The new wearable looks good, but does it make you healthier?
[View this email in your browser]( Why is everyone wearing the Oura Ring? Sleep tracking sounds like a dream. You get a gadget that tells you how you slept and then gives you tips on sleeping better and â boom â youâre better rested. As a parent of a young child, I know this is not how it would work for me, but Iâve been feeling desperate lately. If Iâm sleeping less, then maybe with the help of a wearable, I could simply sleep smarter. Thatâs how I got drawn into the promise of the Oura Ring, a $350 device you wear on your finger to track a number of different health metrics, including sleep. Youâve probably [seen a celebrity wearing one]( in the tabloids. Mark Zuckerberg [wears one to optimize his sleep](. The big problem is that wearables donât come with any guarantees. This fall, weâve seen these gadgets gain new abilities like [detecting sleep apnea]( and [working as hearing aids](, making wearables seem more and more like medical marvels. However, research over the years has shown that doctors donât currently find data from these devices very useful in a clinical setting, and left to their own devices, consumers might feel worse when using a wearable. The positive effects of sleep trackers, in particular, are difficult to nail down. But if I just wanted a few data points to direct me toward better habits, surely a little ring couldnât hurt. After spending a couple of days scouring medical journals in order to make a better decision about what a wearable could do for my sleep, however, I now feel more exhausted than ever. Buying a new gadget wonât fix that for a number of reasons. Nevertheless, if youâre thinking about using a wearable to improve your health, itâs helpful to know where the marketing stops and the proven benefits begin. Despite what the marketing suggests, very few wearables are FDA approved The Oura Ring 4, [out this week](, uses a variety of lights and sensors to measure your heart rate, respiration rate, blood oxygen, temperature, and movement. For an extra $6 monthly membership fee, you get access to things like detailed sleep analysis, advanced temperature monitoring, and reproductive health insights. The ring doesnât have a screen; it connects to your phone via Bluetooth so you can see all your health data there. The Oura Ring âis not a medical device.â This is the first thing the companyâs PR team told me when I reached out to them for this article. In its marketing, however, Oura does bring up the potential health benefits often, and it [promotes its medical advisory board]( prominently on its website. Jason Russell, Ouraâs vice president of consumer software, explained that the company is tapping into a real demand. âPeople want to understand their bodies and live long and healthy lives, but they donât want another tech device to manage,â Russell said, flagging the discreteness of the Oura Ring. Even royalty wear Oura Rings: Prince Harry, Duke of Sussex, was spotted wearing the device on a trip to Melbourne, Australia, with Meghan, Duchess of Sussex, in 2019. (Scott Barbour/Getty Images) You can also [use your health savings account (HSA) and flexible spending account (FSA) funds]( to buy an Oura Ring, which is confusing since youâre only supposed to use those [for medical and dental expenses](. The Oura Ring does not have FDA clearance, although it [can be used with the FDA-cleared Natural Cycles app]( for menstrual cycle tracking. According to some reviewers, it is [especially useful for women]( for this very reason. Natural Cycles [describes itself as]( âa hormone-free alternative to the pill that is 93% effective with typical use.â This maze of regulations and clearances makes it hard to know if the Oura Ring, which is being marketed [as a device that can improve your health](, comes with real medical benefits. The same is true for other wearables, like the Apple Watch, which recently [got FDA clearance for detecting sleep apnea](. Thatâs on top of the device [being FDA-cleared]( for detecting irregular heart rhythms and for recording electrocardiograms. (Smartwatches and fitness trackers from Google, Samsung, and Fitbit have similar clearances.) Even Apple AirPods Pro got clearance from the FDA this year for a new feature that turns them into â[the first over-the-counter (OTC) hearing aid software device](.