How to setup and check respiratory rate monitoring on Apple Watch and iPhone

One of the newest metrics for your Apple Watch to collect as part of its Sleep Tracking feature is your sleeping respiratory rate, also called the at rest respiratory rate. Your sleeping respiratory rate is an important health metric that indicates overall health.

When your respiratory rate is significantly higher or lower than normal while you sleep, that may indicate illness or a health condition. Understanding and interpreting respiratory rates can also be beneficial in understanding your sleep patterns.

Related reading:

• How to track your sleep using Apple Watch or iPhone using third-party apps
• Just a short video clip can now detect your breathing rate, heart rate, and more
• How to set up and use multiple timers on your Apple Watch
• How to turn on High Heart Rate notifications and alerts on Apple Watch
• Apple’s new research shows that Respiratory Rate can be monitored using AirPods or wearables with Audio.

Track your your nighttime respiratory rate over time using your Apple Watch

The Health app now offers excellent sleep comparison charts that dive into metrics like your heart rate and sleeping respiratory rate so you can see any changes while you sleep.

Now, with watchOS (using watchOS8 and higher), you can use your Apple Watch to keep an eye on your nighttime respiratory rate and review that data in the Health app. To get this data, you must wear your watch to bed when sleeping.

The Apple Watch Respiratory Rate feature is for adults only and is not available for children (under 18 years old.)

So lets’ get started.

What is Respiratory Rate?

As the name suggests, it is the number of times you breathe in a minute. Your respiratory rate can increase when your body needs more oxygen (climbing up a flight of stairs) or decrease when you need less while resting.

Breathing in provides oxygen to your body, and breathing out removes carbon dioxide from your body.

The measurements for Respiratory rate are shown as BrPM (Breaths per minute) on the Apple Health app. On other wearables, you might see this as RPM (Respirations per minute).

What is a normal respiratory rate?

The normal respiratory rate for adults at rest is between 12 and 20 times per minute. Children tend to breathe slightly faster at 18 – 30 breaths per minute.

When you work out regularly, your body’s muscles and tissues become more efficient in taking in oxygen. Therefore, the more fit you are, the lower your respiratory rate will likely be.

In terms of Apple device metrics, if you see an increasing trend in your Cardio Fitness level scores, the chances are that your respiratory rate will stay lower with all things being equal. 

Why is a nighttime sleeping respiratory rate lower?

Most people generally breathe slower when they are asleep.

During sleep, your breathing slows, and you take deeper breaths at more regular intervals. One exception to this is when you are in REM sleep ( dreams ), your respiratory rate increases, and you take more shallow and less regular breaths. 

Respiratory rate changes as your body experience different sleep stages.

The respiratory rate is a key metric that your healthcare can evaluate to determine if something is off with your sleeping patterns during the nighttime.

How to track Respiratory Rate using your Apple Watch and iPhone

With watchOS 8+, you can easily track your respiratory rate and review the detailed trends around the metric using the Apple Health app on your iPhone. This function requires that you wear your Apple Watch when sleeping.

Basic Requirements for monitoring Respiratory Rate

1. Apple Watch Series 3 or newer running watchOS 8 and above.
2. iPhone running iOS 15 or later and have.
3. Sleep Tracking is enabled on your Apple Watch.

To use your Apple Watch to monitor your respiratory rate, set up your Bedtime and Wake up time using the Sleep app and enable Sleep Mode.

You can do this directly on your Apple Watch using the Sleep app or set it up using the Watch app on your iPhone.

If this is the first time you are using Sleep monitoring on your Apple Watch, follow these steps: 

1. Open the Watch app on your iPhone.
2. Tap on the ‘My Watch’ tab at the bottom, scroll down, and tap on ‘Sleep.’
3. Select Use this Watch for Sleep.
4. Toggle on Turn On at Bedtime to use the Sleep Focus.
   1. Depending on your watchOS version, you may see instead options to set up your Bedtime and Wake up times. Then, set up Enable Sleep mode.
5. Scroll down and enable Track Sleep with Apple Watch.
6. Toggle off or on any other sleep settings, including having your watch and iPhone show a simplified sleep screen and show the time. You can also choose to get charging reminders.
7. For other sleep options like setting up your sleep schedules, adding a sleep goal, or setting up a wind-down, tap Open Sleep Options in Health.
   1. Set up, add, or edit your Full Schedule.
   2. Add or change your Sleep Goal.
   3. Choose the length of your Wind Down and add shortcuts to your Wind Down, if desired.
   4. Scroll down and select Options.
      1. Access more like Tracking Time in Bed with iPhone, turning on notifications for Sleep Reminders, and when you meet or exceed your sleep goals via Sleep Results.

