | What makes you so sure it's not technical?
        
           | yumraj wrote:
           | 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 wrote:
             | 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 wrote:
             | Someone else claims the 9 has a better accelerometer...
             | what's your source that 'there are no new sensors'?
        
             | MBCook wrote:
             | > 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 wrote:
         | atleast due to processing/battery reasons.
        
         | brandonb wrote:
         | 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.
        
         | ezfe wrote:
         | The Series 9 has a better low-power background accelerometer
         | than the Series 8, which is likely the reason.
        
           | Weryj wrote:
           | But, both devices have breathing rate detection during sleep.
           | So it's active in both devices over-night.
        
             | ezfe wrote:
             | Right, but I assume the "breathing rate" system kicks on
             | much less frequently and precisely than what is needed to
             | be clinically accurate.
        
               | MBCook wrote:
               | Or perhaps the system in the 9 is more accurate/detailed
               | in preparation for this feature.
        
         | can16358p wrote:
         | Apple has their standards high (though I agree they sometimes
         | can't meet it themselves).
         | 
         | They wouldn't want their brand to be associated with some half
         | baked feature that either runs very slow, or draws too much
         | power/heats up, or unreliable.
         | 
         | So even if another version is technically capable of that
         | feature, if it runs slowly/inefficient, they'd not enable it to
         | protect their brand value which makes sense: as a user if Apple
         | announces a feature, I know it's more "done" compared to the
         | competition like say Samsung/Android etc. and I trust that it's
         | not half baked (which sometimes fails to meet the expectations,
         | but still MUCH better than the competition)
         | 
         | The business reasons are just a plus _on top of_ these reasons.
        
         | nerdjon wrote:
         | If it was purely a business one, they would not have put it on
         | the Apple Watch 9 which is no longer available. Putting it on
         | the 9 doesn't do anything for sales.
         | 
         | There must have been some hardware difference.
        
       | renewiltord wrote:
       | This is fantastic. Breaking into medicine would be amazing.
       | Apple's products are generally great. M
        
         | talldayo wrote:
         | Tim loves when you bounce on it.
        
       | Circlecrypto2 wrote:
       | 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 wrote:
         | 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 wrote:
           | 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.
        
         | frankacter wrote:
         | >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-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.
        
       | nextlevelwizard wrote:
       | Will this work outside of US or does it need to get approved by
       | other orgs, like whatever is EUs FDA?
        
         | brandonb wrote:
         | 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 wrote:
           | 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-...
        
             | adw wrote:
             | The equivalent is the EMA.
        
       | ortusdux wrote:
       | Time to buy stock in the leading apnea machine manufacturers.
        
         | arcticbull wrote:
         | 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-zepb...
        
           | blackeyeblitzar wrote:
           | Is it GLP-1 or just weight loss due to it? Most sleep apnea
           | is caused by weight issues after all.
        
             | outworlder wrote:
             | > 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 wrote:
               | 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
               | 
               | [2] https://www.pennmedicine.org/news/news-
               | releases/2020/january...
        
       | wincy wrote:
       | 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 wrote:
         | 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 wrote:
           | 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 wrote:
         | 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 wrote:
         | 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 wrote:
           | As an alternative, the opposite may also be true. I could
           | never sleep when I had the slow ramp of pressure.
        
           | baldeagle wrote:
           | The 'ramp' setting made me panic and felt like a couldn't
           | breathe. We go from zero to full force now, and it works just
           | fine. I use a nose adapter.
        
             | TylerE wrote:
             | That's what I found too (minus the nose part).
             | 
             | It's low pressures that feel suffocating (because there
             | isn't sufficient airflow). High pressure feels great... as
             | a life long asthmatic it's the best I ever breathe.
        
         | Arelius wrote:
         | That sounds like a huge problem! Which masks have you tried?
         | There are many different mask options that you may respond
         | differently to
        
         | 6gvONxR4sf7o wrote:
         | Honestly? Find a new doc. I went to one for sorta similar
         | issues and their advice was basically "oh well that sucks" and
         | then years later went to another who said "okay let's try this
         | instead"
         | 
         | Now I'm on a bipap and tolerate it through the night.
        
           | SoftTalker wrote:
           | Check with your dentist also, some apnea cases can be treated
           | with a mouthpiece you wear while you are sleeping.
        
         | hiddencost wrote:
         | Have you looked into "elastic mandibular device"? You can get a
         | mouth guard that keeps your jaw from falling away from
         | alignment. It was enough for me to avoid a machine entirely.
        
         | jvans wrote:
         | EASE and/or MMA
         | 
         | https://sleepapneasurgery.com/about-dr-kasey-li/
        
           | atotic wrote:
           | My kid had sleep apnea. His problem was narrow nasal
           | passages. He got EASE surgery from Dr. Kasey Lee when he was
           | 14, and was completely cured. You get better results getting
           | surgery while bones are still pliable. It was like a miracle,
           | an outpatient procedure that changes your life.
           | 
           | After the surgery, he was finally able to get quality sleep,
           | and his personality changed. Before the surgery he was super-
           | intense, slightly ADHD, not doing great in school. All this
           | went away after the surgery, he is just a regular bright kid
           | now. We noticed changes in the first week, took about 2 years
           | to find new normal. Before the surgery, we tried CPAP for a
           | while, and it helped a bit.
           | 
           | My wife also had the same surgery. It helped, but did not
           | completely cure her apnea.
        
