Sats drop but no apnea during sleep study?

[3isles]

Hey here's a weird scenario: my daughter's home care nurse just had a sleep study last night. She had been dx'd with apnea years before, but doc wanted a new study because she was having Way more daytime sleepyness and had a wreck from falling asleep driving.

Anyway during the sleep study last night they found she had desats but did not have apneas. How can this happen? She sleeped about 5 hours so they should have had a good sample. Anyone ever heard of this before????

[ofarchesandants]

I don't have apneas nor do i snore but i've been exhausted my whole life. At worst i desat in the upper 80's but am usually above that. My problem and maybe hers too is that i guess my brain is super sensitive to minor desats or constrictions in air flow so i have the arousals (though of course i'm never aware of them) prior to a major desat or full apneic event. While i can't say that's her problem, perhaps it's somethimng similar.
cheers,
gregg )

[3isles]

thanks Gregg,
I told her I would ask here as if anyone ever heard of it someone here would. She says her sister has the same thing going on, and is on bipap.

[CpapMasks]

The desats are caused by hypopneas........ involves episodes of overly shallow breathing or an abnormally low respiratory rate. This differs from apnea in that there remains some flow of air. Hypopnea events may happen while asleep or while awake.

During sleep, hypopnea is classed as a sleep disorder. With moderate to severe hypopnea, sleep is disturbed such that patients may get a full night's sleep but still not feel rested because they did not get the right kind of sleep. She can qualify for a CPAP machine as long as she has a secondary diagnosis of excessive daytime sleepiness. Hope that helps.... cpapmasksonlinedotcom

[Goofproof]

We could use some real facts, what did her O2s drop to and how long, did she reach REM sleep. What were her stats while on room air and while on XPAP. We all know of bad sleep studies. Jim

[ofarchesandants]

as cpapmasks sts, you need a secondary diagnosis to qualify for insurance to cover when you only have the hypopneas. I went through that with the initial diagnosis not being covered and the doc had to rewrite or add in the EDS (excessive daytime sleepiness) bit which wasn't any stretch since that's what got me to get the study in the first place.
gregg )

[Julie]

She should see a doctor for a general checkup. She may well have cardiac or other problems, if not apnea, and needs to be seen. There are many illnesses that cause low 02 (like COPD/emphysema... does she smoke?) without being apnea.

[3isles]

thanks all,
Lets see...I'll fill in the blanks as best I can:

she only had the study 2 nights ago. The tech told her she had no apneas, but of course someone else will read the study and she will have a follow up appt with doc who will hopefully (haha I almost said doubtless, where was my head???) explain to her whats going on. I don't know any specifics and I don't know if the tech gave her any info re how low o2 went and for how long...also I don't know if the tech said anything about hypopneas. I'll ask her when she is working here again on Tuesday.

she had a previous dx (several years) of osa, so on the prev sleep study must have had apneas(?)


re heart, lungs etc she has been seen quite a lot in the last 2 months, had a cancer scare in lungs, but it was some benign growth, maybe she has an infection brewing from the bronchoscopy, I'll suggest she have her doc re-check that. was in er for chest pains, but full workup showed nothing, probably anxiety over lung stuff.

Thanks for all the good input, you guys are so far ahead of the average RT in understanding the finer points of sleep disorders, its impossible to even ask the right questions with the zero knowledge base most of us go into that first sleep doc appt with. This board should be suggested study before any sleep study or appt.

[momadams]

The morning after my sleep study, the tech reported that she'd noticed no apnea events (or some such words - it was a year and a half ago). That was a Friday. That Monday, I had a call from the sleep clinic asking me to come in as soon as possible for a titration since I'd had 35 events per hour.
FWIW
Shari

[GumbyCT]

Hey here's a weird scenario: my daughter's home care nurse just had a sleep study last night. She had been dx'd with apnea years before, but doc wanted a new study because she was having Way more daytime sleepyness and had a wreck from falling asleep driving.

Anyway during the sleep study last night they found she had desats but did not have apneas. How can this happen? She sleeped about 5 hours so they should have had a good sample. Anyone ever heard of this before????

Not a doc here but if blood O2 is used faster than it is replaced that would cause a desat. Crystal ball has me guessing there are other medical problems. What about PLM's? The legs are large muscle which use up O2.

[echo]

Or lung disease?
But we should stop speculating until we get the entire PSG.. as momadams pointed out the tech could have been wrong.