Apple Watch SpO2 during sleep.

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Janknitz
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Apple Watch SpO2 during sleep.

Post by Janknitz » Mon May 23, 2022 10:48 pm

Any thoughts on accuracy of the Apple Watch blood oxygen meter?

I recently figured out how to add my Apple Watch SpO2 data to the sleep app Auto Sleep. Apple does not claim FDA approval accuracy of the O2 sensor. Often when I try to measure it on purpose with the watch the reading fails, so I don’t know that I can trust it when it records spontaneously.

Last night the Blood oxygen app reported my O2 ranging from 85 to 87% all night with an average of 86.0%. But my ahi was 0.3. And today it’s reporting my average awake O2 as 92%. My doctor wanted to hospitalize me when I had pneumonia and it fell below 92%. But I generally run a little low all the time and I’m not bothered by it at all.

I feel fine. I have a finger pulse oximeter and when I compare them they often match but sometimes they are within 1-2% either way (which seems like a lot when normal BO level is a fairly narrow range). I am rarely over 96% and tend to run 94-96 when awake. I don’t have a recording meter, unless you count the watch.

Since I just started adding that data to the sleep app I don’t have a trend. Before adding it to the sleep app I’d have a random low reading during the day when I was awake and felt fine, but the overnight measurements were fine.

Anyone else using the watch and AutoSleep app? Any thoughts?

My sleep maintenance is lousy. Occasionally I take half a THC gummy (after 62 years of clean living I’ve become a “user”😂) which helps, but haven’t had any in the past week.
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lazarus
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Re: Apple Watch SpO2 during sleep.

Post by lazarus » Tue May 24, 2022 1:45 am

My understanding is that wrist measurement of SpO2 is generally less accurate than fingertip measurement and that pulse rate is generally considered more accurate than SpO2 with the Apple Watch, which tends to OVERestimate SpO2.
Based on the mean differences between the devices, the Apple Watch has a tendency of higher SpO2 values than commercial oximeters; however, heart rate measurements were similar in both devices (Fig. 3).
https://www.nature.com/articles/s41598-021-98453-3
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Janknitz
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Re: Apple Watch SpO2 during sleep.

Post by Janknitz » Tue May 24, 2022 10:40 am

Hmm, not encouraging that AW tends to score blood oxygen high when my scores were low. Last night was much better 91% average. Perhaps it’s just going to take some time to calibrate and Sunday night was an outlier. But if I see more of that, it’s time for a recording pulse oximeter.

Thinking back, I did not have my usual glass of wine with dinner Sunday night. Maybe the wine helps. 😂
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lazarus
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Re: Apple Watch SpO2 during sleep.

Post by lazarus » Tue May 24, 2022 12:38 pm

Janknitz wrote:
Tue May 24, 2022 10:40 am
But if I see more of that, it’s time for a recording pulse oximeter.

Thinking back, I did not have my usual glass of wine with dinner Sunday night. Maybe the wine helps.
In case you didn't see my post in another thread, the $39 (today, anyway) recording pulse-ox seemed to work well for me last night. I should have warned my wife about all the blue tape she would see on my hand this morning holding it in place on my finger, though. :)

viewtopic/t184376/Desaturating-with-CPA ... l#p1412219

And no gummies/wine for you after 5p or I'm calling your sleep doc to tell on you! :lol:
The people who confuse "entomology" and "etymology" really bug me beyond words.
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Janknitz
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Re: Apple Watch SpO2 during sleep.

Post by Janknitz » Tue May 24, 2022 12:50 pm

lazarus wrote:
Tue May 24, 2022 12:38 pm
Janknitz wrote:
Tue May 24, 2022 10:40 am
But if I see more of that, it’s time for a recording pulse oximeter.

Thinking back, I did not have my usual glass of wine with dinner Sunday night. Maybe the wine helps.
In case you didn't see my post in another thread, the $39 (today, anyway) recording pulse-ox seemed to work well for me last night. I should have warned my wife about all the blue tape she would see on my hand this morning holding it in place on my finger, though. :)

viewtopic/t184376/Desaturating-with-CPA ... l#p1412219

And no gummies/wine for you after 5p or I'm calling your sleep doc to tell on you! :lol:
Thanks, I hadn't seen your other post, so I just ordered it!

Gummies are for sleep. I have to take it just before bed because it helps me go BACK to sleep after my usual 4 a.m. wakeup. :D
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colomom
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Re: Apple Watch SpO2 during sleep.

