Abstract
Objectives
Methods
Results
Conclusions
Keywords
Introduction
- Braun F
- Theurillat P
- Proenca M
- et al.
- Braun F
- Theurillat P
- Proenca M
- et al.
Participants and methods
Participants
Tested device

Performance evaluation of oxygen saturation obtained using GW4
SpO2 calculation method
Performance evaluation of WristO2 and the association between AHI and GW4-ODI
Statistical analysis
Results
Variables | All | Normal (n = 18) | Mild OSA (n = 21) | Moderate OSA (n = 23) | Severe OSA (n = 35) | P value |
---|---|---|---|---|---|---|
Demographics | ||||||
Age, years | 44.4 ± 13.0 | 39.1 ± 15.0 | 47.3 ± 12.3 | 43.4 ± 13.7 | 46.0 ± 11.5 | .30 |
Male, n (%) | 74 (76.3) | 10 (55.6) | 12 (57.1) | 18 (78.3) | 34 (97.1) | <.001 |
BMI, kg/m2 | 26.3 ± 4.4 | 23.4 ± 2.4 | 24.3 ± 3.1 | 26.1 ± 5.0 | 29.2 ± 3.9 | <.001 |
PSG parameters | ||||||
Total sleep time, min | 342.4 ± 61.3 | 364.9 ± 56.0 | 347.4 ± 52.7 | 351.1 ± 53.4 | 322.2 ± 69.4 | .22 |
Sleep latency, min | 11.1 ± 12.9 | 14.3 ± 14.7 | 10.5 ± 8.6 | 11.9 ± 18.6 | 9.3 ± 9.1 | .63 |
Sleep efficiency, % | 82.9 ± 11.2 | 82.0 ± 11.3 | 84.5 ± 9.4 | 84.6 ± 9.6 | 81.3 ± 13.1 | .73 |
WASO, % | 14.9 ± 10.8 | 15.4 ± 10.6 | 13.3 ± 9.3 | 12.9 ± 9.4 | 16.8 ± 12.5 | .53 |
Arousal index, /h | 29.3 ± 20.1 | 17.1 ± 6.5 | 18.8 ± 7.5 | 23.1 ± 6.3 | 45.9 ± 24.5 | <.001 |
AHI, /h | 28.9 ± 27.4 | 2.8 ± 1.4 | 9.2 ± 3.2 | 21.2 ± 3.7 | 59.1 ± 22.8 | .73 |
Lowest SpO2, % | 84 ± 8.5 | 92.0 ± 2.8 | 87.0 ± 5.2 | 86.1 ± 3.3 | 76.7 ± 8.9 | <.001 |
ODI, /h | 24.3 ± 26.6 | 2.0 ± 1.8 | 7.0 ± 3.6 | 15.2 ± 6.3 | 52.1 ± 25.7 | <.001 |
Oxygen saturation
- Fine I
- Kaminsky A
- Braun F
- Theurillat P
- Proenca M
- et al.

Performance evaluation
Specification | Values |
---|---|
RMSE | 2.28% |
Bias | -0.16% |
95% lower limit of bias | -4.63% |
95% upper limit of bias | 4.31% |
Total data duration | 672.3 hours |
Valid data duration | 490.8 hours |
Data rejection rate | 26.5% |

