Sleep study O2 sat 49% - how bad is that?

Guest · Post by **Guest** » Tue Mar 13, 2007 8:40 am

Hey guys.

A female relative of mine just had her first sleep study last night (no mask or titration, just wiring her up and collecting data), and her O2 sat got into the 49-50% area. The technician was worried enough to wake her up and put her on oxygen, but even with the O2, once she fell asleep she got into the 70's. She's received no AHI or other stats yet, she must wait for the doctor appointment to get them. But the technician did share the O2 numbers, while explaining the need to put her on O2.

How bad are 49-50% desats in sleep apnea? From what I've heard, they're horrible... my nurse friend calls them "incompatible with life".

Anyone else get that low? How bad is that? How common is that in sleep apnea? Thanks.

Wulfman · Post by **Wulfman** » Tue Mar 13, 2007 8:54 am

That's probably about the lowest numbers I've heard in the last two years of reading these forums.

Typically, the threshold for being concerned is around 88%. Mine dipped into the 60's in my sleep study and averaged in the low 80's.

I would say your relative is lucky to be alive.

Best wishes,

Den

pedroski · Post by **pedroski** » Tue Mar 13, 2007 9:03 am

Hi Guest,

Mine was 71% and regarded as severe. No wonder the tech put your friend on oxygen! Good luck with your friend and keep us posted.

Peter

Slinky · Post by **Slinky** » Tue Mar 13, 2007 9:30 am

Good Lord!!!! I have COPD and at my sleep evaluation (on room air, no 02)the lowest my 02 sats went were 81% with a respiratory event and that occurred whilst in REM sleep!!! I did drop to somewhere between 51% and 60% once but only for a duration of just 0.1 minute and thus not considered a respiratory event nor did it cause an arousal. I had been told prior to the evaluation that if my sats dropped below 88% I would be put on 02 but that didn't occur.

linda b · Post by **linda b** » Tue Mar 13, 2007 9:46 am

Yes, that is pretty bad!! During the overnight oximetry test I had over a year ago, I got down to 40 twice for 6 minutes and 2 minutes, respectively. Also had events in the 50's and 60's totalling over 10 minutes. She should run, not walk to a pulmonologist and find out if COPD or some other serious lung condition is causing such low numbers in addition to probably having sleep apnea. Believe me, the difference in the way I feel after being on oxygen is amazing.

Slinky · Post by **Slinky** » Tue Mar 13, 2007 10:12 am

Amen, Linda!!!

lvwildcat · Post by **lvwildcat** » Tue Mar 13, 2007 3:15 pm

Mine got as low as 57% during my sleep study. Yes,it was for a brief period of time but as an ICU RN with 25+ years experience-I was totally FREAKED to say the least!!!

tomjax · Post by **tomjax** » Tue Mar 13, 2007 7:07 pm

To put your sats in perspective, there are very few breathing at those numbers.

Some with slightly less than those include Anna Nicole Smith, James Brown,
R Reagan to mention a few.

I wonder what values are common in vegetative (?) states?

You need O2 IV ASAP. Tell St Pete Hello.

tomjax

Linda3032 · Post by **Linda3032** » Tue Mar 13, 2007 10:03 pm

Has other have said, THAT'S VERY BAD.

She needs for her doctor to put her on oxygen and Apap (auto pap) immediately. She shouldn't wait for a titration study -- and apap can titrate her until her study is scheduled.

dsm · Post by **dsm** » Wed Mar 14, 2007 5:32 am

Yup,

I'll even repeat Linda's comment & say it again, that is not good !

Needs investigating & my guess is that there is some lung issue.

Is this person a long time smoker ?

DSM

Guest · Post by **Guest** » Wed Mar 14, 2007 9:31 am

She has no apparent lung issues, just long apneas... 65 seconds was typical, from what she said. Her bed partner said she stops breathing every 2-6 breaths, too.

She had her titration (second) study the night after the first (that is, last night), and the doc's going to see her tomorrow. So tonight (only), she has to go without a machine.