Post by colomom » Tue May 24, 2022 2:01 pm

I have an Applewatch series 6, I’ve found the O2 data to be pretty accurate. Of course a watch is never going to be 100% accurate. I had a chuckle the other day when after a day of Jeeping on some pretty rough roads my watch showed during that time period I had climbed a couple hundred flights of stairs 😉. My watch usually shows my nighttime O2 ranging from 88%-96% which is lines up with overnight oximetry my doc has ordered in the past. When I’ve checked the watch against an oximeter it’s always been within 1%. One important thing I’ve found is to make sure your band is tight enough to keep the watch from moving around to much, but not so tight that it cuts off circulation. Also important to note that the Applewatch only occasionally checks O2 throughout the night, so it doesn’t give as full of a picture as a recording oximeter. The range of 85-87% it’s showing for you is low, it’s good you plan to check your O2 with a recording oximeter. I also use the AutoSleep app, i find it gives you a decent overall representation of your sleep, but definitely not completely accurate. Every now and again a pack of coyotes hangs out in our yard howling all night which makes my dogs go crazy. On most of those nights my watch shows me as asleep during all the ruckus (I wish) my guess maybe it thought I was still asleep because I didn’t move around.

If you aren’t aware another good place to look at the O2 data is in the health app. If you click on O2 in the app then scroll to the bottom there is a show all data link that details each individual reading and the time it was taken.

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lazarus
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Re: Apple Watch SpO2 during sleep.

Post by lazarus » Tue May 24, 2022 2:41 pm

Not to derail, but my understanding is that THC, much like any sedative, when taken near the start of sleep, can appear to give short-term benefits to sleep for a few days/weeks but then can cause longterm detriment to sleep, especially for the last half of the night. It is one of those coping mechanisms in which anecdotal and personal observations on what seems to help can lead to inadvertently making the overall problem worse over time. That effect is well-documented in respect to alcohol. It's still early days for true consensus from serious medical THC studies, but I believe there appear to be similarities for ramifications for sleep.

Not trying to give you a hard time. Just trying to be a friend. Hope the rec-pulse-ox does the trick for ya!
The people who confuse "entomology" and "etymology" really bug me beyond words.
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Re: Apple Watch SpO2 during sleep.

Post by chunkyfrog » Tue May 24, 2022 3:32 pm

If it's on a watch or your phone, is it fair to equate it with a real medical device?
These novelty features are primarily designed for entertainment.
Fun to have--interesting for a while.
Bad to bet your life on it.

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lazarus
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Re: Apple Watch SpO2 during sleep.

Post by lazarus » Tue May 24, 2022 3:43 pm

chunkyfrog wrote:
Tue May 24, 2022 3:32 pm
. . . watch . . . phone . . . device . . . life . . .
Seems all these newfangled computer-interweb-thingies are what life is now.
The people who confuse "entomology" and "etymology" really bug me beyond words.
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chunkyfrog
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Re: Apple Watch SpO2 during sleep.

Post by chunkyfrog » Tue May 24, 2022 4:14 pm

Mmmmmm-hmmmm.
So is identity theft, bitcoin, and NFTs.
First adopters can get burned--badly.
I am no Luddite, but I can smell BS a long way off.

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ChicagoGranny
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Re: Apple Watch SpO2 during sleep.

Post by ChicagoGranny » Tue May 24, 2022 4:57 pm

My average is showing 96.1 - 96.9% for the last 12 months. (I don't know why the Health app reports a range for an average.) Many nights, the app will report one or two readings in the low 80s. I believe those are inaccurate readings. OSCAR does not show events, and I feel fine.

If you are feeling fine, I would guess an average of 86% is not accurate. If the watch is still under warranty, you might want to report the problem. My watch got to where it wouldn't do an ECG. I called and one day later a package and return authorization showed up at my door. From the time I returned it until a new (or reconditioned watch) came back was three days. They even called to make sure the new watch was doing EKGs. I was impressed with their warranty coverage.

Unless someone has significant desats, I don't think the watch is very useful for monitoring blood-ox. If a person has significant desats, it might be a good warning for them.

My recording pulse-oximeter is kaput. If the watch starts showing significant desats, I will buy another recording pulse-oximeter.

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Re: Apple Watch SpO2 during sleep.

