A Doctor's Take On Apple's "Blood Oxygen" Sensor
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- Опубліковано 20 сер 2024
- As a physician who is infatuated with tech, I often live at the intersection of medicine and technology. Naturally, wearable biosensors have piqued my interest over the last several years. In this video, I discuss Apple Watch Series 6's "blood oxygen" sensor (essentially a reflectance pulse oximeter), what this biosensor is ACTUALLY measuring, and why the semantics can matter.
Apple Watch Series 6 Does Not Measure "Blood Oxygen": rk.md/2020/app...
What Does A Pulse Oximeter Tell Us?: rk.md/2016/pul...
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Great discussion. You have a knack for explaining things. Keep up the great work!
Hahaha, I appreciate the feedback!
I had my Apple watch report LOW blood oxygen. Due to this my PCP referred to a Pulmonologist who did an overnight SpO2 which resulted in up to 10 minutes of SpO2 below 86%. Then he ordered a Sleep Lab study and we'll figure what to do after that. So, I feel the Apple watch alerted me to a problem (even though I am on cPAP with low AHI). Thank you Apple.
I am coming across these positive reviews consistently. Strongly considering to buy iPhones and then Apple watches. Thanks for sharing.
While I didn’t actually catch it as I haven’t had my series 7 very long, it could have told me I was going to be sick up to 2 days before I had any symptoms.
My usual resting heart rate is around 50, on Sunday it spiked up to and then held at around 80, Wednesday I lost my voice, Thursday I went home feeling like crap, and now Friday I’m really bad.
Will be making sure to check my resting heart rate from now.
As for my blood oxygen reading, it dipped a little, but not enough to actually notice anything strange.
I’m consistently getting low blood oxygen readings on my Apple Watch, particularly at night, but my doctor doesn’t think the watches are accurate and my levels with a pulse oximeter when I’m at an appointment are generally 96 or above, but I have terrible fatigue and periods of a racing heart that makes me cough. I bought a pulse oximeter and when I have both on the Apple Watch is normally never out buy more than two points.
@@kayelle8005 I suggest you discuss with your Dr ordering an overnight SpO2 test rental at your home for at least 2 nights in a row.
It takes an SpO2 reading every few seconds continuously for 24 or 48 or 72 hours but you probably only "wear" it while sleeping.
When you return the device a tech lists all the dips and produces a report.
It only cost $39 that my insurance paid for.
The results will be "official" and lets him treat from it.
"Nocturnal hypoxemia was defined as more than 10% of total sleep time below a SpO2 of 90%" (Deflandre et al., 2018).
My Dr (pulmonologist) treats if SpO2 is less than or equal to 88% for 5 continuous minutes.
I am now on BiPap (looks like a cPap but forces a breath if you stop) and 3L/m O2 which was tried in a sleep study first.
No more waking up with a racing heart or hand and feet tingling - and I feel better.
@@georgeadleman4678 thanks for taking the time to provide all that information George. Very generous of you and much appreciated.
Huge fan man. I’m currently doing my anesthesia critical care fellowship and read your stuff all the time. I also shared your critical care reference sheet with my medical students and residents. They loved it!
Really appreciate the support! 🙏🏽
You raised an important point about O2 SAT’s limitation by only measuring the percentage of oxygenated hemoglobin molecules while not reflecting the blood oxygen content because it does not take into consideration of the serum hemoglobin concentration. But the same limitation also applies to the finger tip oximeter used in physician offices. The important take-home lesson should be for both Apple Watch and finger tip oximeters users to not rely only on the O2 SAT reading from the watch, but always consult a physician for evaluation of symptoms of anemia or general health concerns.
Very well said! Thanks for the comment!
This is very important for people to know! Very well said Rishi!
Thanks so much!
Apple does have several disclaimers about the oxygen sensors being for exercise and well being, not medical purposes.
But they know what it's being used for too!
Wink, wink.
I love apple and this review was so well said. I was born with a vsd, epilepsy, and hemophilia as well as ehlers danlos. I really lost out on the genetic lottery and obviously have a lot of specialty doctors who work as a team. I love technology and the advances that we are making in medicine, I have a VNS device for my epilepsy and chest ports.. So I can not wait for the day that wearable devices become common household items for healthcare, but after this video and chatting with my cardiologist trying to decide if paying to upgrade my watch was worth it, our technology isn't there yet in my opinion, but normal apple users using their watch regularly will help them home in and perfect the devices over time.
