Sleep tracking sounds like a dream. You get a gadget that tells you how you slept and then gives you tips on sleeping better and — boom — you’re better rested. As a parent of a young child, I know this is not how it would work for me, but I’ve been feeling desperate lately. If I’m sleeping less, then maybe with the help of a wearable, I could simply sleep smarter. That’s how I got drawn into the promise of the Oura Ring, a $350 device you wear on your finger to track a number of different health metrics, including sleep. You’ve probably seen a celebrity wearing one in the tabloids. Mark Zuckerberg wears one to optimize his sleep.  The big problem is that wearables don’t come with any guarantees. This fall, we’ve seen these gadgets gain new abilities like detecting sleep apnea and working as hearing aids, making wearables seem more and more like medical marvels. However, research over the years has shown that doctors don’t currently find data from these devices very useful in a clinical setting, and left to their own devices, consumers might feel worse when using a wearable. The positive effects of sleep trackers, in particular, are difficult to nail down. But if I just wanted a few data points to direct me toward better habits, surely a little ring couldn’t hurt. After spending a couple of days scouring medical journals in order to make a better decision about what a wearable could do for my sleep, however, I now feel more exhausted than ever. Buying a new gadget won’t fix that for a number of reasons. Nevertheless, if you’re thinking about using a wearable to improve your health, it’s helpful to know where the marketing stops and the proven benefits begin. The Oura Ring 4, out this week, uses a variety of lights and sensors to measure your heart rate, respiration rate, blood oxygen, temperature, and movement. For an extra $6 monthly membership fee, you get access to things like detailed sleep analysis, advanced temperature monitoring, and reproductive health insights. The ring doesn’t have a screen; it connects to your phone via Bluetooth so you can see all your health data there. The Oura Ring “is not a medical device.” This is the first thing the company’s PR team told me when I reached out to them for this article. In its marketing, however, Oura does bring up the potential health benefits often, and it promotes its medical advisory board prominently on its website. Jason Russell, Oura’s vice president of consumer software, explained that the company is tapping into a real demand. “People want to understand their bodies and live long and healthy lives, but they don’t want another tech device to manage,” Russell said, flagging the discreteness of the Oura Ring. You can also use your health savings account (HSA) and flexible spending account (FSA) funds to buy an Oura Ring, which is confusing since you’re only supposed to use those for medical and dental expenses. The Oura Ring does not have FDA clearance, although it can be used with the FDA-cleared Natural Cycles app for menstrual cycle tracking. According to some reviewers, it is especially useful for women for this very reason. Natural Cycles describes itself as “a hormone-free alternative to the pill that is 93% effective with typical use.” This maze of regulations and clearances makes it hard to know if the Oura Ring, which is being marketed as a device that can improve your health, comes with real medical benefits. The same is true for other wearables, like the Apple Watch, which recently got FDA clearance for detecting sleep apnea. That’s on top of the device being FDA-cleared for detecting irregular heart rhythms and for recording electrocardiograms. (Smartwatches and fitness trackers from Google, Samsung, and Fitbit have similar clearances.) Even Apple AirPods Pro got clearance from the FDA this year for a new feature that turns them into “the first over-the-counter (OTC) hearing aid software device.” None of these devices are FDA approved. There’s a difference between FDA approval, which is a very involved process, and the less rigorous FDA clearance. There’s also a third designation called “de novo classification” reserved for low-risk devices that don’t already exist in the market. (The new hearing aid feature on the AirPods Pro got this designation recently.) The FDA acknowledges that its name gets tossed around in misleading ways, so much so that it has a whole explainer on what FDA approval actually means. So even though I can use this year’s leftover FSA dollars to buy an Oura Ring, the FDA has not put its stamp of approval on the device. Thanks to its partnership with Natural Cycles, the Oura Ring does enjoy a bit of that FDA-cleared glow, but that has nothing to do with the rest of its features.  In any case, you’d be forgiven for thinking a device you can buy with funds set aside for health care costs from a company that name-checks the FDA in its press release would lead to health benefits. When it comes to wearables, this isn’t always the case. At the end of the day, you might not need a stamp of approval from a government agency to know whether a gadget is useful to you. I bought an Apple Watch not because I wanted something to alert me of an irregular heartbeat but because I liked getting notifications on my wrist. It’s easier to glance at a text message on my watch than it is to pull out my phone. The fitness tracking that comes with the watch is a bonus, and I can confidently say I move my body more because my watch tells me to. Research suggests that smartwatches and other fitness trackers are best at this. A systematic review covering nearly 200,000 study