         | m463 wrote:
         | I went through the same thing.
         | 
         | - #1 - switch to Nasal pillows.
         | 
         | - I had to learn to breathe through my nose
         | 
         | - I had to learn to sleep on my back with a pillow that cradled
         | my head without raising it
         | 
         | - I had to make sure the level of distilled water in the
         | humidifier was not too high.
         | 
         | - make sure the tubes are not higher than your nose (otherwise
         | condensation water drips into your nose)
        
         | jrockway wrote:
         | I was prescribed a CPAP (well, APAP as you mention) and the
         | first week was miserable. I think I got 3 hours of sleep total
         | that week, and obviously felt like crap. I talked to my primary
         | doctor and she's like "well then go back to the specialist".
         | That's what I'm doing.
         | 
         | My plan is to get a prescription I can use to buy a bunch of
         | different masks (I don't care about the cost), and get a few
         | days of sleep aids. That should sort it out.
         | 
         | The few hours I did sleep with a CPAP were crazy. I forgot that
         | I stopped having dreams. I had so many dreams while I could
         | breathe at night.
        
           | Aloha wrote:
           | What bothers me is that you need a prescription to get a mask
           | for a CPAP - I kinda get the prescription needed for the CPAP
           | - but the accessory mask - that just seems absurd to me.
        
             | Bjartr wrote:
             | Looks like there's plenty of masks available on Amazon. I
             | suspect a major part of why the mask gets a prescription is
             | to make insurance covering it simpler.
        
               | kube-system wrote:
               | Yeah, doctors can write a prescription for over the
               | counter drugs for this reason.
        
               | TylerE wrote:
               | There's a funny workaround where mask _parts_ don 't
               | require a subscription. The ones I've seen on Amazon are
               | usually selling parts, perhaps a kit of parts, and not a
               | complete mask.
        
             | outworlder wrote:
             | I bought masks at sleeplay and another cpap store and they
             | didn't ask for prescriptions. Sleeplay did ask for a
             | prescription when I wanted to buy a travel CPAP.
        
             | elric wrote:
             | You don't need a prescription for CPAP masks and you don't
             | need a prescription for CPAP devices. You can freely buy
             | both in most parts of the world. If you happen to live
             | somewhere where you can't (and you can't get a prescription
             | for some reason), then I suggest you find an online
             | reseller anyway.
        
               | david-gpu wrote:
               | From a few minutes on Google, it appears like most
               | developed countries require a prescription to purchase a
               | CPAP device, including the US (varies per state), Canada,
               | UK, Australia, Germany, France and Italy.
               | 
               | The most notable exceptions I find are Japan and
               | Singapore, where it can be purchased without an Rx.
        
               | elric wrote:
               | I think those places need a prescription in order for
               | insurance to pay for the machine, not to buy the machine.
        
               | david-gpu wrote:
               | That is incorrect in at least Canada and Spain.
               | 
               | As for other developed countries, they typically have
               | universal healthcare and the patient does not need to pay
               | for CPAP devices. Regardless, insurance and prescriptions
               | are orthogonal.
        
               | abrichr wrote:
               | You can order them online, not sure if a prescription is
               | required:
               | 
               | https://cpapoutlet.ca/
        
               | david-gpu wrote:
               | You need to email them or fax them a prescription. I live
               | in Canada. I know this for a fact. I had to do it myself.
               | 
               | From the website you linked:
               | 
               |  _> All CPAP machines require a prescription for
               | shipment. Details of submitting a prescription are
               | provided below. If you have any questions or concerns,
               | please call us toll-free at 1-855-542-2727._
               | 
               | Source: https://cpapoutlet.ca/pages/shipping-returns-
               | policy
        
               | blackeyeblitzar wrote:
               | No, you need a prescription in the US. And that
               | prescription is withheld by sleep specialist "doctors"
               | until you do an expensive and unnecessary sleep study.
               | These doctors serve no useful role other than telling you
               | really obvious things, but you are forced into multiple
               | appointments with them just for the prescriptions. Going
               | through insurance then can require at least one more
               | follow up appointment, but sometimes more depending on
               | your plan. Some of them require multiple appointments
               | where the doctor confirms your usage.
        
           | bobthepanda wrote:
           | at least for me, it took like two weeks of adjustment to get
           | used to a CPAP.
           | 
           | one big thing is that you really should only breathe through
           | your nose if you're using nasal pillows.
        
           | BurningFrog wrote:
           | I buy my masks on Amazon. No prescription needed.
           | 
           | Also, the nasal pillow "masks" are vastly superior.
        
         | NelsonMinar wrote:
         | This is a common and difficult problem. Has your sleep doctor
         | helped you with it? You might also find an online Sleep Apnea
         | forum has ideas for you. I learned a lot from
         | https://www.apneaboard.com/
        
         | seraphsf wrote:
         | That feeling of being "smothered" might simply be that you need
         | a higher pressure setting. The pressure that feels comfortable
         | while awake might not be sufficient when your body is asleep.
        
         | mikaraento wrote:
         | Things that have helped me:
         | 
         | - nose mask rather than full face mask
         | 
         | - nasal spray if my nose feels congested
         | 
         | - upping the pressure. In theory a professional is supposed to
         | set your pressure but I do tweak mine. If the setting is not
         | visible it's probably in a hidden menu - Google for how to
         | enable it for your machine.
         | 
         | - sleeping pills
         | 
         | I hope you find a solution. Sleep apnea is terrible.
        
           | elric wrote:
           | Please don't recommend sleeping pills to people who have
           | sleep apnea. They can make apneas worse.
        
           | adrr wrote:
           | I've seen someone go from AHI of 15 to a 1 during at at-home
           | sleep study and asked what they did differently, they said
           | their nose was stuffy so they took some cold medicine/allergy
           | before bed.
           | 
           | I wish at-home sleep tests didn't require a physician to
           | prescribe and review results. It would allow people to
           | experiment with sleeping positions, snore guards and other
           | methods to get their AHI down.
        
         | slaymaker1907 wrote:
         | Have you tried playing around with the humidity? If I have it
         | set too low, that definitely makes a big difference. There are
         | also other treatments for sleep apnea that you could look into
         | which might work better.
        
