Monday, January 30, 2023
Home Tech News Apollo Neuro review: a case study in the wellness Wild West

Apollo Neuro review: a case study in the wellness Wild West

I can’t prove or disprove whether this wearable impacted my stress levels, but wellness gadgets need to be better about using science in marketing.

The $399 Apollo Neuro is the kind of wellness gadget that inspires skepticism. In a nutshell, it’s a wearable that claims to relieve stress through touch therapy. Apollo Neuro co-founder Dr. Dave Rabin describes it in a video as a “wearable hug for your nervous system” that uses silent vibrations to “rebalance” your fight-or-flight response. That, in turn, is supposed to make your body more resilient to stress by improving focus, increasing sleep quality, and raising your heart rate variability — a metric often used as a proxy for gauging recovery.

I wouldn’t blame you for snorting in disbelief. My eyebrows nearly flew into the stratosphere while watching that video. Not only is the Neuro expensive for what it is, but touch therapy itself is an alternative treatment without much high-quality scientific evidence to back up its claims.

Even knowing that, I had my reasons for giving this gadget a whirl. The last four years of my life have been spectacularly shitty. My entire immediate family died in tragic circumstances, and it left me a stressed, depressed mess. Mine is not a particularly special story. Like many people, I just got worn down to the point where any relief was welcome, no matter how unlikely the source. I also have a lot of experience wading through unregulated wellness gadgets that come with lofty, scientific-sounding claims. I figured reviewing the Apollo Neuro was a good opportunity to revisit the wellness Wild West from the perspective of someone in dire need of a break.

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At a glance, the Apollo Neuro reminds me a lot of the Whoop 4.0 — albeit a bit bigger and chunkier. Both are screenless devices, similarly shaped, and can be worn on different areas of the body thanks to various accessories. That’s about where the similarities end. 

The Apollo Neuro is about 50mm long, 35mm wide, and 14mm thick — not too far off from my Apple Watch Ultra, though much lighter. You can wear it with a band on your wrist or ankle or use the clip to attach it to your waistband, shirt collar, or bra — anywhere with skin contact, ideally close to a bone or joint. The back of the device is slightly curved to better fit the contours of your body, while the front has a metal cage that you slip the clip or band through. On the right side, you’ll find a charging indicator and two buttons that control the intensity of the vibrations. 

The Apollo Neuro with the clip attachment in someone’s palm

The Apollo Neuro with the clip attachment in someone’s palm

The Neuro gets a day or two of battery life, depending on how closely you hew to the recommended three hours of use per day. That’s not great, but it’s not the worst I’ve seen either. More upsetting is the fact that it uses a Micro USB charger. Before this, the only two devices in my house that still used Micro USB were my old Kindle Paperwhite and a mini UV lamp for curing gel nails. I just traded in that Paperwhite for a USB-C version, and the UV lamp has been collecting dust for months. It’s a small-ish gripe, but in 2023, this is a sub-par design choice.

It’s not a pretty device, but it’s relatively discreet, and I appreciate that you can wear it in multiple ways. Since it doesn’t actually track any body metrics, I opted to wear it on my hip or ankle. (As a wearables reviewer, I don’t have a ton of extra wrist space.) You couldn’t really see it when I wore it on the hip since the device itself goes inside your waistband. It was more noticeable when I wore it on my ankle. Multiple co-workers and friends said it looked like I was wearing an ankle monitor — which isn’t exactly flattering. Neither placement was perfect, however. I tested the Neuro in the fall and winter, and I occasionally sent the Neuro flying when removing sweaters and coats. Wearing it on the ankle was more secure, but alas, I have cankles, and the provided band was a bit too snug to wear for long stretches of time.

The Apollo Neuro with both the strap and clip attachments, next to a phone showing the Apollo app.

The Apollo Neuro with both the strap and clip attachments, next to a phone showing the Apollo app.

To use the Neuro, you pair it with the Apollo app. There, you’ll find a series of vibration profiles that you can schedule throughout your day. There are seven modes, each designed to either help you feel more relaxed or focused in different scenarios. Each mode can be programmed for a specific amount of time, ranging from five minutes to an hour. For example, if you want to wake up energized, you can schedule the “Energy and Wake Up” profile to start when you get up. If you’re a wallflower, there’s a “Social and Open” profile to “relieve stress in social situations.” 