Performance based on the severity of OSA

Association between AHI ≥15/h and GW4-ODI


ODI cutoff value | Sensitivity, % | Specificity, % | PPV, % | NPV, % | Accuracy, % |
---|---|---|---|---|---|
≥5/h | 89.7 | 64.1 | 78.8 | 80.6 | 79.4 |
≥10/h | 74.1 | 89.7 | 91.5 | 70.0 | 80.4 |
≥15/h | 56.9 | 100 | 100 | 60.9 | 74.2 |
≥20/h | 48.3 | 100 | 100 | 56.5 | 69.1 |
Discussion
Vandecasteele K, Làzaro J, Cleeren E, et al. Artifact detection of wrist photoplethysmograph signals. In Proceedings of the 11th International Joint Conference on Biomedical Engineering Systems and Technologies. Volume 3: BIOSIGNALS, ISBN 978-989-758-279-0, pages 182-189. DOI: 10.5220/0006594301820189
Phillips C, Liaqat D, Gabel M, de Lara E. WristO2: reliable peripheral oxygen saturation readings from wrist-worn pulse oximeters. 2021 IEEE International Conference on Pervasive Computing and Communications Workshops and other Affiliated Events (PerCom Workshops) 2021:623-629. doi: 10.1109/PerComWorkshops51409.2021.9430986.
Accuracy of SpO2 measurements during sleep
- Braun F
- Theurillat P
- Proenca M
- et al.
Association between AHI ≥ 15/h and GW4-ODI
- Waseem R
- Chan MTV
- Wang CY
- Seet E
- Chung F
- Waseem R
- Chan MTV
- Wang CY
- Seet E
- Chung F
- Dawson A
- Loving RT
- Gordon RM
- et al.
Limitations
Conclusions and future work
Authors’ contribution
Declaration of conflict of interest
Funding
Appendix. Supplementary materials
References
- Photoplethysmography and its application in clinical physiological measurement.Physiol Meas. 2007; 28: R1https://doi.org/10.1088/0967-3334/28/3/R01
- Wearable photoplethysmographic sensors—past and present.Electronics. 2014; 3: 282-302https://doi.org/10.3390/electronics3020282
- A comparison of reflective photoplethysmography for detection of heart rate, blood oxygen saturation, and respiration rate at various anatomical locations.Sensors (Basel). 2019; 19: 1874https://doi.org/10.3390/s19081874
- Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring.Biosensors (Basel). 2021; 11: 126https://doi.org/10.3390/bios11040126
- Pulse oximetry at the wrist during sleep: performance, challenges and perspectives.Annu Int Conf IEEE Eng Med Biol Soc. 2020; : 5115-5118https://doi.org/10.1109/embc44109.2020.9176081
- Wrist-sensor pulse oximeter enables prolonged patient monitoring in chronic lung diseases.J Med Syst. 2019; 43: 230https://doi.org/10.1007/s10916-019-1317-2
- Wearable pulse oximetry measurements on the torso, arms, and legs: a proof of concept.Mil Med. 2017; 182: 92-98https://doi.org/10.7205/MILMED-D-16-00129
- Prevalence of obstructive sleep apnea in the general population: a systematic review.Sleep Med Rev. 2017; 34: 70-81https://doi.org/10.1016/j.smrv.2016.07.002
- The value of oxygen desaturation index for diagnosing obstructive sleep apnea: a systematic review.Laryngoscope. 2021; 131: 440-447https://doi.org/10.1002/lary.28663
- Accuracy and reliability of pulse O2 saturation measured by a wrist-worn oximeter.Int J Sports Med. 2021; 42: 1268-1273https://doi.org/10.1055/a-1337-2790
- Validation of the Withings ScanWatch as a wrist-worn reflective pulse oximeter: prospective interventional clinical study.J Med Internet Res. 2021; 23: e27503https://doi.org/10.2196/27503
- Accuracy and reliability of commercial wrist-worn pulse oximeter during normobaric hypoxia exposure under resting conditions.Res Q Exerc Sport. 2021; 92: 549-558https://doi.org/10.1080/02701367.2020.1759768
- Pulse oximetry: understanding its basic principles facilitates appreciation of its limitations.Respir Med. 2013; 107: 789-799https://doi.org/10.1016/j.rmed.2013.02.004
- The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications, version 2.4. American Academy of Sleep Medicine, Darien, IL2017
- Venous pooling and drainage affects photoplethysmographic signals at different vertical hand positions.SPIE. 2015; 9332 (Optical Diagnostics and Sensing XV: Toward Point-of-Care Diagnostics): 9332
- Possible error in reflection pulse oximeter readings as a result of applied pressure.J Healthc Eng. 2019; 7293813https://doi.org/10.1155/2019/7293813
- How will the digital tools change healthcare?.J Sleep Med. 2019; 16: 71-74https://doi.org/10.13078/jsm.190040
