Hello. New Here. O2 Chart & Questions. Sleep Study next week.

[PurchanceToDream]

Hello,

So glad I found this site.  My story may be like many others... long suspected a problem... finally getting sleep study next week.

For ~ 2 decades now I've suspected problems with sleep, but the trouble has ramped over the last few years, such that I tend to dread (an even put off) going to sleep because of how awful I know I'll feel when I wake up in the morning. Often with aches & pain, like my muscles have been working out all night.  Sometimes I awaken unable to breath for a few seconds, or at least feeling out of breath.  And over the last year or so, for lack of a better way of putting it, I wake up feeling like I'm "vibrating".

I picked up an oxymeter to record data to help confirm my own suspicions.  Attached file from last night (I've got about 10 nights of data over the last 3 weeks that are all pretty similar).

I show the whole night and zoom in on the two areas of interest.  If I have to guess & am reading these charts correctly, I think I only get hypopneas during "deepest" phase of sleep.

The automatic count that Sleepyhead software comes up with seem to put me in the ballpark of "10 events per hour".

My questions to anyone kind enough to respond and who is familiar with what apnea looks like on o2 sat charts are these:

1) Does the way sleepyhead counts events (before or after "automatic oxymetry data cleanup") correlate with the technical definitions used for diagnosis?

2) In general, what do you make of my O2 charts here?

3) Even during the day, I almost never seem my O2 say above 95%, with 92 or 93% more typical. Maybe my oximeter is just badly calibrated and always shows a low reading -- but I have seen it get up to 99 on occasion.  Any thoughts on what this might imply?

If I'm reading it correctly, I think I should fall firmly into the "mild" category based on AHI (events per hour).  Though based on how I feel in the mornings, and am extremely tired all day, every day, and dread sleeping, I do not feel my situation/condition/whatever-it-is is "mild".

I'm feeling rather desperate at this point... and I'm more afraid that I *won't* be diagnosed with apnea than that I will be.  Because if it isn't apnea... then hope of a diagnosis & treatment will seem much further away.

[Sleeprider]

I see you have some very low SpO2 results from your oximeter. Combined with what you are feeling, I'm surprised you have no pursued a sleep study and XPAP treatment. Why?

Get a home sleep study or clinical study, and let's start making you sleep and feel better. What is keeping you from taking that next step, and how can we help?

[PurchanceToDream]

I actually have pursued this in the past... I did get a study about 4 years ago, which came up "negative"... 

I have my reasons to think the results of that study weren't valid... but I lacked energy/was too dejected to follow up and try to get another one, etc...etc... I'm sure a lot of you out there have dealt with the lethargy, depression, lack of motivation...

I had scheduled a sleep study 5 months ago, but cancelled/reschedules/cancelled again, as I was feeling overwhelmed at work... just taking an evening out to do the sleep study seemed like "too much".

I'm in the same boat now... but this time I'm not going to cancel.

[Sleeprider]

If you have good insurance, get a sleep study, diagnosis and prescription. If you have large deductibles and copay you may want to go out of the system and get something like the Resmed Airsense 10 Autoset and an appropriate mask from Amazon or similarly discounted supplier. If correct, your oxygen levels are chronically low, and your health descriptions would probably allow your primary doctor to simply prescribe auto CPAP based on your health and symptoms. With SpO2 at and below 85% for significant periods, you have a health situation that needs addressed. We can't do it for you, however, positive pressure alone will increase your baseline oxygen levels, and an effectively titrated auto CPAP would avoid apnea, hypopnea and the sleep disturbances that go with them.

Let your oximeter investment motivate you. You should not continue to languish untreated with this problem. Getting treated is on you. No one else can drag you into the doctor and insist that the problem be properly treated. Your long-term health is a risk, and these problems are not going anywhere unless you make a change.

[Mogy]

An oximeter isn't really used to diagnose sleep apnea, it is used more as a screening device.
To me, it looks like you may have more than mild sleep apnea. I think the quicker you get a sleep study done the better.
They have home sleep tests that you can get relatively cheap and quite quickly.

[PurchanceToDream]

If you have good insurance, get a sleep study, diagnosis and prescription.  If you have large deductibles and copay you may want to go out of the system and get something like the Resmed Airsense 10 Autoset and an appropriate mask from Amazon or similarly discounted supplier.  If correct, your oxygen levels are chronically low, and your health descriptions would probably allow your primary doctor to simply prescribe auto CPAP based on your health and symptoms.  With SpO2 at and below 85% for significant periods, you have a health situation that needs addressed.  We can't do it for you, however, positive pressure alone will increase your baseline oxygen levels, and an effectively titrated auto CPAP would avoid apnea, hypopnea and the sleep disturbances that go with them.  

