Much lower AHI on O2?

Hi! My AHI during my 1st sleep study was 30. I've been on O2 at night since my 1st overnight pulse oximetry 2 months ago. We recently bought our own pulse ox. (one recommended on this forum) and I tested myself on O2 and had a total of 8 desats all night. This seems like a big improvement from the 18/hr on my first pulse ox. test. I feel better during the day, have more energy and better concentration. My husband used my O2 last night and went from having over 30 desats/hr to having 7 the entire night. Is this some false reading or is the O2 really helping us that much? I plan to do several more nights on the pulse ox. for comparison before my titration sleep study next week to get more data. My questions: Has anyone had good result from just using O2? Has anyone even been tested on O2 alone before trying CPAP?

Pulse oximeters are nice to use. The added O2 will surely help you not have significant desats.
Problem is not everyone has significant desats with their sleep apnea events. I have a friend that has OSA 66 AHI but during her sleep study she only went below 94% O2 once and that was to 90%.

So adequate O2 saturation doesn't negate the need for cpap because there are other stressors that can occur with the apnea events to harm the body.

If added O2 worked to treat OSA all by itself we wouldn't be using these machines. Think about it. If the tissues in the throat collapse completely....how is the O2 going to get to the lungs? Adding O2 just keeps the overall saturation up because of volume getting to lungs before the airway is blocked (either fully or partially). It doesn't stop the blocking from occurring.

Teknomom,

By chance did you see if your Apnea's are Central or Obstructive in nature at your first sleep study? I wjust use O2 by it's self when we go camping, or sometimes on the weekend when I want a break from the mask. And I will sometimes check myself over night on a pulse OX meter. I usully see very few if any destats. But I suffer from Central Apnea and shallow breathing. In my case the extra O2 seems to help contral the number of centrals I have. I say seems, as I have not had a sleep study with just O2, and really thats the only way to know for sure. I do know that with my BiPap without extra O2 bleed in I see a lot of destats.

Pugsy is right about the Airway closing with OSA though, as a XPap splints open the airway for OSA, and with a closed airway no amount of extra O2 is going to help if it can't get down to the lungs.

Just my thoughts on the O2 with Central above. As always one's millage seems to vary with Sleep Breathing Disorders.

With obstruction and with centrals, I had desats before. I thought the desats might still occur but at 96% down to 92% as opposed to 88% down to 84%. I wasn't expecting them to decrease so dramatically. Some of it may be positional since I elevated the head of my bed quite a bit and stay on my sides as opposed to being supine most of my sleep time during the PSG. Some of it may be due to a decrease in central apneas which are higher at my elevation - 8000 ft. (50% of mine were central). Many or most of the effects on the cardiovascular system, brain and endocrine system are due to the hypoxemia, as I understand it. Decreasing hypoxemia is my goal until I see my sleep doc again.

Pugsy, I would be glad to read some studies about the effects of other stressors, such as negative pressure in the chest during obstructive apnea. Some of this information is hard to find and very non-specific. Do you have any links?

I would think that xpap is cheaper than O2. If the xpap eliminates your apneas and thus eliminates your desats you won't need the O2. Have you worn the oximeter while awake? My O2 is 97-98 while up and about, As soon as I lie down it's 90, put the mask on and it's 93-94.

Jordy, 50% centrals, a few total obstruction, the rest hypopnia. I think there are a couple of things going on which I noted in my reply to Pugsy. I would love to see what a PSG on O2 showed but that's probably not going to happen. I'm glad to read that the O2 helps you with centrals. I have a titration study next week and would like to factor in my O2 use. Maybe I could get by without buying an ASV. Expensive little machines!!

Jordy wrote:Teknomom,

By chance did you see if your Apnea's are Central or Obstructive in nature at your first sleep study? I wjust use O2 by it's self when we go camping, or sometimes on the weekend when I want a break from the mask. And I will sometimes check myself over night on a pulse OX meter. I usully see very few if any destats. But I suffer from Central Apnea and shallow breathing. In my case the extra O2 seems to help contral the number of centrals I have. I say seems, as I have not had a sleep study with just O2, and really thats the only way to know for sure. I do know that with my BiPap without extra O2 bleed in I see a lot of destats.

Pugsy is right about the Airway closing with OSA though, as a XPap splints open the airway for OSA, and with a closed airway no amount of extra O2 is going to help if it can't get down to the lungs.

