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

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
USMCVet
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Any clues to why my oxygen is so low based on sleepyhead?

Post by USMCVet » Fri Jan 19, 2018 11:08 pm

Here is my report from overnight oximetry test. Unfortunately I don't have report match up the times. I do know that it got as low as 79%, was under 88% for 93 minutes and under 90% for about 5 hours.
I don't know how to read reports that well. Is my breathing itself bad? Any thoughts or insights would be appreciated.

P.S. Julie your previous suggestion on this topic of raising minimum was brought up as well as a possibility by VA.


Here is sleepyhead report. https://i.imgur.com/TVcdq5X.jpg
https://i.imgur.com/cgL4WCe.jpg

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

Post by USMCVet » Fri Jan 19, 2018 11:24 pm

I see inspiration time is slightly longer the exhalation time. It's small difference so not sure if that would make a difference.

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

Post by ajack » Sat Jan 20, 2018 12:05 am

I would say you need more min pressure, try 7, you may need more.... for one night, I would try 9 and see the o2 result. If that doesn't fix it, it's back to the doctor.

Do you have a recording o2 meter or one you take manually during the night, when you wake up? What o2 readings are you getting? what is your o2 reading during the day. This is all a guide and normally done with a doctor., if you are retaining co2, a blood gas is normally taken for diagnosis. The o2 meter doesn't care what gas it measures, you could have 30% co2 and 70% O2. It will show the o2 drop, but won't show how much co2 is in the system.

first off machines are often wrong...the stats show median minute vent of 6.2, which is ok for a short healthy person. 18 breaths, ideal 12-16, tidal volume 360 and a bit low and is the reason for the faster breath. your body finds it easier to breathe faster, then breathe deeper. ins/exp ratio a bit longer on inhale. do you have a bit of COPD, obesity?

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Last edited by ajack on Sat Jan 20, 2018 12:20 am, edited 1 time in total.

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

Post by USMCVet » Sat Jan 20, 2018 12:20 am

I have recording one that errors on high side if anything. Usual 02 during day is 93 or 94 and deeper breathes generally bring it up higher. I usually also drop to low of around 80 when sleeping and most of night is spent around 88 or 89% if I remember correctly from the couple of nights I've done it.

The thing that baffles me is when I was talking with RT on phone today. My oxygen while sleeping has gotten WORSE since starting CPAP therapy. I was diagnosed with severe sleep apnea so it's kind of crazy I got worse. My AHI during sleep Study was about 35 and now I'm under 1 and with worse oxygen saturation.

I'm going to record again tonight without changes and see what it is.

The only difference between sleep study and latest overnight oximetry test was that I took nothing for sleep study and for last test I took 9 to 12 mg of melatonin.

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

Post by ajack » Sat Jan 20, 2018 12:29 am

ok a recording one is better, you can see what is going on, get the o2 chart up. over 88% is fine, especially when your base is 93-94 during the day. It is only a 5 point drop. what is your breath rate during the day? You didn't say, but do you have a bit of breathing issue, this could account for the lower day rate.

get the min cpap, also called peep pressure to 9 and see what happens. 9 is about a fixed pressure setting by your chart.

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

Post by USMCVet » Sat Jan 20, 2018 12:33 am

I have no diagnosed breathing issues at this time. I find myself taking what I think are shallow breathes at a rate of approximately 20 a minute which seems to be same as when asleep.

I do have an inhaler from last time I had bronchitis and i used it recently and noticed no benefit in oxygen levels either.

Inhaler is Albuterol

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

Post by USMCVet » Sat Jan 20, 2018 12:35 am

Also about 4 months ago I even started running outside before it got cold and was doing well with that making consistent gains in endurance.

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

Post by ajack » Sat Jan 20, 2018 12:43 am

Ok time to go see your doctor, My guess is a bit of lung or heart trouble. 20 per minute isn't a crisis, but it warrants investigation. High 20's is the start of respiratory collapse.

i'd still set the min pressure on 9 to get the peep/min pressure up. It should also clear a lot of the events you are having.

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

Post by USMCVet » Sat Jan 20, 2018 8:19 am

I can't seem to get my sp02 onto today's data in sleepyhead it keeps going to day before. Basically when it drops most is during either a vibratory snore event or flow limitation and not the apnea related events. Maybe tonight I can get the report all worked out. Last night I had an AHI of 1.1

I was under 88% for 6 minutes. Lowest it got was 84% . Basal sp02 was 90.9% and I spent 23 % of 6.5 hours under 90%.

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

Post by USMCVet » Sat Jan 20, 2018 8:22 am

ajack wrote:Ok time to go see your doctor, My guess is a bit of lung or heart trouble. 20 per minute isn't a crisis, but it warrants investigation. High 20's is the start of respiratory collapse.

i'd still set the min pressure on 9 to get the peep/min pressure up. It should also clear a lot of the events you are having.
I've had recent EKG and chest x-ray and both were clear. Monday I go back to sleep specialist for them to review the VA oximetry test. They didn't tell me but I don't need to bring my CPAP right? I was there 1.5 weeks ago and they got the compliance data.

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

Post by Josiah » Sat Jan 20, 2018 9:01 am

Your anecdote (dropping your AHI from 30 to 1 and seeing a worsening in your oxygen saturation) has to be the most anomalous thing I've encountered reading this forum. I have no theories about what is going on, however 9 mg of melatonin sounds like too much. Melatonin dosage is a pretty controversial, I had been taking 5 mg for a long while and I'm now back to 1 mg and sleeping much better. Admittedly changing my melatonin dose was only one of several changes I made at that time so I'm not convinced changing my dose was that helpful. Still you might review the literature on melatonin dosing.
Josiah

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

Post by ChicagoGranny » Sat Jan 20, 2018 9:22 am

Josiah wrote:9 mg of melatonin sounds like too much. Melatonin dosage is a pretty controversial, I had been taking 5 mg for a long while and I'm now back to 1 mg and sleeping much bette
Yes, he is taking a mega dose - way too much!

I don't take it, because you never know what you are getting - viewtopic.php?f=1&t=115825

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

Post by USMCVet » Sat Jan 20, 2018 9:32 am

I don't take that dose every day just when I need to sleep. Here is some talk of dosages https://www.m.webmd.com/vitamins/ai/ing ... /melatonin .
So occasionally taking that amount should be fine.
But yes it is higher the suggested on bottle .

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

Post by USMCVet » Sat Jan 20, 2018 9:52 am

I actually have another serious question as well. Since my AHI has dropped considerably how would increasing pressure help? More specifically worse oxygen now with more pressure then I obviously had using no CPAP?

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

Post by ChicagoGranny » Sat Jan 20, 2018 9:59 am

USMCVet wrote:Here is my report from overnight oximetry test. Unfortunately I don't have report match up the times. I do know that it got as low as 79%, was under 88% for 93 minutes and under 90% for about 5 hours.
I don't know how to read reports that well.
Please post links to a screenshot of the pulse-oximetry overnight study.