Pulse Oximeter & Possible Sleep Apnea?

UndiagnosedGirl wrote:

Sleeping Ugly wrote:So many of your symptoms were the same symptoms that I had before started my CPAP therapy! I can go down your checklist and check them off. Now they are resolved with my CPAP therapy. I sure hope that may be the case for you.

I am real concerned that a doctor would call your symptoms, "normal bad sleep!" What is "normal bad sleep?" How long does normal bad sleep have to continue before it becomes "abnormal bad sleep?" It's ridiculous! As was stated before, you need someone to take you seriously and start you on a path of diagnosing what is going on. Are you having lousy sleep due to health issues or are you having health issues because of lousy sleep?

I hope you can find a health professional that can get you started in the right direction and help you with your issues.

The very best of luck to you!

Oh, your comment gives me HOPE! Yeah, I almost cried back when my doctor handed me a list of sleep habits/routines to follow for good sleep. (As if I hadn't tried ALL of those on my own over the past 10-15 years! Ha!) Anyway, thank you!

You are welcome! There is ALWAYS hope! You are taking matters into your own hands and going forward with this! Good for you! We must be our own advocates for our health. No one is as vested in you as YOU!

Rumbert - what a story! You know, I spoke with my sister about all of this recently... A few years ago at a routine exam her doctor was examining her throat and asked how well she sleeps. She asked why and the doc said something about how narrow her throat or airway was. She is overweight and does snore but she has always says she sleeps like a rock. She ended up getting a sleep study but it came back "normal," just excessive snoring lol. I wonder if I have a narrow airway too? Interesting. Thanks for sharing your story... So happy it was a relatively quick diagnosis for you!

xxyzx wrote: UARS may turn into hypops but not full apnea

they are tricky to diagnose
i think i posted a link to an article on UARS that had the diagnosis methods noted

wavetop flattening on the flow wave is a big sign of UARS
which disturbs sleep a lot but not lower spo2 much

low spo2 sounds more like full apnea

Great info here, thank you!

Everything you've said makes me think you need to be formally tested for sleep disordered breathing. Whether it is OSA or UARS is anybody's guess at this point, but hopefully soon you'll have some answers. I am curious about the other things you're experiencing that you mentioned in passing - sometimes unexpected things can also be clues. Disrupted sleep for whatever reason can throw a lot of things off in the body.

I'm going to throw this in as an outlier. Please do not invest any energy in delving into it at this point, because I'm thinking your issues are sleep breathing related. However, just be aware that periodic limb movements (PLMD or PLMS) can cause frequent wakings and lots of position changes. Sometimes the person holds their breath with the contractions of usually the feet or legs, but can be other parts of the body. While holding the breath is not likely to be long enough to cause a drop in oxygen, I would imagine stranger things have happened. When the onset of a contraction comes suddenly with a jerk, one can be awakened at the point of a catch in their breath. At the end of a contraction is a sense of releasing, which results in movement. Your description of a tremor on waking caught my attention. Also, limb movements can coexist with breathing issues. I would just suggest that if there's any indicators this could be an issue with you that you insist on an in-lab study with your legs wired. Has anyone who has observed you sleeping ever said your legs move a lot?

kteague wrote:Everything you've said makes me think you need to be formally tested for sleep disordered breathing. Whether it is OSA or UARS is anybody's guess at this point, but hopefully soon you'll have some answers. I am curious about the other things you're experiencing that you mentioned in passing - sometimes unexpected things can also be clues. Disrupted sleep for whatever reason can throw a lot of things off in the body.

I'm going to throw this in as an outlier. Please do not invest any energy in delving into it at this point, because I'm thinking your issues are sleep breathing related. However, just be aware that periodic limb movements (PLMD or PLMS) can cause frequent wakings and lots of position changes. Sometimes the person holds their breath with the contractions of usually the feet or legs, but can be other parts of the body. While holding the breath is not likely to be long enough to cause a drop in oxygen, I would imagine stranger things have happened. When the onset of a contraction comes suddenly with a jerk, one can be awakened at the point of a catch in their breath. At the end of a contraction is a sense of releasing, which results in movement. Your description of a tremor on waking caught my attention. Also, limb movements can coexist with breathing issues. I would just suggest that if there's any indicators this could be an issue with you that you insist on an in-lab study with your legs wired. Has anyone who has observed you sleeping ever said your legs move a lot?

