Low Oxygen while on CPAP

I had an appointment with a new sleep doc today. Had no choice since Medicare demands a periodic new prescription to keep paying for supplies and I didn't like the NP I saw the last two times at the previous sleep doc office. Anyway as part of the exam he looked at my lower legs and commented about the swelling I have in them. I told him about having discussed it with my PCP and his testing my blood for PNB, a marker that indicates congestive heart failure. The results were normal. I also take a water retention pill.

He said leg swelling can be caused by low oxygen levels, and low oxygen level can be caused by essentially a brain malfunction. I said you mean CSA? He said no, that CSA is where the brain fails to trigger breathing even when the airway is open. He indicated this is a case where the brain allows oxygen level to drop even in the presence of normal unobstructed breathing pattern. I didn't think to have him write down the terminology and I don't remember it. He has ordered an oximeter for me to use for a night to monitor my oxygen level while using the CPAP.

My search for info here and on Google came up short. Any of you hear or know of this condition? Can you enlighten me any? I'm sure I'll learn a lot more once I do the O2 monitoring.

I've never heard of his explanation, but out of curiosity - is he a pulmonologist, neurologist, or ??

Don't have answers for you but will be following this thread with interest. There are so many possible factors with swelling that until the different avenues have been explored diagnostically it's anybody's guess. Did your doctor mention anything about anemia? I do know someone whose first sign of anemia was swollen ankles. Red blood cells carry oxygen and anemia is a disorder of the red blood cells. Just one of several things I'm guessing your doctor will be looking at. It sounds like you doc is on top of things so hopefully they'll have answers for you soon. Please do not allow any negative test result stop the search, even if the pursing goes beyond the sleep doctor. Anemia would be during the daytime too, not just at night.

I was never given a cause for my severe pitting and even weeping edema. Increases in the Lasix didn't help. It wasn't until they changed the meds that there was some relief. The Lasix had become ineffective. But anyhow, I find my edema is affected by my sleep. Poor sleep results in swelling not going down overnight. Good sleep and I can see my ankles in the morning. Once I began to get my jumpy legs under control and started getting some real sleep my swelling was better. Guess there's some processes that happen during sleep, I don't know.

Hopefully a methodical ruling out by your doctor will give you answers as well as the path to an effective treatment.

Out of curiosity, what blood pressure medicine are you taking? I found that I can't take Amlodipine without getting severe non-pitting edema.

Hypoventillation. Often "obesity induced hypoventillation." Are you overweight?

AVAPS or iVAPS CPAP machines are the usual treatment.

You can buy a recording pulseoximeter outright for $100 to $150.

It's probably really early to draw conclusions that oxygen is the cause.

I had some of this edema from time to time, and figured out it had to do with the recliner I was sleeping or sitting in. It went away when I changed chairs. Apparently, pressure on the wrong part of the legs or buttocks was restricting blood or lymph flow. You might consider what you're sitting on or your position while you sleep.

Julie wrote:I've never heard of his explanation, but out of curiosity - is he a pulmonologist, neurologist, or ??

Here's his credentials as listed on the med group web site:

Cary Jackson, MD
Education: University of Alabama School of Medicine
Residency: USAF Medical Center, Keesler AFB
Fellowship: Wilford Hall USAF Medical Center - Pulmonary Disease
Specialties: Pulmonology, Sleep Medicine, Critical Care
Board Certifications: Critical Care, Pulmonary Medicine, Sleep Medicine

I'm going to call or stop by and find out what exactly the terminology is he used.

idamtnboy wrote:I'm going to call or stop by and find out what exactly the terminology is he used.

It's your business, not mine. But I would wait until the results of the oximetry study are available. I'll bet you 3:1, that low blood-ox is not causing the swelling.

He certainly looks legit, if nothing else!

You could always write and ask about downsides...