Low Oxygen Saturation (SPO2) Data

[scaredstraight]

I am not on CPAP as I am waiting to do my in-clinic sleep test. I have told my doctor about symptoms of suspected central sleep apnea and he is very curious/open to exploring this diagnosis. I am scheduled to hopefully get the treatment I need but in the meantime, I am a bit worried about my SPO2 data from sleepyhead and how much risk/danger I am in until my sleep study and potentially future treatment. I am 30, fit, no heart disease, no other medical conditions. I did have a bout of childhood epilepsy but that went away after 14.

Here is my SPO2 data. I am using a CMS50F and sleepy head. I am puzzled by the very low minimums of both pulse rate and SPO2 - these don't seem to show up anywhere on the graph actually, except for maybe at the very beginning, and I have an alarm for an SPO2 below 80 and pulse rate below 30, and yet the alarms did not go off. I am hoping this is a glitch? A min SPO2 of like 20 does not sound right when the 95% SPO2 is 95%.
Additionally, I am more worried about my usual levels of desaturation - it looks like I am having about 5-15 events per night where my SPO2 is below 88%, max length of event at 43 seconds, usually somewhere around 86-88 but sometimes as low as 80-82; on the rare instance (twice in the past 2 weeks) the SPO2 goes down to below 80 - last night it was at 77 and a week ago it went down to 79 once. Luckily I had an alarm that rang both times. I am not waking up from these below 80 events naturally it seems (how scary is this?). Most of these desaturations happen during sleep onset and in the initial 1/3 of the evening it seems.

I know I need to get tested and treatment, which I am, but there has been some bad delays in having the sleep center contact me (I think they are still waiting on my insurance to authorize it). My immediate question and concern is whether I am in danger of any emergency life threatening situations right now as I wait for my test and treatment, and if I need to go to the ER if my SPO2 goes below 80 again and/or whether I need to let my doctor know ASAP.

Sleep March 24.PNG (90.1 KiB) Viewed 1763 times

Sleep March 20.PNG (91.05 KiB) Viewed 1763 times

Sleep March 18.PNG (84.58 KiB) Viewed 1763 times

[TASmart]

Your low numbers are "spikes" from the sensor moving around on your finger. There is nothing that I see in your SPO2 levels to be concerned about

[palerider]

A min SPO2 of like 20 does not sound right when the 95% SPO2 is 95%.

If your SpO2 were actually 20%, you'd be dead. If you're not dead, it was a glitch.

and if I need to go to the ER if my SPO2 goes below 80 again

Going to the ER is a waste of money, and their time, there's absolutely nothing they can do for you... though, I suppose they COULD admit you to the hospital and you could use THEIR monstrous big CPAP machine....

But they won't.

[scaredstraight]

Your low numbers are "spikes" from the sensor moving around on your finger. There is nothing that I see in your SPO2 levels to be concerned about

Thanks. You don't think the SPO2 in the 70's is something to be worried about? I thought anything below 90% was bad?

[TASmart]

Your SPO2s that drop into the 70s are brief spikes, known as artifacts, that are not accurate or true readings. You are being more than a little paranoid about this. In fact, I don't see much that convinces me that your actual SPO2 ever drops below 90. They are all artifactual spiking. I base this on the speed which I see the lower reading changing, your body is not capable of having your blood O2 change that rapidly.

BTW why is it that you believe you have significant central apnea events?

[ajack]

Your low numbers are "spikes" from the sensor moving around on your finger. There is nothing that I see in your SPO2 levels to be concerned about

Thanks. You don't think the SPO2 in the 70's is something to be worried about? I thought anything below 90% was bad?

I'd use the software that comes with it, it will filter some of the spikes. You can zoom in and see how long and how far the desaturations go. You soon will be able to pick the real from the spikes. You can post the sections you aren't sure about. I use the o2 on sleepyhead to get an idea of what is happening with apnea at the time

[USMCVet]

I think your fine. My pulmonologist didn't seem to worried about mine and yours looks better to me.

[ajack]

as said, your chart isn't that bad. with sleep apnea, it's common to desaturate to below 90%, that's the main reason for cpap.
This is my sisters.
https://imgur.com/a/FrT8O

[scaredstraight]

Your SPO2s that drop into the 70s are brief spikes, known as artifacts, that are not accurate or true readings. You are being more than a little paranoid about this. In fact, I don't see much that convinces me that your actual SPO2 ever drops below 90. They are all artifactual spiking. I base this on the speed which I see the lower reading changing, your body is not capable of having your blood O2 change that rapidly.

