Recently, technology has brought us fitness trackers and smart watches that can help us track our workouts, daily steps, and even monitor our sleep, stress, heart rate, and blood oxygen levels.
However, smart rings have become another way to track our health, and can be used to monitor movement, body temperature, sleep, heart rate, stress, as well as menstrual cycles.
Unlike smartwatches, smart rings don’t have screens to view these health metrics. Instead, they use a Bluetooth connection to send health data to your smartphone.
When a smart ring detects a person’s cardiovascular health, it uses infrared photoplethysmography technology (PPG), which uses a light source and a photodetector on the surface of the skin to measure the variations in blood circulation. These variations can estimate heart rate variability, blood oxygen saturation, blood pressure, and artery stiffness.
Out of the different sensors a smart ring has, the PPG is the most studied one due to its proposed accuracy in tracking heart rate and monitoring overall cardiovascular health. However, most studies note that they are significantly less accurate than medical-grade technology.
According to the National Library of Medicine, in a study with 35 healthy individuals, researchers compared the heart rate and heart variability measured by a smart ring with an ECG during the night. Results showed that some health parameters matched the medical-grade measurement, but most were inaccurate.
To monitor body temperature, smart rings use a sensor called a thermistor, which estimates body temperature based on a person’s skin temperature. Smart rings also use this feature to assess stress levels and identify other bodily issues. However, a systematic review of the sensors and functionalities of wearable health technology, like a smart ring, indicates that these devices may not accurately indicate a person’s core body temperature, as researchers point out that a person’s skin temperature is a few degrees Fahrenheit lower than their body’s temperature.
What’s more, researchers emphasize that a person’s skin temperature fluctuates based on environmental conditions. When considering these two factors, it may be assumed that the thermistor sensor won’t be accurate.
Companies that produce smart rings have detailed the use of a variety of sensors to support women’s health. This feature relies mostly on the smart ring’s temperature feature, which they claim to use to track menstrual cycles and fertility windows.
Numerous studies have examined the accuracy of smart rings, which have produced promising results. According to the National Library of Medicine, in a pilot study with 22 participants, researchers used a smart ring to analyze temperature changes during the menstrual cycle. They discovered that the temperature readings were consistent with oral temperatures that were taken with ambulatory equipment.
In a separate study with 26 participants, it was found that this study was consistent with the previous study’s findings, demonstrating that smart rings could be a beneficial tool for monitoring menstruation. This study also detected that there was a significant temperature drop around ovulation, highlighting that smart rings could be an additional tool to track fertility.
Although these results are promising based on limited studies on smart rings, further research is needed as they are not 100% accurate.
Most of the smart rings on the market combine various metrics such as heart rate, heart rate variability, body temperature, and movement, to estimate a person’s daily stress levels and provide tips to reduce them.
According to the National Library of Medicine, research suggests that there is a connection between stress and decreased parasympathetic regulation, the regulation that affects heart rate, heart rate variability, and respiratory rate. These are changes that a smart ring could potentially detect.
Additionally, a study with 525 college students explored this subject further. The study indicated that sleep data from smart rings could help predict stress. Notably, some experts do not consider smart rings as promising as research, as they highlight the negative effect smart rings may have on mental health. The reason is that while smart rings are promoted as a tool to shift lifestyle habits, they may cause the opposite effect, noting that constant monitoring of health metrics can create obsessive behaviors and paranoia about a person’s well-being. It could also be harmful to a person’s self-confidence, as a person may feel like they are not meeting the expectations and goals that a smart ring sets for them.
Smart rings can perform a sleep analysis by tracking a person’s heart rate, blood oxygen, and sleep cycles. They may also include features, such as a snoring score and a recovery metric that indicates energy levels before a person starts their day.
Polysomnography (PSG) is used to track sleep, which uses a variety of signals such as brain activity, eye movements, muscle activity, blood pressure, heart rate, and more. Although smart rings are not as accurate as PSG, researchers have been drawn to them due to the smart ring’s potential to monitor a person’s sleep at home comfortably.
Any current evidence on smart rings for tracking sleep is still very limited and conflicting. While some small studies highlight their potential. However, studies with bigger sample sizes indicate that smart rings can over- or underestimate some sleep parameters. A study in the National Library of Medicine compared the accuracy of several health technology devices on 35 individuals overnight. The study found that a smart ring surpassed the accuracy of smartwatches in various sleep parameters such as wake, light sleep, deep sleep, and REM sleep.
Smart rings can measure a person’s physical activity with two sensors: an accelerometer that tracks movement and speed, and a gyroscope that helps determine orientation. Smart rings gather data from these motion sensors, as well as the PPG and body temperature trackers, to understand how physical activity affects the body.
Research is limited in this area; however, a study in the National Library of Medicine focused on the accuracy of smart rings in measuring caloric expenditure and steps. The results indicated that smart rings were far from accurate, causing researchers to note the need to improve these devices, specifically their estimation of energy expenditure.
Another study on step count was consistent with a study that indicated a smart ring overestimated step count, compared to a medical-grade device to detect motion called ActiGraph.
A systematic review on wearable tech devices supported the findings of the studies, noting that they may be useful for estimating step count but shouldn’t be trusted to measure calorie expenditure.
Smart rings and other wearable devices that can track a person’s health can be useful. However, it is important not to use them to self-diagnose conditions. It is important to see a healthcare provider when experiencing any symptoms to professionally diagnose conditions.
If you are experiencing any medical problems, you can schedule an appointment at Jamaica Hospital Medical Center’s Ambulatory Care Center. Please call (718) 206-7001.
All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

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