When is sleep apnea related hypoxia clinically significant?

tiredandscared · Post by **tiredandscared** » Fri Jul 31, 2015 4:11 am

It's a question I've been pondering for a while now. Especially since its the number one factor in sleep apnea disease outcome and all associated comorbidites and complications. When is it significant? I have a mild degree of it (my nightly time below 90% SPO2 is less than 0.1%, in my case closer to 0.09 or even less than that. But my nadir spo2 is 87-86% on bad days) I wake up feeling like my head sleept in the toilet. Ive read of examples of people spending 30% of their sleep time below 90% with a nadir even in the 60s. When is it significant? Do all levels of hypoxia cause problems?

SewTired · Post by **SewTired** » Fri Jul 31, 2015 5:45 am

I'm sure others can clarify this, but some of the studies I've read actually DEFINE hypoxia, in relation to sleep studies, as time spent under 90% blood O2. It could be though, that that was just the guiding line for the study rather than the clinically significant line-in-the-sand where patient is affected that you are describing.

JDS74 · Post by **JDS74** » Fri Jul 31, 2015 6:18 am

My understanding is that the Medicare rules ( and most insurance companies follow the Medicare rules ) indicate that supplemental oxygen is indicated when the SpO2 falls below 88% for a total of 5 minutes or more overnight. The effects of low oxygen (hypoxemia) are non-linear and get rapidly worse as the percentage decreases.

Low oxygen levels as defined by the Mayo Clinic occur when the SpO2 level gets below 90%.
Mayo Clinic on Hypoxemia

HairyReasoner · Post by **HairyReasoner** » Fri Jul 31, 2015 8:40 pm

tiredandscared wrote:It's a question I've been pondering for a while now. Especially since its the number one factor in sleep apnea disease outcome and all associated comorbidites and complications. When is it significant? I have a mild degree of it (my nocturnal time below 90% SPO2 is less than 0.1%, in my case closer to 0.09 or even less than that. But my nadir spo2 is 87-86% on bad days) I wake up feeling like my head sleept in the toilet. Ive read of examples of people spending time in 30% of their sleep time below 90% with a nadir even in the 60s. When is it significant? Do all levels of hypoxia cause problems?

When I had my initial sleep study done I apparently spent a lot of time in the mid 80% range They said I hit a low of 72% at one point (although I wonder if there was an equipment malfunction since that seems almost too low), and that's when they woke me up and started oxygen on me. They then initiated a split study. My takeaway from that is the 80% range is considered not good, and if you're in the 70% range it's considered really bad.

SewTired · Post by **SewTired** » Fri Jul 31, 2015 10:27 pm

I can tell you that the best they could titrate me was 91 percent, but it's hard to separate whether the reason I still don't feel great is because of lower oxygen or still not getting 7-8 hours of uninterrupted sleep. For a comparison, a healthy person under 50 with no apnea does not typically have blood oxygen falling below 95 percent while sleeping. Even with a cold, most still apparently maintain that level.

I'll bet those spot 70s are due to a prolonged apnea.

When is sleep apnea related hypoxia clinically significant?

When is sleep apnea related hypoxia clinically significant?

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Re: When is sleep apnea related hypoxia clinically significant?

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