BTW why is it that you believe you have significant central apnea events?

To be honest, we don't know for sure if I have central apnea, and really whether or not I have any kind of apnea and/or how severe it is until I do the full in-clinic sleep study. A while back I did a home sleep study but barely slept a wink that night - the doctor looked at the results on about 2 hours of sleep and said I had maybe some mild or moderate apnea and prescribed me a mouthpiece. I use that mouthpiece now but have since switched sleep doctors (the previous guy seemed like he was just trying to make money off his proprietary home sleep study). The reason i started doing the oximeter is because of the following more pronounced symptoms, which emerged in the last 2 months (but have actually somewhat subsided in the past 2 weeks):

- a throat choaking/gagging sensation when I am sleeping with the appliance, which becomes especially pronounced as I transition from wake to sleep. This does not seem to abate even if I change sleeping positions.
- when I am asleep, the sleep contains lots of vivid dreams (more so than in the past) and feels very light. I do not wake up feeling rested (even less so than in the past).
- I have recorded audio of myself sleeping - I can be heard occasionally groaning/moaning.
- In the 1-3 times I wake up during the night, I can feel a moderate amount of sweat on my shirt. This did not happen very often before - now it is almost guaranteed every night.
- Insomnia/Trouble falling asleep: here is where the symptoms get varied and confusing. 100% of the time, I have struggles transitioning from wakefulness to sleep - I will drift off but wake up again on account of breathing difficulties. This will happen 2-4 times per night before I finally fall asleep (so it usually takes me 30-90 minutes to fall asleep and stay asleep). For a while this mostly felt like physical breathing issues ie. gagging/gasping for air. Occasionally it would feel more neurological ie. "forgetting" to breathe and realizing it. In the past 3 weeks the sleep onset disruptions seem to be predominantly neurological instead of physiological. I described these symptoms to my sleep specialist doctor, who also happens to be a neurologist - he is the one who has suspicions of central apneas. I have heard other people who have sleep onset central apnea describing symptoms similar to mine regarding the sleep-wake transition phase.

[scaredstraight]

Your SPO2s that drop into the 70s are brief spikes, known as artifacts, that are not accurate or true readings. You are being more than a little paranoid about this. In fact, I don't see much that convinces me that your actual SPO2 ever drops below 90. They are all artifactual spiking. I base this on the speed which I see the lower reading changing, your body is not capable of having your blood O2 change that rapidly.

BTW why is it that you believe you have significant central apnea events?

Well the speed with which the 70's dissipated is due to the fact that the alarm goes off below 80 - I woke up and started breathing normally after about 40 seconds of desaturating. But all the other events in t he 80's occurred without any alarm.

[USMCVet]

Did you really sleep for 16 hours?

[scaredstraight]

Ah, okay - here is the CMS50 software data - it is helpful in showing how long each event is and percentage time spent in each saturation range.

Sleep March 24(1).PNG (50.4 KiB) Viewed 1702 times

[scaredstraight]

Did you really sleep for 16 hours?

No - sleepyhead has a weird habit of dilating the times on the data. The starting times will always be correct but for some reason the end times are way later than when I actually wake up,

[TASmart]

Your time below 90% for the 10 hours is 0.9%, which is 5 minutes over 10 hours. It is not significant. But you clearly do not believe me, so let your Dr figure it out and refer you to a good specialist for health anxiety.

[scaredstraight]

Your time below 90% for the 10 hours is 0.9%, which is 5 minutes over 10 hours. It is not significant. But you clearly do not believe me, so let your Dr figure it out and refer you to a good specialist for health anxiety.

You are probably right. That being said, last night at the first sleep onset my SPO2 dropped to 74 - it would have stayed there had my alarm not gone off and woken me up. This seems to be a recurring theme - SPO2 in the 70s (not sure how much lower it would go without the alarm) followed by alarm at sleep onset. Once I am asleep, SPO2 stabilizes at 90s with occasional dips into the 80s. Any idea what is causing the sleep onset 70s?

I know, I know - I am being paranoid and nobody on here is a doctor, so I should talk to them. But still - why is this only happening at sleep onset?