I agree, you are apt to keep an eye on your oxygen level better if you can just tap your watch anytime. Otherwise, I have to go to the drawer and pull out the finger meter and i find it doesn't work at all if my finger is not warm as in holding a cold glass. I tested them together and they were 2 points different (apple being higher). I'm not sure how accurate the finger meter is either really they come in all kinds of price ranges, so I'll probably just deduct 2 from my apple watch then. I might take them both to the doctors and see how theres compares too.
I'm glad to see a Dr to take the time to put out a youtube video to inform people of the pit falls of relying on readings for Oxegen blood levels. I was excited to find out apple had a watch that could monitor this anytime by just a click of the watch. I have COPD and need to keep an eye on my levels. Thank you for clarifying the accuracy issues and excellent presentation.
I'm from Romania with bpoc zimi please how do you feel what treatments her how long have you been with bpoc etc?
Thank you! This was very informative. I was evaluating if the O2 sensor was worth it for an older parent to upgrade their watch for. This was the only attribute that presented a useful upgrade. She already uses a pulse oximeter that works fine. I thought that the watch might be useful for an on-the-go, or just while hanging around, option. It still might be. But the specific caveat you identified was enlightening because I never knew there was a specificity in the way oxygenation is measured. Thanks! It might be just as well to have a few extra pulse oxymeters around that measure reliably in real time. I subscribed!
Great job explaining the limitations with the current Apple technology. Very fair and balanced.
duuude sir your voice is so soothing
and thanks a lot for the info!
Haha, thank you!
@@RKMD pls Samsung watch 3
That's "Doctor" duude sir.
@@timboslice8194 oh shi- sorry my bad
While I didn’t actually catch it as I haven’t had my series 7 very long, it could have told me I was going to be sick up to 2 days before I had any symptoms.
My usual resting heart rate is around 50, on Sunday it spiked up to and then held at around 80, Wednesday I lost my voice, Thursday I went home feeling like crap, and now Friday I’m really bad.
Will be making sure to check my resting heart rate from now.
As for my blood oxygen reading, it dipped a little, but not enough to actually notice anything strange.
Thank you very much I was close to buy 6 series just to use that oxygen level feature but now I'll decide about SE or 5 series watches
The Apple Watch is so inaccurate. My Apple Watch 7 will say 91 - 93%, and a finger pulse oximeter will say 98%
I was looking at how to explain O2 saturation etc to a friend that has a 94 O2 sat but is having major problems. Went to his cardiologist and is repeating tests that showed red blood cell. I use both the same Oximeter you showed and do wear Apple watch though not the series with Oximeter yet. They are great tools but as you point out only one piece of a huge puzzle called health. I have forwarded a link to this for my friend to watch. Thank you for taking the time to explain this so understandably.
During my last infusion for my RA treatment; my blood oxygen was 90 then 91 my nurse was concerned with low number; I started retaking my asthma inhaler (was having issue of being tried and sleeping all the time) thinking about getting Apple watch or the blood oxygen senor
I never understood why by finger measurements were about 2-5 points lower than my Apple 8. Thank you
Ty for this detailed explanation! I was A little leery about the blood oxygen w/my apple 7 series watch level compared to my pulse oximeter on my finger because there are many points difference. I love all of my Apple devices however I will stick with my doctors recommended devices for more serious issues.
I know" a difference" now.
However is there a sensor that can measure hemoglobin density in the blood so we can have a more complete picture of respiratory health?
Thanks for the explanation. Would love to also hear your explanation on these smartwatches on measuring SPo2 in the context of acclimatisation when climbing. what should we keep in mind on its methods, accuracy?
Thank you for giving us a more clearer picture vs Apple marketing
So, if you are suffocating due to low hemoglobin, an 02 sensor won't detect it?😨
Your eyes lit up once you spoke about what technology can do but also that we need not to put all our faith in the flashy apple waches but check into a drs now and again😊
Great Video, thanks Doc!! It was an awesome explanation ! Facts, and figures without bashing a great product and feature. Wonderful explanation!
