Oximeter Results Help? Newbie Train Snorer

[studio500]

Hello Everyone

I'm new here and looking for some help and advice.
I have tried searching for a few hours so apologies if posted wrongly.

I'm a 45 year old Male, sadly a smoker and a pensioned policeman due to health grounds. I snore like a steam train and have done since childhood.

I was pensioned from the force due to suspected TIA's or damage caused by regular Hemiplegic Migraine which cause temp numbness down my one side and sleep disturbances. I have headaches daily, a chronic short term memory oh and a recently diagnosed moderate hole in my heart plus a right bundle branch block. I feel like a bag of plop every morning and have days of zero energy when even climbing stairs is a chore. I'm pretty slim in build, 5ft 10ins 1.78m and weigh around 180lbs.

Anyhooooo, I purchased an oximeter due to my elderly mother and daughter who both profoundly hold there breath for what seems like forever during sleep. I guess it's Apnea and wanted to check myself out.

My wrist machine is a CMS50F

I have read through many posts and have an understanding of how the results are displayed etc and I know my GP is the best person to diagnose but I hate making a nuisance of myself.

Would anyone please give me a loose idea if it is even worth me going to see him based on my results.

My Oximetry report is below.
I think my 02 levels look ok compared to some I have seen but my pulse seems very low.

I have 13 SP02 Events and 104 Pulse Events.
I'm trying to find out if I do have a sleep Apnea problem or not before wasting my docs time.



I would really appreciate your thoughts as at present it's all a little strange to me.

My regards

Studio500

[HoseCrusher]

Pulse oximeter data can't provide information on arousals that can interfere with sleep, but it does give information on obstructions that cause oxygen desaturation.

Since you didn't have any desaturations below 90%, obstructions are not a problem.

Keep in mind that you can have other problems that erode the quality of your sleep, but you don't seem to show the data that indicates classic obstructive sleep apnea.

Your pulse rate looks fine.

To get a better idea of your oxygen levels, you can expand the scale to 10 minutes per screen and look at the oxygen levels at that magnification. Apneas cause a saw tooth pattern of desaturation.

Code: Select all

    **
   *   *
  *       *
 *            *
                 *

Something like that with the desaturation dropping lower each time. When it drops low enough, your heart rate will increase, you will wake up a little, and then take a breath that will increase your oxygen saturation back to where it should be.

[studio500]

Thank you so much for your reply, it really is appreciated very much.

I was perhaps being over concerned as my pulse would drop to 37 a few times but I will do a few more tests in the next few days.

I have posted a few of the 10 min prints below which seems to show the saw pattern you describe.

At least I probably wont have to bother my doctor now which is good. I just wish that I didn't wake up with a hangover most days and I don't even drink lol









I know my watch alarm went off a few times during the night but my brain just doesn't work when I wake up lol, even in the morning I have to wait an hour to come round

Thank you once again for taking the time to give me such a great reply.

[studio500]

If it turns out to be just a result of snoring I was going to buy a chin strap and see how it goes.

The sad thing is I've recently got married and I think my new wife is wishing that she hadn't

Oh and I forgot to add that very often I will wake at night saturated in sweat (Nice I Know), my T shirt will often be drenched or the exact opposite I am freezing cold to the core as if I've been outside all night.

We don't have any heating on in the room and it's winter here but even my hair can be drenched which is never under the quilt. I'm at a loss to explain this.

[HoseCrusher]

OK, next you need to look at variations in heart rate while those desaturations are going on.

If you look at the data from about 7:57:30, you see the heart rate increase at the same time as the saturation goes up. Then there is a small desaturation and the heart rate drops down. At 7:58 you seen another rise in heart rate that corresponds to a saturation peak and it is followed by a small desaturation.

The pulse oximeter reads heart rate instantly, but the oxygen saturation is measured at your finger and there is a time delay between the blood pumping from your heart to finally being measured at your finger.

With obstructive events you see a desaturation. About 1/3 into the desaturation, you see an increase in heart rate. This increase will ramp up and peak about the time of the valley of the desaturation. Then the heart rate will drop off and the oxygen saturation will sharply rise. I seem to recal that the transit time from the heart to the finger tip being around 12 seconds, or something like that. This accounts for the offset.

This is where the pulse events come in. You go to the beginning of a pulse event, backtrack 15 seconds or so and review what is going on with oxygen saturation. The magnitude of the pulse rate change varies, but a good starting point is to look at a 10% change. If your pulse rate is 60 beats per minute and it suddenly jumps to 66 beats per minute, it is worth looking at the saturation levels to see what is going on.

Your pulse event at 8:09:20 comes close to illustrating this, but it is still a little off.

Remember that there are natural variations on oxygen saturation and pulse rate that take place while we sleep. While this adds "noise" to the data, significant patterns do develop and can be recognized.

