Low SpO2 but CPAP doesn't react - high altitude

[sleepfatigued]

Hi all,

I recently relocated from near-sea level to Mexico City, which is at ~7500 ft. Since I arrived, my Wellue Sp02 ring is reporting low oxygen levels with many drops, but my CPAP doesn't seem to register these drops - it maintains low pressure and reports low AHI. Qualitatively, my sleep quality feels much worse.

I've now been here for 12 nights. I'd expect lower sp02 levels while I acclimate, and also lower-quality sleep, but the drops in oxygen that the ring is reporting are concerning.

I'm including here Oscar + Sp02 ring screenshots of a particularly poor night of sleep (2 nights ago), and another of good sleep just before I left sea level. Apologies for using separate screenshots for the Sp02 - for some reason, the Sp02 and pulse data are showing up as compressed in Oscar.

My primary questions:
- Should I be concerned about these Sp02 drops? Or is possible that the ring is misbehaving in the higher altitude?
- Is there a change in CPAP settings that might help it react to those events?

Secondary questions:
- How long might it be until I'm fully acclimated and my Sp02 levels return to my sea level "normal" levels?
- How can I fix the compressed way that my Sp02 and pulse data is showing up in Oscar?

Thanks! As always, very much appreciate this forum for providing support where the healthcare system doesn't.

Cheers

[SarcasticDave94]

Welcome to the Apnea Board,

As I understand it, CPAP doesn't have a programmed action to act against low SpO2. Regardless, yes you need to have some concern and take action yourself. Get your doctor involved, because the SpO2 drop was below 90% for over 38 minutes 52 seconds, lowest was down to 83%. I think your elevation change had a negative effect.

You could increase pressure, but I'm not sure it helps. An actual ventilator would be quite a bit different. I'm thinking you may be headed to get supplemental oxygen. Ask for a home SpO2 monitor and/or a 6 minute walk test.

[Gideon]

 SpO2 monitor and/or a 6 minute walk test.

AT ALTITUDE!

[Sleeprider]

It is common for SpO2 to be reduced at altitude, and both altitude and air quality are issues in DF. If you recently moved here, it may adapt in time and Diamox can significantly help with altitude adjustments including central apnea. I’m on a phone now, but can look closer at this later today. Just be assured this is fairly common with altitude adjustments.

[SarcasticDave94]

Yes, correct. The tests need to be done at your attitude.

[sleepfatigued]

Thanks all. The lower overall oxygen makes sense to me, but the *drops* in oxygen are surprising - especially because the CPAP doesn't seem to be picking them up.

[SarcasticDave94]

My somewhat informed opinion is the CPAP won't respond to this, because that's not the job of PAP. It's job is combat Apnea, which it's doing pretty good.

[sleepfatigued]

What else could cause drops in oxygen like that besides apnea?

[desaturator]

In my case it's periodic breathing that is not (usually) pronounced enough to be reported as an apnea. If you zoom in on the flow graph so that it shows just a minute or two, centred on an SpO2 drop, you might get a clue whether you're experience something similar.

BW, DS

[staceyburke]

I use oxygen 24/7. I have a enlarged Artery between my heart and lung, causing lower blood flow.

There are many things that cause lower oxygen. Right now it appears you just have to adapted to the higher altitudes where air is thinner.