participants published in the Lancet in 2022 found that wearables indeed improved physical activity and helped people lose weight. People who wore fitness trackers walked an extra 1,800 steps a day, on average. But they had little effect on other health markers, including blood pressure and cholesterol. A smaller meta-analysis in the BMJ, a peer-reviewed journal from the British Medical Association, showed similar conclusions: over 1,200 extra steps a day. Fitness tracking, it seems, leads to better fitness. Sleep tracking is not so clear-cut. Whether it’s on your wrist, under your mattress, or wrapped around your finger, a sleep tracker will measure everything from your movement and body temperature to your heart rate and blood oxygen in order to determine how long you’ve slept and how well. The idea here is that by having more details about how you slept, you could link what you did before bed — say, rigorous exercise, drinking, or doomscrolling on your phone — with your quality of sleep. If bad habits lead to bad sleep, you can stop the bad habits. Many sleep trackers will crunch all that data through an algorithm that spits out a score. (The Oura Ring’s app gives you three scores: one for sleep, one for activity during the day, and one for “readiness” which tells you on a scale of 1 to 100 how ready you are for the day.) Experts warn that these scores can be arbitrary, if not downright useless. Plus, most trackers can’t directly measure brain activity, which is the standard for diagnosing sleep disorders. Furthermore, obsessing over sleep data, scores, and metrics can actually increase anxiety and lead to worse sleep, according to a recent study from the American Academy of Sleep Medicine. It’s possible that some of this data could come in handy in a clinical setting. Newer Apple watches can perform an ECG that’s roughly as good as what you’d get in a doctor’s office, according to one study. The problem is, for now, it’s not always easy for doctors to get access to the data collected by wearables. This is not to say that doctors aren’t optimistic about a future in which they can access that data. Many doctors tell their patients to buy wearables and use them to help manage disease, especially heart-related issues that devices like the Apple Watch are designed to detect. Medical device or not, all wearables come with benefits and drawbacks, largely depending on how you use them. The Oura Ring rabbit hole I fell into left me feeling more confident about how I was using the one wearable I own, my Apple Watch. It also talked me out of buying an Oura Ring. To be clear, I haven’t tried the new Oura Ring, and for now, I’m holding off. Even though I do have some FSA funds to spend before the end of the year, I think the sleep-tracking function would make me anxious in the long run. At this phase of my life, sleeping smarter isn’t exactly an option. I simply need more hours in the day, and that gadget has not been invented yet. A version of this story was also published in the Vox Technology newsletter. Sign up here so you don’t miss the next one!

So much jamming is taking place in northeastern Norway, regulators no longer want to know.

For more than a year, Joseph Clifton Smith, a man who says he is intellectually disabled, has sat on death row, waiting to find out if the Supreme Court will greenlight his execution. Smith’s case, known as Hamm v. Smith, first arrived on the Court’s doorstep in August 2023. Since then, the justices have met more than two dozen times to decide what to do about the case, and each time they’ve put the decision off until a future meeting. No one outside of the Court can know for sure why the justices keep delaying, but if you follow the Court’s Eighth Amendment cases closely, it’s easy to see how the Hamm case could open up all kinds of internal rifts among the justices.  The Eighth Amendment, which has a vague ban on “cruel and unusual punishments,” is at the center of the Hamm case because, for decades, the Court has held this amendment forbids executions of intellectually disabled offenders (and offenders who commit a crime while they are juveniles). The idea is that both groups have diminished mental capacity, at least as compared to non-disabled adults, and thus bear less moral responsibility even for homicide crimes. That idea, however, has long been contested by the Court’s various ideological factions, and the Hamm case potentially reopens up all of the Court’s issues with the amendment at once. Indeed, in the worst-case scenario for criminal defendants, the justices could potentially overrule more than 60 years of precedents protecting against excessive punishments. In two 2000s decisions, Atkins v. Virginia (2002) and Roper v. Simmons (2005), a coalition of Democratic and moderate Republican justices handed down decisions that barred youths and people who are intellectually disabled from being executed. Those majority decisions came down over bitter dissents from the Court’s right flank — the same right flank that has since gained a supermajority on the Supreme Court. At least some of the current Court’s Republicans seem eager to use their newfound supermajority to blow up those two cases (and pretty much everything the Court has said about the Eighth Amendment in the last six or seven decades). So it’s possible that the Court is fighting over what to do with the Hamm case because many of the justices want a wholesale revolution in Eighth Amendment law. Beginning in the mid-20th century, the Supreme Court maintained that the Eighth Amendment “must draw its meaning from the evolving standards of decency that