Low oxygen on Bipap reason for tiredness?

Hi all. I have been on Bipap for 1 1/2 year, I have excellent results on AHI but still tired. I have had some good suggestions on adjusting setting s from the folks here and I sleep well and tolerate the mask, even like it. But it has been a struggle and been back to the doc many times. I did sleepy head and one of you, forgive me if I forgot who said my AHI was really good but still had lots of hypopnias. I also was on facebook group and someone said they were on Cpap over a year and had same problems as me. Someone suggested getting intouch with Doctor and pretty much tell them we needed to do the overnight oxygen test because they had same problem and their oxygen levels were still low. They were feeling great now that oxygen was added.
I got to thinking maybe that was my problem. My hypopneas were causing the tiredness and feeling like crap. My Dr agreed to the test and sure enough it is still low level. Got the call from Doc today and they are scheduling another study for me.
Want to thank you for reading my sleepyhead and telling me about hypopneas I would never have known and the Dr I don't think look at anything but Ahi.
Wish me luck that this will make a diffence because I was about to give up after trying for so long.

Thanks,
Sleepyv

Hypopneas are part of the AHI results...

Do you sleep on your back? Hypos are often lessened, if not eliminated by side sleeping instead.

I do sleep on side but go on back too. I toss and turn in sleep. I think I sleep in every position.

I'm happy to know this, I've been trying very hard to figure out why I haven't been feeling well and tired.

What is your average AHI and what is the breakdown? Hypopneas on a bi-level are *usually* addressed by increasing IPAP, while Obstructive Apneas are addressed by EPAP. Either can cause oxygen desaturations.

Someone with simple OSA will not have low O2 once sleep-breathing is corrected enough to have fixed the sleep by getting the AHI as low as possible.

Adding in O2 is not something that is done for people with OSA alone; it is done for people with other health issues beyond OSA.

But yes, it is true that if you have issues beyond OSA and adding in O2 addresses those issues, then, of course, adding O2 can help someone feel less tired. That is so in the exact same way that someone without OSA who has issues that require O2 is helped by O2.

At least, that is my overly-simplified understanding as someone with no medical training whatsoever.

My AHI are 0.8-2.5. I have always had good AHI. Im not sure the other readings Im not that educated about all that. I don't have any other health issues. I have had all kinds of test, blood work, cardo test, all good. Just tired even after over a year on Bipap. Some good days but a lot of very tired days.

xxyzx wrote: it is the O2 levels that matter not AHI
and yes that can make you tired


if the hypopnias are severe enough or long enough your o2 will go too low
it can drive your heart rate WAY up
and that is very tiring

I think what people disagree with is the extreme, that O2 levels are the only important part and not ahi. It really is a combo of both. Either one going bad can cause a big problem.

For example, my mom and I both have OSA, but we have very different versions. She has a much lower untreated ahi, but her events are longer and clustered together, so she would have much larger drops in O2. Her sleep apnea was listed as moderate, but was probably just as severe as mine when considering actual damage. My sleep apnea is more events, mostly short ones, that totally destroy my quality of sleep. My untreated ahi was 79+ with no deep sleep or REM during the sleep study. My O2 barely dropped because my brain would pop out of sleep every time I stopped breathing. So, my brain was doing a better job of protecting me against O2 deprivation, but at the expense of my sleep. Another difference between us. She does NOT snore. I snore and gasp scary (as reported by others). Strangely, we use the same model machine and almost the same pressure range.

So, while you are correct that O2 is very important, you tend to be very extreme about it and dismiss the ahi. Doctors tend to do the opposite extreme and look at ahi and assume O2 is fine. I think most of us who have been at this a while realize that both need to be okay for us to feel good.

in the context of sleep-apnea (SA) your O2-levels can only drop if you have breathing-events.
If you simply monitor the O2 drops you miss a lot - as pointed out by zoocrewphoto.

AHI is not THE only value in diagnosing SA. Total time in apnea (TTIA) is also always recorded and evaluated, as are Arousals (which can happen without the 2). There is also the desaturation adjusted AHI. And not every central event is a bad thing - the (normal) respiration works on a "need to have" basis. Too much oxygene in the blood is just as bad as too much CO2 or too low O2.
On the other hand some may need supplemental O2 on top of their CPAP-treatment.

xxyzx wrote: when you only measure some of the important parameters and ignore two major ones
your results are meaningless

you have to know that the O2 is not dropping to cause the heart to work harder and make you tired

Please learn to read! I was talking about SA! just SA!

how in your world should the O2 drop without any breathing events.
(please keep in mind: normal persons do make a sleepstudy - in contrast to just buying a pulseoxymeter and some random ranting in online-boards!)

Sleepyv wrote:I'm happy to know this, I've been trying very hard to figure out why I haven't been feeling well and tired.

If you are having a titration study, it should be resolved. They will set up the BPAP as best they can and add O2 if needed. I would be under the care of a pulmonary doctor and that a serious disorder isn't being masked by treatment.

My sleep Doctor is a Pulmonary Specialist . I have no trouble during the day, just sleeping. I hope this works. I am worried that increasing pressure will be uncomfortable for me to sleep. Hope not.

My oxygen level is actually lower than before I went on Bipap????

My O2 levels were 78 % for 75 minutes with Bipap. My Ahi's are great. My sleep study a year and a half ago Lowest level was 80%. That was
before I started Bipap.

So now I go for another study at sleep lab. July 31. I have no health issues and am just a little overweight. Trying to lose but hard when I'm
always so tired.

That's not too long a wait, In the interim, you could increase the minimum ps, so it is running closer to the set maximum. That may ventilate you more. What median/average tidal volume is sleepyhead or perhaps machine read out showing? As you know, an auto bpap doesn't react to o2 levels.