Digital Sleep Medicine: from Cognitive Therapy to the Apple Watch

We trust fitness trackers to count our steps and calories, but can we trust a smartphone or watch with our sleep? It turns out, yes, provided we are talking about apps that have undergone clinical trials and received medical approval. Let’s look at three digital solutions that go beyond collecting data to actually diagnosing and treating sleep disorders.

𝐒𝐥𝐞𝐞𝐩𝐢𝐨,  developed by Big Health UK, is presented as a full cognitive behavioral therapy (CBT) program. Users follow an online course with personalized exercises, a sleep diary, and algorithmic support. Effectiveness was confirmed in a 2012 randomized trial: patients using Sleepio experienced improvements comparable to in-person CBT sessions. In 2020, more than 7,000 people participated in the service-evaluation program, with a 56% reported improvement in sleep quality. FDA-cleared as a Class II “computerized behavioral therapy device for insomnia”, CE-marked (Class I).

𝐒𝐥𝐞𝐞𝐩𝐂𝐡𝐞𝐜𝐤𝐑𝐱 uses a smartphone’s microphone to record breathing and snoring during sleep. Machine-learning algorithms then assess the risk of obstructive sleep apnea (OSA). The app is designed for home use without extra devices — just place the phone next to the bed. In 2022, the FDA authorized it for preliminary OSA screening. 

How does it work? A physician provides a code for downloading the app. After answering basic questions (age, sex, body parameters, STOP-BANG test), the user activates the recording before sleep. In the morning, the iPhone analyzes the sounds and shares a risk assessment (low, medium, or high) with the physician via a portal.

In 2022, the app’s developer, ResApp Health, was acquired by Pfizer, which confirmed plans to continue SleepCheckRx’s commercial rollout — though this has not yet materialized.

𝐌𝐞𝐚𝐧𝐰𝐡𝐢𝐥𝐞, the latest Apple Watch models (Series 9, 10, and Ultra 2) have introduced a built-in screening feature for obstructive sleep apnea, similar to what SleepCheckRx offered. The watches use an accelerometer and respiratory micro-movement sensors to detect characteristic pauses in breathing.

The algorithm was assessed in a clinical validation analysis, assessing 3,936 nights of sleep. Findings come from Apple’s white paper (peer-reviewed replication is pending) but the technology is compelling enough to be approved as a Class IIа by the Australian Therapeutic Goods Administration — an update Apple announced in July.