mark the progress of a maturing society.” Thus, as a particular method of punishment grew less common, the Court was increasingly likely to declare it cruel and unusual in violation of the Constitution. At least some members of the Court’s Republican majority, however, have suggested that this “evolving standards of decency” framework should be abandoned. In Bucklew v. Precythe (2019), the Court considered whether states could use execution methods that risked causing the dying inmate a great deal of pain. Justice Neil Gorsuch’s majority opinion, which held that potentially painful methods of execution are allowed, seems to exist in a completely different universe than the Court’s Eighth Amendment cases that look to evolving standards. While the Court’s earlier opinions ask whether a particular form of punishment has fallen out of favor today, Gorsuch asked whether a method of punishment was out of favor at the time of the founding. Though his opinion does list some methods of execution, such as “disemboweling” and “burning alive” that violate the Eighth Amendment, Gorsuch wrote that these methods are unconstitutional because “by the time of the founding, these methods had long fallen out of use and so had become ‘unusual.’” What makes Bucklew confusing, however, is that it didn’t explicitly overrule any of the previous decisions applying the evolving standards framework. So it’s unclear whether all five of the justices who joined that opinion share a desire to blow up more than a half-century of law, or if the justices who joined the Bucklew majority simply failed to rein in an overly ambitious opinion by Gorsuch, the Court’s most intellectually sloppy justice. In any event, Hamm opens up at least two major potential divides within the Court. Smith says he is intellectually disabled; the state of Alabama wants to execute him anyway. So the case perfectly tees up a challenge to Atkins if a majority of the justices want to go there. Meanwhile, Bucklew looms like a vulture over any cruel and unusual punishment case heard by the Court, as it suggests that the Republican justices may hit the reset button on all of its Eighth Amendment precedents at any time. The Court receives thousands of petitions every year asking it to hear a particular appeal, and it typically only grants several dozen of these petitions. The vast majority of these cases are nominally discussed at one of the justices’ regular conferences, then promptly denied. In recent years, the Court often discusses a case in two different conferences before agreeing to hear it — for this reason, I and other Supreme Court reporters often watch the list of cases the Court “relisted” for a second conference to identify cases the justices are more likely to hear. Occasionally, a case may be relisted for several conferences in a row. But this is rare, and typically is a sign either that the justices are negotiating over which issues they wish to decide in a particular case — or, more often, that a justice is dissenting from the Court’s decision not to hear a case and the “relists” are really just buying that justice time to draft an opinion. Hamm, however, has now been relisted in every single conference since the justices first discussed it on October 27, 2023. That is, to say the least, highly unusual. And it suggests that some particularly bitter internal negotiations are ongoing. If someone were dissenting from the Court’s decision to turn the case away, they likely would have released that dissent last July, because the justices typically try to resolve loose ends before they go on their summer vacation. Hamm involves a question that would inevitably arise once the Court decided Atkins — though it is unconstitutional to execute intellectually disabled offenders, there will always be some offenders who are on the borderline of what mental health professionals consider an intellectual disability. The specific question before the Court is what to do with these borderline cases. As a general rule, someone must have an IQ of 70 or below to be considered intellectually disabled. But IQ tests aren’t particularly precise — as the Supreme Court acknowledged in Moore v. Texas (2017), the IQ of someone who scores 74 on a particular IQ test falls within “a range of 69 to 79.” So, if courts read IQ tests as if they can identify an offender’s IQ score exactly, an intellectually disabled person could be executed due to something as arbitrary as a measurement error. Accordingly, the Court held in Hall v. Florida (2014) that a capital offender with an IQ score slightly above 70 must be given “the opportunity to present evidence of his intellectual disability, including deficits in adaptive functioning over his lifetime.” That is, such an offender must be allowed to present additional evidence beyond their IQ score to show that they are, in fact, intellectually disabled. Hamm is such a case. Smith took five different IQ tests, four of which showed him with an IQ in the low to mid-70s. Accordingly, two lower courts looked at additional evidence of his disability, determined he is, in fact, intellectually disabled, and ruled that he must receive a sentence other than death. In asking to execute Smith, in other words, Alabama is asking, among other things, that the Supreme Court overrule Moore and Hall, both cases that were handed down before former President Donald Trump remade the Court in the Federalist Society’s image. If the Court agrees, that alone would be a very significant legal development, both because it could allow intellectually disabled inmates to be executed due to a testing error, and