Thank you for your input! I've read about limb movements like that, however I've never noticed (or had my husband notice) that I do that. The "tremors" I refer to are more like shakey fingers. That was actually the first big symptom that seemed to start a couple of years ago. (Not seemingly attached to any stressful event or feeling of anxiety either.) After a quick neurological exam I was told they are just essential tremors. It's just hard for me to believe that since they seemed to come out of nowhere, and there is no history of it in my family. The shaking is always the worst upon waking, through the morning, and usually gets better later in the day. Before bed, they are sometimes nonexistent. I know stress/anxiety can make them worse, but I don't feel stressed at all right now, and my thumbs are shaking horribly as I type this here. (And I haven't had any caffeine yet.) ANYway, I've just always thought my sleep problems might be contributing to the tremors, even if they aren't the cause, I bet it's making them worse. We'll see. Thank you for your input!

Mabe this is radical, but doctors minimizing health complaints is wrong.

One small way to make a doctor pay attention to your concerns is to provide your medical concerns in writing. It changes the whole dynamics from, "she said, she said", to evidence - empirical proof.

Also document your visit while there with the doctor. Just treat the appointment like a business meeting. You go through your points one by one and write down what the doctor said. If at this point the doctor hasn't got the message, press a little. Ask, is there any other possible reasons for this.

O! And don't be afraid to tape the meeting. I believe in the US both parties must be aware. Just say, sorry my memory is shot from poor sleep, may I tape this to assist my memory.

And/or bring your husband in.

In the past doctors have been reveared like the village oracle.

I have an excellent doctor who takes my issues seriously. But, there has been one or two specialists.........

Cpapian wrote:Mabe this is radical, but doctors minimizing health complaints is wrong.

One small way to make a doctor pay attention to your concerns is to provide your medical concerns in writing. It changes the whole dynamics from, "she said, she said", to evidence - empirical proof.

Also document your visit while there with the doctor. Just treat the appointment like a business meeting. You go through your points one by one and write down what the doctor said. If at this point the doctor hasn't got the message, press a little. Ask, is there any other possible reasons for this.

O! And don't be afraid to tape the meeting. I believe in the US both parties must be aware. Just say, sorry my memory is shot from poor sleep, may I tape this to assist my memory.

And/or bring your husband in.

In the past doctors have been reveared like the village oracle.

I have an excellent doctor who takes my issues seriously. But, there has been one or two specialists.........

Great advice, THANK you!!

Ok, so for those who are curious and/or would like to chime in, I used a recordable pulse oximeter to try and confirm my suspicions (until I can get in for an apointment). Turns out I might not be having as many low oxygen readings as my other oximeter suggested. However I do have a question about the Pulse Rate events. Here are my results from last night...

SpO2
Total Events: 3
Time in Event: 2.2 minutes
Avg Event Duration: 44 secs
Basal SpO2: 97.4
Min SpO2: 93
Avg Low SpO2: 94.3

Pulse Rate
Total Events: 173
Time in Event: 85 minutes
Avg Event Duration 29.5 seconds
Avg Pulse Rate: 59.9
Low Pulse Rate: 48

I know that if Pulse Rate Events coincide with SpO2 events, that obviously signals a problem. But since I'm not having many SpO2 events, do the 173 Pulse Rate Evens mean anything on their own? Am I actually waking up during those Pulse Rate Events? It sure feels like I wake up wide awake often. Could I still have obstructed sleep yet wake up early enough, before my SpO2 drops? I may be wrong but I thought I read somewhere that that is why many doctors don't catch UARS because they think since Oxygen is okay, there is no sleep issue. Really looking forward to doing a legit sleep study for more answers. Maybe I'm just a "light sleeper" after all of this haha. I'm just so sick of wake up wide awake so often during the night. Hopefully I'll have answers soon. Thanks everyone!

Do you WANT to be sick? Do you WANT some kind of treatment? Maybe stop looking for trouble and get busy living.

UndiagnosedGirl wrote: Am I actually waking up during those Pulse Rate Events?

Unfortunately no way to know for sure one way or the other.

UndiagnosedGirl wrote:Could I still have obstructed sleep yet wake up early enough, before my SpO2 drops?

Yes, it's possible. I have a friend with severe OSA and an AHI of over 60 but her oxygen levels never really dropped significantly at all.
Her baseline while awake was 96% and it never dropped below 93% when asleep. The little drop she had was actually considered not that big of a deal because it's normal for oxygen levels to drop a little while asleep anyway.
Not everyone will have a significant drop in oxygen levels with OSA which is why we don't put all our eggs in the pulse ox data alone for diagnosing OSA. If a person has some significant drops that is likely a clear indication of OSA (assuming not related to other health issues) but not having any significant drops doesn't necessarily mean that there is no OSA.