           | elric wrote:
           | Heated humidification is a crux. You only "really" need it
           | when you have a mouth leak ( or if it's awfully cold and dry
           | in your bedroom, like an igloo?). It also vastly increases
           | the amount of maintenance you have to do on your CPAP device.
           | It makes your masks wear our quicker. It makes your hose more
           | susceptible to growing mold etc.
           | 
           | The real trick is to fix your mouth leak. Getting on the
           | right pressure helps with that. Fixing your sleeping position
           | can help. Mouth tape can help. A cervical collar can help.
           | Anything that will help you keep your mouth shut at night.
        
             | david-gpu wrote:
             | Humidification is necessary in any place where winter is
             | cold. Cold air can't hold much absolute moisture, and as
             | you warm it up to room temperature, the relative humidity
             | of that air drops. In Canada you will often find the
             | relative humidity of the room to be below 10% in winter,
             | which is uncomfortable even in the absence of CPAP.
        
         | bboygravity wrote:
         | Reddit is pretty great for cpap related help and hints.
         | 
         | I just did 3 nights with mine and conclusion: it's all about
         | the type of mask + settings.
         | 
         | First 2 nights was terrible (and painful on the face) due to
         | wrong masks and wrong settings. 3rd night was best I've slept
         | in a longgggg time.
         | 
         | I can't tell you which masks or settings (it will be completely
         | different per person), but reddit is pretty great at providing
         | hints.
         | 
         | My case: disaster with nasal mask and full face mask size L and
         | high pressure settings (lots of central apnea). Almost perfect
         | with 4 to 10 pressure setting and face mask size M (which
         | should be too small for me according to the manufacturer).
         | 
         | I use a Resmed Airsense 11, soon getting a heated tube so I can
         | crank up the moisture setting without getting condensation and
         | noises in the tube. Will try more different full face masks as
         | well.
        
           | jeffwask wrote:
           | This is 100%. I've been using mine close to a decade not only
           | mask size but seal type. My wife can only use the foam rubber
           | type masks I use the regular ones. I also have a Resmed
           | Airsense with the heated hose and it really helps.
           | 
           | It took me a few weeks to truly get comfortable but now I
           | can't imagine life without it. Never thought there would be a
           | time when I could get 6-7 hours sleep and I would be fully
           | rested.
        
         | ScoobleDoodle wrote:
         | I've been using a CPAP for 15 years. A few items I had to
         | adjust when getting that suffocating feeling a few times:
         | 
         | 1. When getting a new CPAP I had to reduce the pressure from 15
         | to 14 or 13 to mitigate the suffocating feeling. I still get my
         | normal 0.5 events per hour while I'm use. I also got a
         | different type of mouth and nose mask which may have
         | contributed to needing to adjust the pressure.
         | 
         | 2. I was trying to mitigate the colder air being distracting by
         | enabling the humidifier and tube heater. With the humidifier
         | level too high at 5 I got a suffocating feeling, reduced it
         | down to 2 or 3 and the air was warmer while not feeling
         | suffocating. 3. I also turned off the dynamic pressure on
         | breathe out as the timing felt off and would cause a hitch in
         | breathing, so I have just plain constant pressure.
         | 
         | The name of the game is tweaking and experimenting.
        
         | outworlder wrote:
         | > as soon as I try to go to sleep I feel like I'm being
         | smothered and my heart starts racing
         | 
         | You may need your pressure adjusted. You are awake so whatever
         | pressure the machine is using is fine. Then you start falling
         | asleep and that's when your apnea kicks in.
         | 
         | If you are using the standard autoset 4-20 setting it may not
         | be enough. Ideally this would be done by a medical professional
         | and yada yada - insert standard disclaimer here. I would
         | suggest increasing the lower pressure (say, to 7) to see if it
         | helps you. I was using the default for years and, while it did
         | help me, apparently it wasn't enough. After increasing, it's
         | been night and day.
         | 
         | It _could_ be an issue with your mask but given what you
         | described, probably not.
        
         | elric wrote:
         | Followup sucks in most part of the world, unfortunately, which
         | leads to awful compliance.
         | 
         | Best thing to do is install Oscar [1], take screenshots of your
         | data, and post it to Apnea Board [2]. The folks there will
         | likely be able to offer some solid advice.
         | 
         | Without knowing anything about you or your data, all of this
         | speculation, but: APAP sucks, it is always too slow to respond,
         | it won't know to increase the pressure until after you needed
         | more pressure. This is especially true for wide ranges which
         | are often the default (like 5-20cm). If you need 15cm, it will
         | take forever to get there, because you'll start at 5, start to
         | drift off, get an apnea, the machine will increase the
         | pressure, you'll wake up ever so slightly from the apnea, the
         | machine will decrease the pressure because now you're breathing
         | fine, and the cycle will continue.
         | 
         | [1] https://www.sleepfiles.com/OSCAR/ [2]
         | https://www.apneaboard.com/forums/
        
       | tiltowait wrote:
       | 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.
        
       | xnx wrote:
       | 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 wrote:
         | Sleep apnea is not completely due to being overweight.
        
           | a_wild_dandan wrote:
           | Hence their qualifier "rarity."
        
             | JohnMakin wrote:
             | 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/
        
               | david-gpu wrote:
               | 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 wrote:
               | 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 wrote:
               | What's crazy is all the downvoting. Why are people so
               | invested in this idea that BMI is the primary/sole cause
               | of OSA? It's literally killing people and the science is
               | pretty conclusive. It should be one of those screens you
               | take at certain milestone ages like colonoscopies.
        
