Increased CA's, unusual SpO2 drops during REM - Obesity Hypoventilation Syndrome(OHS)?

WarpedTrekker · Post by **WarpedTrekker** » Mon Jul 08, 2019 7:12 am

I've been having increased CA's, now up to 7-8 of them each night. Also some unusual SpO2 drops with little or no event corresponding to them. I've confirmed my SpO2 drop when I wake up with my Contec 50F and another finger sensor, and both show my SpO2 dropping to 80%'s. Also when I lie down, my SpO2 drops to 90% or so, and I notice a little bit of lightheadedness like not getting enough O2. Then in a couple minutes, it balances back up to 93-95%. I'm not sure why that is.

Last night I had the SpO2 alarm set to 87%. It woke me up around 4:20am, and I woke with night sweats. I turned off my machine for a moment, to mark that location so I would remember later to check it. All I see during that time, is about a 40sec period with erratic breathing. Other nights though, I don't see much if anything of an event and both oximeters would show a drop to 80%'s.

When I wake up from a low SpO2 event like this, I always remember that I was having some type of dream. This is unusual.

1. Is it unusual to have SpO2 drops during REM, or increased CA's over time?
2. Is fluctuation of respiration rate and SpO2 normal under REM sleep?
3. Is it normal when lying down for SpO2 to go down temporarily, say from 94% to 89-90% then go back to normal?

Also noticed the Inspiration/Expiration times are missing on the chart. Maybe I restarted it to quickly and it got messed up.

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raisedfist · Post by **raisedfist** » Mon Jul 08, 2019 5:16 pm

WarpedTrekker wrote: ↑
Mon Jul 08, 2019 7:12 am
1. Is it unusual to have SpO2 drops during REM

No

WarpedTrekker wrote: ↑
Mon Jul 08, 2019 7:12 am
or increased CA's over time?

Hard to answer that. Every night of sleep is different. And sometimes we change settings. Who knows if every CA is real or not.

WarpedTrekker wrote: ↑
Mon Jul 08, 2019 7:12 am
2. Is fluctuation of respiration rate and SpO2 normal under REM sleep?

It's not abnormal.

WarpedTrekker wrote: ↑
Mon Jul 08, 2019 7:12 am
3. Is it normal when lying down for SpO2 to go down temporarily, say from 94% to 89-90% then go back to normal?

Not unless you have a heart, lung or some other disorder that affects your diaphragm such as a neuromuscular disease. Most of the time the dip is probably explained by you moving around and the pulse oximeter having to get a good reading against once you've settled down.

I don't know anything about you, but OHS is usually when the person is morbidly obese; it's considered a chest wall disease. They must have their carbon dioxide levels monitored to confirm hypoventilation, and OHS is a diagnosis of exclusion - they must rule out every other cause of hypercapnia (if evident) to determine OHS.

Judging by your respiratory rate, tidal volume and minute ventilation, I'd say that's evidence against any form of hypoventilation; then again, you have to be measured overnight using capnography to confirm either way.

WarpedTrekker · Post by **WarpedTrekker** » Mon Jul 08, 2019 8:52 pm

ok thanks! I'm not morbidly obese, although am obese at 248lbs 6'2". I am planning to get back down a little in weight to 220lbs or so. I've had two DVT's and PE's, but all tests show there were no damage to my heart or lungs from the blood clots. I'm on Xarelto now for life. Although they did find some minor scarring on base of one of my lungs, maybe due to a slight pnemonia or something I had in the past. They are not sure how it got there, and I'm not sure either.

I do still think I may be making some type of effort sometimes to breathe during sleep, causing these night sweats. Or maybe the night sweats is due to my O2 dropping low.

I went on several recent flights the other month, and while up in the air, I was feeling a little dizzy and short of breath. I took out my oximeter and it read in the 80's most of the flight. That seemed unusual, and I had to breathe deeply to get my O2 back up, but it only worked temporarily. But all tests my doctors have done, including a Pulmonologist, say my SpO2 is normal, even though I only hover at 94-95% and never higher on the ground. I had an Echocardiogram Stress Test, and that was normal, and actually they measured my O2 much higher at 98%. Although I had some AFIB during the test recur. Never had AFIB since 2017 my first time. Cardiologist already had me on 2 week Holter, and that was negative for AFIB at that time.

So all tests negative. I just hope on my next flights, my O2 doesnt drop again to the 80's. Because I felt like I wasn't getting enough oxygen. But if all tests are normal and doctors say I'm okay, I'm not sure what else to do.

raisedfist · Post by **raisedfist** » Tue Jul 09, 2019 9:39 am

WarpedTrekker wrote: ↑
Mon Jul 08, 2019 8:52 pm
ok thanks! I'm not morbidly obese, although am obese at 248lbs 6'2". I am planning to get back down a little in weight to 220lbs or so. I've had two DVT's and PE's, but all tests show there were no damage to my heart or lungs from the blood clots. I'm on Xarelto now for life. Although they did find some minor scarring on base of one of my lungs, maybe due to a slight pnemonia or something I had in the past. They are not sure how it got there, and I'm not sure either.

I do still think I may be making some type of effort sometimes to breathe during sleep, causing these night sweats. Or maybe the night sweats is due to my O2 dropping low.

