Apple Watch sleeping respiratory rate: how to read a higher-than-usual value

Sleeping respiratory rate means breaths per minute

One inhalation and exhalation counts as one breath. Apple Watch estimates how many breaths occur per minute during sleep and saves the figure in Health.

On iPhone, you can see the nightly range and daily, weekly or monthly trends. The number does not directly measure depth of breathing or blood oxygen.

There is no universal normal value

Apple does not give one normal range or diagnostic threshold for everyone’s sleeping respiratory rate. Age, body size, sleep stage, health and measurement method can affect the value.

A 2021 wearable study of healthy adults found 90% of nightly respiratory rates between 11.8 and 19.2 breaths per minute, with a mean of 15.4. It used Fitbit devices and a proprietary algorithm, however, and all authors were affiliated with Fitbit. It cannot define normal and abnormal Apple Watch values.

First review several weeks when you feel well to learn your own usual range. A reading of 18 differs from usual in someone normally at 14–16 in a different way than in someone normally at 17–19.

For a higher reading, check conditions and the previous night

A single higher night does not immediately mean illness. Review measurement conditions and what happened around that time. Apple notes that medications, altitude, alcohol and illness may affect overnight Vitals measures.

Wearable research has found relationships between nighttime respiratory rate and heart rate. Some people also show higher-than-usual respiratory rates during respiratory infections. A high value alone cannot identify the cause.

• Nasal congestion, cough, feeling feverish or another health change
• Alcohol, medication or other unusual circumstances
• A large altitude change during travel or climbing
• Sleeping heart rate or wrist temperature also differs from usual
• The watch was loose, came off, or sleep was short

Breathing speed and breathing disturbances are different measures

Respiratory rate describes breathing speed in breaths per minute. Breathing Disturbances is a separate feature that analyses wrist movement during sleep and classifies a night as Elevated or Not Elevated.

Sleep apnoea notifications use at least 10 nights of data within 30 days. Repeatedly elevated disturbances can prompt notification of signs of possible moderate-to-severe sleep apnoea.

Two nights may have the same average respiratory rate even if breathing was steady on one and disrupted on the other. A high rate therefore cannot diagnose sleep apnoea, and a usual rate cannot rule it out.

• Sleeping respiratory rate: breathing speed in breaths per minute
• Breathing Disturbances: classifies a night as Elevated or Not Elevated
• Sleep apnoea notifications: analyse a 30-day pattern of breathing disturbances

Four steps after a higher night

1. Separate one night from a continuing change

   Switch to week or month view instead of concluding from one night. See whether subsequent readings return to your usual range.

2. Check other overnight measures

   Review whether sleep duration, sleeping heart rate, wrist temperature or breathing disturbances also differ from usual.

3. Note the preceding day’s circumstances

   Briefly record anything unusual, such as alcohol, medication, altitude, congestion or feeling feverish.

4. Put symptoms first

   Prioritise actual breathlessness, cough, fever or marked fatigue over whether the number falls in a particular range.

Five checks when data is missing

1. Check sleep tracking

   In the iPhone Watch app or Health, check that Track Sleep with Apple Watch is enabled.

2. Sleep wearing it for at least an hour

   Apple recommends sleeping with Apple Watch on for at least one hour to obtain sleep data.

3. Charge to at least 30% before bed

   If the battery runs out during sleep, recording stops. Charging reminders are also available.

4. Check fit

   Wear it neither too tightly nor too loosely, with the back maintaining contact with your skin.

5. Check respiratory-rate settings

   On Apple Watch, go to Settings → Privacy & Security → Health → Respiratory Rate and check that measurement is not turned off.

Where to find sleeping respiratory rate on iPhone

1. Open Health

   Open the Health app on your iPhone.

2. Choose Respiratory

   Tap Browse/Search at the bottom, then choose Respiratory.

3. Open Respiratory Rate

   Choose Show More Respiratory Rate Data to view the sleeping range in the Sleep section.

4. Check the period and source

   Switch to week or month view. Show All Data lets you check record times and sources.

Seek advice if higher rates or symptoms persist

One unusual night does not necessarily mean illness. But consult a clinician if higher values persist, you have cough or fever, someone reports heavy snoring or breathing pauses, or you experience marked daytime sleepiness.

For severe breathlessness, chest pain, unusual lip colour or clouded awareness, do not wait for Apple Watch numbers or notifications. Use local emergency or medical services.