Apple's support guidance for its watch
What blocks a wrist sensor
Low blood flow in the skin, as in the cold, can stop the sensor from getting a reading. Some tattoos block its light. Rhythmic movement such as running reads better than irregular movement. Apple suggests a Bluetooth chest strap when readings stay unreliable.
What this does not show
Guidance from the maker, not a study. It does not say how often gaps happen.
50 adults on a treadmill, bike and elliptical, against ECG
Wrist, arm and chest sensors
The chest strap agreed with ECG most closely. Wrist monitors were less accurate, and their accuracy changed with the activity. The forearm band in the study was less accurate than the best wrist monitor.
What this does not show
One centre, healthy adults, devices from 2016. It measured accuracy, not gaps. Newer arm bands were not tested.
16 adults, 9 activities from lying down to hard intervals
An upper-arm band against a chest strap
An optical band on the upper arm read within about 1.4 bpm of a chest strap on average. The authors suggest the upper arm moves less than the wrist or forearm, so it reads more steadily.
What this does not show
A small study of healthy adults, with one band. It compared heart rate, not gaps.
28 adults at rest, in a warm-up, in burpees and on a graded treadmill test, against a chest strap
The same sensor on the wrist, forearm and upper arm
Three identical sensors were worn at once. The one on the upper arm agreed with the chest strap most closely, and the one on the wrist least. All placements were accurate at rest and in steady running.
What this does not show
Young, healthy adults. Accuracy fell in short, full-body efforts such as burpees, at every placement. It compared accuracy, not gaps.