31 Jul 2024
Josh
Ultrahuman Ring Air review
For many years, an Oura ring has been my sleep tracking device of choice. I was keen on the ring form factor because it's small, light, and unobtrusive — wearing a watch to bed has never seemed comfortable to me. So when we bought an Oura ring to use for testing an integration for Exist, I was happy to stick with it personally. I didn't care about its activity tracking, but I trusted its sleep tracking well enough. I set my sleep data in Exist to sync from Oura and left my activity data coming from my Samsung watch.
With the ring now being at least four years old, the battery life has declined to the point that it requires a charge every two or three nights, which is often enough to be irritating for me. It finally tipped me over the edge recently to hunt for a replacement sleep tracking device, ideally another ring.
You'd think that a new Oura ring would be an easy choice, but recently Oura has announced that, on top of the AU $456 cost of the hardware (converted from USD on 30/07/24), I would be spending AU $110 each year in order to get access to all sleep metrics beyond a simple "score", the score itself being worthless. I'm not against subscription costs, and I actually think a hundred bucks a year is acceptable for something I use nightly, but I object to another ongoing cost on top of the significant outlay for the ring itself. Subsidise the hardware cost and I'd find it a better proposition.
There are some other competitors in this space. There's something called Circular, which has bad reviews and doesn't appear to export any data to Apple Health or Health Connect, a must for me both personally and ethically; RingConn, another newcomer with pretty iffy reviews; and the Samsung Galaxy Ring, which sounds pretty good in initial reviews but hasn't launched in Australia yet. Ultrahuman's offering is more expensive than the Oura ring up front at AU $532, but crucially, they've promised they won't require a subscription to access all the stats the ring provides. They also sync sleep data to Health Connect and Apple Health. After looking around at the competition and reading some reviews, I decided to buy their Ring Air.
To save you from reading all the way to the end to see my verdict, let me tell you now: I was quite disappointed with the quality of sleep tracking, and asked for a refund. Read on to find out why!
Company background
Ultrahuman are a startup out of Bangalore, India. They were founded in 2019, and initially launched with Series A funding as a paid-subscription app offering content around workouts, meditation, bedtime stories, and "brain music". In the next few years they raised further rounds of funding and in 2022 finally launched their first ring device called the R1. The successor, the Ring Air, launched in mid-2023, making it about a year old now. The company also offer a continuous glucose monitor, or CGM, that is essentially the combination of an existing Freestyle Libre 2 needle and their own app. At CES 2024 they've announced a new home monitoring device that tracks things like air quality and noise levels in order to further give feedback on things affecting your health and sleep. It feels like they're really going for it in attempting to cover all angles. In my experience, though, they need to get the basics right before spreading themselves too thin.
The ring
When you buy the ring, Ultrahuman uses the same process as Oura — you pay up front, they ship you a sizing kit, and once you choose a size they'll send the ring itself. The whole process took just under two weeks for me. The ring looks and feels very nice. I opted for the matte black option, unsure if it would look cheap and tacky, but it delivers. The plain silver Oura always felt light and cheap to me, but somehow the Ultrahuman ring looks and feels more premium. Perhaps the almost $100 more it costs over the Oura is the reason for this.
Like Oura, the ring ships with a charger that matches the size you've chosen. Just like Oura, the charging light on the charger blinks very slowly while charging, a long-standing peeve of mine as it makes it very hard to determine at a glance if it's solid or actually slowly flashing. Unlike Oura, the Ultrahuman charger does not turn off the light when you remove the ring, making it unsuitable to leave plugged in anywhere in your bedroom overnight. But also, like Oura, the app does not reliably tell you when charging is complete, meaning you'll need to remember to go and check it.
I've always had trouble with my phone not connecting to my Oura ring, across multiple phones I've owned, and syncing each morning took forever as I tapped "Retry sync" over and over, or quit and reopened the app. In my experience the Ultrahuman app finds the ring nearly immediately every time, which is a vast improvement.
The app pushes you to charge the ring when it gets below 30%, which worked out to five nights of sleep for me. I'm pretty sure I could have eked out six nights if I didn't mind pushing it to about 15% battery left.
