There should be a way around with the regular alarms as an audible backup without having to be on silent mode, although I can't pinpoint one last problem.
Ok, so the regular wake with sound is pretty much out for most of us in this thread, if we intend on having the watch do sleep through the Apple app as well.
Disabling silent and so forth shouldn't be required for the non-sleep alarms, as they should be audible no matter what, but they aren't always, and I'll explain what I mean.
First, I now set it so DnD and Sleep are not turned on automatically. I enable it on the watch or on the phone, and moved the toggle in both "control centers" to an easier to spot location. Enabling sleep manually allows you to have it toggle DnD on/off with it, so that if you go back to sleep after your alarm you can just make sure you still have sleep mode on.
So that takes care of the tracking part not having to be locked solely to your bedtime schedule on the device.
Second, I set Alarmy as my secondary alarm, and make sure it's always running in the background before bed. (You shouldn't need to do this, as the non-bed alarms should break through the silence, but they don't always).
Here's the problem, even with manual work arounds: This morning, I had the bed alarm set as usual, knowing it would only vibrate. It was set for 9am. The first regular Apple alarm was set for 9:15, and should have been audible. It was not, and the only reason I can think of is that the iPhone gets confused if there are two alarms trying to play at once, and the net result can be that you get nothing at all. This appears to have been what happened to me today, although Alarmy still kicked in as a fail safe at 9:25am.
Tonight I'll see how the following works... I'm going to leave the bedtime alarm turned off permanently, but leave the homescreen sleep shortcut settings and sleep time in place, and run everything manually, with only the regular alarms, and see how that goes. If the regular alarms won't get defeated by the silent one, that's good enough.
It would have just been so much easier to make it a simple option to have the wake up alarm do vibration and audible.