- Future sleep medicine: mobile health and big data.J Sleep Med. 2019; 16: 1-10https://doi.org/10.13078/jsm.18016
- Reflectance pulse oximetry: practical issues and limitations.ICT Express. 2016; 2: 195-198https://doi.org/10.1016/j.icte.2016.10.004
Vandecasteele K, Làzaro J, Cleeren E, et al. Artifact detection of wrist photoplethysmograph signals. In Proceedings of the 11th International Joint Conference on Biomedical Engineering Systems and Technologies. Volume 3: BIOSIGNALS, ISBN 978-989-758-279-0, pages 182-189. DOI: 10.5220/0006594301820189
Phillips C, Liaqat D, Gabel M, de Lara E. WristO2: reliable peripheral oxygen saturation readings from wrist-worn pulse oximeters. 2021 IEEE International Conference on Pervasive Computing and Communications Workshops and other Affiliated Events (PerCom Workshops) 2021:623-629. doi: 10.1109/PerComWorkshops51409.2021.9430986.
- The effect of venous pulsation on the forehead pulse oximeter wave form as a possible source of error in SpO2 calculation.Anesth Analg. 2005; 100: 743-747https://doi.org/10.1213/01.Ane.0000145063.01043.4b
- Effect of respiratory-induced intensity variations on finger SpO2 measurements in volunteers.Annu Int Conf IEEE Eng Med Biol Soc. 2013; 2013: 3937-3940https://doi.org/10.1109/embc.2013.6610406
- The light-tissue interaction of pulse oximetry.Anesth Analg. 2007; 105: S10-S17https://doi.org/10.1213/01.ane.0000269522.84942.54
- Accuracy of pulse oximetry during hypoxemia.South Med J. 1994; 87: 518-521https://doi.org/10.1097/00007611-199404000-00019
- Errors in 14 pulse oximeters during profound hypoxia.J Clin Monit. 1989; 5: 72-81https://doi.org/10.1007/BF01617877
- Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine.J Clin Sleep Med. 2012; 8: 597-619https://doi.org/10.5664/jcsm.2172
- Oxygen desaturation index differs significantly between types of sleep software.J Clin Sleep Med. 2017; 13: 599-605https://doi.org/10.5664/jcsm.6552
- Value of pulse oximetry watch for diagnosing pediatric obstructive sleep apnea/hypopnea syndrome.Acta Otolaryngol. 2018; 138: 175-179https://doi.org/10.1080/00016489.2017.1384569
- Pulse oximetry monitor feasible for early screening of obstructive sleep apnea (OSA).J Med Biol Eng. 2019; 40: 62-70https://doi.org/10.1007/s40846-019-00479-6
- Predictive performance of oximetry in detecting sleep apnea in surgical patients with cardiovascular risk factors.PLoS One. 2021; 16e0250777https://doi.org/10.1371/journal.pone.0250777
- Assessing the Fit of the Model. Applied Logistic Regression.3rd ed. John Wiley & Sons Inc., New Jersey, NJ2013: 177
- Pulse oximetry: sufficient to diagnose severe sleep apnea.Sleep Med. 2002; 3: 133-138https://doi.org/10.1016/s1389-9457(01)00122-8
- Diagnosis of obstructive sleep apnea using pulse oximeter derived photoplethysmographic signals.J Clin Sleep Med. 2014; 10: 285-290https://doi.org/10.5664/jcsm.3530
- Oxygen desaturation index from nocturnal oximetry: a sensitive and specific tool to detect sleep-disordered breathing in surgical patients.Anesth Analg. 2012; 114: 993-1000https://doi.org/10.1213/ANE.0b013e318248f4f5
- Type III home sleep testing versus pulse oximetry: is the respiratory disturbance index better than the oxygen desaturation index to predict the apnoea-hypopnoea index measured during laboratory polysomnography?.BMJ Open. 2015; 5e007956https://doi.org/10.1136/bmjopen-2015-007956
- Validation of overnight oximetry to diagnose patients with moderate to severe obstructive sleep apnea.BMC Pulm Med. 2015; 15: 24https://doi.org/10.1186/s12890-015-0017-z
- Evaluation of pulse oximeter derived photoplethysmographic signals for obstructive sleep apnea diagnosis.Medicine (Baltimore). 2017; 96: e6755https://doi.org/10.1097/MD.0000000000006755
Pulse Oximeters - Premarket Notification Submissions [510(k)s]: Guidance for Industry and Food and Drug Administration Staff. 2013.
Article info
Publication history
Identification
Copyright
User license
Creative Commons Attribution (CC BY 4.0) |
Permitted
- Read, print & download
- Redistribute or republish the final article
- Text & data mine
- Translate the article
- Reuse portions or extracts from the article in other works
- Sell or re-use for commercial purposes
Elsevier's open access license policy