[Pugsy]

Not everyone with OSA will experience significant Oxygen level drops. While most will, not everyone will.
If 95% of the people with OSA had desats, that still leaves the 5% that don't. (I don't know the exact breakdown, numbers chosen for explanation purpose)
Not everyone that snores has OSA. There are people with OSA that don't snore.

So while you may not exhibit one of the classic symptoms (Oxygen desat) it is possible to still have OSA. It is also possible that something other than OSA is contributing to your symptoms.

An unremarkable overnight pulse ox doesn't automatically give a person the "all's clear". It just means that there may be other things and even mild OSA with no desats, could still be a problem that warrants attention.

If you are concerned enough to use the pulse ox and come here, then talk to your doctor about all of it. Get a complete work up. You may not have OSA (we don't really know from just the pulse ox) but there are many other things that disturb sleep and many other physical causes for fatigue, drowsiness, etc.

[snnnark]

I have to respectfully disagree with Hose crusher. I think you do have a case for a sleep study. AFAIK the official definition of an apnea is 4% desaturation. And I see plenty of those. They do not go below 88% but they are still desaturations. And with heart damage there may be cheyne stokes respiration which may also explain the saw tooth pattern.

On my sleep study my O2 levels did not drop below 92% but I was diagnosed with borderline severe OSA 30.1 AHI.

If Studio500 can swing it I would suggest a sleep study.

Just my IUESHO (ignorant uninformed ever so humble opinion) !

[studio500]

OK, next you need to look at variations in heart rate while those desaturations are going on.

If you look at the data from about 7:57:30, you see the heart rate increase at the same time as the saturation goes up. Then there is a small desaturation and the heart rate drops down. At 7:58 you seen another rise in heart rate that corresponds to a saturation peak and it is followed by a small desaturation.

The pulse oximeter reads heart rate instantly, but the oxygen saturation is measured at your finger and there is a time delay between the blood pumping from your heart to finally being measured at your finger.

With obstructive events you see a desaturation. About 1/3 into the desaturation, you see an increase in heart rate. This increase will ramp up and peak about the time of the valley of the desaturation. Then the heart rate will drop off and the oxygen saturation will sharply rise. I seem to recal that the transit time from the heart to the finger tip being around 12 seconds, or something like that. This accounts for the offset.

This is where the pulse events come in. You go to the beginning of a pulse event, backtrack 15 seconds or so and review what is going on with oxygen saturation. The magnitude of the pulse rate change varies, but a good starting point is to look at a 10% change. If your pulse rate is 60 beats per minute and it suddenly jumps to 66 beats per minute, it is worth looking at the saturation levels to see what is going on.

Your pulse event at 8:09:20 comes close to illustrating this, but it is still a little off.

Remember that there are natural variations on oxygen saturation and pulse rate that take place while we sleep. While this adds "noise" to the data, significant patterns do develop and can be recognized.

I see what you mean, so they work together but with a delay. I was looking at them with a direct comparison but that certainly helps. So my sats arn't at all bad except for the odd peak and trough. I was surprised to see so many pulse events that seem to register either side of a sp02 event but I guess that could also be affected by a dream or noise etc.

Would it help to wear the device again for a few nights or are the results likely to be the same. ie is Apnea there always or could it be sporadic?

[studio500]

Not everyone with OSA will experience significant Oxygen level drops. While most will, not everyone will.
If 95% of the people with OSA had desats, that still leaves the 5% that don't. (I don't know the exact breakdown, numbers chosen for explanation purpose)
Not everyone that snores has OSA. There are people with OSA that don't snore.

So while you may not exhibit one of the classic symptoms (Oxygen desat) it is possible to still have OSA. It is also possible that something other than OSA is contributing to your symptoms.

An unremarkable overnight pulse ox doesn't automatically give a person the "all's clear". It just means that there may be other things and even mild OSA with no desats, could still be a problem that warrants attention.

If you are concerned enough to use the pulse ox and come here, then talk to your doctor about all of it. Get a complete work up. You may not have OSA (we don't really know from just the pulse ox) but there are many other things that disturb sleep and many other physical causes for fatigue, drowsiness, etc.

Thank you for your reply Pugsy.

I didn't know that, I thought most snorers had OSA, it just shows my level of ignorance for which I apologise.

My snoring seems to be getting worse, much worse which is why I bought the machine. In fact I can even snore in the day while awake when I'm working lol, to me that's weird. I can feel like the back of my throat and nose passage kind of collapse if that makes any sense.
Plus my night sweats and night freezes were causing me concern. My doctor is pretty harsh and short to say the least. At least I don't think I need to bother him just yet or not perhaps until I have monitored a few more nights. I just wish my brain fog would clear but that's probably just my make up.

Please don't think I'm not following your sdvice about seeing my Doc, I think I will if I have a little more to go on.
Last nights sleep actually felt pretty good compared to many that I have, so time may reveal more info.

I really appreciate your reply

Studio500

[Pugsy]

Please don't think I'm not following your sdvice about seeing my Doc, I think I will if I have a little more to go on.

