Sleep doc told me oxygen desaturations were "insignific

I purchased a Nonin "Wrist-Ox" pulse oximeter with nVision software several months ago and discovered I was still having lots of oxygen desaturations into the high, mid and even low 80s. This is despite using my CPAP diligently, never skipping a night.

I saw my sleep doctor today and brought with me copies of the home oximetry I did recently. I had been telling him since last December that my sleep quality was better in some respects, but basically, still very poor. He replied today after I showed him the copies of my home oximetry that the oxygen desats were "insignificant" and "not to worry about it."

Several nights ago, I had six events in the 89-85 range and one in the 84-80 range, with my lowest 02 being 83%.

Sunday night, I had 3 events in the 89-85 range, with two of them being 87%.

Last night, I had 8 events in the 89-85 range, with one of them below 88%, the event dropped to 85%.

To quality as an event on this Nonin gear, I had to have a drop in nocturnal 02 by at least 4% for a minimum of 10 seconds.

Im skeptical of what my sleep doc told me today, my understanding is anytime you have a desat less than 88%, its not acceptable if anything can be done about it. I have no history of heart problems or central apnea, just mild to moderate OSA.

When I told him my sleep quality was very poor still, he told me to contact my DME and to ask them what to do and maybe get a new mask, etc. I already have my mask situation squared away and use a Resmed Mirage Quattro full face mask. Ive already worked my DME hard in the past year and they cant do anything for me that hasnt already been done by them.

Im thinking this "sleep doc" is full of sh*t.

This sleep doc is a pulmonary doc who does sleep medicine on the side, sleep medicine is not this guy's primary function. I haven't been impressed with the followup he's given me after he put me on CPAP last summer. I'm seriously thinking of dumping him for a full time sleep doc, maybe one thats board certified in sleep medicine.

Any suggestions?

thanks,

Fred

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CPAPopedia Keywords Contained In This Post (Click For Definition): resmed, mirage, CPAP, DME

MrGrumpy wrote:Im thinking this "sleep doc" is full of sh*t.

Me thinks you may have found the proverbial head on the end of the nail!! But I will withold my opinion until the 30th whin I will take my similiar data in to my Doc and see what he says.

Jerry

If you are not satisfied with your doctor's opinion of the pulse ox reading then it is time to find another doctor for a second opinion. Hopefully you can find one who is board certified in sleep medicine.

Good luck,
Sundra

Fred, Run - RUN to another doc. Does this guy have a license? You would think a pulmonary doc would understand the damage these desats are doing. You mean -
you haven't had any heart problems yet!!! Just how long can YOU hold your breath?

Hopefully you also have a smartcard & the software. Meanwhile you need to learn how to take charge of your therapy and also learn how to adjust your own pressure. It doesn't sound like this nitwit will help you.

RUN. Don't look back.

Good Luck,
GumbyCT

My % of saturation was the firts thing my pulmonary doctor talked to me about, stressing on the fact of all the other problems related to it if nothing was done!
Basically, if you were to be in the hospital with these results, they would have you on a continuous oxygen mask ! Anything below 94% isn't good...
I'LL go with what GumbyCT said:"Fred, Run - RUN to another doc!"
Let us know how this turns out!

Also, run out get a machine that stores real data, and the software to read it. It sounds life your XPAP treatment isn't correct. If you had filled in your profile in text we would have some idea about your XPAP treatment. That helps. Jim

I'm a mind reader, me thinks "Nasal Mask victim.

Goofproof wrote:Also, run out get a machine that stores real data, and the software to read it. It sounds life your XPAP treatment isn't correct. If you had filled in your profile in text we would have some idea about your XPAP treatment. That helps. Jim

I'm a mind reader, me thinks "Nasal Mask victim.

Just curious, but what do you mean fill out my profile? I filled it out as complete as I thought I could do...list my gear there.

Does the software really help that much? I mean, if my 02 is going down despite my current pressure, my pressure probably needs to be increased.

I have no probs tolerating CPAP and use a Quattro FFM.

Fred

Ask your GP for a script for an overnight pulse ox run by the DME or a hospital outpatient service. Get many nights if you can.

If you are still having many and long O2 desats on that testing then ask if you need to add O2 to your routine. If the GP can't answer, find a real sleep doc who will retest you etc.

Adding pressure may not solve your problem. Some ppl need to be on both O2 and CPAP.

GumbyCT wrote:Fred, Run - RUN to another doc. Does this guy have a license? You would think a pulmonary doc would understand the damage these desats are doing. You mean -
you haven't had any heart problems yet!!! Just how long can YOU hold your breath?

Hopefully you also have a smartcard & the software. Meanwhile you need to learn how to take charge of your therapy and also learn how to adjust your own pressure. It doesn't sound like this nitwit will help you.

RUN. Don't look back.

Good Luck,
GumbyCT

Thanks...this is sorta what Im thinking. No...no heart problems. I swim a mile a day three or four times per week.


Ive tried holding my breath while awake long enough to drive it down under 90%. I cant do it while awake!


So you know its gotta be bad when its going that low in my sleep.

I think this current dude is just ignorant about sleep medicine beyond a basic rudimentary level. He primarily does pulmonary stuff and most of his patients I see are ex smokers with some form of lung disease or pulmonary disease. He sees 02s in the 70s, 60s and 50s all the the time Im sure. When he sees me, a guy in his late thirties, with a 02 still in the mid to high 80s, I think he's insensitive and actually thinks thats not too awful bad compared to what he sees regularly.

But thats not good for moi.

Fred

sleepydoll wrote:My % of saturation was the firts thing my pulmonary doctor talked to me about, stressing on the fact of all the other problems related to it if nothing was done!
Basically, if you were to be in the hospital with these results, they would have you on a continuous oxygen mask ! Anything below 94% isn't good...
I'LL go with what GumbyCT said:"Fred, Run - RUN to another doc!"
Let us know how this turns out!

mine never mentioned the dangers of oxygen desaturation. I learned about that part on my own.

I was reading they came out with board certification for sleep medicine in 2007. I checked the credentials of my sleep doc and he's board certified in Internal medicine, subspecialty board certified in pulmonary...but no board certification in sleep medicine.

Confirms the impression I get of him...no good for sleep medicine stuff

Here is the website Im using to locate a PURE sleep doctor who is board certified in sleep medicine in my area.

http://www.abms.org/

Fred

It's filled out now. Is your Resmed set to the correct setting for your mask? If your leak rate isn't too high, the readings for your treatment should be close. The software is important, resmed's seems to be the under dog when it comes to software, but I'd think anything would be more useful than none.

I said that about the nasal mask because the two most likely causes of poor treatment are mouthbreathing and dumb XPAPs supplied by dumb DME's. With a FF mask that's one less problem.

perhaps if you post your general location people will post or pm you with suggestions of who they think is good and who to avoid

[quote="Goofproof"]It's filled out now. Is your Resmed set to the correct setting for your mask? If your leak rate isn't too high, the readings for your treatment should be close. The software is important, resmed's seems to be the under dog when it comes to software, but I'd think anything would be more useful than none.

I said that about the nasal mask because the two most likely causes of poor treatment are mouthbreathing and dumb XPAPs supplied by dumb DME's. With a FF mask that's one less problem.

jules wrote:perhaps if you post your general location people will post or pm you with suggestions of who they think is good and who to avoid

Thanks, Im in Charlotte, North Carolina.

Fred

with the absence of seeing when those desats occurred, those could easily be sleep onset events or REM events, in which case they would be considered normal.

Given that you still feel your sleep is of poor quality, I would definitely look into it, but keep in mind that frequency of desats is considered well within the normal range.