Post by Janknitz » Tue May 24, 2022 8:15 pm

lazarus wrote:
Tue May 24, 2022 2:41 pm
Not to derail, but my understanding is that THC, much like any sedative, when taken near the start of sleep, can appear to give short-term benefits to sleep for a few days/weeks but then can cause longterm detriment to sleep, especially for the last half of the night. It is one of those coping mechanisms in which anecdotal and personal observations on what seems to help can lead to inadvertently making the overall problem worse over time. That effect is well-documented in respect to alcohol. It's still early days for true consensus from serious medical THC studies, but I believe there appear to be similarities for ramifications for sleep.

Not trying to give you a hard time. Just trying to be a friend. Hope the rec-pulse-ox does the trick for ya!
I don't take it consistently. I had a bad month or two when I was waking (as usual) but couldn't get back to sleep. It helped a little, so I took it every night for about 2 weeks, and now only occasionally as my sleep latency with the wake ups is back to where it usually is.
chunkyfrog wrote:
Tue May 24, 2022 3:32 pm
If it's on a watch or your phone, is it fair to equate it with a real medical device?
These novelty features are primarily designed for entertainment.
Fun to have--interesting for a while.
Bad to bet your life on it.
As I pointed out, Apple makes no medical claims on the BO app (but it has validated the atrial fibrillation detection via the heart rate monitor). I don't bet my life on it. I'm quite skeptical about these low numbers, actually, since I think I would be having a lot of symptoms if I had frequent nights like that. OTOH, it doesn't make sense to ignore the low numbers, either. That's why I'm looking for other validation.
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ChicagoGranny
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Re: Apple Watch SpO2 during sleep.

Post by ChicagoGranny » Wed May 25, 2022 6:57 am

Janknitz wrote:
Tue May 24, 2022 8:15 pm
(but it has validated the atrial fibrillation detection via the heart rate monitor)
I like the watch, but Apple irritates me in the way they promote this. They mislead by claiming Apple watch will warn of AFIB. The only time the watch does an ECG is when the wearer stops, sits quietly, presses the crown for an ECG, and quietly holds a finger on the crown for 30 seconds. Intermittent fibrillations are common. There is a good chance that most of them happen when the user is not taking an ECG. Of course, the problem of intermittent fibrillation is also present with ECGs in a doctor's office.

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Re: Apple Watch SpO2 during sleep.

Post by Janknitz » Wed May 25, 2022 12:23 pm

ChicagoGranny wrote:
Wed May 25, 2022 6:57 am
Janknitz wrote:
Tue May 24, 2022 8:15 pm
(but it has validated the atrial fibrillation detection via the heart rate monitor)
I like the watch, but Apple irritates me in the way they promote this. They mislead by claiming Apple watch will warn of AFIB. The only time the watch does an ECG is when the wearer stops, sits quietly, presses the crown for an ECG, and quietly holds a finger on the crown for 30 seconds. Intermittent fibrillations are common. There is a good chance that most of them happen when the user is not taking an ECG. Of course, the problem of intermittent fibrillation is also present with ECGs in a doctor's office.


Not true, there are two ways that the Apple Watch can detect irregular heart rhythms:
On Apple Watch Series 1 or later, the IRNF analyzes pulse rate data collected by the photoplethysmograph (PPG) sensor to identify episodes of irregular heart rhythms suggestive of AFib, and it provides a notification to the user when it detects an episode. On Apple Watch Series 4, Series 5, and Series 6, the ECG app can generate an electrocardiogram (ECG) waveform similar to a Lead I electrocardiogram, then
provide a classification of that waveform as sinus rhythm (SR), atrial fibrillation (AF), high or low heart rate,
or inconclusive; with ECG 2.0, additional classifications of AFib with high heart rate and poor recording
are available.
https://www.apple.com/healthcare/docs/s ... ection.pdf

The first method does not require use of the ECG app, and the heart rate monitor will monitor intermittently without having to actively use the heart rate app.

It's not going to be as accurate as a hospital grade heart monitor. It only checks heart rate intermittently, so it may miss episodes. It doesn't work if it's off (and the watch must be charged daily, for about an hour), if it's not fit well, etc. But there are many stories of people who first learned they had A-fib or other arrhythmias from the watch detection. And it has a very low false positive rate
https://newsroom.clevelandclinic.org/20 ... detection/
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ChicagoGranny
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Re: Apple Watch SpO2 during sleep.

Post by ChicagoGranny » Wed May 25, 2022 1:00 pm

Well, thanks. That's good to know. Gramps and I have been wearing Apple watches for about two years with no alerts.