               | david-gpu wrote:
               | People are ignorant about conditions they don't have and
               | they want to believe that it won't affect them.
               | 
               | I started noticing clear symptoms of OSA when my BMI was
               | less than 20 and my VO2Max was around 51. That is to say,
               | I was leaner and fitter than most.
               | 
               | I completely agree that they should screen folks
               | routinely.
        
         | willcipriano wrote:
         | I wouldn't count the Ozempic chickens before they roost. So far
         | it looks like it's a costly lifelong injectable drug with a lot
         | of reported uncomfortable side effects. That doesn't bode well
         | for adherence at the population level.
        
           | mannyv wrote:
           | Actually, it's also a miracle drug that can reduce
           | inflammation and reduce the medication load of millions of
           | people.
           | 
           | From what I've seen anecdotally, Ozempic adherence is much
           | higher than most other meds. And the side effects are minor
           | compared to, say, being 200 lbs overweight.
        
             | blackeyeblitzar wrote:
             | That depends. A lot of people experience significant GI
             | issues. And it isn't clear yet if those issues are
             | reversible after stopping. It's still best for people to
             | naturally control their weight and diet. Is one better than
             | the other - depends on how overweight and how severe the
             | side effects. Right now I feel like there isn't much focus
             | and rigorous study of those side effects but over time I
             | expect it will reduce the overall positives of the drug
             | somewhat.
        
               | djur wrote:
               | "A lot of people experience significant GI issues. And it
               | isn't clear yet if those issues are reversible after
               | stopping."
               | 
               | I don't think there's any reasonable definition of "a
               | lot" where this is true. A significant number of people
               | experience GI issues. Most of them subside after a time.
               | There is some evidence that a small number of people may
               | experience more severe GI issues that don't go away after
               | stopping.
               | 
               | "It's still best for people to naturally control their
               | weight and diet."
               | 
               | What is your evidence for this? Right now, it's looking
               | like the "unnatural" GLP-1 agonists are racking up quite
               | a score against "natural" methods like "willpower" and
               | programmed diets. It's not a useful distinction, in any
               | case. These medications cause reduced calorie
               | consumption, and reduced calorie consumption causes
               | weight loss naturally.
        
             | outworlder wrote:
             | Given that >80% of Americans have some form of metabolic
             | dysfunction, it's not surprising that those drugs are
             | having miraculous effects.
        
             | max51 wrote:
             | >And the side effects are minor compared to, say, being 200
             | lbs overweight.
             | 
             | I was about the reply the same thing. Obesity is directly
             | or indirectly a risk factor for almost every health problem
             | imaginable.
             | 
             | Even for a situation that looks completely unrelated like
             | getting shot in the knee by a gun, the risk of dying during
             | the surgery will be significantly higher if you are obese.
        
           | cameronh90 wrote:
           | Weekly injectable semaglutide is the first generation.
           | 
           | Tirzepatide is already more effective and better tolerated
           | for most people, and there is also semaglutide as a daily
           | oral pill available as Rybelsus. Further generations of
           | obesity drugs are already in human trials, and are showing
           | even greater effects relative to the side effects (e.g.
           | retatrutide and combination therapy with cagrilintide).
           | 
           | Price is an issue, but with multiple pharma companies that
           | have effective drugs, the prices have already come down quite
           | a lot. My tirzepatide is running me less than PS200/month
           | now, and I'm saving at least that on groceries and eating
           | out. Not even counting that it's effectively cured a few
           | weight related medical conditions that were costing me more.
        
         | outworlder wrote:
         | > I wonder how many years are left before Ozempic-like drugs
         | make sleep apnea a rarity.
         | 
         | Obstructive sleep apnea is not caused by being obese or old,
         | although those things don't help. In _some_ people, losing
         | enough weight may allow for sufficient airflow despite their
         | airway restrictions.
        
       | techwizrd wrote:
       | I would be interested in knowing whether these are effective at
       | detecting sleep apnea in flight crews to aid aeromedical
       | certification.
        
         | sandworm101 wrote:
         | >> 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 wrote:
           | Treated sleep apnea is not a disqualifier.
        
           | techwizrd wrote:
           | 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?
        
       | gijsnijholt1980 wrote:
       | 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 wrote:
         | 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?"
        
         | NelsonMinar wrote:
         | 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....
        
           | BurningFrog wrote:
           | How can a phone know which position you're sleeping in?
        
             | ASalazarMX wrote:
             | Obviously the user untapes the tennis ball on their back,
             | and tapes on their iPhone instead.
        
               | xattt wrote:
               | I thought you were supposed to use an iPad Pro.
        
             | NelsonMinar wrote:
             | I wore it on a chest strap. awkward but not impossible
        
               | BurningFrog wrote:
               | Aha!
               | 
               | Yeah, that would work!
        
         | AStonesThrow wrote:
         | Can you get your app to detect if your user's weight suddenly
         | doubles while they're lying down?
        
           | saagarjha wrote:
           | Pets giving you a hard time?
        
             | wyldfire wrote:
             | It's for when the AG unit breaks on space stations. :(
        
               | sweetjuly wrote:
               | Boeing has really gone down hill since the 2800s
        
         | eli wrote:
         | Makes sense. Apple could be held liable for any false or
         | misleading health claims made about an app.
        
           | vasco wrote:
           | Ironically if they stopped this gimmick they keep up to be
           | able to charge 30% they could have the app and the developer
           | would be the liable one. But the developer doesn't even have
           | to make these claims, they can just put it up and say "this
           | may detect if you're on your back".
           | 
           | Apple isn't liable for you looking up medical misinformation
           | that kills you using your iPhone on the Safari browser. Why
           | would it be for an app that is clearly made by someone else?
           | The difference is only because of the vetting, and they only
           | do vetting to charge their fee, otherwise they'd vet other
           | things too.
           | 
           | It's incredible how companies bend backwards to bullet proof
           | any liability whatsoever on anything, except if they can make
           | money on it.
        