Appreciate it!
apple watch caught me with the 02 sensor great vid how about asthma patients thanks doc!
This is one the best, most informative videos I’ve stumbled upon in a LONG time: No wonder it was the top result! Thank you for getting straight to the point, providing valuable information, and not wasting any time trying to stretch this video out to the 10-minute mark. Subscribed immediately!
Really appreciate the kind words! 🙏🏽
So from my studies the pulse oximeter or heart rate sensor in the actual Samsung smartphones is clinical grade and uses infrared AND visible light. When compared next to a hospital pulse oximeter the Samsung smartphones were giving the exact same reading. However in smart watches they only use visible light and not infrared light. Making them less accurate. So the phone that has the most accurate pulse oximeter or heart rate reading would be Samsung smartphones as the technology is the same as the hospital, using infrared spectrum and visible light spectrum
I have advanced COPD, Lung scaring and doesn't have a strong response to Albuterol trying to workout again after pulmonary. I wonder if you know of a smart watch or something that can do an alarm if your blood ox hits 92% I have been know to drop and after getting up off the floor learn finding out I dropped to the low 80s without noticing do to the speed of the drop and adrelen
As a respiratory therapist,I love this video
Doctor has a great down to earth attitude showing sincere care thus shows he really understands what it means to be a doctor. I've been sick for over 4 months and getting worse with (constant) esophagus and throat pain and no doctor that I see seems to care if I get better or I die. Waited to see a gastroenterologist for almost two months and all I got was a sonogram to my chest and acid reflux meds. I had to beg for liver and pancreas bloodwork but I only got the liver test. I could have stomach virus or a bleeding ulcer as the pain is constant but no other tests were performed except an ekg and a chest xray . The liver test was slightly high in protein and and albumin and a prior CBD was also irregular with low lymphocyte levels but they said that I'm fine. Why is it so hard to get a decent amount of bloodwork going being that correct bloodwork can find many deceases. I can feel the pain in my back at times, also have yellowing in my face and hands at times thus why I wanted a simple pancreas blood test. Getting blurry and at times foggy vision lasting hours, loosing weight. Maybe it's just my luck not finding a good doctor. My last option which I've been trying to avoid due to covid is to travel to Mexico where I I can get all the test I need in days not months and most doctors down south show the same down to earth and professional attitude that this guy has. Not to say that I haven't met good down to earth doctors here in US which I have but no luck with my health getting better.
Really appreciate the kind words! Thanks for sharing your story!
Thanks for the insight into the wearable technology deductions.
Thanks for a very informative video...being a heart disease patient alongwith atrial flutter has driven me to seek instruments for measuring my blood O2 level...it seems that I was wrongly trusting smartwatches to do it.
I'm really interested in health tech nerd stuff. Keep it up
Apple Watch is saying resting heart rates of 57 and I’m not an athlete and o2 of 93 should I call the dr
The oxygen levels of my iWatch 6 are waaaayyy off compared to other fingertip oximeters I own. The measurements I get from my iWatch are constantly in the 80’s, and very rarely, in the low 90’s, whereas my fingertip oximeters always give readings of 96 or higher.
I don’t trust the iWatch. I don’t know why Apple provides this instrument when it is totally inaccurate. What good is it?
iWatch👺
Thank you.
Say you have allergic asthma, would the pulse ox reading alone be good enough to monitor that? I have no known issues to blood volume and I’m young and healthy, but if my allergies get bad it can become hard to breathe, and I often don’t notice (because it’s a gradual shift) until it gets really bad and I need my inhaler. An accurate sensor could help me know if I need to go inside or take meds to keep it from getting really bad and freak me out, or keep me from getting caught without an inhaler when I need it.
I know you posted a while ago hopefully you found device that helps, I use app called medisafe and it can do reminders of medication and i think it ios android can take measure of oxygen , write down your allergies in journal so you can keep track of attacks just a suggestion that helped me
Thank you for the explanation! ❤
I was just at the Cleveland Clinic and one of the leading cardiologist/electrophysiologists in the country said: Get an Apple watch! Arrhythmia's caught through their ECG and pulse oximeter can be live savers. I'll listen to him.
