Can wearable devices accurately measure oxygen saturation (S) in patients with COPD at rest and after physical exercise during pulmonary rehabilitation?
Wearable Pulse Oximeter, a cross-sectional study in 36 participants (Respir Care 2023, PMID 37193599) — for the Apple Watch, the root mean squared error (RMSE) was 3.5% at rest, 4.1% after the 30-s sit-to-stand test, and 3.9% after the 6MWT. Scope: 36 participants, and the abstract states no limitations.
Source: Respir Care 2023, PMID 37193599 ↗ · Research map · How Magellan grades evidence · evidence confidence: medium
Respir Care · 2023 · PMID 37193599 · DOI 10.4187/respcare.10760
Smartwatches are not accurate enough to monitor oxygen saturation in COPD patients during pulmonary rehabilitation.
The question
Can wearable devices accurately measure oxygen saturation (S) in patients with COPD at rest and after physical exercise during pulmonary rehabilitation?
What they tested
The study aimed to examine the accuracy of S readings from wearable devices in patients with COPD, implying a question about their reliability compared to a standard pulse oximeter.
How they did it
This cross-sectional study included 36 participants with COPD (20 women, ages 52-89). Oxygen saturation was measured concurrently using a Contec Pulse Oximeter CMS50D (comparator), an Apple Watch Series 7, and a Garmin Vivosmart 4. Measurements were taken at rest, immediately after a 30-s sit-to-stand test, and after a 6-min walk test (6MWT).
What they found
For the Apple Watch, the root mean squared error (RMSE) was 3.5% at rest, 4.1% after the 30-s sit-to-stand test, and 3.9% after the 6MWT. For the Garmin Vivosmart, RMSE was 3.3% at rest, 6.1% after the 30-s sit-to-stand test, and 5.4% after the 6MWT. Both devices showed considerable measurement variance and tended to be less accurate at lower saturation levels.
| Apple Watch - Rest | 3.5 | |
|---|---|---|
| Apple Watch - Sit-to-Stand | 4.1 | |
| Apple Watch - 6MWT | 3.9 | |
| Garmin Vivosmart - Rest | 3.3 | |
| Garmin Vivosmart - Sit-to-Stand | 6.1 | |
| Garmin Vivosmart - 6MWT | 5.4 |
Root Mean Squared Error (RMSE) values indicate the deviation of smartwatch oxygen saturation readings compared to a pulse oximeter at rest and after two exercise tests.
What it means
The Apple Watch Series 7 and Garmin Vivosmart 4 overestimated S when it was < 95% and underestimated it when S was > 95% in participants with COPD. Wearable devices should not be used for monitoring oxygen saturation during pulmonary rehabilitation.
Limitations
The abstract does not explicitly state limitations beyond the observed inaccuracies of the devices, which inherently limit their utility.
Where the published abstract does not list limitations, we say so rather than inventing them. Read the full paper on PubMed before drawing conclusions.
The paper at a glance
| Title | Assessment of Noninvasive Oxygen Saturation During Pulmonary Rehabilitation: Smartwatch versus Pulse Oximeter |
|---|---|
| Journal | Respir Care |
| Year | 2023 |
| PMID | 37193599 ↗ |
| DOI | 10.4187/respcare.10760 ↗ |
| Topic | General aging biology & healthspan |
Read the source: PubMed record (authors, abstract, full citation) ↗ · Publisher via doi.org ↗
Where Magellan uses this paper
This citation sits behind the evidence grade on the pages below. Grades are set from the research and are independent of affiliate commissions.
Wearable Pulse Oximeter
Research on the biomarker this device tracks - blood-oxygen saturation and nocturnal hypoxemia - links greater overnight oxygen desaturation (quantified as the sleep apnea-specific 'hypoxic burden') to higher risks of hypertension, cardiovascular events, all-cause mortality, and cognitive decline in large cohorts…
A wearable pulse oximeter is a non-invasive device that estimates peripheral blood-oxygen saturation…
Research describes the compound or intervention studied. It is not a claim about any specific product.
Cite this page
These citations point at this summary. To cite the original paper with its full author list, use the PubMed record or doi.org.
Magellan Longevity. (2026). Can wearable devices accurately measure oxygen saturation (S) in patients with COPD at rest and after physical exercise during pulmonary rehabilitation? [Plain-English summary of Respir Care 2023, PMID 37193599, DOI 10.4187/respcare.10760]. Magellan Longevity. https://magellanlongevity.com/study/d37193599.html@misc{magellan_d37193599,
title = {Can wearable devices accurately measure oxygen saturation (S) in patients with COPD at rest and after physical exercise during pulmonary rehabilitation?},
author = {{Magellan Longevity}},
year = {2026},
howpublished = {\url{https://magellanlongevity.com/study/d37193599.html}},
note = {Plain-English summary of PubMed PMID 37193599; DOI 10.4187/respcare.10760; Respir Care 2023. Reviewed by Gabriel Radu, DO},
urldate = {2026-08-11}
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