Enable Sleep tracking and respiratory rate using Apple Watch

You can also enable respiratory rate tracking directly from your Apple Watch without using your iPhone.

1. Open the Sleep app on your Apple Watch. You can also open Settings > Sleep.
2. If you see that Sleep tracking is not enabled on this watch, scroll down and tap Open Settings.
3. Tap Use This Watch for Sleep.
4. Verify that Turn on at Bedtime is toggled on to use your Sleep Focus.
5. Scroll down and toggle off or on sleep’s additional features like simplifying your screens when sleeping and showing the time.
   1. Make you sure toggle on Sleep Tracking to track your sleep.
   2. We highly recommend that you keep Charge Reminders toggled on to ensure your Apple Watch has enough battery juice during the night when monitoring your night-time respiratory rate.
6. Open the Sleep app again.
7. Tap Full Schedule to add or change your sleep schedule.
8. Toggle on Sleep Schedule.
   1. To change a sleep schedule, tap the listed scheduled times and make adjustments.
   2. Tap Add Schedule to add a new sleep schedule.
   3. Scroll down and tap Sleep Goal to set the amount of time you want to sleep.
   4. Tap Wind Down to set the amount of time you want sleep mode to be active before bedtime.

That’s it!

Now you can wear your Apple Watch when you sleep, and it tracks your respiratory rate automatically.

Check Respiratory Rate on your iPhone.

To review your Respiratory rate, open the Health app on your iPhone,

1. Tap on the Browse tab at the bottom of the screen.
2. Next, scroll down on the screen and choose ‘Respiratory.’
3. Select ‘Respiratory rate’ from the options to see your rate.

You can also tap on ‘Show more Respiratory Rate Data’ to see the hourly average, respiratory rate during sleep, and the overall range of the metric.

Where is the Sleep Lock Mode on the Apple Watch on watchOS

Users who manually set up their Sleep Mode using Apple Watch will see that the familiar ‘bed’ icon has been removed from the control center list of toggles on the Apple Watch.

This change has been added since Apple is using the new ‘Focus’ features on iOS 15+.

The Sleep mode toggle has been moved to the Do-Not-Disturb section, which works as a focus selector.

Once you turn on Sleep Mode from the Do-Not-Disturb section, it enables the toggle control in the control center section of your Apple Watch.

Resting Heart Rate vs. Respiratory Rate and HRV

Resting Heart rate is not to be confused with respiratory rate. Resting heart rate is the average heart beats per minute measured when inactive or relaxed for several minutes. 

A lower resting heart rate typically indicates better cardiovascular fitness.

Those who habitually monitor their health metrics must understand the relationship between Resting Heart Rate, Heart Rate Variability (HRV), and Respiratory Rate.

Typically, your respiratory rate increases when your resting heart rate increases and decreases when your RHR ( Resting heart rate) decreases.

While HRV and resting heart rate may change daily, the respiratory rate generally does not. It is a very stable metric for most people.

When there are sudden movements or spikes in respiratory rate, it could signal that your body is coming down with an infection.

 Respiratory rate is the metric that many wearable makers use to help detect the onset of Covid symptoms. 

High Respiratory Rate on your Apple Watch? Here’s what you should know

Respiratory rate is one metric that does not change frequently. If you see weird trends in your respiratory metric, you should reach out to your physician and consult them.

According to ClevelandClinic, a respiratory rate under 12 or over 25 breaths per minute could signal something abnormal.

This could signal conditions for Asthma, anxiety, pneumonia, and other issues.

Respiratory rate is an early, excellent indicator of physiological conditions such as hypoxia (low oxygen levels in the cells), hypercapnia (high levels of carbon dioxide in the bloodstream), metabolic and respiratory acidosis.