This is informative. However, I would like to know how often can our haemoglobin change? Like my Haemoglobin stays between 14-16. So I believe it's very unlikely that it will drop to 7-8 over time? My point is, if someone is measuring their haemoglobin every year or two, and they know their range, then the Apple Watch can be helpful.
DK, to dumb down what this doctor said, he relays to us that for the average, healthy consumer that uses this product, it can be reliably accurate. Most people do not walk around with a below normal hemoglobin (anemia). So I thought that this video was a little silly, however he does make some good points. If you have no underlying pathology (congenital disease, etc.) then you can expect that your hemoglobin will not go below what is normal range, barring hemorrhage or disease. I hope this answered your question in your second sentence about hemoglobin and how often it can change.
Apple needs a disclaimer. If you're tired, faint, dizzy, bleeding, disoriented, bruising easily, call your Dr no matter what your watch says.
Great video! My situation is that I came down with Covid and spent the last 2 months in the hospital recovering. Had to go so far as re-learning how to walk. Well, pulseox was a key metric we watched while I was in the hospital. I'm just wondering if the iwatch is a good "ballpark" device to monitor what it can. (I understand the shortcomings as you describe them). I have a medical grade fingertip device, but I need my fingers for my day to day work. Thank you.
So happy to hear you're on your way to recovery! For the purpose you mentioned, I do think the Watch will be fine (with the limitations I outlined).
Hay. My Father is in the codition like you, it is 21 days treatment in hospital. It is a great idea if you want to share your condition with me, so i can do the same to my father. Thanks you
How are you doing now
How accurate are the pulse oximeters on Amazon? I really need it mostly for pulse, but would like an accurate oximeter as well
It is very accurate. But you can get false readings if you have some nail polish on it.
Thank You Doc...I had a feeling this was not a feature that should decide my choice of a smartwatch.
Your content was excellent. You presented it well, and I wish you well in all your endeavors. I'm sure I speak for many people when I say, "It was helpful. Thank you.
How accurate are CVS (etc...) Pulse Oximeter?
Thanks for this- Someone with Asthma ❤️
I understand and appreciate the critique and explanation between a clinical O2 reading vs a store bought device, but unless I’m bed ridden in an ICU, I’ll have to use what’s best available. I’m a recovering COVID patient suffering from COVID fibrosis. My pulmonologist recommends I cary a (store bought) pulse ox unit to monitor as I use supplemental oxygen. The Apple Watch, though considerably more expensive), would make monitoring my O2 levels much easier.
The problem of a well saturated anaemic person is not isolated to Apple’s reflectance oxymetry. I think this should’ve been made clearer in the video because some may think that they can rely on an oximeter more than an Apple Watch, even though the watch is always on their wrist and just as valid as an occasionally used finger tip oximeter.
Correct me if I’m wrong but this isn’t any different than a regular pulse oximeter. Outside of a certain kind of Masimo pulse ox, normal pulse oximeters also only measure the oxygen content of the available hemoglobin so the oxygen percentages would essentially be the same between the two devices (allowing for the fact that it is normal for there to be up to a 3% difference between oximeter units). So, although what you’re saying is correct, you’re “issue” is with ALL oximetry devices, not just the Apple Watch.
I don't have any issue. I use pulse oximeters in the OR and ICU ALL THE TIME. They're arguably the singlemost important monitors to come out in the last 50 years. My point was to illustrate that "blood oxygen" (how Apple phrases it) is not entirely accurate given that the number is just a saturation of hemoglobin. Second, transmittance pulse oximeters (what we generally use) versus reflectance pulse oximeters (biosensors like on the Apple Watch) might not be comparing apples-to-apples.
I am considering a apple watch with a pulse ox to monitor oxygen saturation levels for asthma related issues. Do you think it would still be reliable for that?
Toxicologist here to say Dr. Kumar is WRONG about what SpO2 measures. The SpO2 in pulse oximeters is NOT a measure of the oxygen bound to Hb.
SpO2 is actually a measure of the sum of oxygen and carbon monoxide bound to Hb, because pulse oximeters with 2 wavelengths cannot tell them apart (COHb also peaks at 660nm).
