Test shows not much improvement in O2 with Cpap

Hi! Thanks for any input—I am new to Cpap —user for 3 months initial test AHI 29.6,
mean O2 89, min 81,
69 Hypopnoeas

55 year old female, BMI 25, stage 3 CKD, autoimmune disorder (lupus-like) slight asthma, good BP, no tobacco. Have noticed at times lightheadedness. Only check my 02 when I have had a chest cold or the rare asthma flare-and it is always low 89-93 when ill

Just did a pulse oximetry overnight with the Cpap and the results were
ODI 16, events 87? Not sure what that means
Oxygen Low 81, basal 91-
94% in bradycardia - is this a good thing to have all night?
The report says I need O2 at night.

My Sleep Dr says I need to see a ENT and the oxygen thing will work itself out? I have a full face mask. He bumped my machine to 10-15, it was 9-14 instead of O2 and wants to wait a couple months to check after the ENT and adjustments. I am wondering about consulting a pulmonologist?? I made an appt for a second opinion- with another sleep center.
I am not sure this is a big problem or if I am being an over reacting Newbie- thanks!

What is your AHI with CPAP in use? If that's not under good control, that could be at least a partial explanation of why you oxygen is low.

I have not had a test with the Cpap yet- he just did the pulse oximetry.
Thx

**** I haven’t had a sleep study again with the Cpap - just the Cpap using the pulse ox

What is your resting heart rate when awake?

How is your asthma being managed medically? Is treatment constant?

KatnapZ wrote: ↑

Fri Feb 01, 2019 9:07 am

My Sleep Dr says I need to see a ENT and the oxygen thing will work itself out?

Does your primary agree?

What specific issue for the ENT does the sleep doc have in mind for him to address?

Depending on how the various issues interact, I, as a non-medical person, think you may possibly be a good candidate for autobilevel. But it may be that your sleep doc would have to be convinced to make that case for trying that based on input from your primary or your other specialists. Bilevel can lessen work of breathing for some, which can help comfort and efficacy of treatment in a number of circumstances. A full overnight NPSG in a lab/center for titration would be able to discern the particulars either way if the sleep tech for the NPSG has the heads-up from the sleep doc to see what bilevel would do for you.

"Events" from a pulse ox test is just the number of times the oxygen changed levels by whatever criteria they were using...probably 3 or 4 %.

Your basal level is on the low side unless you live at the higher altitudes.

Brachycardia is a slow heart resting heart rate. It may or may not be significant for you...Like was it at 59 most of the night or below 50 most of the night kind of thing. Were you ever an athlete of some sort? On any heart meds or BP meds?

I am confused...your topic says "test shows not much improvement in O2 with cpap"...yet you say you aren't using cpap yet.
Which is it?

Yes...considering all that is going on with you I do think a chat with a pulmonolgist is in order.

Sorry to confuse
The initial test was without Cpap
The second test was with Cpap

I have been very active in years before but less the last couple years, due to fatigue.

I live at 5,500 ft

No medication but for hypothyroid.

You need to be having a chat with the pulmonologist about things...the O2 level while awake is going to be a factor.
You live at higher altitudes where there is less oxygen in the air and it's common to have a lower awake O2 level.

It is quite common for athletes with years of special training to have a low resting heart rate even years after doing much training.
Again...something for the pulmonologist to offer their input on.
A lot depends on just how low the heart rate went below 60.

3 months on cpap and still having significant desats down to 81%.....needs to be evaluated by a pulmonologist for sure.
Now maybe you went down to 81% very briefly and spent the bulk of the night around 88% or more...but 88% is the cut off line for needing O2 if you spend much time below it.

Thanks for the replies-Newbies.. .I was able to get another sleep center to see me next week. I will ask about the Pulmonologist referral. I have a family Dr appt in a couple weeks- but she and the sleep Dr don’t want to seem to own the management.

I thought I sent a reply to the thread-about being more aware of this O2 deal and have checked it during the day lately. A couple days it was 88-91 during the day and I called the family DR and she said ask the Sleep Dr... lol!!

More facts from the initial sleep study no Cpap
50% in 80-89
35% in 90-92
11.8% in 92-94


With the Cpap and pulse oximetry still low - I guess I expected it would be solved. I understand the time in the desaturation is much less but the test paper still said with the events I needed O2 at night.
14 min in <88
37 min < 89
The brachycardia 51 low- 84 high, avg 56

This all is quite interesting but, will be relieved when we get it squared away.

Thanks everyone!!

The DeSats may be a big deal. and You have Apnea and need CPAP, your Asthma (COPD) imply that a higher more advanced CPAP machine may be appropriate for you or as a minimum an Auto-CPAP with supplemental oxygen at night. (Medicare says More than 5 minutes at or below 88% is the criteria for supplemental oxygen)

You may want to ask your Asthma doctor for a Pulmonologist Sleep Doctor.

If the CPAP in your profile is the one you actually have (which is the same one I have), it tracks your AHI every night. You don't even need a phone or a computer to retrieve it.