O2 drop with CPAP

[NewToSleepApnea]

Hey guys -

So I have a recording Pulse Oximeter and my O2 levels are still dropping to mid/high 80's sometimes 20 times a night. Mostly during the times I am first trying to get to sleep.

Is this a normal thing? Does this happen to anyone else? Is the answer to go on oxygen or does your body get used to the CPAP and this stops happening?

My doctors both suggested that my O2 would stop dropping once I used the CPAP. Any thoughts?

Chris

[LSAT]

The CPAP does not supply O2...It keeps your airway open so you don't stop breathing as often as before CPAP. When you stop breathing, you are not supplying O2 to your heart. If your AHI is low, and you still have very low O2 readings, I'm sure your doctor will recommend that O2 is added to your CPAP. If your AHI is not under control, you need to work on that.

[NewToSleepApnea]

That’s the thing. My AHI is under 5 for the past week. Sometimes under 2 or 3.

But this only happens when I’m falling asleep. Not in the middle of the night. Sleep wake transitions.

Just tried to go to sleep tonight. My body Woke me up because my O2 was 84 and stayed there for a bit. Machine didn’t even record an AHI. I don’t think I was actually asleep.

My pulmonologist and sleep doctor aren’t helpful.

Just need to hear if this is that bad or common for people while using the CPAP and having low AHI

[LSAT]

Where are you seeing these numbers of AHI and O2 readings ? Do you have a recording Puls Ox that records all night or are you taking your O2 readings when you wake up? What about AHI...Are you looking at the machine when you wake up? You need to download Oscar software and post some pictures.
https://www.sleepfiles.com/OSCAR/

[Sheriff Buford]

I agree with LSAT.... you need to see a doctor about the low O2. As he stated, the cpap machine is suppose to keep your airway open so you can breath. Without the cpap (in many cases) the airway closes at night which can cause the O2 to drop. In most folks, the cpap remedies that. But if your O2 is still low with cpap, you need to see a doctor.

Sheriff

[NewToSleepApnea]

Here's the Oscar readout from last night.

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Here's the O2 readout from my oximeter last night. Almost all the drops were while I was attempting to go to sleep, not already sleeping.

IMG_2926.PNG (298.99 KiB) Viewed 13391 times

My first desat didn't register any AHI on the machine.

[Pugsy]

Those sudden drops are loss of contact artifacts. When oxygen levels really drop the drop is more gradual and the going up is also more gradual.

It's normal to see a 3 to 4% drop during sleep and your O2 line that goes down and up more gradually is normal and corresponds with sleep.
Those spikes down below 90....loss of contact. The sensor lost good contact and takes a bit to stabilize.

Your O2 is NOT dropping while transitioning to sleep but the sensor is losing contact briefly causing the registering of the lower levels.

[Goofproof]

Data is a fine thing, but only if you know what it means. Data that only serves to add more stress to your life, is worse for your health than no data.

Your body isn't a fine tuned machine, and no two are alike, and they don't react the same minute to minute. Data allows you to see trends and averages, for example when asleep, the rules change, you breath slower and more shallow, you also need less O2 as you aren't working as hard. Jim

[NewToSleepApnea]

Pugsy. This has happened for weeks now. No matter the position. Sometimes with people watching me with my hand stretched out. It never "loses contact" any other time. Ive tried working out with it, being awake, moving around. The only time the O2 reads this low is when I am in sleep wake transitions in the first half of the night. I wish you were right, but its been consistent. Only at those times, never went down moving around, wearing it etc. 3 different oximeters.

Most of the time I "wake up" during this exact time the O2 is dropping. What is if wasnt contact artifacts? Should I be alarmed or is this dropping O2 levels normal?

[Pugsy]

It's not normal.

If it isn't loss of contact it sure isn't presenting like a normal O2 level will drop.

Put the pulse ox on your finger securely so it won't move. Don't move around either.
Hold your breath as long as you can hold it to mimic an apnea event of similar duration....and then watch the O2 level for 5 minutes after you resume breathing normally....did the O2 level ever change?

All it takes is a millisecond loss of good contact to cause the device to need to reset and cause those sharp drops. Just a millisecond.

[NewToSleepApnea]

Just held my breath (for about a minute). And o2 never went below 98%.

Even if I move a ton, never had it drop.

Here is a picture of what I use. Not a clip on but wraps around the finger. Hasn’t had any issues with registering. This is why I’m concerned about this and posting so much. Just doesn’t seem like a normal sleep apnea thing. And can’t get any doctor to be concerned over it. It’s the only thing that’s bothering me. For weeks, same issue.

Again, only when I’m first trying to get to sleep.

147EC8DB-CA77-4493-A2C2-23BC0C4E3DD1.jpeg (27.47 KiB) Viewed 13370 times

[Pugsy]

Well...it's not apnea causing the drop...assuming that the drops are real and not loss of contact.
They aren't sustained for any duration though which is our main concern with low O2...prolonged duration damage.

So then you look at other potential causes and position might be one of them including position of the arm/finger.
Is it possible that you get your arm or finger in a position that sort of crimps off blood supply????

[chunkyfrog]

" . . . only when I’m first trying to get to sleep."
For this reason, I would rule out the cpap, and probably the pulse-ox, too.
I would want to consult a doctor about a blood flow anomaly.
But I am no expert--just a frog on the internet.

[NewToSleepApnea]

I dunno, maybe? I have had it happen in a ton of different positions. I know it almost always wakes me up when it gets that low too.

My PCP just recommended 0.5mg of Xanax. So I will try that I guess.

Pugsy, I really appreciate you looking at this with me. I feel like there's no next step to take and its killing my career and family time. All my doctors just say "give it time" and "I'm sure your O2 levels are fine, just anxiety" but it seems to be getting worse. And I haven't been able to get in contact with any of the doctors since getting my O2 recorder on Monday. (besides PCP who doesn't know about sleep stuff)

Had 2 nights with only a drop of 88/89 and 10 or less drops a night. The last four nights I've gotten crushed.

[Pugsy]

Change the pulse ox position placement....different fingers/thumbs/arms. See if that impacts anything.
Play with it while laying down in different positions.

Those aren't real drops in oxygen of the sort that will cause damage and they shouldn't be the cause of the wake up or disturbed sleep.
More likely I would think that the drop is caused by the sudden wake up most likely but short of my being a little fly on your bedroom wall and watching you all night....I can't prove it.