I understand. My husband told me for 2 years that I stopped breathing and I still never told the doctor.

You may or may not have OSA. I just wanted to clarify that a "negative" pulse ox doesn't always mean negative for OSA.

With your other complaints and problems, OSA would be a likely culprit but then again so could a lot of other things.

Don't wait too long getting into the mindset that you want to investigate the cause or causes of not feeling so good.

[Leadhead]

Studio
I was feeling awful every morning and had the same brain fog you talk about. I was so tired during the day that I was afraid of losing my job. I told my doctor about it and told him I thought I had sleep apnea. He dismissed it and told me to get more sleep. I went around him and went to a sleep doctor who listened to me and gave me a sleep study. I was diagnosed with severe apnea at 90 OAs.
If you are not comfortable talking to your doctor, get a new one...you are responsible for your health and no one else.

[studio500]

I have to respectfully disagree with Hose crusher. I think you do have a case for a sleep study. AFAIK the official definition of an apnea is 4% desaturation. And I see plenty of those. They do not go below 88% but they are still desaturations. And with heart damage there may be cheyne stokes respiration which may also explain the saw tooth pattern.

On my sleep study my O2 levels did not drop below 92% but I was diagnosed with borderline severe OSA 30.1 AHI.

If Studio500 can swing it I would suggest a sleep study.

Just my IUESHO (ignorant uninformed ever so humble opinion) !

Sorry Snnark, I cross posted and missed your, my sincere apologies.

I'm going to look up cheyne strokes as at present I have no idea what they are.

You see without going into a very long story I was pensioned because they thought I was having mini strokes or possibly TIAs.
They were not sure if it was linked to my hemiplegic migraine and still arn't sure.

They do know I'm suffering from the symptoms of stroke but my scans show no scarring hence no full diagnosis of a stroke. I still get regular numbness in my face and severe pins and needles now and then in my fingers but they think that may be a trapped nerve.

So I was pensioned because of mini strokes which they now say they think I havent had. They think it may be migraine linked but not sure. They found a hole in my heart but say they don't want to operate because of the risk of stroke. My memory is like a goldfishes, I have days when I could take on the world and days when I struggle to get upstairs but no one knows why.

I lost my career of 15 years because of a 'Diagnosis' that now appears unanswered. I snore like a diesel engine and I know that as a fact.

Something is affecting my memory, energy, headaches, sweats etc etc etc but I have no idea what.

I had not even considered any link with those conditions to any sleep problem and I'm writing this before looking up what a Cheyne Stroke may be so as not to taint anything in my mind.(It's prpbably nothing to do with it, it's just the word stroke appearing ).

I thought my sats were ok but I also see the desats you mention. I do know one thing though, I have for as long as I can remember never woken up full of the joys of spring and refreshed lol. I wake up every morning with no ability to communicate (A telephone conversation is impossible) as my brain just doesn't function. I actually feel like I have been hit by a bus lol but I'm used to that.

Right off to research the Cheyne thing.

Thanks you so much again everyone

[studio500]

Studio
I was feeling awful every morning and had the same brain fog you talk about. I was so tired during the day that I was afraid of losing my job. I told my doctor about it and told him I thought I had sleep apnea. He dismissed it and told me to get more sleep. I went around him and went to a sleep doctor who listened to me and gave me a sleep study. I was diagnosed with severe apnea at 90 OAs.
If you are not comfortable talking to your doctor, get a new one...you are responsible for your health and no one else.

Hi Leadhead

Brain Fog.... It's a common joke in my house. "let your Dad come round first", lol it takes at least an hour so I can only empathise what you went through my friend. My Doc is always dismissive and perhaps that's what's holding me back....Hell no...That is what's holding me back.
I'm just so fed up of the every morning hangover and daily head throbs. I've had the latter all my life since my teens yet I have never had an answer just the loss of my career.

I know what you mean about work too as I being a law enforcement officer, I couldn'r remember someone I'd perhaps arrested a few weeks before. Good for them lol not for me and so embarrasing too when I even forget friends names.

I think I may have to bite the bullet and follow your example. I hope you are feeling better now? Has it changed your life much?

My best regards

Studio

[Leadhead]

Studio
Like you, I snored loudly since being a teen. My first wife left me for many reasons but my snoring was certainly one of them. CPAP stops snoring for most people and it did for me. I feel 100% better since going on the machine and my OAs
are now <1. My new wife has no issues with the machine.

Most GP docs know squat about sleep apnea. You should find a specialist if your insurance allows for that.
Good luck and be persistent.

[snnnark]

Stokes... not strokes! It's a breathing pattern caused by low output from the heart. Here are some articles.
http://chestjournal.chestpubs.org/conte ... /1627.full
http://pats.atsjournals.org/cgi/content/short/5/2/226

Not trying to worry you, I just personally feel that the sleep aspect of the way you feel should be investigated.