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Predicting severity of sleep apnoea with just oximetry?
#1
Hello. Would appreciate expert views please.

A friend suspects he has sleep apnoea (snoring etc) but does not yet want to 'put his head above the parapet' by seeing a doctor or having a sleep test. He has been using a Contec oximeter which showed a night with total of 149 desats at oxygen of 90-94%, 25 desats between 85-89. (A desaturation event defined by 4% drop for at least ten seconds). He didn't give me his basal pO2 measure.

Someone else has advised him that, in his absence of any chronic lung disease, these figures demonstrate that (1) he has diagnosable sleep apnoea and that (2) his AHI will therefore be 174 events divided by 8 (hours sleep) = approx 22.

I am not so convinced about a mechanism that allows one to either specifically diagnose SA on this basis (but it does seem very likely), and particularly not to be able to predict what a sleep test AHI might be.

What do people think?

Thanks for any replies.
................................................................................................
All my opinions are only as a xPAP user trying to help another xPAP user.
No suggestions I may make should be taken as medical advice.
If you have medical concerns I suggest you consult a doctor

My current pressures: Auto-ASV. EPAP 10-13. PS 3-10





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#2
Oxygen desaturations are significant, and in the absence of other causes, is likely SA. Additional indications would be monitoring for snoring, sleepyness, fatigue etc. It might be sufficient evidence to either prescribe a polysomnograpy or CPAP. Insurance may require additional evidence for reimbursement. I would consider those results along with snoring a pretty strong indicator of at least moderate apnea.
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#3
Some medications can suppress respiration and that could reduce saturation levels. Without any further indicators and not knowing anything else, I think I would advise them to overcome their reluctance and bring the subject up with the family doctor.
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#4
I did an oxy. test on myself....93-95% start.....74-78% drop. Showed it to my primary. Had sleep test a few days later. That pretty much matched mt sleep study....huhh. Best to be safe then sorry. Good luck to your friend...
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#5
When I complained of extreme tiredness to my GP, she sent me for a raft of tests, including overnight oximetry.
I went through the motions and got the test from the local Sleep Clinic.
One day after I returned the equipment, the lab rang and told me to come back as I needed an urgent sleep study.... "Sorry" I said, "My doctor only referred me for oximetry" .... "You need to come back ASAP, and we will ring your doctor and deal with the referral"
Later, I found that my O2 sats went down to 56% and on the sleep test my AHI was 69.

Really, in hindsight I should have realised when my new Fit Bit Fitness Tracker, which also reports on sleep quality, was giving me heaps of overnight activity and wakefulness, which I had no memory of. I assumed the programme was faulty, and stopped using it ... duh !!!
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#6
That could be my story. Best of luck to you. We sure have some hard heads.
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#7
Just to be sure, get tested.
Cheers,
otrpu
Love your family, treat your friend(s) well, and don't waste your time. Everything else is just so much BS. Sleep-well
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#8
(05-25-2016, 05:28 PM)Rip and Rosie Wrote: When I complained of extreme tiredness to my GP, she sent me for a raft of tests, including overnight oximetry.
I went through the motions and got the test from the local Sleep Clinic.
One day after I returned the equipment, the lab rang and told me to come back as I needed an urgent sleep study.... "Sorry" I said, "My doctor only referred me for oximetry" .... "You need to come back ASAP, and we will ring your doctor and deal with the referral"
Later, I found that my O2 sats went down to 56% and on the sleep test my AHI was 69.

Really, in hindsight I should have realised when my new Fit Bit Fitness Tracker, which also reports on sleep quality, was giving me heaps of overnight activity and wakefulness, which I had no memory of. I assumed the programme was faulty, and stopped using it ... duh !!!

Hi R&R, after reading your quote, I couldn't help (or control) my empathy for you!! I honestly got a headache! Those numbers are scary & I do hope you find safe resolution to your problem! If you have been feeling like you are "in a fog"
those numbers are literally "in THE fog" ..Just think how much BETTER you will feel to have O2 sats in the 90's
I enjoy being with a group who like to share their "Hosehead" experiences, to remind me I am not alone.
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#9
In my opinion, if an overnight pulseox shows many "properly shaped" desats during the night, you have sleep apnea or something really serious like heart/lung trouble.

"Properly shaped" in this case means that it's a drop in O2 that takes the right amount of time. If it drops 20% in 10 seconds, it's probably a sensor problem. Your blood O2 just doesn't drop that fast. You also usually get a spike in pulse rate.

The main problem with an overnight pulseox is that you can have severe apnea, but still not show an O2 desat. We almost all "wake up" and catch our breath before we die from a single apnea. Some wake up before SpO2 drops much, but still suffer from the disturbed sleep, stress, and other problems of apnea.

i.e. An overnight pulseox can show apnea pretty well, but it can't rule it out.
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#10
I think the answer is pretty straightforward. If you get significant desats during the night, you should talk to your doctor because you might have sleep apnea-or something else that needs correction. The severity of your desats should correlate with the severity of what is causing the problem.

If you do not suffer significant desats, it does not necessarily mean that you do not suffer from sleep apnea and there are other problems that sleep apnea excaserbates that require thaat the sleep apnea be controlled for your good health.

Maybe stated a little differently but basically the same as others have said.

Best Regards,

PaytonA
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