Oxygen levels advice

[john1977]

  o2.pdf (Size: 261.12 KB / Downloads: 22) [attachment=52236]

Hi i have been on Cpap therapy for a few months now and wonder if anyone can give me advice on my oxygen levels.

My AHI average over last few months is 1.3 so not to bad but wondering if my oxygen levels are dangerous or bad? they seem to occasionally spike down?

What does having low levels of oxygen when you sleep  do to you, does it damage your brain or heart?

Cannot really see much info online about this.



Thanks

John

[staceyburke]

I have been using oxygen for over 25 years at night.  I have taken reports like this to a pulmonologist and his advice was that the sharp spike is nothing to worry about.  He said it is the probe moving on my finger when I turned over or moved in bed.  
That I needed to look for a drop in oxygen that was sustained for a period of time and not just a spike.

[john1977]

  O2 5282_20230712141735.pdf (Size: 266.67 KB / Downloads: 13)
hi 
i don't think the spikes on mine are the probe moving on my finger, if you look at my report from before i started using cpap the drops were a lot worse?
nobody seems to know what's happening and what damage it could have done,? i spoke to my doctor and he told me he wasn't sure what was up. and i should go to a sleep clinic
I cannot get into a sleep clinic in the UK as there is a long waiting  list till next year.

thanks

[Old Mike]

It's possible that you had a couple of lengthy apnea events (30 sec +). Do you use Oscar as well? If so, should be able to check correlation with events. I get the occasional drop into the mid-80's, maybe once a week, and a corresponding apnea of 30-40 seconds. From what I've read, periodic drops like this are nothing to be concerned about.

[Apnea23]

I will keep shouting from the roof about this. A lot of people on PAP therapy, especially those with residual symptoms, it can be an o2 issue and not an obstructive issue. The sucking for air/o2 can cause obstruction itself.

See a respiratory doctor, explain to your GP that you're concerned that CPAP isn't curing all of your daytime symptoms and you're concerned you're intermittently hypoxic throughout the day and night, and you would like extensive pulmonary function tests.

Measure your spo2 during the day, it will perhaps be much worse. After food, at rest and while walking around and without any caffeine in your system. Caffeine helps a ton with o2 levels and will skew your results.

Good luck.

I do good on 3L/min during the night and no longer use PAP after 2 years of perfect AHI scores but very messed up fragmented REM due to underlying lung issues.

It is worth checking out.

[Old Mike]

Maybe I missed an earlier post, but average SPO2 is 96% and only sub-90% for 1 min 28 sec. If that's as bad as it gets, definitely no need for supplementary oxygen, as just advised here. What one needs to look out for, if concerned about pulmonary disease, are extended periods sub-90%. Short bursts are more typical of apnea and can be treated with CPAP. In my own case, I was sub-90% for 1 hour and 12 mins during a 6.5 hour sleep study - that was all due to multiple apnea events. CPAP has reduced it to an average AHI of 1.5 and usually less than a minute sub-90% SPO2. So I don't see anything to be concerned about here.

[john1977]

Old Mike pid='480871' dateline='1689227092']Maybe I missed an earlier post, but average SPO2 is 96% and only sub-90% for 1 min 28 sec. If that's as bad as it gets, definitely no need for supplementary oxygen, as just advised here. What one needs to look out for, if concerned about pulmonary disease, are extended periods sub-90%. Short bursts are more typical of apnea and can be treated with CPAP. In my own case, I was sub-90% for 1 hour and 12 mins during a 6.5 hour sleep study - that was all due to multiple apnea events. CPAP has reduced it to an average AHI of 1.5 and usually less than a minute sub-90% SPO2. So I don't see anything to be concerned about here.

thanks for reply, i have searched the net for days and cannot find any info on what damage low  SPO2 for long periods of time ie 15mins does to the body i would have been having years 
of low oxygen levels and concerned if i have damaged my  heart or brain, i spoke to my doctor and he aint got a clue? i am probably worrying for nothing as i feel fine, suffer from health anxiety so that's not helping.

i have attached my sleep report so you can see my spo2 levels before cpap

thanks

[Old Mike]

My sleep study results were very similar to yours, John, in terms of mean SPO2 (93%) and 1 hour and 14 mins sub 90%, even though my AHI was much lower at 22.6. I have a bit of health anxiety too and worry about all those years of untreated apnea, but all you can do really is accept that what's in the past is done. Unless you develop cardiac symptoms (a Kardia monitor is good for detecting Afib), and as long as your apnea is now treated, my advice is to just get on with enjoying life. Something is going to get us all eventually and worrying won't help!

[cmpman1974]

This is my sleep with a 2L O2 bleed into my BPAP line.   None of my apneas are over 15 sec in duration so now way they are responsible for this many periodic drops.  I still had 28 min under 90%.   Without supplemental O2, I'm usually 1.5 - 2.5 hrs under 90%.  Working with a pulmonologist now to try to understand that is happening.

I am NOT sold on the VI Health / Wellue devices being completely accurate though. I really would like to compare min by min findings on my CheckmeMax to the $1k Nonin oximeter my pulmonary doc had me wear. I think Wellue greatly exaggerates the levels and duration of O2 drops, but the devices have some merit. Until you compare on to the other, it's hard to know for sure.

[Apnea23]

This is my sleep with a 2L O2 bleed into my BPAP line.   None of my apneas are over 15 sec in duration so now way they are responsible for this many periodic drops.  I still had 28 min under 90%.   Without supplemental O2, I'm usually 1.5 - 2.5 hrs under 90%.  Working with a pulmonologist now to try to understand that is happening.

I am NOT sold on the VI Health / Wellue devices being completely accurate though.  I really would like to compare min by min findings on my CheckmeMax to the $1k Nonin oximeter my pulmonary doc had me wear.  I think Wellue greatly exaggerates the levels and duration of O2 drops, but the devices have some merit.  Until you compare on to the other, it's hard to know for sure.

They're accurate enough. That's why they're FDA approved.

Now you are supplementing with o2 overnight it's time to use reduced pressures without as much pressure support. 

These settings and this much pressure support is probably not what your lungs need and could/will be making things *far* worse, as they did in my case before I discovered o2 and lung dysfunction was the real culprit all along. Especially during your REM cycles.. these settings will be causing absolute chaos. You can see the chaos all night in your flow chart from it all. Significantly worse during REM.

You're having to breathe out against EPAP 9 /and/ you're being significantly ventilated with your incredibly high IPAP. A recipe for disaster.

I would be interested to see that 2L bleed with a lot less assistance from the PAP and pressure support.

It's time to titrate yourself again from square one and throw out all previous assumptions regarding PAP therapy.

You could start with Vauto mode, EPAP 4 with pressure support of 2 and let the machine go where it wants to. Trigger very high.

The important thing is reducing that EPAP and pressure support so you can exhale easier and reduce the respiratory swings from crazy over-ventilation.

I think you'll be pleasantly surprised and the next breakthrough in your sleep will happen.