It has also been shown as a strong and explicit forecaster of cardiac arrest and unexpected health problems. (Cretikos et al. 2008 study).

Trends of increasing respiratory rate are suggestive that a patient is becoming unwell because the body responds by trying to maintain the correct amount of oxygen to the tissues (Kelly, 2018).  

Other studies have also shown how the respiratory rate was negatively correlated with heart rate variability in patients with epilepsies or Migraines. 

Respiratory Rate Not Showing up?

Are you unable to track down your respiratory rate on your iPhone? Is your Apple Watch not capturing your Respiratory rate?

When the respiratory rate information is not being collected via your Apple devices, you will see this “No Data” message on the metric screen.

If you see this, the chances are that you may be missing some of the elements regarding the setup of respiratory rate.

No Data for Respiratory Rate? Check these key tips.

Here is a checklist of items that can help you find this issue and quickly fix the problem of missing respiratory rate data from your Apple device.

• Check if your iPhone has been upgraded to iOS 15+ and your Apple Watch is running on watchOS 8+.
• This functionality is only supported on Apple Watch models Series 3 and higher.
• Check if ‘Sleep Tracking’ has been enabled on your Apple Watch.
  • On your Apple Watch, open the Settings App.
  • Scroll down and select ‘Sleep.’
  • Confirm on this screen that Sleep Tracking has been enabled.

If your Apple Watch meets the criteria and you have enabled all the key settings as described above and are still missing respiratory rate data, check if your Apple Watch is capturing any data at all related to health.

Start with Heart rate information from the Apple Health app. If the nighttime BPM readings are showing up, it means that your Apple Watch is, in fact, measuring your nighttime statistics, and you are wearing the watch correctly.

Either way, sometimes the data sync goes for a toss immediately following a watchOS upgrade on the watch. The best thing you can do is unpair and repair the Apple Watch with your iPhone, confirm the sleep-related settings, and try it out again.

Wear your Apple Watch during the night for a few nights, and you should see the Respiratory rate showing up on the Health app on your iPhone.

Try a third-party app

Another way to ascertain that the Apple Watch is reading your respiratory rate without enabling different settings is to use a third-party app.

The third-party app ‘Medtimer’ on Apple Watch can show your heart rate and respiratory rate. You can use this also to check out your daytime respiratory rate.

You do not need to be on watch OS 8 to run this app on your Apple Watch to get your on-demand respiratory rate.

For most folks, once they have confirmed the required sleep-related settings needed to enable nighttime respiratory rate on their watch, a simple unpairing and re-pairing of the watch and iPhone fixes the issue of missing respiratory rate data.

• Health Trends in iOS 15 provide actionable insights through highlights and notifications

Apple Watch Studies with Respiratory Focus currently in progress

Although Apple Watch can detect various arrhythmias and help users set up notifications for irregular heartbeat and high/low heart rate notifications, there is no such mechanism yet for Respiratory rate. Your best bet is to monitor it using the ‘Trends’ on the Apple Health app on your iPhone.

As Apple’s algorithms get more powerful and move towards sleep apnea detection, asthma onset detection, and other such use cases, the respiratory rate will become a more important metric in the coming years.

Elements of Heart rate monitoring combined with Blood oxygen level determination on the Apple Watch are currently powering numerous studies, such as the one at the University of Irvine, CA, to examine how longitudinal measurements of blood oxygen and other physiological signals can help manage and control asthma. 

The Seattle Flu Study at the University of Washington School of Medicine is also trying to learn how signals from apps on Apple Watch, such as Heart Rate and Blood Oxygen, could serve as early signs of respiratory conditions like influenza and COVID-19.

Wrap up

When you turn on your Apple Watch’s sleep tracking and wear your Apple Watch to bed, your watch (and Apple Health app) automatically measures and records the number of times you breathe in a minute–your resting respiratory rate.

To view your Respiratory Rate Data, open the Health app on your iPhone, tap Browse, choose Respiratory, and finally open tap Respiratory Rate Data.

What are some of the features that you like and use most on your Apple Watch today? Please let us know using the comments below.