There are many reasons out there for waking up often in the middle of the night.
OSA is but one of many. Google "sleep maintenance insomnia" and start reading.

Pulse rates will vary through the night anyway so I have no idea how significant your pulse rate changes are. They could even be related to the wake ups you are having and of course wish you didn't have.

Julie wrote:Do you WANT to be sick? Do you WANT some kind of treatment? Maybe stop looking for trouble and get busy living.

Yes, I'm completely fabricating all of my symptoms for attention. Wow. I apologize for reaching out to a forum that I figured was more knowledgable than Google. I've been through a lot and have been struggling getting answers so I've started to try and find answers on my own. Thank you for being so judgemental and sensitive in your reply. You know, if you see something on the internet that bothers you or you don't agree with, it IS possible to ignore it and carry on with your life. You don't need to chime in so negatively and project your anger or whatever that was out on someone struggling. Doesn't help anyone. Just a thought.

Pugsy wrote:

UndiagnosedGirl wrote: Am I actually waking up during those Pulse Rate Events?

Unfortunately no way to know for sure one way or the other.

UndiagnosedGirl wrote:Could I still have obstructed sleep yet wake up early enough, before my SpO2 drops?

Yes, it's possible. I have a friend with severe OSA and an AHI of over 60 but her oxygen levels never really dropped significantly at all.
Her baseline while awake was 96% and it never dropped below 93% when asleep. The little drop she had was actually considered not that big of a deal because it's normal for oxygen levels to drop a little while asleep anyway.
Not everyone will have a significant drop in oxygen levels with OSA which is why we don't put all our eggs in the pulse ox data alone for diagnosing OSA. If a person has some significant drops that is likely a clear indication of OSA (assuming not related to other health issues) but not having any significant drops doesn't necessarily mean that there is no OSA.

There are many reasons out there for waking up often in the middle of the night.
OSA is but one of many. Google "sleep maintenance insomnia" and start reading.

Pulse rates will vary through the night anyway so I have no idea how significant your pulse rate changes are. They could even be related to the wake ups you are having and of course wish you didn't have.

Thank you Pugsy.

Welcome to the forum. Hopefully, you will stick around. As you have found, there are all kinds of people here on the forum. Most try to be helpful. Others are down right rude, and don't filter their thoughts prior to posting them. You will also find your questions will often get hijacked by others that want to jump on your post rather than make their own post. Others seem to post only for the chance to bicker and disagree with someone. There is way too much bickering and backbiting here, but it is what it is. You can get a lot of good help if you stick around and develop a thick skin. You will easily learn who the helpful people are, and who to ignore. Wish you the best of luck in your search for the cause of your fractured sleep pattern. For what it's worth my "sleep doctor" is actually a nurse practitioner who work under the supervision of a pulmonologist who is a certified sleep specialist.

UndiagnosedGirl wrote:

Julie wrote:Do you WANT to be sick? Do you WANT some kind of treatment? Maybe stop looking for trouble and get busy living.

Yes, I'm completely fabricating all of my symptoms for attention. Wow. I apologize for reaching out to a forum that I figured was more knowledgable than Google. I've been through a lot and have been struggling getting answers so I've started to try and find answers on my own. Thank you for being so judgemental and sensitive in your reply. You know, if you see something on the internet that bothers you or you don't agree with, it IS possible to ignore it and carry on with your life. You don't need to chime in so negatively and project your anger or whatever that was out on someone struggling. Doesn't help anyone. Just a thought.

+1 well said.....

Okie bipap wrote:Welcome to the forum. Hopefully, you will stick around. As you have found, there are all kinds of people here on the forum. Most try to be helpful. Others are down right rude, and don't filter their thoughts prior to posting them. You will also find your questions will often get hijacked by others that want to jump on your post rather than make their own post. Others seem to post only for the chance to bicker and disagree with someone. There is way too much bickering and backbiting here, but it is what it is. You can get a lot of good help if you stick around and develop a thick skin. You will easily learn who the helpful people are, and who to ignore. Wish you the best of luck in your search for the cause of your fractured sleep pattern. For what it's worth my "sleep doctor" is actually a nurse practitioner who work under the supervision of a pulmonologist who is a certified sleep specialist.

Yes, that.