             | kube-system wrote:
             | > they only do vetting to charge their fee, otherwise
             | they'd vet other things too
             | 
             | They also vet apps to keep garbage and scams out of it.
             | 
             | Many of the things they prohibit are things that are
             | overwhelmingly good for their users:
             | 
             | https://developer.apple.com/app-store/review/guidelines
        
               | dylan604 wrote:
               | Now we're into a semantics meaning over "garbage and
               | scams", as I believe pretty much all social media apps
               | are a form of "garbage and scams". They just happen to
               | have enough features that people like so they accept it.
        
               | kube-system wrote:
               | Which is why Apple's page that I linked is quite a lot
               | longer than my comment. It is more carefully worded. It
               | also isn't based on _your_ particular preferences or
               | tastes, but the tastes and preferences of their target
               | market(s), which may vary well not include you.
        
             | kstrauser wrote:
             | There's a reputational risk in selling software that gives
             | unvalidated medical advice.
        
             | eli wrote:
             | No, it's illegal to participate in the advertising or
             | promotion of products making false health claims in any
             | way.
        
               | vasco wrote:
               | > But the developer doesn't even have to make these
               | claims, they can just put it up and say "this may detect
               | if you're on your back".
        
               | kaba0 wrote:
               | I am no lawyer, but I guess any such law has to take into
               | account physical possibility. Like, e.g. youtube itself
               | can't possibly flag every copyrighted content streamed
               | live/etc.
        
           | adrr wrote:
           | Sleeping on your back isn't a medical treatment. It's a
           | snoring reduction. You can buy snore guards, nose strips,
           | special pillows etc to prevent snoring and none of those
           | require FDA approval because snoring isn't a medical
           | condition.
        
             | eli wrote:
             | So long as you're very careful what you say in the ad and
             | within the app, sure.
        
             | tptacek wrote:
             | Is it marketed as "intended for use in the diagnosis of
             | disease or other conditions, or in the cure, mitigation,
             | treatment, or prevention of disease, in man or other
             | animals"? That's one of three things that gets you
             | categorized under the FDA regulation. There's even a term
             | for it: "SaMD".
             | 
             | It seems less likely to me that this is Apple being
             | ruthless or pigheaded and more than you really do have to
             | be careful how you market your iPhone apps.
             | 
             | I take your point; the FDA doesn't recognize "snoring" as a
             | medical condition (but OSA is!)
        
             | kemayo wrote:
             | Yeah, but the question is really about how the app was
             | presenting it. If it was making anything that sounded like
             | a health claim...
        
         | Spivak wrote:
         | Is this a sleep apnea thing because I've always been told you
         | want to sleep on your back?
        
           | ayhanfuat wrote:
           | Yes, sleep apnea mostly gets worse if you sleep on your back
           | so they suggest sleeping on your side.
        
             | outworlder wrote:
             | Yes, although untreated sleep apnea is dangerous and you
             | shouldn't rely on this if you suspect you have it. It may
             | make it better but you may still be starving your tissues
             | of oxygen.
        
               | jfengel wrote:
               | Conversely, for my case:
               | 
               | I was told that my sleep apnea didn't rise to the level
               | of a medical condition needing intervention, but I should
               | try to avoid sleeping on my back to help with the
               | problems that do present.
        
               | fahrnfahrnfahrn wrote:
               | I have sleep apnea that I treat with a BiPAP machine. The
               | neurologist who manages it said that everybody has sleep
               | apnea to some degree, and, as a matter of fact, with my
               | BiPAP machine, I have fewer episodes than the average
               | person.
        
           | elric wrote:
           | Told by whom? Gravity works against you when you sleep on
           | your back: your jaw falls in on itself, your tongue relaxes
           | down into the back of your throat, stomach acid can flow up
           | into your esophagus with relative ease. AFAIK the left side
           | is generally the "recommended" position. It addresses all of
           | those issues.
           | 
           | In some cases sleeping on the stomach might be preferred, as
           | that helps the lungs take in more oxygen, which is why
           | patients on respirators are often kept on their stomachs in
           | hospital.
           | 
           | That being said: if you don't have sleep apnea or reflux, any
           | position that's comfortable is probably fine. No one stays in
           | one position the whole night anyway.
        
             | bryanrasmussen wrote:
             | >Told by whom?
             | 
             | I sort of feel my body telling me, my back hurts because I
             | never sleep on my back (because of sleep apnea, or at least
             | horrendous snoring) but when I lay on my back it feels much
             | more comfortable, but can't sleep that way because I will
             | wake up the house.
        
               | jacobgkau wrote:
               | > my back hurts because I never sleep on my back
               | 
               | Try a body pillow. Having something to wrap your arms &
               | legs around and keep your spine aligned counteracts at
               | least some of the discomforts of sleeping on your side.
        
               | sva_ wrote:
               | > just get a waifu bro
        
             | swyx wrote:
             | > AFAIK the left side is generally the "recommended"
             | position
             | 
             | whats wrong with right side?
        
               | daedrdev wrote:
               | Your heart is on the left side of your chest so its
               | probably reacted to that
        
               | fahrnfahrnfahrn wrote:
               | Sleeping on the left side allows the stomach to operate
               | better while sleeping on the right favors the heart. I'd
               | always heard this, but recently read a short article
               | confirming it. Dunno if it's true, though.
        
               | delecti wrote:
               | The arrangement and orientation of organs means you're a
               | bit more likely to have acid indigestion if you're on
               | your right.
        
         | ayhanfuat wrote:
         | How does it detect your sleeping position? Is it based on the
         | watch position or is there another trick?
        