Just my thoughts on the O2 with Central above. As always one's millage seems to vary with Sleep Breathing Disorders.

teknomom wrote: I would be glad to read some studies about the effects of other stressors, such as negative pressure in the chest during obstructive apnea. Some of this information is hard to find and very non-specific. Do you have any links?

No, unfortunately nothing handy. I am not one to keep stuff like that once I read it. Just general reading in the past about the events and what happens to the body.
Stress on the heart which causes production of a stress hormone (with a long name I can't remember) which the heart sends to the kidneys and thus the kidneys kick into over drive producing more urine...thus nocturia that OSA people have. That is one stressor that comes to mind quickly.

I don't recall reading anything about negative pressure in the chest cavity though.

Now that you mention you have high percentage of centrals then I can understand the decreased number of desats with your pulse ox report. Your airway was open and not closed a good bit of the time. The O2 made it to the lungs just fine since no physical obstruction during a potential central event.

There must be some valid reasons for using xpap therapy for centrals instead of O2 alone. People with predominately central apnea use the ASV machines and may or may not supplement with added O2. Perhaps John Fisher will chime in. He knows a lot more about central apneas and their potential damage to the body than I could ever possibly know.

If you would modify your topic title to mention centrals, I bet it would get his attention.

I have plain jane OSA. No centrals so I have never really done much reading about them.

Thanks for the response, Pugsy. Every answer I get brings on more questions for me, so I keep reading and asking. Over active curiosity? Probably!

You will always have more and more questions I think. Thats a good sign.

For me I find I start draggin about day 5-6 if I just run on O2 alone. (Possibly because there are a few (very few) but a few obstructive's that are seen with me. I know my Pulese OX Meter would always show really good O2 levels but after a week of O2 only I was getting tired. Else I would just do O2.

I am just on a BiPap, not a ASV, but when they were running me through my 3rd sleep study, I failed the ASV as well. I did just as good on a Bipap as I did on a ASV. Which I guess means better than without, but not what they wanted. With the cost of a ASV double the cost of a Bipap, And needing O2 either route it was a easy choice for me I think.

One thing i have come to realize, there is not thing simple when it comes to Centrals. And everone with Sleep Apnea seems to be just a little bit diffrent.

Lizistired wrote:I would think that xpap is cheaper than O2. If the xpap eliminates your apneas and thus eliminates your desats you won't need the O2. Have you worn the oximeter while awake? My O2 is 97-98 while up and about, As soon as I lie down it's 90, put the mask on and it's 93-94.

I answered this and then lost it - probably a good thing because I got onto another topic and lost track of your suggestion. They want to titrate me on ASV which is quite expensive so probably more expensive than O2 combined with another xpap. My daytime O2 is 94-95. Average nighttime low on O2 is 94.

Even if O2 stays up, obstructive and/or central apneas can cause arousals.

Too many arousals can wreck sleep architecture -- preventing a person from spending sufficient time in the various stages of sleep.

rested gal wrote:Even if O2 stays up, obstructive and/or central apneas can cause arousals.

Too many arousals can wreck sleep architecture -- preventing a person from spending sufficient time in the various stages of sleep.

Do most people see a big reduction in arousals on xPAP? That would be a huge benefit since my sleep has always been fragmented. I guess I only read on this forum about people having problems sleeping on xPAP - those who sleep well don't need to post. Poor sleep seems to have much the same effects on the various body systems as sleep apnea, so if xPAP can reduce apnea and help sleep architecture that would be wonderful. I just don't want to pay big bucks to slide from one sleep problem into another that's just as damaging to my health.

teknomom wrote: Do most people see a big reduction in arousals on xPAP? That would be a huge benefit since my sleep has always been fragmented. I guess I only read on this forum about people having problems sleeping on xPAP - those who sleep well don't need to post.

It depends.
Fragmented sleep for any reason can create havoc which is obvious. Unfortunately there are other things that can cause fragmented sleep besides OSA, arousals and such. I sleep great using the machine. I have pain issues that can cause fragmented sleep. We can't expect the xpap machine to fix something it wasn't designed to fix..though it sure would be nice if it did.

If your sleep was/is fragmented for years from something unrelated to sleep apnea, it may improve if some of the components are sleep apnea related but if caused from something else then you may have some detective work to do to see what else might need improvement.

And yes, we see problems here because people with problems look for a solution. Those lucky people who slap the mask on and feel like a new person from day one aren't likely to find their way here. They won't have the need to go looking.
Or some people don't do well and don't find their way here and the machine ends up in the closet.