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Does Measurement Site Matter? A Comparison Between Finger, Forehead, and Toe Pulse Oximetry Measurements in
Kellie R Strickland1,2,3, Chris J Brown3, Leigh Wilks2
1School of Science, Technology and Engineering, University of the Sunshine Coast, Sippy Downs, Queensland, Australia.
Journal of Sleep Research
|July 17, 2026
Summary
Peripheral blood oxygen saturation (SpO2) measurement site matters in sleep studies. Forehead readings showed fewer artifacts and desaturations compared to finger or toe, impacting sleep disorder diagnosis.
Area of Science:
- Sleep Medicine
- Cardiorespiratory Physiology
Background:
- Accurate peripheral blood oxygen saturation (SpO2) monitoring is crucial for diagnosing sleep disorders.
- Pathological breathing events during sleep can cause significant SpO2 desaturations.
Purpose of the Study:
- To compare SpO2 measurements from finger, forehead, and toe sites during polysomnography (PSG).
- To assess the impact of anatomical site selection on SpO2 variability and artefact occurrence.
Main Methods:
- Synchronized SpO2 recordings from 41 sleep patients at finger, forehead, and toe sites.
- Comparison of SpO2 desaturations, signal dropouts, and artefact occurrences against finger oximetry.
Main Results:
- Significant differences in mean SpO2, desaturations per hour, and time below 95% SpO2 across sites (p < 0.01).
- Forehead oximetry yielded higher mean SpO2, fewer desaturations, and less artefacts.
- Finger oximetry had the most signal dropouts (p < 0.01), while finger and toe showed strong concordance for desaturations (r = 0.948).
Conclusions:
- Anatomical site choice for SpO2 measurement during PSG significantly affects sleep disorder classification and diagnosis.
- Perfusion variability may explain SpO2 measurement differences between sites.
- Further research is needed to identify the optimal anatomical site for SpO2 monitoring in sleep patients.
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