Confused about Oxygen

Greetings, I was diagnosed with sleep apnea 6 months ago. My sleep study showed an AHI of 14.6. My oxygen saturation was below 90% for 2.8% of total sleep time and was at or below 88% for 0.0 minutes. The mean was 93.1%. At that time I focused on the apneas.

I started using the machine/mask and did well, although I continued having apneas, around 9 a night on average. The people that supplied the machine suggested testing my oxygen at home because "that was what really matters". So I did. The sleep study people reviewed the results and said my oxygen was just fine and no change in pressure was needed.

Here's the thing...my results were about the same as my initial sleep study! Time with Spo2 < 90 was 2.4% and time with Spo2 < 88 was 1.9% (actually worse than my initial sleep study). The mean was 95.9%, which IS up from 93.1% from initial study.

Am I missing something? Is the 3% change in mean more significant that I think it is? Thanks for any input!!

They were worried about your O2 because thats another very good source of income for them.

What I'd do was to get the software to monitor your xpap treatment and make it work first, then check on the O2 levels again. Jim
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Do you sleep on your back normally? If so I'd look at this thread - viewtopic/t94745/Positional-Therapy--Us ... -Year.html and consider if you even need cpap at all - your numbers are very low and just not sleeping on your back might make them normal.

Goofproof, I do get printouts from the people that rent me the machine on a weekly basis. Wouldn't that be the same thing?

Julie, I never sleep on my back.

I have called the sleep center 3 times about this and left messages, no call back. I am starting to feel like I was scammed!!

I used O2 at night for years with my cpap. Having a machine is no guarantee that your O2 level is adequate. I am on O2 24 hours now.

Hi Stormy, I'm not using oxygen with my cpap. I'm trying to figure out if I even need to use a machine!

It seems like my oxygen level was pretty good before I started using the machine and using the machine has improved it SLIGHTLY. Is that improvement enough to justify use of a machine? Or is it an issue of apneas disturbing my sleep? If so, I am still having up to 13 apneas a night and the sleep center seems to think that is just fine.

Can you tell us what your pressure setting is? It may need to be tweaked. An AHI=14 is considered mild sleep apnea (0-15), 15-30 is moderate and 30+ is considered severe. Keep us posted.

Hi Dori, my pressure is at 9 and the sleep center (after reviewing my recent oxygen monitor results) says no increase is needed.

This prompted me to look at my oxygen levels before and after cpap and the oxygen numbers are almost the same.

Looking at my numbers causes me to ask 2 questions:

Why do I need a machine if there is almost no change in my oxygen level? (Or, does a small change matter more than I think?)

Why is my pressure fine if I am still having up to 13 apneas a night? (Maybe it is the LENGTH of apneas?)

It just doesn't add up for me.

Maybe what I should focus on is that I had an apnea that lasted 42.4 seconds at my initial sleep study (although I have nothing to compare that with ....yet).

Try holding your breath for 42secs. You may need more pressure to help keep your airway open. The severity of your OSA has nothing to do with how much pressure is needed to keep your airway open, some people with mild OSA need higher pressure than than those with severe OSA, it's a matter of architecture.

Dori, the sleep center is saying they will NOT raise my pressure. Can I do it myself?

Yup, the first thing I did was try to EXHALE and hold my breath after my initial study, although I do realize oxygen requirements are different while asleep.

Bottom line, my oxygen levels are about the same, I am still having several apneas a night and the sleep center says I am doing just fine. Something isn't adding up for me....yet.

Hello Aisa,
If I understand you correctly:
1 - during your sleep study, assumption is this is without any therapy, AHI of 14.6. Oxygen saturation was below 90% for 2.8% of total sleep time and was at or below 88% for 0.0 minutes. The mean was 93.1%
2- with treatment at home - Time with Spo2 < 90 was 2.4% and time with Spo2 < 88 was 1.9% (actually worse than my initial sleep study). The mean was 95.9%, which IS up from 93.1% from initial study. apneas, around 9 a night on average.

So - CPAP treatment is more that just about oxygen levels. Yes, oxygen levels matter a lot in my opinion - after all without oxygen we would not survive very long. The other concern is fragmented sleep. The body heals and the mind organizes and everything about us as humans tends to improve with a good nights sleep. The mind does most of it repair and organizing during REM sleep. If you awake frequently during the night, you might not get any or very little REM sleep.

Apneas tend to wake us, even if we don't remember it, for a short time to tell the body to breathe again. A constant flow of these will prevent us from reaching REM sleep and getting all of its benefits. With an AHI of 14.6, this means that you get on average 14.6 events per hour. So if you sleep say 7 hours, then you have 14.6*7 = 102.2 events during your night. With treatment you have 9 events. So if you slept 7 hours again, then you have an index of 9/7 = 1.3. A marked improvement in sleep I would think.

Do you feel better and is your mind sharper now with treatment? If so then you have a benefit from the treatment that you can feel. Again, oxygen is only part of the benefit.
edit - fixed a typo

Hooray! I finally got a call back. The sleep center says that oxygen level really isn't the big thing they look at...sawtoothing is. (Note to self: research 'sawtoothing'.) But the thing that interests me most is they they tell me that my cpap will NOT let me go 44+ seconds without breathing. Maybe I should have explicitly known this, but I didn't. That is reason enough to keep using the machine, altho I would think that my oxygen level would have gotten much better if I quit the long apneas...I should have asked her about that. So, again, something is not adding up!

Anyways, they will take a closer look at my next printout to see if they should rent me a machine that records breathing.

Informed decisions require data. You have 2 data points on O2 saturation levels.

You may want to consider improving your data database and pick up or borrow a recording oximeter and use it for a week. Adding an additional 7 nights of data to what you already have may make the picture clearer.

The problem with this approach is that there is a learning curve to collecting data and your doctor may not appreciate your efforts.

Aisa wrote:Hooray! I finally got a call back. The sleep center says that oxygen level really isn't the big thing they look at...sawtoothing is. (Note to self: research 'sawtoothing'.) But the thing that interests me most is they they tell me that my cpap will NOT let me go 44+ seconds without breathing. Maybe I should have explicitly known this, but I didn't. That is reason enough to keep using the machine, altho I would think that my oxygen level would have gotten much better if I quit the long apneas...I should have asked her about that. So, again, something is not adding up!

Anyways, they will take a closer look at my next printout to see if they should rent me a machine that records breathing.

Your sleep centers data doesn't compute, your xpap will try to open your airway, that doesn't meam it can, it's NOT a ventolator. It's purpose is to raise the air pressure in your airway to hold it open so you can breath, it provides no garrentee you will breath....

I get my data from the software made for me machine, I use the Daily printout views to see the data I need to make decisions on what I need. I have a o Pulse Ox to check overnight destats, I only use it every now and again, as I feel while useful O2 recording don't show as much useful data and the xpap. As long as the heart is pumping the blood holds O2 for a few minutes use, it has to measure the Fingers blood supply thats not the main supply line. I'd learn how to read my own data, and wouldn't count as much on the DME provider or the sleep center. First max the xpap treatment, then worry about the O2, one will improve the other. Jim

you need the minutes, not the percentage. o2 should be prescribed if you are <88% for a total of somewhere around 5 minutes for the whole night. if the doc orders it then, insurance should pay for it. but............... be careful what you wish for. paying rent for the o2 generator every month for the rest of your life adds up. they are not rent to own and they are expensive to buy. pray that you don't need o2.