The app experience
When you consider that Ultrahuman launched as a content-only service, the complexity of its app makes more sense. It is a confusing mess. The tabs in the Oura app correspond to different types of data that are tracked by your ring, and it's easy enough to find where things are. The Ultrahuman app, however, has tabs for Home, Metabolism, Zones, Discover, and Profile. The last one does what you'd expect, but of the others, only Home has anything to do with the data coming from the ring. (Really, it should be called "Ring".) Metabolism is a dedicated tab for the CGM, Zones is something to do with sharing data with other users (no thank you), and Discover is full of content I don't need like the aforementioned "brain music". I can understand why things are laid out the way they are, but I don't enjoy it. The majority of the core navigation is irrelevant to me.
When I first connected the ring, the app asked to track my location so that it can help locate the ring in future. The copy mentions that it only keeps my location client-side, but the Android pop-up asking for location permissions notes that according to Ultrahuman's Play Store details, my location is sent to their servers. Which one is it? (I also noted with amusement the copy that says "Your data is 100% secure. We ensure all your data is encrypted." This vague reassurance is no less empty than hearing "your call is important to us" while on hold, and just as much of a lie.)
As I kept using the app, I was dismayed to discover the glut of ads beseeching me to upgrade to "Ultrahuman X", which is an optional paid subscription. The app tells me this is billed yearly at $30, but doesn't include the currency, and I don't trust them that it's AUD. The headline benefit for Ultrahuman X membership seems to be a free sleep mask. Otherwise it's billed like AppleCare — longer warranty, cover for if you damage the ring, and so on. The app really wants you to upgrade and pay for a subscription, which makes me uneasy and undermines the trust I have that they won't charge for access to the ring's data in future.
The next thing I noticed were all the notifications. Personally, I only want to wear the ring at night, but Ultrahuman clearly wants you to wear it all day, and reminds you of this fact by sending multiple "off-body warnings" a day. Not only are these annoying, but they're badly done. On Android generally, all notifications belong to one of many "channels" an app manages, meaning you can turn off the channel entirely to silence a particular category of notifications without blocking any others. In the Ultrahuman app, the channel for "off-body reminders" is called Miscellaneous! I turned it off regardless, so if I'm missing out on other miscellaneous updates, I'll never know. Hilariously, the day after I turned off this channel, I got a new notification warning that I wasn't wearing the ring. It came from a second channel! I've since turned this one off too. Best practice here would be to send all these notifications from a new "Off-body reminders" channel and make sure all other types of notifications come from other channels.
Sleep data
For the first week I wore both my Oura and the Ultrahuman Ring Air, so that I could compare the data. When making notes for this review I've been wondering, how do I personally know what is accurate sleep tracking? If the two devices disagree, which one is correct, and how can I accuse them of inaccuracy with any certainty given I'm not awake to measure things myself? The short answer is that I just don't know. However, I do have some small qualitative factors available to me, like how tired I am and how restful the sleep felt; more concretely, I can use my knowledge of times I woke in the night or when I was definitely still awake before sleeping to assess whether the devices tracked these accurately.
And here's where it all falls down. Every night, while reading in bed before sleeping, the Ultrahuman ring would decide that I was already asleep. With this single flaw, all of my trust in Ultrahuman's tracking is undone. If it thinks I'm asleep when I know for sure that I'm awake, how can I believe anything else it says about my sleep? (Oura does not have this problem.)
In the screenshots above, I've manually edited my sleep record to begin when I actually first slept.