Do you guys have suggestions on how to minimize her apnea problems tonight? Hopefully it's her last night ever having to sleep without xPAP, but I need to know what to do to minimize the problem, since it's apparently so incredibly severe.

She's retired, so she has no need to be alert during the day. Keeping her up as late as possible (possibly all night, even?) is an option. If she really wants to sleep, would sleeping sitting up in a recliner or a sofa help?

Thanks guys.

Wulfman · Post by **Wulfman** » Wed Mar 14, 2007 9:38 am

Anonymous wrote:She has no apparent lung issues, just long apneas... 65 seconds was typical, from what she said. Her bed partner said she stops breathing every 2-6 breaths, too.

She had her titration (second) study the night after the first (that is, last night), and the doc's going to see her tomorrow. So tonight (only), she has to go without a machine.

Do you guys have suggestions on how to minimize her apnea problems tonight? Hopefully it's her last night ever having to sleep without xPAP, but I need to know what to do to minimize the problem, since it's apparently so incredibly severe.

She's retired, so she has no need to be alert during the day. Keeping her up as late as possible (possibly all night, even?) is an option. If she really wants to sleep, would sleeping sitting up in a recliner or a sofa help?

Thanks guys.

The recliner would by my (first) thought.

Best wishes,

Den

NightHawkeye · Post by **NightHawkeye** » Wed Mar 14, 2007 9:50 am

Anonymous wrote:She's retired, so she has no need to be alert during the day. Keeping her up as late as possible (possibly all night, even?) is an option. If she really wants to sleep, would sleeping sitting up in a recliner or a sofa help?

What are the possibilities?
- Yeah, you could try to keep her up all night, but when she does get to sleep, she'll be even more tired, and more likely to not wake up when apnea happens.
- Yeah, sleeping in a chair all night, in my pre-CPAP days, worked better for me than lying down. I'm not sure it helps everyone though, or even most folks. It might even be worse for some.
- You could get the doc to prescribe an overnight oximeter to alarm if her PsO2 drops too low. It'll be dinging all night . . ., so that's probably not gonna work too well, either.
- You could get the doc to write a prescription for CPAP and/or O2 today! Seems like a good solution to me.
- You could get the the doc to write a prescription for CPAP and/or O2, along with an alarming oximeter today. Yep, I think that'd be my recommendation.

Maybe some of the medical professionals here would be willing to chime in here and provide pointers to motivate the doc to get moving on this. Geez, a CPAP prescription does not require a doctor's visit, for crying out loud.

Regards,
Bill ( . . ., and some folks wonder why I'm hard on physicians sometimes . . . )

Wulfman · Post by **Wulfman** » Wed Mar 14, 2007 9:57 am

And, I also agree with Bill's analogy.
I've been wondering why they didn't give your relative one (and oxygen) the day following the sleep study.

Den

Guest · Post by **Guest** » Wed Mar 14, 2007 10:02 am

Thanks guys, for all the help. We'll probably sit her up in a chair tonight. Her bed partner confronted the sleep doc directly (happened to see him in the hall at the sleep clinic!) and asked if he could look at the data and schedule an appointment with her ASAP, and also asked point-blank if she should have an APAP between now and the appointment. The doc said he'd put a rush on it, and then called to say he'll see her tomorrow. Apparently he doesn't think one night's going to be too big a deal, and keeping in mind that she's probably been this way for a very long time, the body's probably used to it, to some extent. I know it's very bad, but the doc probably figures one more night is very unlikely to cause a horrible outcome.

We'll try the chair. She's done it before due to various pains that made lying down difficult, so we know she can do it. It should help with the apneas.

Either that, or we'll keep her up all night, particularly if she has a morning appointment tomorrow (I'll have to check). If she can stay up all night successfully, it might be the best route. If she can't, as one of you guys said, it might make it less likely she'll wake up during an apnea.... so we have to be careful.

Thanks again, to all! She should be treated and improving soon!

Mask

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