Oxygen Desaturation

[2bitwise]

Is there a way to find out if you are experiencing oxygen desaturation by viewing your machine data? My S-9 reports AHI typically about .2 for a 6-8hr period. Do you multiply AHI times the time period to get events per hour? I do not have an oximeter. My red cell count is up (52.0) and my Dr thinks my APAP may be the cause. Other causes negative. Can restricted air flow without apnea cause this?

[HoseCrusher]

To measure oxygen saturation you need an oximeter.

[Todzo]

Is there a way to find out if you are experiencing oxygen desaturation by viewing your machine data?

None that I am aware of.

My S-9 reports AHI typically about .2 for a 6-8hr period. Do you multiply AHI times the time period to get events per hour?

Apnea Hypopnea Index (AHI) is a number which represents the sum of the apnea and hypopnea events which occurred taken as a per hour average.

I do not have an oximeter.

They are nice to have but you probably do not need one.

My red cell count is up (52.0) and my Dr thinks my APAP may be the cause.

It would nice to see some of your nighttime data so that we might figure out why.

Other causes negative. Can restricted air flow without apnea cause this?

The reasoning I have heard regarding why sleep apnea tends us toward more red blood cells is simply that the times of low blood oxygen levels provokes the body to make more of them so there is a higher “carrying capacity” to make sure that oxygen gets to the hungry cells.

Restricted air flow might lower blood oxygen levels. Perhaps so.

[Julie]

There are various causes of high Rbc's that have nothing to do with OSA or Cpap - your doctor should look into those.

[JDS74]

... My red cell count is up (52.0) and my Dr thinks my APAP may be the cause. Other causes negative. Can restricted air flow without apnea cause this?

Do you have a copy of the lab report where the RBC is reported?
Can you look at the 'normal range' or 'reference interval' on that report and tell us what those number are?
My reports show the reference interval as being 4.14 - 5.80 which is very different from your value of 52.
That is likely because your lab reports differently. If the upper end of the reference interval is only slightly below the reported value of 52, then it is not too concerning.

Looking back over my reported RBC values - during the period when my apnea was untreated and comparing the current values, there seems to be no significant difference. Perhaps you should be looking for a different cause if it is of concern.

[Julie]

First you have to find out if results are measured in Imperial or metric numbers... of course they will look very different to each other even if they express the same levels.

[Todzo]

https://ahdc.vet.cornell.edu/sects/clin ... am/rbc.htm

[jnk]

This post is not to address the OP, but I feel like writing it anyway.

There are a number of myths surrounding O2 desats and PAP therapy that are believed by some doctors who are not fully informed about sleep medicine. Some of those myths also appear on this board from time to time:

Myth #1: A great way to figure out whether a person might benefit from PAP therapy is simply to check O2 overnight.
Reality: Many people who have zero significant sustained O2 desaturations still need PAP therapy to improve their sleep.

Myth #2: A great way to figure out whether a person on PAP is using the right pressure is to check O2 overnight.
Reality: Even when a pressure that is sufficient to prevent significant sustained O2 desaturations is used, the pressure still may not be optimal for the best sleep.

Myth #3: If my O2 saturation drops a few points for a few seconds overnight, that likely means that my PAP therapy is not optimal.
Reality: It is true that a sleep study may use sensitive equipment to monitor brief desats in order to score events, but that does not make a brief drop seen in a home monitor as significant as sustained significantly low O2 during much of the night.

Myth #4: PAP therapy is all about O2.
Reality: PAP in the context of OSA is mostly about sleep, even though it will also improve O2 for some, especially those who suffer from moderate-to-severe OSA.

The above is my opinion as nothing more than a fellow patient with no medical training whatsoever. I can't even put a band-aid on right.

[palerider]

I do not have an oximeter.

you can get a recording oximeter for 50$ from amazon, search for the cms50d plus (has to be the plus model, with the usb cable)

[HoseCrusher]

To add to jnk's post...

If you are one of those that experiences O2 levels dropping as you stop breathing during sleep, an oximeter can let you know if the pressure you are using will eliminate those drops.

My sleep disorder involved desaturations during the night. I recorded data for a couple of weeks before my sleep study. I also recorded data during my sleep study. When I started my xPAP therapy I dialed my pressure in using the data from my oximeter.

It has worked out very well.

I will add that the measure of good treatment is how well you feel after a restful nights sleep. If I and good oxygen saturation and still felt like crap in the morning, I would be looking further.

I am lucky because simply stinting my airway open eliminated the desaturations and was all that I needed.

My take on this is that if you record your oxygen levels during sleep and find that you have desaturations, you need to explore xPAP therapy. If you have good oxygen saturation while sleeping but wake up feeling like crap, you need to explore xPAP therapy to try to figure out why you aren't getting restful sleep.

I will add that life is all about O2. If you don't have adequate levels of O2 your health suffers. Sleep is all about resting up for the next day's activities. If you don't maintain a high enough level of O2 your health suffers, but that is only one thing that is capable of disrupting your sleep.

As a screening effort if you aren't maintaining a decent level of O2, you have problems. If you do maintain a decent level of O2 that doesn't mean that other problems can creep in and disrupt your sleep.

The question that needs to be asked is

Do you jump out of bed ready to face the day, or do you slither out of bed looking for the first opportunity to take a nap?

O2 can make a difference but it isn't the only thing that disrups sleep.

[2bitwise]

Thanks for all the replies. The top of the Hematacrit normal range is 50, so I am not out by much. I think I will get a recording Oximeter to get some idea of what is happening with my O2. My Resmed S-9 is set to APAP mode, and I recently narrowed the pressure range to 8-16. I have to review my graphs to see the 95th percentile pressure-I think it was around 12. The sleep report on the machine shows good mask fit and an AHI of .2 typically each day. There is a delay in response to required pressure in APAP mode, which concerns me(typical for APAP). Could be experiencing breathing restriction without a full on apnea. I may try switching to CPAP mode, once I figure out a trial pressure. I don't fall asleep during the day; once awake I stay awake.

[JDS74]

Referencing Hematocrit (% of blood volume occupied by cells) suggests that you have a copy of the lab report.
The other values of interest are:
RBC - this it the quantity of red blood cells and a normal range should look like 4.xx - 5.xx
MCV - this the mean corpuscular volume (how big the cells are) and its range should look like 80 - 100
and
MCH - this is the mean corpuscular hemoglobin and it is an indicator of how much oxygen carrying hemoglobin you have
its range should look like 26 - 33

Are these out of range also?
Mine are all just slightly out of range except hematocrit with is dead normal and the doctor indicates nothing exciting there.

A slightly elevated Hematocrit can indicate a little dehydration and may not be particularly significant.
Does your doctor suggest the a new blood test should be ordered to confirm the value?

An untreated sleep apnea problem can also be a cause but with your low AHI this is very unlikely.

All in all, it doesn't sound like anything to get particularly excited about.