Let your oximeter investment motivate you.  You should not continue to languish untreated with this problem. Getting treated is on you. No one else can drag you into the doctor and insist that the problem be properly treated.  Your long-term health is a risk, and these problems are not going anywhere unless you make a change.

Thanks for the encouragement.  Is that chart really that bad?  When I uploaded, I wasn't really thinking about the deepest drops there.  I'd say going below 75 is rare if ever -- might be anomalies from moving around.  A few drops touching or dipping just below 85 are typical each night I've recorded.

I should be OK on the insurance side/out-of-pocket side of things.  

Jumping through hoops at doc office, I'm not so good at.  Live alone, so there really is no one around to drag me to a doc.

But I have the sleep study scheduled for next wednesday, no intention to cancel.

I'm looking on amazon now... 

Wait... those can be purchased without an Rx????    wtf have I been waiting for?

[OpalRose]

Hi PurchaseToDream,

Yes, you can purchase Cpap machines, masks, and other supplies from Amazon without a script.  Selection is never the same though, so you just have to search.  Be careful of the descriptions and read reviews.

It's unlikely you would receive reimbursement from insurance if purchased out of pocket, but we do what we have to do.  

Let us know how your Sleep Study goes and post results here if you wish.  Use the links in my signature line for "how to's."

[trish6hundred]

Hi PurchanceToDream,
WELCOME! to the forum.! It's great to hear that you have a sleep study scheduled and that you aren't going to cancel this time.
I wish you luck as you start your sleep apnea journey.
Hang in there for more responses to your post and please keep motivated to get better sleep.

[ShaunBlake]

... 

Wait... those can be purchased without an Rx????    wtf have I been waiting for?

Please don't get ahead of yourself! Finish the sleep study, then decide on what machine and where to buy it based on what your results tell you. Your issue may be something other than apnea -- there are other causes of low O2 besides sleep apnea. And you might not benefit from a CPAP machine if you really need a BiPAP or ASV. Or just need supplemental oxygen.

[Sleeprider]

... 

Wait... those can be purchased without an Rx????    wtf have I been waiting for?

Please don't get ahead of yourself! Finish the sleep study, then decide on what machine and where to buy it based on what your results tell you. Your issue may be something other than apnea -- there are other causes of low O2 besides sleep apnea. And you might not benefit from a CPAP machine if you really need a BiPAP or ASV. Or just need supplemental oxygen.

I think there is significant evidence of a problem that is likely to be some form of sleep apnea.  It is tempting to self-treat, and save the cost of a home or clinical sleep study.  As noted by Shaun, it is not possible to make a positive diagnosis of sleep apnea, without, at a minimum, monitoring a patient for reductions or cessations in breathing, along with the oximetry data.   Most doctors are going to want this level of diagnostic evidence that CPAP is going to be effective, and that a different problem is not being missed.  

xPAP machines are available at a good price without prescriptions.  It's not supposed to work that way, but reality is that the machines are available for much less money outside the durable medical equipment supply market.  The decision whether to pursue that avenue is a risk decision, that the therapy may not be effective or necessary, not that it might be dangerous or risk your health.  Non-invasive pressure will either solve the problem or not, and the risk is mainly financial. 

Here is a fair discussion of this from the Singularsleep website:

There are various questionnaires, applications, and algorithms that attempt to predict whether you do or do not have sleep apnea but the bottom line is that you cannot make the diagnosis without a formal sleep apnea test (in-lab or home sleep study). While you might surmise that you have obstructive sleep apnea (OSA) based on symptoms and signs such as chronic snoring, witnessed apneas, and gasp arousals, you won't know with 100% certainty until you have a sleep study showing that your apnea hypopnea index (AHI) - average number of abnormal breathing events per hour - is ≥5. Often patients will ask, "Based on my symptoms, I know that I'm highly likely to have OSA so what's the harm in trying CPAP or another treatment for OSA?" It is true that non-invasive treatments for sleep apnea have very few side effects so there is little risk in trying them. CPAP and Provent Sleep Apnea Therapy have the fewest side effects - with these treatment modalities, probably the worst thing that could happen from experimentally trying them would be wasting your money on unnecessary medical products if you didn't actually have sleep apnea. The hidden danger in this self-treatment approach lies in the potential to under-treat your OSA (and thereby still be at risk for the medical consequences of OSA) and/or not identify and treat other sleep breathing disorders besides OSA (see below). On the other hand, it would be a bad idea to try an oral appliance for sleep apnea or sleep apnea surgery before being formally diagnosed with the disorder because of the potential side effects of these treatments.