The vibrations are adjustable: you’re supposed to set it so you can feel them without getting distracted. Fortunately, even if you crank it up really high, others won’t be able to hear you buzzing. That’s good since I always had to turn up the intensity to feel anything. 

I didn’t love the Apollo app for tracking. My scheduled sessions often didn’t start, even if I got a reminder on my phone. The app also failed to accurately log my sessions. Several times, I would finish a two- to three-hour session only to find that it wasn’t logged within the Apollo app. 

In practice, it felt like wearing a wellness beeper. Except when it buzzed, I wasn’t looking to see who called. Instead, I was reaching for my phone, trying to remember what mode was supposed to be playing. As for whether using the Neuro helped me feel less stressed… it’s a little complicated.

The company claims that in its studies, people who used the Neuro consistently had better sleep and increased heart rate variability. Quick refresher: HRV refers to the time between heartbeats. It’s often used as a proxy to gauge stress and how well-rested you are. Higher HRV means you’ve recovered well. Lower HRV means you may be ill or that your body needs more rest to recover from stress or physical exertion. These days, HRV is a commonly tracked metric on dozens of wearables, of which I have plenty

Close up of the curved side of the Apollo Neuro

Close up of the curved side of the Apollo Neuro

I split testing into two phases over three months. For the first, I tried more experiential testing, where I wore the device for at least an hour per day. That’s less than Apollo’s three hours, five times-per-week recommendation — but it was more sustainable and closer to how I think most people would really use this. In phase two, I followed Apollo’s recommendation to the letter. I kept track of my HRV trends and sleep data over the entire period of time with my Oura Ring, which I often use as a control device for sleep-tracking testing. (It’s also what Apollo itself uses in one of its clinical trials for the Neuro.)

While it’d be swell if I isolated the Neuro’s impact by controlling for everything else, I’m not a clinical researcher. I’m a reviewer who has to simultaneously test other gadgets for my day job. Also, I’m a sample size of one. I suspect my testing is closer to how the average person would use this device, but it by no means reflects anyone else’s experience but my own.

After all that, I’m sorry to say my final results are inconclusive. After roughly 11 weeks, I have no concrete evidence that regularly using the Neuro made any impact on my stress levels — good or bad. Even if I used it exactly as prescribed.

During the test period, my HRV sharply declined before spiking way back up… and then down and up. The graph looks like a wonky sine curve. My sleep scores have stayed static, with the same spikes in the weeks my HRV trended up. I’m 99.99 percent sure that the spikes in HRV and sleep quality are not the Neuro’s “retraining” finally kicking in. For the first spike, I was tapering before a race and made a conscious effort to go to bed two hours earlier every day. The second was because I caught a cold over the holidays and logged 10-12 hours of sleep per night. (It was glorious.) The weeks when my HRV trended down coincided with increased half-marathon training.

Close up of Apollo Neuro worn on ankle with person pressing buttons on side of device

Close up of Apollo Neuro worn on ankle with person pressing buttons on side of device

If consistently using the Neuro really did retrain my nervous system, I’d expect to see some gradual improvement over time. Instead, for much of the period, my HRV notably decreased while my sleep quality was relatively unchanged. To me, that seems to say the Neuro either had no effect or the effect was so minimal it wasn’t able to offset my daily stressors — at least not in any quantifiable way. 

There were a handful of instances where the Neuro had a mildly positive impact on my well-being — anecdotally speaking, of course. I’ve been having mild leg pain from training, and when I wear the Neuro on my left ankle, it seems to help. The relief is temporary, but I don’t know what else to say other than a 30-minute session when I’m achy seems to do the trick. When I wake up in the middle of the night, starting up a “Sleep and Renew” session sometimes helps me fall back asleep. Sometimes it doesn’t. I tried the “Social and Open” profile while making a few customer service calls — something I abhor with every fiber of my being — and it was somehow easier. 

