A question often misunderstood by those with health anxiety is that of Pulse oximeter readings.

Many with heath anxiety will become obsessed with constantly checking and rechecking their pulse ox. So today, I want to explain why the readings can change and often be so different between people.  Many have even gone to the Doctor who reassures them that their readings are normal. Today I will try to explain some reasons why it differs from person to person and why it changes constantly and the different things that can affect it.

Everything I will tell you is all perfectly  normal and expected! The last thing I want is for someone to see an answer and then start to worry about something else.

This should reassure you that if you are breathing and your color is good so there is no need to be concerned.  In fact, there is no need to repeatedly check your pulse ox.

FOR 9 MONTHS an infant lives in the uterus. We do not take a B/P we do not take a pulse ox… we just  excitedly await their arrival!  For 9 months they just grow and develop.  We are so wonderfully made that  it all starts with 2 cells to create a baby.  With this in mind realize that our body functions masterfully. If you can change the way you think about your body and normal body functions, you can become free from health anxiety. You can enjoy your life and not live in fear worry and stress.


It is generally agreed upon that anything over 92 is good. Whether it is 92 – 93 or 98 -99 it makes  no difference.

Even a number slightly under 92 can be perfectly normal on occasion for some specific reasons. IT does not have to mean doom and gloom.

Here are some reasons that alter pulse oximeter reading!

Those more physically  fit, that exercise more may have more consistent higher readings. Think of an athlete they exercise and can lower their pulse  –  because their heart gets stronger and more effective at pumping the blood.

Nail polish and or the thickness of a nail can make it more difficult for pulseoximeters to read correctly. (even some lighting conditions can alter the oximeter not just nail polish) Before surgery we usually remove nail polish on at least one nail.

Your capillaries may be smaller or deeper than someone else’s. (This can be seen with heavier people.) It must first find your pulse. When it is searching you may see a number flash, and until it finds your pulse the numbers may be inaccurate.

Some people  just breath more rapidly, and shallow. They most likely chest breath instead of doing it correctly by belly breathing, using their diaphragm.

Chest breathing even though it is not natural is something that actually most people do. I think women tend to do this more than men, because they are more subconscious about their waistline and if tend to hold it in (even subconsciously), therefore they get a habit of chest breathing. Examples infants belly breath, it is natural. If you lie on your back put your right hand on your belly your left on your chest your right hand should raise with inspiration However, over time many  people convert to chest breathing.

Temperature,  be it by fever or externally, and humidity can also affect your breathing. Ex. Fever/ heat causes an increase in the heart rate, breathing rate and blood circulation to the skin. This is how the body tries to reduce the heat caused by fever. 

Some people run hotter than others, some people have colder hands and feet our circulation may be different than those around us  but we are in good health. Temperature changes even between 2-3 degrees. And humidity between 40 – 60  can  affect different people differently.

The oximeter may fail to detect a signal if the patient is very cold and peripherally vasoconstricted. When you are cold Vasoconstriction takes blood away from the surface of the skin to help prevent it from losing heat. That is it reduces blood flow to the peripheries. Pain can also lead to peripheral vasoconstriction. Vasoconstriction can lead to lower B/P. Medications that cause vasoconstriction include: antihistamines, decongestants, and stimulants. In the cold, blood vessels at the skin’s surface close.

Mucous build up can alter the pulse ox. Ex. Post surgery a person has been asleep they want you to deep breath cough and DB&C…… A simple mucous plug can give me a reading of 88  but after proper DB&Cing, their pulse ox can  increase to the  mid 90’S.   This does not happen immediately!  It takes a little time

Now ask yourself:  Do I ever have mucus congestion, in the morning…. with a cold….. with certain  irritants…  how about allergy symptoms….

IF you cough a few times initially your pulse ox will go down before it goes up.

IF you smoke your pulse ox could be higher, or if there is a lot of side stream smoke  – reason is because the carbon monoxide level in the blood is up (not good) but the oximeter cannot tell the difference.  So, a person smoking may get a  false positive high reading. In fact, side stream smoke can higher in carbon monoxide and give those in close proximitry of the smoker a false positive higher reading as well.

IF it is too bright for example it can alter the reading.

IF you are shivering or moving it can be difficult to pick up a signal.

If you B/P is low or you are dehydrated. If you are dehydrated it can  be more difficult to pick up your pulse because your blood volume will be less. That is why they may tell you to drink a lot before a blood draw if you have small veins. The fluid will increase the size of your veins making it easier to draw.

ANXIETY ! is a big culprit

Even if you just anticipate , i.e. speculate, that when you take your pulse ox it will be of concern that in itself can change the reading.  Here is a good article on How Anxiety Can Cause Shortness of Breath and What You Can Do . And shortness of breath can alter a pulse oximetry reading!

When you start to become even a little bit anxious the first tendency is for people to hold their breath  in anticipation or speculation that something must be wrong. Most people are unaware they hold their breath even a little bit can alter reading.


Also with any simply put any adrenaline rush  from any source,  because fear can put you into fight of flight. Your blood is shunted to the vital organs and major muscles so you can get away… therefore it can alter your B/P PULSE AND PULSE OXIMETER READINGS  as well as producing  cardiac symptoms, digestive symptoms etc. and  that is what adrenaline is supposed to do.


Hope I have given enough reasons for someone to start to change the way they think to help them overcome health anxiety about pulse oximeter readings.

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Published by: Your Path to Freedom

This blog is all about attacking panic attack and anxiety with a positive mindset. Not long ago a good friend disclosed he had been a victim of panic attack for 10 years. I never would have guessed! Isn't that what you would want for yourself? Through trial and error he found what worked for him and we want to share his path to freedom with you.

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