Just got a look at my full sleep study. how bad is 74% SaO?

Just got a look at my sleep study. Quoting from the study:

"The AHI was 99. SaO during wakefulness was 90%, typical low saturation during respiratory events was in the 75% to 85% range. The lowest SaO was 74%.... effective treatment with nasal CPAP at a pressure of 9cm of H2O. At the CPAP pressure of 9 cm of H2O the patient's AHI was WNL at 3... lowest oxyhemoglobin saturation was 88%.

I'm doing well with nightly CPAP treatment. I have no oximeter, I'm just going by the AHI reports on my machine (down around 2.5/night now) and how I feel. Based on the above should I get an oximeter?

dans wrote:Just got a look at my sleep study. Quoting from the study:

"The AHI was 99. SaO during wakefulness was 90%, typical low saturation during respiratory events was in the 75% to 85% range. The lowest SaO was 74%.... effective treatment with nasal CPAP at a pressure of 9cm of H2O. At the CPAP pressure of 9 cm of H2O the patient's AHI was WNL at 3... lowest oxyhemoglobin saturation was 88%.

I'm doing well with nightly CPAP treatment. I have no oximeter, I'm just going by the AHI reports on my machine (down around 2.5/night now) and how I feel. Based on the above should I get an oximeter?

I dont think you would have to get one right now unless you just wanted to know your O2 level for your own reassurance. You were at 88% O2 at a presseure of 9 during your titration and your AHI was at 3 and now you are around 2.5 so I would assume that your Oxygen saturation while sleeping should be at or above 88%. But we all know where assumption can get us so ultimately the decision is yours. At some point if you start to feel more tired during the day or if your numbers go up then it might be a good idea to get one. I am glad to hear that you are doing well with your therapy.

If it were me, I'd want a recording pulse oximeter to use occasionally at home.
But then I'm extra nosy about seeing data regarding how my therapy goes. It's not particularly a "must have" given that you had a titration in a sleep lab and they found a pressure that prevents apneas for you very well.

Good thing you got yourself in for a sleep study. A very good thing.

Don't go to sleep (not even for naps) without CPAP.

Let me preface this by saying that I am fairly new and by no means an expert, and I probably quality as being a data hound (oximeter on order and my O2 just hit 88 I think one time)--so take this for what it's worth.

At 90 during wakefulness it seems that is already right at the cut off point for having concern. And going down to 74 during episodes gets serious. The sleep study is only one snapshot of your sleeping during one night--and only the details of your sleep study would indicate if you spent much time in deeper stages of sleep where more problems tend to occur. Other nights could be better or worse depending on a lot of variables. And AHI, given that it is an average over the night is not the best indication of how your oxygenation is doing during specific periods. And at the "end of the night" so to speak, it is how much and how consistently we are being properly oxygenated that is the key.

It is good to hear that you're having a positive response to CPAP in terms of AHI. If it were me, I'd want to know what was happening with my oxygen levels if I sometimes went down to 74. You can get very good recording pulse oximeters, like the CMS 50E or CMS-50F for as little as $110-175. If that is a price that would be prohibitive or if you just don't think you'd ever use the thing, then I can see not getting one. But for me it seems worth it even if only for the peace of mind of knowing with reasonable assurance what O2 levels are doing.

I would definitely recommend an oximeter. At least it will easy your worry. I got one recently although my Sp02 is above 90, I still want to see how I am doing in deep sleep. Sleeping in a sleep lab is different from sleeping on your own bed.

I purchased mine from : http://pulseoxstore.com. Kevin is a good guy to deal with. I am just a satisfied customer.

kf10 wrote:I would definitely recommend an oximeter. At least it will easy your worry.

Hi,

I'll second that. I have been going through a bit of a bumpy period. It was very helpful to be able to dig the oximeter out of my CPAP drawer and run it for a night. I found that I never dropped below 94% for the night, which was very reassuring. Just knowing that my O2 level was OK was well worth the $150 I spent on the device.

kf10 wrote:I purchased mine from : http://pulseoxstore.com. Kevin is a good guy to deal with. I am just a satisfied customer.

I wish I had bought my device from Kevin. I did get some software and instructions from him, which he provided despite me not having purchased anything from him.

-john-

Hi John, it is off topic but what version of the software you are using? Some people might have problem with the software that come with the CD, so Kevin kind enough to post an older version (0.981?) on his website. However I have tried both the newer version (version 1 that come with the CD) and the older version. Both work ok. However, version 1 seems to provide more accurate calculation on events.