Is this the placebo effect? Almost certainly. I put on a buzzy lil gadget, and my lizard brain tricked itself into calming down. There’s some truth to vibrations having a calming effect. Fun fact: the frequency of a cat’s purr is thought to have healing effects, and it’s why cats purr when stressed or injured. And, I mean, who doesn’t feel more chill when a cat is purring next to them? There are also baby rockers that vibrate to calm infants. Even if there isn’t a whole lot of concrete scientific evidence for touch therapy, does that matter if it delivers the desired result? That’s a more complicated question.

This whole experience reminds me of my aunt. A few years ago, she started suffering from severe, chronic fatigue. Nothing seemed to work, and her doctors were stumped. One day, she started going to acupuncture, and my entire family of doctors and nurses teased her for believing in that hokey pokey baloney. The acupuncture worked, my aunt told us all to stuff it, and now she’s fine. 

I’m sure that for some people, the Apollo Neuro could relieve stress in the same way that acupuncture helped my aunt. As far as I can tell, the Neuro isn’t going to harm anything other than your wallet. It’s just not for me.

The wellness industry has always been a perfidious one, but my main beef with wellness gadgets is how they use “science” in marketing. The Apollo Neuro is no exception.

Credit where credit is due, Apollo Neuro’s science and research sites are some of the better ones I’ve seen. Spend some time there and you’ll come across several terms like “clinical trials,” “clinically validated,” and “preliminary results.” There are links out to research, as well as easy-to-read summaries of completed trials. Many of the “learn more” pages have bibliographies linking to studies hosted on PubMed. There’s a scientific advisory board with a lot of credentialed psychiatrists and neuroscientists. To the layperson, this looks pretty legit. 

Downward view of the Apollo Neuro worn on someone’s foot.

Downward view of the Apollo Neuro worn on someone’s foot.

But none of it is definitive proof that the Apollo Neuro is efficacious or “backed by science.” As this Harvard Health blog points out, many of the cited studies on Apollo Neuro’s site are not actually about the device itself. Also, preliminary results are not the same thing as final, published, peer-reviewed results. Even peer-reviewed studies don’t automatically mean a product’s claims are 100 percent kosher either, especially when so many list the co-founder as an author. Ideally, you’d have more independently run assessments, though this is a challenge for many wearable startup companies. 

A more trustworthy conclusion for experimental wellness products tends to be along the lines of “Here are some promising results; more research needs to be done.” It’s a red flag when the majority of your evidence is small-scale trials with overwhelmingly positive results that are then spun as clinical validation, especially when you’re not talking about an FDA-regulated product. Technically, nothing in Apollo Neuro’s marketing is illegal, and there’s little to indicate its founders don’t believe their product could help people. I’ve seen companies do a lot worse.

But most people desperate for relief are not going to spend time clicking through each link, reading through abstracts, and critically analyzing the sample size and methodologies of each clinical trial. They’re going to look at the wealth of links on a neatly designed site and think, “Oh, well, there’s science behind this.” And that’s a slippery slope. It’s relatively harmless in the case of the Neuro, but for other products, it very well may not be. 

I can’t recommend this $400 stress relief wearable because, for me, it did not live up to its claims. That’s it. But while writing this review, I’ve become more convinced than ever that something has to change about how science is used in wellness gadget marketing. Scientific honesty may not be profitable, but if your product is genuinely good, it won’t need to rely on gimmicks, either.

Every smart device now requires you to agree to a series of terms and conditions before you can use it — contracts that no one actually reads. It’s impossible for us to read and analyze every single one of these agreements. But we started counting exactly how many times you have to hit “agree” to use devices when we review them since these are agreements most people don’t read and definitely can’t negotiate.

To use the Apollo Neuro, you must pair it with an iPhone or Android smartphone. That includes the phone’s Terms of Service, privacy policy, and any other permissions you grant. You may also grant optional permissions like Bluetooth, notifications, background app refresh, cellular data, and integration with Apple Health or the Oura Ring. Should you choose to share data with either service, you are also agreeing to their terms, conditions, and privacy policies.

By setting up the Apollo Neuro, you’re agreeing to:

Final Tally: Three mandatory agreements and several optional agreements

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