because it would be a severe blow to stare decisis — the idea that judicial precedents shouldn’t be tossed out simply because the members of a court change. Of course, this Court’s Republican majority has shown little regard for stare decisis, at least in cases that divide along partisan lines. Since Justice Amy Coney Barrett’s confirmation gave the Republican Party a supermajority on the Supreme Court in late 2020, the Court has behaved as if it was going down a checklist, overruling liberal victories such as the cases establishing a constitutional right to abortion or the line of cases permitting affirmative action in limited circumstances, and replacing them with whatever outcome the GOP prefers. Yet, while this process has been painful for Democrats and toxic for the Court’s approval rating, it hasn’t been comprehensive — occasionally, one or more of the Republican justices signal that they will allow a previous liberal victory to remain in effect. Concurring in the Court’s decision to overrule Roe v. Wade, for example, Justice Brett Kavanaugh identified the Court’s past decisions protecting a right to contraception, as well as the right to marry a person of your own choosing, as cases he did not intend to overrule. All of which is a long way of saying that there’s no good way to know if Atkins or Roper is on the Court’s checklist of past liberal decisions to be overruled. These justices’ approaches to specific cases are often idiosyncratic, unpredictable, and unbound by preexisting law — just look at the Republican justices’ recent decision holding that Trump was allowed to commit many crimes while he was in office. The question of whether Atkins survives or falls will turn on whether there are five justices who want intellectually disabled people to be executed, and nothing else. But the fact Hamm has been relisted so many times suggests, at the very least, that there is a vocal faction within the Supreme Court that wants to use this case to aggressively reshape the law. The other uncertainty looming over Hamm is the Bucklew decision, which didn’t so much overrule the Court’s last six decades of Eighth Amendment precedents as pretend that they didn’t exist. Bucklew involved a death row inmate who claimed that the Eighth Amendment would not allow him to be executed using Missouri’s lethal injection protocol — he said he had an unusual medical condition that would cause him to experience extraordinary pain before his death. So the question was whether the Constitution allows a state to execute an inmate in a manner that may amount to torture. Gorsuch’s opinion denying relief to this inmate reads like the Court’s “evolving standards of decency” framework never existed. This phrase appears nowhere in Gorsuch’s opinion, and the only citation to Trop v. Dulles (1958), the first Supreme Court case to use that phrase, appears in Justice Stephen Breyer’s dissent. Rather than follow longstanding law, Gorsuch asked whether capital offenders could be subjected to similar pain “at the time of the framing.” This is the Eighth Amendment rule long favored by the Court’s rightmost flank, including in Justice Antonin Scalia’s dissenting opinion in Atkins. Scalia’s Atkins dissent, moreover, doesn’t simply disagree with the Court’s past decisions. It lays out many examples of how the law would change — and how much easier it would be to subject even minor criminal offenders to outlandish punishments — under a framework that looks to how things worked in the 1790s. For starters, Scalia argues that only “severely or profoundly” intellectually disabled people enjoy some protection against execution (he argues these individuals were often “committed to civil confinement or made wards of the State” rather than being criminally punished). One of the sources Scalia cites suggests that only people with an IQ of 25 or below enjoy any constitutional protection. More significantly, Scalia also argues that the Eighth Amendment only forbids “always-and-everywhere ‘cruel’ punishments, such as the rack and the thumbscrew,” and that it does not prohibit the government from imposing excessive punishments for minor crimes. Under Scalia’s framework, if the death penalty can constitutionally be applied to murderers (and he believes it can) then it can also be applied to shoplifters. If a rapist can be sentenced to life in prison, so too can a jaywalker. Gorsuch’s Bucklew opinion elaborates on the sort of punishments that, under this originalist framework, are prohibited by the Eighth Amendment. He lists “dragging the prisoner to the place of execution, disemboweling, quartering, public dissection, and burning alive” as examples. So there is a faction within the Supreme Court that would drastically shrink Americans’ constitutional protections against cruel and unusual punishment. This faction would allow more people to be executed. They would apparently eliminate any concern that punishments must be proportionate to the crime. And the kinds of punishments they do offer up as examples of impermissible sanctions are the kinds of things normally depicted in torture scenes from movies set in the Middle Ages. Will five justices go there? It’s impossible to know. But that a total of five justices joined Gorsuch’s opinion in Bucklew suggests this faction could very well prevail — if and when the Court decides to take up Hamm.

Security researchers created an algorithm that turns a malicious prompt into a set of hidden instructions that could send a user's personal information to an attacker.

This fundamentally alters our understanding.

This fundamentally alters our understanding.