â None of these devices are FDA approved. Thereâs a difference between FDA approval, which is a very involved process, and the less rigorous FDA clearance. Thereâs also a third designation called âde novo classificationâ reserved for low-risk devices that donât already exist in the market. (The new hearing aid feature on the AirPods Pro got this designation recently.) The FDA acknowledges that its name gets tossed around in misleading ways, so much so that it has [a whole explainer on what FDA approval actually means](. So even though I can use this yearâs leftover FSA dollars to buy an Oura Ring, the FDA has not put its stamp of approval on the device. Thanks to its partnership with Natural Cycles, the Oura Ring does enjoy a bit of that FDA-cleared glow, but that has nothing to do with the rest of its features. In any case, youâd be forgiven for thinking a device you can buy with [funds set aside for health care costs]( from a company that [name-checks the FDA]( in its press release would lead to health benefits. When it comes to wearables, this isnât always the case. What wearables do for our health At the end of the day, you might not need a stamp of approval from a government agency to know whether a gadget is useful to you. I bought an Apple Watch not because I wanted something to alert me of an irregular heartbeat but because I liked getting notifications on my wrist. Itâs easier to glance at a text message on my watch than it is to pull out my phone. The fitness tracking that comes with the watch is a bonus, and I can confidently say I move my body more because my watch [tells me to](. Research suggests that smartwatches and other fitness trackers are best at this. A systematic review covering nearly 200,000 study participants [published in the Lancet]( in 2022 found that wearables indeed improved physical activity and helped people lose weight. People who wore fitness trackers walked an extra 1,800 steps a day, on average. But they had little effect on other health markers, including blood pressure and cholesterol. A smaller meta-analysis in the BMJ, a peer-reviewed journal from the British Medical Association, [showed similar conclusions](: over 1,200 extra steps a day. Fitness tracking, it seems, leads to better fitness. Sleep tracking is not so clear-cut. Whether it's on your wrist, [under your mattress](, or wrapped around your finger, a sleep tracker will measure everything from your movement and body temperature to your heart rate and blood oxygen in order to determine how long youâve slept and how well. The idea here is that by having more details about how you slept, you could link what you did before bed â say, rigorous exercise, drinking, or doomscrolling on your phone â with your quality of sleep. If bad habits lead to bad sleep, you can stop the bad habits. The new Today tab (left) and Vitals tab (right) in the Oura App serve as dashboards to view various data collected by the Ring. (Oura) Many sleep trackers will crunch all that data through an algorithm that spits out a score. (The Oura Ringâs app [gives you three scores](: one for sleep, one for activity during the day, and one for âreadinessâ which tells you on a scale of 1 to 100 how ready you are for the day.) Experts warn that these scores can be arbitrary, [if not downright useless](. Plus, most trackers canât directly measure brain activity, which is the standard for diagnosing sleep disorders. Furthermore, obsessing over sleep data, scores, and metrics [can actually increase anxiety and lead to worse sleep](, according to a recent study from the American Academy of Sleep Medicine. Itâs possible that some of this data could come in handy in a clinical setting. Newer Apple watches can perform an ECG thatâs roughly as good as what youâd get in a doctorâs office, [according to one study](. The problem is, for now, [itâs not always easy]( for doctors to get access to the data collected by wearables. This is not to say that doctors arenât optimistic about a future in which they can access that data. Many doctors [tell their patients to buy wearables]( and use them to help manage disease, especially heart-related issues that devices like the Apple Watch are designed to detect. Medical device or not, all wearables come with benefits and drawbacks, largely depending on how you use them. The Oura Ring rabbit hole I fell into left me feeling more confident about how I was using the one wearable I own, my Apple Watch. It also talked me out of buying an Oura Ring. To be clear, I havenât tried the new Oura Ring, and for now, Iâm holding off. Even though I do have some FSA funds to spend before the end of the year, I think the sleep-tracking function would make me anxious in the long run. At this phase of my life, sleeping smarter isnât exactly an option. I simply need more hours in the day, and that gadget has not been invented yet. â[Adam Clark Estes](, senior technology correspondent Getty Images [The shady origins of the climate haven myth]( How the media, city mayors, and the real estate industry filled us with false hope. [These remote workers moved to Portugal for work-life balance. Is their life as fun as it looks?]( For the Portuguese, the answer is complicated. [A woman uses her smartphone while surrounded by debris in the aftermath of Hurricane Helene in Bat Cave, North Carolina.]( Sean Rayford/Getty Images [Your iPhone is probably a satellite phone. Hereâs how it could help you.]( Cell towers in space are more capable than ever of helping people on the ground. [Californiaâs governor has vetoed a historic AI safety bill]( SB 1047 would have been a landmark in AI safety. Gavin Newsomâs veto is a major setback in the fight against AI risk Getty Images for REVOLVE [Venmo and Chime donât have fees. 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