Any clues to why my oxygen is so low based on sleepyhead?

When I was first diagnosed a year ago I had SpO2 under 90% for the full time of the original sleep test. I was told that my moderate OSA didn't account for such a low oxygen level. I had a few tests for lung and heart and was told everything was normal. I never got a diagnosis.
APAP helped a bit. Mostly it didn't allow the dips. My basal SpO2 was about 90%.
My BMI was between 29 and 30 and I have GERD. I reduced my weight by about 30lb during the first 2 months after diagnosis, and also started treating my GERD seriously (PPI). Elevate bed, don't eat within 4 hours of bedtime. After about 1 month my oxygen level started to improve. After a few months my basal SpO2 got to about 94%, where it currently is.

https://www.mdedge.com/internalmedicine ... tion-flags

I don't have it. I have note that just says the info I have but don't have the actual test data with graphs. I haven't seen it but hope to get it Monday .

Understanding what your problem is is I'm sure a top priority goal, but in the mean time have you considered adding supplemental oxygen to your cpap therapy?

Josiah wrote:Understanding what your problem is is I'm sure a top priority goal, but in the mean time have you considered adding supplemental oxygen to your cpap therapy?

Bad idea. You don't add oxygen on a whim. There should be a clear diagnosis and a firm reason to add oxygen.

Don't worry, no doctor (except a quack) would add it based on the limited information the OP has given here.

DeepFriedDuck wrote:

Josiah wrote:Understanding what your problem is is I'm sure a top priority goal, but in the mean time have you considered adding supplemental oxygen to your cpap therapy?

Bad idea. You don't add oxygen on a whim. There should be a clear diagnosis and a firm reason to add oxygen.

Don't worry, no doctor (except a quack) would add it based on the limited information the OP has given here.

It's funny you say this.... What kind of Dr. Do I have? Mine reviewed the results of overnight oximetry which again for those who haven't read first page is 93 minutes under 88% with a low of 79% and 55% of 9 hours and 23 minutes under 90%. These results are worse then my sleep study results 2 months or so ago when I wasn't even on therapy and my AHI was 35 and now is less then 1 usually.

Nurse told me my Dr said no to oxygen and I didn't need any treatment at all. Not so much as a we need you to come in or let's run some other tests. Just we aren't going to do anything. What kind of Dr is that lol?

Monday I have appointment at sleep center to go over the results with them to see what they recommend. Plus I asked for second opinion at VA and it's been escalated to Chief there who I trust.

Josiah wrote:Understanding what your problem is is I'm sure a top priority goal, but in the mean time have you considered adding supplemental oxygen to your cpap therapy?

Honestly this is what I want to do. Give me some oxygen so I can at least function . My memory is getting really bad so I started writing down my issues so I don't forget them.

Here is my list so far
People around me have said I am 50% dumber then normal
I am very forgetful now
I am having more headaches
Chest pain more often for which they have found no cause
More shortness of breath which hasn't been looked into at all
Trouble concentrating
Getting dizzy
Still coughing even though stopping Lisinopril a few weeks ago
Less patience
Exhaustion getting worse after it initially got a little better with therapy
Zoning out and forgetting what I was doing which is getting worse.
My thought filter is gone so I pretty much say what I think and hold nothing back

So my doctor wants to do nothing lol.

My 2 cents.
https://www.medicalnewstoday.com/articles/314531.php

What drugs are you taking?

Have you recently had a major life change such as retirement?

Currently in amplodipine besylate and hydrochlorothiazide which replaced lisinopril.i wish I could retire at 33! Crazy work schedule so I thought I was burned out but then found out I had sleep apnea. Had tonsils taken out when I was 20 if that matters and for a while had stuff going up nose afterwards.

Plot thickens??? Respiratory rate changes significantly between days and it was on the upper side night of latest oximetry test.

I'm only going to repeat my self a bit. I would delete the part of adjust pressure to 9, near fixed pressure for a night. Saying it 4 times is just silly. I'd just say the, go and see doctor part, again. He should titrate you and you may need to be moved from cpap to bpap.

ajack wrote:I'm only going to repeat my self a bit. I would delete the part of adjust pressure to 9, near fixed pressure for a night. Saying it 4 times is just silly. I'd just say the, go and see doctor part, again. He should titrate you and you may need to be moved from cpap to bpap.

I'll be honest you seem intelligent and you seem to know what your talking about. I'm not trying to be difficult or ungrateful. Could you please explain the mechanics of pressure of 9 helping vs my current of 6 with 90% being 8 and highest it's ever gotten in 13.
The idea of more pressure seems to make sense on the face of it definitely. But when I had to pressure without CPAP my 02 was better. That's what I'm confused about. I'm always willing to admit when I'm wrong and open to all ideas so please don't give up on me lol

PS my RT scared me a bit and said not to tell Dr assassin I changed my prescription already. I have argument that I have a right to be apart of my health care decision making lol

http://www.prehospitalpush.com/2016/02/ ... 2-problem/

Bipap?

USMCVet wrote:

ajack wrote:I'm only going to repeat my self a bit. I would delete the part of adjust pressure to 9, near fixed pressure for a night. Saying it 4 times is just silly. I'd just say the, go and see doctor part, again. He should titrate you and you may need to be moved from cpap to bpap.

I'll be honest you seem intelligent and you seem to know what your talking about. I'm not trying to be difficult or ungrateful. Could you please explain the mechanics of pressure of 9 helping vs my current of 6 with 90% being 8 and highest it's ever gotten in 13.
The idea of more pressure seems to make sense on the face of it definitely. But when I had to pressure without CPAP my 02 was better. That's what I'm confused about. I'm always willing to admit when I'm wrong and open to all ideas so please don't give up on me lol

min pressure or peep pressure is one of the main ways you increase o2. It was just to see how you went and if you needed to seek further treatment before your next appointment. The VA will take this seriously for you and do a sleep study. Jump up and down if the doctor you see hesitates, in referring you to the pulmonary unit for an assessment and sleep study.

At the end of the day it doesn't matter, as your issues will be resolved through VA.
I was being conservative at 9 but it is about your 95% pressure. for 95% of the night you are under this and 5% you are over this.. If you were going to go fixed cpap pressure it is one of the main numbers used. It was to remove some of the variables you are having and see what basic cpap will do.

Aggressive would be for a medical person to have the min on 10, see the result, if still no good, then try 15. if still no good, it's the end of cpap and move up the machine list, try bpap and if still no good and can't keep the o2 above 90%, supplemental o2. o2 is the last on the list, given your charts and you are 93/94 during the day. so don't buy an o2 concentrator off of C/List. A change to bpap is a high probability