I went on several recent flights the other month, and while up in the air, I was feeling a little dizzy and short of breath. I took out my oximeter and it read in the 80's most of the flight. That seemed unusual, and I had to breathe deeply to get my O2 back up, but it only worked temporarily. But all tests my doctors have done, including a Pulmonologist, say my SpO2 is normal, even though I only hover at 94-95% and never higher on the ground. I had an Echocardiogram Stress Test, and that was normal, and actually they measured my O2 much higher at 98%. Although I had some AFIB during the test recur. Never had AFIB since 2017 my first time. Cardiologist already had me on 2 week Holter, and that was negative for AFIB at that time.

So all tests negative. I just hope on my next flights, my O2 doesnt drop again to the 80's. Because I felt like I wasn't getting enough oxygen. But if all tests are normal and doctors say I'm okay, I'm not sure what else to do.

Oxygen saturation decreases a bit while on an airplane but staying in the 80's does not sound normal in a pressurized cabin.

Did they do a lung VQ scan? It looks for blood clots/PE and makes sure the circulation and perfusion of blood in the lungs is normal.

WarpedTrekker · Post by **WarpedTrekker** » Tue Jul 09, 2019 10:10 am

raisedfist wrote: ↑
Tue Jul 09, 2019 9:39 am
Oxygen saturation decreases a bit while on an airplane but staying in the 80's does not sound normal in a pressurized cabin.

Did they do a lung VQ scan? It looks for blood clots/PE and makes sure the circulation and perfusion of blood in the lungs is normal.

No I never had a post CT scan or VQ scan after my last DVT/PE. My hematologist says they normally never do scans afterwards, and just keep people on blood thinners. All my hematologist does is blood work (D-Dimer) test, to check for any clotting. I've been negative. But from what I read, that wouldn't determine if you had damage to lungs or blood vessels in lungs, or any residual clots.

My Pulmonologist said depending on my Echocardiogram Stress Test, they would determine if I needed a VQ Scan. So far I've heard nothing, since my stress test was normal.

I'm planning another trip here soon. I guess my only choice is to fly again and see what happens. Or should I push them to have a VQ scan? I'd prefer not to have any more radiation.

raisedfist · Post by **raisedfist** » Tue Jul 09, 2019 4:03 pm

WarpedTrekker wrote: ↑
Tue Jul 09, 2019 10:10 am

raisedfist wrote: ↑
Tue Jul 09, 2019 9:39 am
Oxygen saturation decreases a bit while on an airplane but staying in the 80's does not sound normal in a pressurized cabin.

Did they do a lung VQ scan? It looks for blood clots/PE and makes sure the circulation and perfusion of blood in the lungs is normal.
No I never had a post CT scan or VQ scan after my last DVT/PE. My hematologist says they normally never do scans afterwards, and just keep people on blood thinners. All my hematologist does is blood work (D-Dimer) test, to check for any clotting. I've been negative. But from what I read, that wouldn't determine if you had damage to lungs or blood vessels in lungs, or any residual clots.

My Pulmonologist said depending on my Echocardiogram Stress Test, they would determine if I needed a VQ Scan. So far I've heard nothing, since my stress test was normal.

I'm planning another trip here soon. I guess my only choice is to fly again and see what happens. Or should I push them to have a VQ scan? I'd prefer not to have any more radiation.

Your medical team knows way more than I do! With the normal d-dimer and stress echo further scanning for clot/pe is probably not necessary and would just be money spent for nothing.

I'd just follow up with your team and be persistent on how you feel.

ajack · Post by **ajack** » Wed Jul 10, 2019 7:16 am

Your chart doesn't look like OHS. Raise your min epap to 6, a bit over your 95% number, then check your o2. Mostly your tidal volumes minute vent and o2 look good.

WarpedTrekker · Post by **WarpedTrekker** » Sun Jul 14, 2019 8:40 pm

Well it's back to normal again. I'm trying out a new oximeter, the Contec 50F Plus with new finger probe and bluetooth. It seems to fit better, but it's basically the same readings as the cheaper model. So I'm returning it. It actually showed 92% SpO2 for part of the night which I guess is still okay.

Only thing I keep seeing consistently on my charts, are that I take a deep breath every 15-20min, as seen on the flow rate graph. Not sure why I do that, unless that was learned in the past, when I had no machine. Also on the SpO2 Chart, during what I think was REM or deep sleep, my HR flucuated from 60's-80's.. I see that a lot too almost every night, so I suppose that is just normal, or normal for me.

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Increased CA's, unusual SpO2 drops during REM - Obesity Hypoventilation Syndrome(OHS)?

Increased CA's, unusual SpO2 drops during REM - Obesity Hypoventilation Syndrome(OHS)?

Re: Increased CA's, unusual SpO2 drops during REM - Obesity Hypoventilation Syndrome(OHS)?

Re: Increased CA's, unusual SpO2 drops during REM - Obesity Hypoventilation Syndrome(OHS)?

Re: Increased CA's, unusual SpO2 drops during REM - Obesity Hypoventilation Syndrome(OHS)?

Re: Increased CA's, unusual SpO2 drops during REM - Obesity Hypoventilation Syndrome(OHS)?

Re: Increased CA's, unusual SpO2 drops during REM - Obesity Hypoventilation Syndrome(OHS)?

Re: Increased CA's, unusual SpO2 drops during REM - Obesity Hypoventilation Syndrome(OHS)?

Re: Increased CA's, unusual SpO2 drops during REM - Obesity Hypoventilation Syndrome(OHS)?

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