         | brandonb wrote:
         | We have an app which delivers medical care, and Apple let us on
         | but required proof of medical licenses, malpractice insurance,
         | etc. Medical apps are allowed, but there's a higher bar for
         | evidence.
        
           | hulitu wrote:
           | > Medical apps are allowed, but there's a higher bar for
           | evidence.
           | 
           | Except when you are Apple. /s
        
             | theFco wrote:
             | What do you mean? The article is about how they got FDA
             | approval... Isn't that the way to go? As in, it's a much
             | higher bar than having a medical license and insurance no?
        
             | atonse wrote:
             | Simply not true. I once spoke to an old coworker (who's now
             | a senior executive at a Fortune 500 company, not Apple).
             | And he said in these large companies, there is so much
             | discussion around risk, because the larger the company, the
             | more of a juicy target they are for lawyers and lawsuits.
             | 
             | So the thought that Apple wouldn't have their ducks in a
             | row isn't true. Especially since any feature they release,
             | will be used by millions of people pretty quickly.
             | 
             | Just to be clear, I'm not claiming Apple doesn't give
             | themselves special treatment in the App Store. They
             | absolutely do (as you'd expect). Just pushing back on the
             | notion that they wouldn't have documentation and all their
             | legal stuff taken care of.
        
           | golergka wrote:
           | Good. Back in 2015-2016, I worked on an app that improved
           | user's vision. Genuine science, publications in peer-reviewed
           | journals (even Nature). But the whole category was a vast
           | ocean of bullshit apps, and our product just sank in it,
           | unable to differentiate itself and prove to the users that it
           | was the real thing.
        
             | jfengel wrote:
             | Got any links to the research? My vision sucks.
        
               | wiseowise wrote:
               | Commenting here as a bookmark to not forget.
        
             | ransom1538 wrote:
             | Can you post this app?
        
         | mullingitover wrote:
         | Just say it's a game. Add some social widgets ("Get your non-
         | back sleeping scores on the leaderboard!"). Maybe throw in a
         | T&C forbidding using it for medical purposes.
        
         | Eric_WVGG wrote:
         | Any chance that you'd be interested in open-sourcing that app?
         | 
         | A very long time ago, I got the impression that sleeping on
         | your back is healthy, and successfully "trained" myself into
         | the practice... now I'm trying desperately to untrain the habit
         | 9_9
        
           | bhelkey wrote:
           | If they open source it but the app isn't allowed on the app
           | store, how will anyone install it?
        
             | freehorse wrote:
             | In my understanding it can be allowed as long as they do
             | not market it as medical app?
        
           | freehorse wrote:
           | It is healthy, unless you have sleep apnea or snore a lot.
        
         | noman-land wrote:
         | Everyone's talking about the app but I'm impressed by the
         | tennis ball idea.
        
         | isodev wrote:
         | If you're based in Europe you could launch it on the AltStore.
        
       | NelsonMinar wrote:
       | 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 wrote:
         | 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 wrote:
           | 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 wrote:
             | 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 wrote:
         | 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_Not...
        
         | elric wrote:
         | I don't think the apple watch is as accurate as they claim, and
         | it seems to need many nights of data to make a sleep apnea
         | decision, so in that respect it is vastly inferior to
         | polysomnography. But hey, if it helps more people seek a proper
         | diagnosis, then I'm all for it. Sleep apnea sucks. It seriously
         | ruins lives.
         | 
         | Also: SpO2 is less useful here than you might think. Most at-
         | home sensors are pretty unreliable, and it's possible to have
         | sleep disordered breathing without having significant
         | desaturation.
        
           | firesteelrain wrote:
           | Well if you already have an Apple Watch and don't want to
           | spend the night plus potential sleep study cost (can be above
           | $1000 for a lot of people), then this may help someone.
           | Especially if they don't even know.
           | 
           | I have sleep apnea and used Lofta's service for $187 and paid
           | for the machine out of pocket. So there is definitely a need
           | for this type of testing.
        
         | hinkley wrote:
         | Are the patent issues just refusing to pay now or are they more
         | complicated than that?
        
       | alex_lav wrote:
       | 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 wrote:
         | 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 wrote:
         | "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.
        
       | whatnotests2 wrote:
       | Now we know why it's called Apple Watch.
       | 
       | It watches you.
        
         | FabHK wrote:
         | 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 wrote:
         | That's precisely why I got one.
        
       | tw04 wrote:
       | 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 wrote:
         | It takes like 20 minutes to charge the watch. Just don't wear
         | it for that time
        
           | tw04 wrote:
           | 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 wrote:
             | 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.
        
         | Arubis wrote:
         | At the risk of sounding like a shill, you can get by on the
         | Apple Watch ecosystem's battery life. The charge time is really
         | quick, so throwing it on the charger while showering each day
         | is sufficient.
         | 
         | Your point that a 36 hour battery life on a watch is pretty
         | inconvenient stands. I have an Ultra 2 almost entirely because
         | it can be described as an Apple Watch with a slightly more
         | reasonable battery life. That's a price I don't expect most
         | folks to pay.
        
           | tommi wrote:
           | The 36 hour battery life also isn't a best-case scenario.
           | According to apple.com
           | 
           | "All-day battery life is based on the following use: 90 time
           | checks, 90 notifications, 45 minutes of app use, and a
           | 60-minute workout with music playback from Apple Watch via
           | Bluetooth, over the course of 18 hours;"
        
           | servercobra wrote:
           | This is the approach I take and it works well enough to let
           | me wear it while sleeping. With a USB-C charger (faster) and
           | not putting it back on until I'm all done getting ready, I
           | rarely have to charge outside of showering.
        
         | tracerbulletx wrote:
         | It is a bummer not to have Garmin like battery life, but it
         | takes like 15 minutes to charge so you just sit it on the
         | charger while Itake a shower or something or while im working
         | and other than that I can wear it all the time. Battery life is
         | mostly an issue if trying to do a long hike, need a garmin for
         | that.
        