This is not a big error if you are healthy with normal COHb around 1%. But arterial COHb may be 5%, 10%, 20% or more from either exogenous (inhaled) and/or endogenous (internal) sources of CO exposure (as in COVID) -- in which case your actual oxygen level would be that much lower. Only pulse CO oximeters with more wavelengths, such as Masimo's RAD57, can distinguish COHb and O2Hb, but they cost $5000 to $10000. (I have no affiliation)
The correct way to describe any pulse ox SpO2 display is as a measure of the total O2 and CO bound to arterial Hb. If normally low methemoglobin is >1%, it also may be misread as SpO2. Since the SpO2 value is always closer to the saturation pressure of all bound Hb than to the pressure of O2Hb alone, it is more accurate to think (and speak) of SpO2 as SpHb.
so get the cheaper watch and the finger test device?
Missing: When is SpO2 a useful measurement? What causes a low SpO2 measurement?
I assume that it means that your lungs are not working properly. (Or maybe there's too much carbin monoxide? Will CO binding appear different or read the same?)
Well, I just got my Apple series watch nine and Apple has discontinued blood oxygen. Do you no longer have that I have an Apple series 7 that does have it on there but what do you suggest let’s say from Amazon or manufacture for the fingertip is a good O2 sensor.???
That was a great explanation I hope that everybody got the idea that if you’re so low on hemoglobin you could be having tissue hypoxia and still show up as 98 or 100% saturated because everything that you have a saturated but there’s nothing there to carry the oxygen! Nice back to basics for this respiratory therapist as well thank you so much!
I don't get the hemoglobin thing personally. I have COPD and it's important to watch your blood oxygen levels now I don't know how this other part factors in.
Hi! My watch says I'm between 80% and 100% today. Am I need to worry about that? The everyday average is 92%.
What are your thoughts on this function in helping alert to sleep apnea?
It'd be interesting since there's a noise meter too. Maybe excessive noise at night could be indicative of snoring (a sign of obstruction). Couple that with desaturation overnight, and that might alert a user to go for a formal sleep study. Just a thought.
So the concern is for Apple watch AND finger devices?
Why must I not wear a fitness tracker when I'm getting blood work done? Would fitness tracker effects your results?
What can someone use for apnea monitoring? Using a backpack to sleep on each side and want to see if it prevents apnea.
Great stuff, may you continue do your take on all things health & apple/tech.
Thank you so much!
It’s not good for blood oxygen. Ever got a reading below 90%?
I don’t think it can read below 90%.
I’ve manipulated my blood oxygen down to 70% by breathing exercises and the watch always fails to read it
GREAT LESSON
Hi, I have a question. First, thanks for this video. I have talassemia (the small one - its basically anemia) which has something to do with my blood oxygen level. Is it a good idea to upgrade my apple watch 5 to 7 to have this sensor to measure my blood oxygen level or it will not be usefull in my case (and many others). Thanks again! Hope you see this comment!
Thank you Doctor. Greatly appreciate this video.
I was disappointed to find that the watch doesn’t give a pleth/waveform. Still excited about having a convenient way to ballpark measure and trend SpO2 without a traditional pulse oximeter.
It certainly would have been nice! Maybe not totally out of the picture with future software updates?
Thanks for this clear and important info. I have subscribed. Hope to hear more
Thanks for the sub!
Great job
Really great explanation. Thank you
Then what would be the most accurate and best way to measure real oxygen levels?
Wonderful info. Thanks! I wonder why Apple lost their lawsuit to Masimo for theft of their patent on the "light emitting technology" that was invented & patented by Masimo? Maybe Masimo also invented the reflectance technology you're speaking about as well?
Hi, great video. I have sleep apnea and use a CPAP nightly and I also live at altitude (7500 ft). Do you have an opinion about the pending Masimo Freedom watch as it relates to its tech, accuracy, and providing more reliable data vs. other watch brands? Thanks!
I was told this will maybe help dectect a seizure coming is this true or maybe give some type of alert that one is coming on
It did say that it’s not meant for medical use
The point of these measurements isn't to know your hemoglobin concentration but to detect sleep apnea and similar disease
Keep up the good work you make this very easy to understand... So would you consider these instruments okay to use in addition to really paying attention to how we feel? I know that if I was really tired or having chest pains a short of breath I would definitely go to the doctor and if my watch agreed I'd probably go a little bit faster LOL also do you have an opinion on the sleep apps on the watches I know that when I don't sleep good my watch agrees with me..
