Oxygen desats - how serious is this?

[Chalkie]

I have just returned from the PLMD clinic armed with a copy of an overnight study. It looks very detailed and looked at many things including apnea and PLMD events.

I can now take it to the apnea doc for that appointment tomorrow.

I will post the results here in due course in the hope of getting detailed feedback.

For now, one stat in the summary struck me. My average oxygen sat was 93% (OK) but the nadir was 83% (definitely not OK). This is a shock to me.

I am guessing it coincided with worryingly long centrals, which while quite few (about six per hour) were in one case up to nearly a minute long. OSA was negligible (<1 per hour) but PLMD arousals were sky high.

[nicholasjh1]

I have just returned from the PLMD clinic armed with a copy of an overnight study. It looks very detailed and looked at many things including apnea and PLMD events.

I can now take it to the apnea doc for that appointment tomorrow.

I will post the results here in due course in the hope of getting detailed feedback.

For now, one stat in the summary struck me. My average oxygen sat was 93% (OK) but the nadir was 83% (definitely not OK). This is a shock to me.

I am guessing it coincided with worryingly long centrals, which while quite few (about six per hour) were in one case up to nearly a minute long. OSA was negligible (<1 per hour) but PLMD arousals were sky high.

Though the missed sleep was bad, for me the worse effect of the apnea was probably the oxygen desat, I went as low as 70, I think that people who get an IMMEDIATE benefit are probably sufferers that have appreciable oxygen destats, and they finally sleep without killing their brains.

[Chalkie]

Did you need oxygen or did xPAP do the trick?

[jnk...]

nadir was 83% (definitely not OK).

My understanding is that severity is often a matter of (1) how many times desats occurred and (2) how long O2 was at that level.

[nicholasjh1]

Did you need oxygen or did xPAP do the trick?

For me Xpap did the trick. No oxygen was needed. I'm no doctor, but I think needing oxygen is more related to lung malfunctions, like CPOD, But with sleep Apnea oxygen desats are generally related to the apnea part of the sleep apnea... I don't know why general doctors emphasize the sleep part so much. I guess they want their patients to comply so say it will make you sleep better, but the oxygen desats which are quite normal for moderate to severe sleep apnea are probably just as or even more important than the sleep issues in my opinion, but either way your doctor should be able to tell you if the desats are a lung or apnea issue. If you desat when you're having a lot of apneas... that's a pretty obvious sign. I actually had a follow up check up of cpap treated apnea with an oxygen monitor, and my oxygen numbers were much better.

[palerider]

. I don't know why general doctors emphasize the sleep part so much. I guess they want their patients to comply so say it will make you sleep better, but the oxygen desats which are quite normal for moderate to severe sleep apnea are probably just as or even more important than the sleep issues in my opinion,

Sleep deprivation is no less serious than oxygen deprivation, possibly more so.

Neither should be discounted.

[D.H.]

Sounds like the OP has Central Sleep Apnea and PLMD. His therapy needs to focus on controlling those. It sounds like his obstructive events were minimal.

[StuckOnRepeat]

Have you been told the origin of your centrals? Ask your doctor if there is a cause that can be addressed (like medication side effect) or if you need to treat the centrals with a type of machine that resolves them for you. While it's a long shot, also ask the doc if there's any chance any of your centrals could be episodes of holding your breath during limb movements. Breath-holding was an issue for me, but I don't know if that would be clear on a study or not. If prior studies with fewer limb movements also had fewer centrals, it would make the question worth asking. Just hoping you gain some clarity going forward. Let us know how the appointment goes.

[Chalkie]

Thanks for these replies, I head off to see the sleep doc in two hours, so I appreciate most forum users, in the USA, will be fast asleep(hopefully) right now.

[kteague]

Sounds like the OP has Central Sleep Apnea and PLMD. His therapy needs to focus on controlling those. It sounds like his obstructive events were minimal.

In my opinion the results of a sleep study where one has both obstructive sleep apnea and periodic limb movements should not be taken as definitive. There is a phenomenon called masking, where either disorder can be obscured by the other, depending on which had stronger activity at the time of the study. It's possible if the person's limb movements become controlled, the resultant sleep would provide more opportunity for obstructives to manifest.