         | copperroof wrote:
         | I charge it when I shower.
        
         | hakanderyal wrote:
         | Everyone sets their own routine. I charge it every morning when
         | I start working. Takes about an hour.
         | 
         | It is manageable, but really sucks.
        
         | bombcar wrote:
         | When I come home from my morning walk, I'm usually a bit hot
         | and sweaty, and it feels good to sit down and take the watch
         | off and throw it on the charger. 10-30 minutes is enough for it
         | to charge; I wish it would ding when full.
         | 
         | If it lasted 36 hours that would be enough for me to sleep with
         | it.
        
           | bryceacc wrote:
           | your phone should get a notification when its full!
        
             | bombcar wrote:
             | It does - but by then I'm working and don't look at it, and
             | forget until I stand up a few hours later.
        
         | anotherboffin wrote:
         | I'm on Garmin watches as well but this line of thinking is
         | getting old. Partner has an Apple Watch and they charge it
         | while in the shower/getting dressed and occasionally 10-15
         | minutes in the evening to make sure it gets through the night.
         | Charger is in a convenient location and it's dead easy to drop
         | the watch on it. If you're running ultras, then by all means
         | stay on Garmin. But honestly for the day to day I've rarely
         | seen it be an issue.
         | 
         | ETA: there's plenty of valid reasons to prefer other watches
         | (ANT+ compatibility being one of mine) but honestly the battery
         | life thing is really not that bad for most users.
        
           | rtkwe wrote:
           | Same ish pattern for me on my Pixel Watch (2 mabye?) unless I
           | forget there's plenty of time to keep it topped up for a day
           | and change of use with just a quick charge in the mornings.
           | There's plenty of time I don't need a watch on to give it a
           | quick top up.
        
         | boesboes wrote:
         | How does this relate to sleep apnea detection?
         | 
         | I agree the battery life is shit compared to Garmin, but then
         | you need to compare features and usability too. And as a long-
         | time Garmin owner I am 100% certain that is not a fair
         | comparison either.
        
           | tw04 wrote:
           | >How does this relate to sleep apnea detection?
           | 
           | Because every friend I've talked to about the apple watch
           | tells me charging isn't a big deal because they just throw it
           | on the charger at night with their phone and use it in the
           | morning. If I'm wearing it all night to track sleep apnea,
           | when do I charge it? Per my original post. It looks like it
           | takes an hour and a half to do a full charge, so it's not
           | like you can just throw it on the charger for 15 minutes in
           | the morning while getting ready for work.
        
             | buzzerbetrayed wrote:
             | There are already numerous people in this thread saying
             | that they charge it while showering in the morning and that
             | is enough.
        
         | spike021 wrote:
         | My Series 6 Apple Watch lasts from about 8am to midnight every
         | day. If I wanted to sleep while wearing it I'd just take it off
         | around 11pm and it'd be done charging almost every time by
         | midnight, sometimes even sooner.
         | 
         | I used to religiously wear Pebble watches because they lasted
         | forever between charges. But in all honesty I just don't find
         | the one day battery life of AW to be that bad considering how
         | quickly they charge. IMO they do have all-day battery.
        
         | FabHK wrote:
         | How is 36 hours different from 3600 hours, in your scenario?
         | Either way, you need either need two watches, or not wear it
         | sometimes.
         | 
         | The answer is, of course, that sometimes you don't wear it, but
         | charge it. Like a few minutes in the morning and/or a few
         | minutes in the evening while you shower or eat or whatever.
         | Done.
        
           | eitally wrote:
           | The difference is that you don't need to do it every day. On
           | the one hand, it's pretty easy to "multitask", like charging
           | while while brushing/flossing, shaving, etc. But it's
           | certainly much easier to not have to think about charging it
           | at all in the evening basically ever, which is the joy that
           | Garmin users have.
           | 
           | I currently have an Epix Pro and I use it to track a 45-90min
           | workout about 6 days a week. I also have it set to "most
           | accurate" (GPS + Galileo + GNSS) positioning and to sample
           | blood oxygen all day rather than just at night, so it's
           | getting quite a battery workout for a non-ultra-endurance-
           | athlete user. When I opened this thread I decided it was a
           | good time to charge it, since I'm in a work call anyway, and
           | it was only at 53% after about a week since the last charge.
           | I'll have it plugged in for 20-3min and it'll probably be
           | around 90% when I put it back on after the meeting, and I'll
           | find some other convenient time next week... but not until
           | next week.
        
             | cruano wrote:
             | See you say that but I know if I had 5-day battery I'll
             | keep forgetting about it. Happens with my airpods all the
             | time.
             | 
             | But Apple Watch is part of my routine, same as with the
             | iPhone.
        
         | Jtsummers wrote:
         | > 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?
         | 
         | That only makes sense if you think it takes 12+ hours to
         | charge. 20 minutes on the charger in the morning while I'm
         | taking a shower and getting dressed and it's fine for the next
         | 24 hours. Oh no, I can't wear it in the shower. I wasn't going
         | to anyways.
        
           | ballenf wrote:
           | You're going to miss out when Apple expands the hand-washing
           | nag to hair washing.
        
             | Jtsummers wrote:
             | "'Wash. Rinse. Repeat.' You didn't repeat."
             | 
             | - This was just a quick rinse
             | 
             | - I already repeated
        
         | Kirby64 wrote:
         | You're not supposed to wear it while you shower (soap is
         | generally bad for any waterproof seals...). Just slap it on the
         | charger while you shower. Or slap it on the charger when you
         | wake up, during your usual morning routine. It's a bit of a
         | change of paradigm from the 'charge while you sleep' that we do
         | with phones, but you get used to it.
        
