Pulse oximetry is a well-established tool routinely used in many settings o
f modern medicine to determine a patient's arterial oxygen saturation and h
eart rate. The decreasing size of pulse oximeters over recent years has bro
adened their spectrum of use. For diagnosis and treatment of sleep-disorder
ed breathing, overnight pulse oximetry helps determine the severity of dise
ase and is used as an economical means to detect sleep apnea. In this artic
le, we outline the clinical utility and economical benefit of overnight pul
se oximetry in sleep and breathing disorders in adults and highlight the co
ntroversies regarding its limitations as presented in published studies.