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Oxygen Level and Dr's Comments
#1
Hi. I'd appreciate any feedback on my oxygen level and, especially, my doctor's comments.
I took an overnight oxymetry  test with the cpap on all night, 7hrs 40 min. He told me the result was an oxygen saturation level of 88% with less than 12 seconds below 88%. Everything I've read says the level should be 94% or above. So I'm very concerned about this, especially since my daytime fatigue persists.
I'm wondering if this doctor's feedback on this is at all "factually" correct or if he's a dope and I should drop his ass. His comments:

"A normal oxygen level is 90% or higher. A level of 88% is not normal. However, current treatment guidelines for a low oxygen level below 90% require you to be less than 88% for at least 5 minutes. I think the cpap use may be helping your oxy level from dropping even further."

"Alternative treatment options would be to provide supplemental oxygen which you don't qualify for based on current treatment guidelines (ie insurance will not cover treatment) If the oxy level is of concern to you, one way to possibly help is to increase the pressure settings".
The pressure was increased a while ago from 7 to 9.

Thanks
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#2
Your pressure was changed back in October, and you still have never shown a single graph or data summary. How in the world are we supposed to second guess a doctor? I'll give him the benefit of the doubt he is giving you correct information.
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#3
I'll agree with Sleeprider

I'll also point out that spikes (12 seconds under 88%) really don't matter.

In addition IF you had downloaded Sleepyhead you may have been able to look at a chart of your O2 levels and correlate them with events.  That would be really insightful as to if you have a problem and what may be causing it.
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#4
You may wish to review your blood tests and look for anemia or polycythemia (more red blood cells than normal). Both affect how much oxygen is being carried in your bloodstream and can serve as a secondary check on any significant long-term desaturation.

As for second-guessing a physician with subject-matter expertise, I would be cautious of succumbing to the "Internet Syndrome" where non-expert advice is often given equal weight with expert advice or we pick and choose the results or answers we wish to see. (confirmation bias).

Best of luck.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#5
If it helps any, the best they can get my o2 is 91% with the cpap. Doc (including primary) considers that good enough. You do have a choice though - you could ask the doc if his 'guidelines' are based on what insurance will pay. If they are, tell him that you are willing to pay out of pocket for a concentrator. Would an oxygen concentrator for nighttime be appropriate at this time? While you wait for your appointment, do some looking around at the prices for a continuous (not pulse) concentrator. I've been looking at getting a used one for nighttime. I've been trying to educate myself about these as I probably have one in my future.
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#6
Mosquitobait raises a valid question. Put another way, should your doctor's recommendation be based on insurance criteria, or what is best for you. Based on a SpO2 of 88%, but lacking 5 minutes below that threshold, seems like a fine line to be drawing. It would seem a doctor could recommend oxygen noting the facts of the case, and let insurance sort things out based on their policy. I don't see the purpose of the doctor reciting insurance policy as a basis for his recommendation, other than making you aware, that insurance may not pay for the equipment until you meed certain diagnostic thresholds.
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#7
It could also be a red blood cell issue. Perhaps a full blood count test is needed as well? Any thoughts
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#8
Point here guys. we know 1 point in the study, 12 seconds below 88%.

We do not know levels in the rest of the study. was the balance at 88-89%? we don't know. The balance could have been at 96%

IMHO, non medical, IF the O2 was at 88% for hours, O2 is likely warranted. But we don't know
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#9
Mosquitobait I got a used oxygen concentrator and started using it without my doctors ok. When he got around to saying he would order me one I had improved so much that I told him to keep it. I have two that I own so I did not want another one. They are simple machines and are for sale often at flea markets or on craiglist.

Sleep-well
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#10
Let us not forget that oxygen is a drug and can produce unintended consequences if used inappropriately in otherwise healthy people. Self diagnosis and the placebo effect can mask other symptoms. Best practices is to consult your physician before starting on supplemental oxygen. The last thing you need is to habituate your system to supplemental oxygen and find that it becomes a permanent necessity.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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