Breathing Disturbance Index
Breathing Disturbance Index (BDI) is the number of detected breathing irregularities per hour of sleep. The metric quantifies how frequently breathing patterns deviate from normal rhythmic respiration during sleep. Unlike the clinical Apnea-Hypopnea Index (AHI) which requires specific diagnostic criteria and polysomnography, BDI is a wearable-derived screening indicator based on signals available to consumer devices.
Typical Adult Ranges
events per hourBased on population studies. Individual needs vary by age and health status.
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Key Takeaways
Represents frequency of detected breathing irregularities per hour.
Higher values indicate more disrupted breathing patterns.
Screening indicator, not clinical diagnosis.
Influenced by position, alcohol, congestion, and anatomy.
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How It's Measured
Oura detects breathing disturbances using signals from the PPG sensor and accelerometer.
Common Influences
Sleep position: Supine (back) sleeping is associated with more breathing disturbances in susceptible individuals.
Deep Dive
BDI represents the frequency of breathing pattern disruptions during sleep. Higher values indicate more frequent irregularities; lower values indicate more stable, rhythmic breathing throughout the night.
A useful framing is that BDI indicates how often breathing was disturbed, not the severity of individual events. The metric captures pattern disruptions—pauses, reductions, or irregularities—without distinguishing between different types or causes. It serves as a general indicator of breathing stability during sleep.
Normal sleep breathing is rhythmic and relatively consistent. Various factors can disrupt this pattern: upper airway collapse (obstructive events), central nervous system signal interruptions (central events), partial airway obstruction, positional factors, or other respiratory irregularities.
Sleep-disordered breathing exists on a spectrum from occasional minor events (common in general population) to frequent, severe events (clinical sleep apnea). BDI provides a quantitative summary of event frequency without diagnosing specific conditions.
Breathing disturbances can fragment sleep architecture by triggering arousals, reduce oxygen saturation, and affect cardiovascular regulation. Frequent disturbances are associated with non-restorative sleep and daytime consequences.