Hi,

I have the 0.981 version. I run it in an XP VM under Parallels on my Macintosh. I accidentally tossed out my CD, so I was very happy to get the software from the pulse ox web site.

-john-

I suggest having an overnight oximetry done. Your doc should be able to write a prescription for the study. They will use one of their units. This way, it will be covered by insurance and you don't have to buy one. After that, if you want to continue monitoring your oxygen level, then buy one.

If you are in the 89% range with CPAP you are not doing too bad but need to monitor your SaO2 each night to make sure it does not drop. 74% is deadly. I would not go to sleep without CPAP. Ever.

The Contec CMS50E is good, has a rechargeable battery, comes with software, etc. It's about $130 give or take and worth every penny. Don't screw around with anything else unless you have money to burn. I would get one immediately and start recording.... and I would be watching it closely to make sure that it doesn't go much below that 89% mark. I generally monitor now 4 or 5 days out of 7... even WITH cpap my SaO2 can go down into the 70's. My oxygen concentrator is on order and am going to order a spare.

If you obtained your xPAP from a DME, you most probably can borrow a recording oximeter (for a night or two) with a prescription from your doctor. That way you can get an idea of where you stand at no cost.

dans wrote:At the CPAP pressure of 9 cm of H2O the patient's AHI was WNL at 3... lowest oxyhemoglobin saturation was 88%.

Your lowest oxygen saturation on CPAP of 9 was 88%? I'm not very knowledgeable about oxygen saturations, but I would have expected it to be higher (in the 90's) on CPAP.

SleepingUgly: It should indeed have been over 90% and even around the 95% range. That is healthy. There are numerous reasons that it may have dropped below 90% which is "DANGER! Will Robinson, DANGER!" scenario. When on life support and generally in hospital last summer the alarms were set to bring a nurse when my SaO2 went below 90% awake or asleep.... in my case the reason for very low SaO2 is both hypopnea and lung damage due to acute pneumonia and suctioning to save my life (guess it worked). I can actually have an AHI of 0.0 and still drop down into the desat state... 80's and even 70's if I am breathing shallow.

In this case I am going to take a quick guess and say that our friend is/was a smoker or worked in a smokey environment or has lung issues as I do, either from damage as in my case, or from COPD, or from another ailment that we are not privy to.

With CPAP running, with low AHI etc., one should be running SaO2's in the mid nineties as a healthy person.

The consequences of low SaO2, even if only at night, are immense and lengthy and include such things as greater chance of stroke, heart attack, etc. The organs and in particular the liver does not perform its function properly and results in medications not working effectively, diabetes due to the liver not stripping blood glucose from the hemoglobin and so on. Drug efficacies are way out of whack (working better or worse); food is not being processed normally; even drug interactions change. The downsides are myriad to say the least.

In my case, I was not given supplemental nightime O2 as suggested by the MD and after ten months of research decided that I needed O2... pulled out the original Rx to order an oxygen concentrator and there it was in black and white! **O2! DUH? Someone screwed up somewhere. Bigtime.

My O2 supply arrives next week and I am hoping that it will be something of a magic bullet. To our friend... your low O2 sats require further and urgent investigation as a sleep study is merely a SNAPSHOT in time of what is going on. If it is O2 that you need infused into the CPAP line it is no big deal.... and not very expensive. And it will (may) change your life for the better overnight. I am waiting to see what my O2 does with great anticipation and will report back.

Whatever you do, you need to ask questions and push for that O2 infusion if it is what you need. You now know just a few of the bad side effects of having low SaO2 at night. And we have not even mentioned until this point the fact that your autonomic nervous system is going to be attempting to awaken you all night to get you to breathe deeper and get that SaO2 UP UP UP! So the bottom line asides from your general health is that you may find yourself getting a good night of sleep!

Good luck. Be a pitbull.

I don't hear any more commentary nor information from dans, the original poster, so I am going to assume that dans is off to other parts or has died in his sleep from that 74% SaO2 and am not going to bother wasting my time further. How about a little feedback here dans? You are amongst friends. You have not even had the courtesy of filling in your profile so we know where you are, if you are male or female or what gear you are using.

A little more information and social intercourse would be of assistance to all - you are probably going to start finding that your level of responses dropping off. Time to jump in with both feet and put some effort into this.