Are Health Trackers Making Us Healthier, or Just More Anxious?
Wearables now flag everything from irregular heartbeats to dips in blood oxygen, but the data is only as useful as a person’s ability to interpret it. Doctors say the real question isn’t whether to trust the alert. It’s what to do next.
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Somewhere between the Apple Watch buzzing at 2 a.m. and the Oura Ring’s morning readiness score, a lot of people have started treating their wrist like a diagnostic lab. Smart rings, fitness bands, and continuous glucose monitors have turned health tracking into a daily habit and the data they generate can be genuinely useful. But it can also send someone into a spiral over a heart rate blip that actually means nothing at all.
The Wearable Health Metrics That Actually Matter (and the Noise to Ignore)
The metrics worth paying attention to are narrower than most dashboards suggest. Heart rhythm monitoring tops the list. Roughly a third of people will develop atrial fibrillation at some point in their lives, according to a cohort study published in The BMJ, often without any symptoms, and even short, silent episodes raise the risk of stroke and heart attack. Sleep tracking matters too: a 2026 study in JACC: Advances found that adults with healthy, multidimensional sleep patterns had significantly lower all-cause mortality and gained as much as three years of life expectancy compared with those who slept poorly.
Heart rate variability, a measure of how much the time between heartbeats fluctuates, is a reasonable proxy for cardiovascular fitness and recovery, and a 2021 systematic review in the Journal of Science and Medicine in Sport found that training adjusted to a person’s HRV produced better outcomes than a fixed plan, useful mainly because it lets someone see whether changes like cutting back on alcohol or sleeping more are actually moving the needle.
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And drops in blood oxygen during sleep can be one of the earliest signs of undiagnosed sleep apnea, a condition the U.S. Preventive Services Task Force links to elevated cardiovascular risk in its 2022 recommendation statement, but one that’s treatable once caught. Most of what a wearable flags day to day isn’t any of that. It’s noise. A loose band, a sweaty wrist, an arm pressed wrong against a pillow, and there’s an alert for an elevated heart rate that has nothing to do with the heart at all.
Dr. Scott Braunstein, double board-certified in internal medicine and emergency medicine and Chief Medical Officer at Sollis Health, a membership-based medical practice that gives patients direct, around-the-clock access to physicians, sees this play out constantly. Many of the alerts patients bring in, he explains, turn out to be artifacts caused by movement or poor skin contact rather than anything physiological. Patients, according to Braunstein, “often don’t know whether they’re looking at a false alarm or an early sign of something meaningful.”
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Smartwatch Heart Rate Alerts: When to Worry vs. False Alarms
Braunstein has also seen alerts catch something real. He describes a patient whose Apple Watch flagged a heart rate that had stayed elevated for several days. When she came in, the workup turned up not just a fast heart rate and high blood pressure, but severe thyrotoxicosis, a dangerous overactive thyroid condition that required urgent lab work and treatment before she stabilized. “The device identified that something was wrong,” Braunstein notes, “but it couldn’t determine the cause. Patients still need access to medical expertise, testing, and treatment to understand what the data actually means.”
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According to Braunstein, the alerts worth taking seriously are notifications suggesting an irregular heart rhythm, low oxygen readings during sleep or exercise, and any sustained shift away from a person’s normal baseline, especially alongside chest pain, shortness of breath, dizziness, fainting, or a racing heartbeat. The ones that tend to cause unnecessary alarm are brief, isolated readings: an elevated heart rate for twenty minutes with no symptoms attached, the kind of thing that resolves on its own. “A wearable notification alone rarely tells the full story,” Braunstein points out. “The patient’s symptoms, medical history, and any additional testing are often far more important than the alert itself.”
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The Truth About Sleep Scores and the Value of Resting Heart Rate
The nightly sleep score, meanwhile, is the metric getting the most attention and arguably the least deserving of it. Those scores tend to overstate sleep disturbance, according to Braunstein, partly because true sleep staging requires polysomnography, the kind of brain activity monitoring done in a sleep lab, something no consumer device can replicate. A more reliable habit is tracking sleep duration alongside heart rate and oxygen levels overnight.
The metric that gets ignored, by contrast, is resting heart rate, which Braunstein describes as one of the simplest numbers to track and one of the most informative. A lower resting heart rate generally tracks with better cardiovascular conditioning, and a shift away from someone’s own baseline can be an early signal of declining fitness, dehydration, illness, or poor recovery, long before any single dramatic alert would catch it.
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Braunstein sees the rise of wearables as a net positive overall. Patients tell him the data has motivated them to exercise more consistently, sleep better, drink less, and manage stress, even as a smaller group gets overly fixated on individual numbers. “The real value,” he explains, “comes from having timely access to medical expertise that can help you interpret the data and take action when needed.”
The people who get the most out of their data, in Braunstein’s experience, are the ones who treat a single alert as a prompt to check the trend rather than a verdict to panic over, and who know that a doctor, not a notification, is what actually closes the loop.
Dr. Scott Braunstein is double board-certified in internal medicine and emergency medicine and serves as Chief Medical Officer at Sollis Health, based in Southern California.