           | tw04 wrote:
           | So you're telling me a 20 minute charge is going to get you
           | through 24 hours with a workout every day? That just seems
           | unlikely to me based on everything I've read.
        
             | Kirby64 wrote:
             | If you're working out every single day, probably not. But
             | it should absolutely be plenty to get you through a day and
             | then you can top it off for another 10-15 mins before bed.
             | It'll even give you an alert informing you it needs
             | charging to make it through the night at the appropriate
             | time before your configured "wind down" period so you can
             | charge right before bed.
             | 
             | Lower states of charge will charge faster, so 2 smaller
             | charging sessions would result in less total time spent
             | charging, actually.
        
         | outworlder wrote:
         | > in practice this feature seems almost useless to me
         | 
         | Maybe to you, assuming you don't have sleep apnea.
         | 
         | Far too many people have it and it goes undiagnosed. Until that
         | person goes on to have a stroke, heart attack or sleeps at the
         | wheel.
         | 
         | It's a silent killer and I suspect we have an epidemic.
        
           | tw04 wrote:
           | You're missing the point. It's not useless as a feature in a
           | vacuum. It seems useless on a device that needs to be charged
           | every night to be used during the day. I'm extremely
           | skeptical of the folks saying they only need to charge for 20
           | minutes to get by for 24 hours when the specs say other wise
           | and friends that have Apple Watches say otherwise as well.
        
         | nerdjon wrote:
         | Don't get me wrong, a better battery would be great. But the
         | only time I ever run into issues with my apple watch dying is
         | when I am traveling and my routine is messed up anyways.
         | 
         | Otherwise I am just in the habit of waking up, sticking it on
         | the charger, getting ready for my day and putting it back on.
         | Doesn't take long to get to a full charge.
         | 
         | I get access to all of the features and just loose it for 30
         | minutes to an hour.
        
         | petesergeant wrote:
         | I charge when I'm in the shower each day and this works fine
         | for me.
        
       | efsavage wrote:
       | Does this mean that you could be prescribed an Apple Watch if you
       | were at risk of apnea? Or even use an HSA?
        
         | Bluecobra wrote:
         | I have been really curious to this. In IRS Publication 502, it
         | states: "Medical care expenses must be primarily to alleviate
         | or prevent a physical or mental disability or illness."
         | 
         | You could make the argument that the Apple Watch can be used to
         | manage your sleep apnea condition. On the off chance you get
         | audited by the IRS you might just be better off paying for it
         | with non-HSA funds rather than dealing with that mess.
         | 
         | PSA: HSA expenses are based on the honor system, but obviously
         | don't go to Best Buy and buy a PS5 on a HSA debit card. You are
         | allowed to reimburse yourself for medical purchases. For
         | example, if you have a large ticket medical expense you can use
         | a credit card that provides a perk like air miles and then just
         | transfer the funds from your HSA checking account to your
         | regular checking account. Just remember to keep detailed
         | records/receipts.
        
         | tantalor wrote:
         | 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 wrote:
           | 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 wrote:
             | 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.
        
         | rootusrootus wrote:
         | No, the watch is not a medical device intended to treat
         | something. Just a general fitness device. Even the built-in EKG
         | doesn't qualify it for HSA, and that is a lot closer to being
         | medical than a notification pop-up saying you might want to ask
         | your doctor to test you for sleep apnea.
        
       | blackeyeblitzar wrote:
       | 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 wrote:
         | 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 wrote:
         | > 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.
        
         | elric wrote:
         | > They claim it is so they know your air pressure numbers but
         | it is all just regulatory capture
         | 
         | I disagree. In lab titration is not about regulatory capture.
         | It's the best place to get a good ballpark start. The rest
         | should be up to the patient, but informing the patient of that
         | is where things go wrong, alas.
         | 
         | > CPAP machines can auto adjust your pressure and people like
         | to tweak numbers manually to their comfort level anyways.
         | 
         | They cannot. See my rant about APAP in the comments here, or my
         | previous APAP rants in my history. Current generation APAP is
         | awful and it needs to die. PAP machines are awful at detecting
         | events. This could probably be partially mitigate with better
         | software. But there is a reason why a sleep study is very much
         | the gold standard. 12+ channels of valuable information. Versus
         | 1 channel on the PAP device.
        
           | blackeyeblitzar wrote:
           | Current generation APAP works great - not sure why you're
           | calling it awful. And I disagree that more channels are
           | necessary - that's a statistical implication that not true in
           | general and shouldn't be assumed blindly here. What needs to
           | die is regulatory capture and bureaucratic barriers that take
           | health care out of patients own hands, which is what the
           | sleep study scam does, at least in the US, where you cannot
           | get a CPAP/APAP device otherwise.
        
       | swyx wrote:
       | > 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 wrote:
         | The announcement said that the feature was pending FDA
         | approval.
        
         | nobrains wrote:
         | 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 wrote:
           | 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 wrote:
       | Is any VC guy here that is interested in medical devices? I would
       | have something for you.
        
       | nox101 wrote:
       | 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 wrote:
         | 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_ wrote:
           | 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 wrote:
           | > 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=33737577
           | 
           | https://news.ycombinator.com/item?id=35133917
           | 
           | https://news.ycombinator.com/item?id=22146082
           | 
           | https://news.ycombinator.com/item?id=22705122
           | 
           | https://news.ycombinator.com/item?id=4013799
        
             | yreg wrote:
             | Those are all Google, argsnd is talking about Apple. But
             | I'm sure one can get randomly banned by Apple as well.
        
         | yreg wrote:
         | You don't lose your HealthKit data when your AppleID gets
         | banned. The data is still on your phone.
         | 
         | You can also backup your phone outside of iCloud.
        
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