Would the oxygen level measurement from the Apple Watch be helpful to diagnose sleep apnea issues?
No
@@BlackMamba-lt8oe can you elaborate / Thanks
Great great video. Thank you for making it :)
Thanks for watching!
I get it the other way around. My watch gives a 94 and my finger monitor gives me 98.
So, what’s up with that?
Excellent information ! Thanks !
That's why we say apple a day keeps doctors away 😂😂
I guess it's good that you're explaining this, but as an Apple Watch owner without knowledge on the topic I've never assumed this blood oxygen feature tells you how much actual blood you have, I think it's only a few people who stupidly assume that's the case.
Rightnow its showing 89% is it good ?
if buying an apple watch for a senior person and primarily for the acute health features (such as detecting a fall), is there a good justification to buying the apple watch series 7 over the SE, or are the cardiology features non essential in this respect? I would really appreciate your thoughts on this.
Great explanation. Well presented. What would you recommend for an in home pulse ox reader?
Thank you for this. What about the oura ring or device that transmit light from a to b? Could a watch band help these o2 level readings when it takes 2 point readings ?
Thank you so much. I think you just save me quite a bit of money.
ok but in practical application where hemoglobin content is fairly constant it does provide enough feedback from static state to workout or from sea level to high elevation no?
I have anemia and I am very athletic, I go through periodic fatigue + anemic flare ups. I currently don’t own an Apple Watch but O2 level reader definitely caught my eyes. Do you think it will help with monitoring my Anemic symptoms?
There's no monitor that replaces symptomatology. Plus the pulse oximetry technology won't really tell you anything about your anemia (ie, your hemoglobin concentration).
Thank you so much!!!
So as someone with PAH and on oxygen 24/7 what device do you suggest I purchase to alert me of low oxygen levels? Id like to wear something all the time.
How to if my pulse oxymeter if accurate ?. i order it online
When I go to the doctors they say my blood oxygen is great but I always feel short of breath since COVID 4 months ago is the finger test enough to tell me that I don't have enough oxygen in my blood
Thank you so much for the wonderful video.
Thanks
ok so should I get workout smartwatch with O2 sensor or not?
I have a question. I am 73 and have a lot of shortness of breath. In 2015 I had a triple bypass, and presently I have apnea but cannot use the cpap machines because it makes my stuffy sinuses even more stuffy and basically I can’t sleep with the machine on. I’ve started gargling warm salt water before bed which has improved the sinuses greatly so I’m glad that’s helping. My question to you is why don’t either my general physician or cardiologist seem to be concerned at all about my shortness of breath? I have stress in my job so I usually blame the shortness of breath on that but that’s not the only time I get it. Thank you for your thoughts on this.
Great explanation and enjoyable video. I have long covid and recovering at home. I was going to get the watch as wearing my battery operated oximeter can be tricky. I have brain fog too so apologies for lack of understanding. Oxygen deprivation is a pain.
Yo man I get u ! My brother has the same problem... don’t loose hope
@@kreemo916 thanks man, us longhaulers have it hard so your support means a lot. I’m in my 8th month now. How’s your brother doing? Has he got support?
I'm searching for the best wearable heart rate monitor for my daughter. She has high blood pressure and a recent stroke. I want something to help with her overall health, any recommendations are welcomed.
Oh well, I guess that's another one the adage creators got wrong. An Apple a day may not keep the doctor away, make sure your Apples are ripe! Thanks, Doc. This one is for you🍎!
yes they are good as long as they are good and yes it can be an optimal parameter year to detect something that saturation and bpm but you can have good saturation and die Gasometry No. 1 year to detect insufficient breathing
Are there any devices we can buy that will include the hemoglobin concentration? I was planning to buy the watch just for this feature but I only because I suspect I have anemia. I’m forever getting crazy heart beats and fatigue. I know it’s nothing to worry about because it’s been going on for years but if I can monitor it that would be great. We also can’t get the ECG feature in Australia.
Masimo's SpHb (www.masimo.com/technology/co-oximetry/sphb/) provides much of the information I need in a clinical setting; however, I'm not sure of any noninvasive devices for consumer use that can measure hemoglobin.
How about getting 2-3 simple blood tests from your/a doctor???