Separate to this, in comparing the data from Oura and Ultrahuman, I found that they largely agree on my heart rate and HRV, in terms of the shape of the graph and what time my heart rate hit its lowest, but Oura often says my heart rate is lower and HRV higher, making my sleep look better. Their tracking of sleep stages matches somewhat, mostly agreeing about deep sleep but disagreeing more often about when I was in REM or light sleep. Oura's awakenings are usually longer and more frequent than Ultrahuman's — on a good night, Oura thinks I wake maybe 2-4 times a night, with an awakening being up to an hour at the outside, where Ultrahuman thinks I woke maybe once or twice in the night and only ever briefly. When I sleep exceptionally badly, the Ultrahuman data does reflect this, but it still overestimates the amount of sleep I got compared to Oura. I've noticed before that Oura sometimes doesn't track awakenings late in my sleep when I know I was awake, because I looked at my phone; Ultrahuman definitely does even worse in this regard, missing all such awakenings so far. So here, I'm forced to conclude that the sleep data provided by Ultrahuman is just Not Very Good. Oura may not be entirely accurate, but I have solid proof that Ultrahuman's accuracy is worse.
Another thing I miss is Oura's breathing rate tracking. Again, I can't know how accurate it is, but I know that broadly, higher values (in breaths per minute) correspond with a less restful sleep for me and, combined with skin temp, can often indicate when I'm getting sick. Ultrahuman promised to add this measure "soon" in an article in 2023, but hasn't yet.
An extra datapoint against the newcomers is that the ring regularly tracks up to 200 steps for me when I'm asleep and, I promise, never left my bed. I thought it was weird that the app told me it wouldn't show my activity tracking until it hit 500 steps for the day; I now suspect this is to hide the fact that you can wake up with several hundred steps already on the clock.
Finally, I want to use this data in Exist, so accurate exporting to Health Connect is critical for me. The app syncs promptly every morning, which is great, but also has a bug where each day it syncs one or more duplicate records with an extra ten minutes duration. For now, I have to manually go into Health Connect and delete these; when I contacted support to make a bug report, they told me they'd pass it on to the developers and then closed my ticket. Perhaps it will be resolved in time, but it hasn't been yet.
Updates and "Plugs"
On the other hand, Ultrahuman are iterating quickly. In the month since I've had the ring, I've had two firmware updates and multiple app updates. Ultrahuman seems to be following a classic startup approach of shipping early, before things are complete, and then iterating often to refine the product. It's entirely possible that they'll be able to fix their sleep tracking algorithms and provide something that seems more accurate. So far, one of the app updates included a new "sleep cycles" visualisation to show how many full sleep cycles I managed, so it was nice to see new user-facing features appearing even in the short time I've had the app. If I could trust this data, I'd find it useful.
As part of those app updates, Ultrahuman have also launched something they call "PowerPlugs" and sometimes just "Plugs". These appear to be integrations and add-ons, with support for third-party offerings. The built-in "stimulant tracking" feature that tells you the time of day to take or avoid stimulants like caffeine has become a free Plug, and there are several more like Atrial Fibrillation (irregular heart rhythm) tracking that already come with a hefty AUD 7.90/month price tag. Apparently menstrual tracking will be available as a free plug.
I can see that with Plugs and their other devices, Ultrahuman is looking to build a platform for tracking activity and body measures. It may be a good sign that they're looking to make more money from optional add-ons, but it further undermined my trust that they wouldn't at some point charge a subscription fee for access to the core data I'm using.
The verdict
The vague bad feeling I have about the company's monetisation plans, on top of the glaring inaccuracies in the data, made me realise I had made the wrong choice in buying an Ultrahuman Ring. I'm also kind of annoyed at the reviews that made vague claims about accurate sleep tracking when all you have to do is lie still and awake to prove that untrue. Fortunately, Ultrahuman offer a 30-day return period (although you have to search their help docs to find this information). Support is conducted via an in-app chat, and when I asked to return the ring, it only took an hour or so to get a response, which was a pleasant surprise. But in what made me feel like I'd made the right choice, the support person put the hard word on me to change my mind with vague promises of future fixes, and asked me to confirm if I really really wanted to return the ring. However, when I said that I did, they offered me a refund without returning the ring, in the hopes that I would find it valuable at some point in the future. So I have kept the ring.
I appreciate that opportunity to keep evaluating it, and I do truly hope that they keep working on it to the point where it provides data that's accurate and trustworthy. For now, I will keep charging my Oura every two or three days, and checking in on Ultrahuman's progress every so often. Maybe later I'll buy a Galaxy Ring.