Oxygen Levels

[jillybean]

When I was diagnosed apparently my levels fell to below 90% for 47% of the time and hovering at 90 for the rest6weeks after starting cpap I was tested again and they have gone up to below 90 for 15% and the rest up to 94. There is obviously an improvement but is that good?? Will they keep improving?
Thanks for putting up with my numpty questions but who else can I ask??

[James @ Intus]

They're good questions! We like people with an above-average interest in their therapy and health. Take Tigers Fan who builds a big hose management rig or Puffin who records great video. We have high hopes for you jillybean

That's a great improvement indeed, it confirms you're doing well indeed. There's room left for further improvement of course, it should all be 95 and above ideally.

But perhaps more important or at least more interesting I find, is the number of events. Do you have a pre and post CPAP on that? How many oxygen desaturation events did they count?

Given every drop is pretty much a micro-arousal with potential short awakening, it's important to get that number as low as possible so you spend as much time as possible in deep phase sleep.

In case of finger pulse oximetry, that number is the ODI (Oxygen Desaturation Index, number of oxygen dips 4% and greater per hour). You can pretty much assume one oxygen desat is the result of one breathing stoppage. It's not quite 1 on 1 but it's an easy rule of thumb.

If you remember another thread today where Tigers Fan said his AHI is now down to 5 and below most nights, this means he gets 5 apnoea or hypopnoea events per hour. Most of those will lead to a micro-arousal or brief awakening (even when you can't remember it), including a shift up in sleep phase, out of deep sleep if that's where he was in. Five and below is considered 'healthy' or normal but of course, the lower the better. Five per hour would still mean 20 minute periods of sleep, perhaps not quite long enough to spend enough time in deep sleep (the restorative phase).

So everyone should try and lower the events index as much as possible, certainly not settle for above 5 as you'd still, clinically at least, still have OSA.

Reducing the events will automatically (unless there's COPD etc.) improve the oxygen levels.

So if you know your ODI or AHI or other respiratory disturbance index type figure, throw that stat in too please!

[jillybean]

Ok James, I have got to go to the sleep clinic next week so will make sure I get the figures, I must admit despite the mask problems I am having I do feel better, as in not so brain dead tired during the day.
Will let you know.

[Poppy56]

These are my sleep study results. 445 desaturations of greater than 4% giving an index of 60 per hour. Mean oxygen saturation is reduced to 93% with a minimum recorded of 72%. Apnoea/hypopnoea index is 55 per hour. I wonder what all that means! I keep thinking how pleased I am that this forum exists.

[Tigers Fan]

Join the Club!

Hi Poppy56

Those results make you an official member! Hose Heads of the world, unite!

James is far better qualified than me to interpret your results, but till he gets back on Monday .....

Ideally, we have an oxygen saturation of 100% and the graph is a straight, horizontal line. Untreated OSA sufferers have a 'saw tooth' graph instead. Seems that you had a downward tooth score of 445 to less than 96% oxygen, with a minimum of 72% oxygen and a mean of 93%. This means you did not sleep well!! and I think AHI 55 is classed moderate to severe (upper end of moderate or lower end of severe). I'm not sure where the line is drawn.

72% is when you wake up scared/panicky after a spell of not breathing.

Did they give you a diagnosis of OSA?

Tigers Fan

[Brummie Jon]

sleep study and oxygen diprate diagnosis

Hi

I am new here and my question seems to relate to this thread so rather than start a new one, I am posting here..... Let me know if you think it is inappropriate and I'll repost as a new thread....

I did my epworth sleepyness scale in November 2008 (scored 19), had my sleep study in January 2009 (4% oxygen diprate = 52) and due for my CPAP on 19th March 2009. I really think that the service from the NHS had been really fast, maybe a little too fast.

I am a scientist and my question is, how can a proper diagnosis of sleep apnea be made on a single nights sleep study? I may have just had a bad night or a stuffy nose.... A google search suggests that an oxygen diprate of over 30 is considered "severe sleep apnea". Does the NHS have some incentive to get people on CPAP ? (says the cynical conspiracy theorist in me)...... I just want to be sure that a single nights study is enough to send me on the CPAP lifestyle.......

Jon

[Tigers Fan]

A simple study

Hi Brummie Jon

As you are about to find out, everything CPAP is subjective except the OSA itself.

Epworth 19 suggests you have symptoms of daytime tiredness, grumpiness, poor memory, fall asleep soon as you sit down and relax - sound familiar?

Try CPAP - give it long enough for you to settle with the kit.

Compare yourself before and after. Only you will know if CPAP is for you.

Your 52 dips to 96% oxygen saturation are considered typical of OSA. I wonder what you lowest was?

Tigers Fan

[Brummie Jon]

just been informed that my driving licence has been revoked

Hi

Thanks for the reply TF, I am now very depressed. My letter from the DVLA came through today informing me that I can no longer drive until I can prove that my apnea is under control. This is the first time in 30 years that I have been without transport, my job relies on me driving, I live 250 miles away from my children and a long way from where I usually socialise.....

I'm not happy at losing my driving licence based on filling out an epworth scale and a single nights oxygen diprate analysis..... As far as I am concerned (and from what you say) my diagnosis is suggestive of OSA, not conclusive evidence, losing ones driving licence based on such flimsy evidence seems ludicrous to me. I intend to appeal and state my case as I am here...... Do you know if anyone has ever appealed and won over the loss of their driving licence for OSA?

Regards

*BJ*

[Tigers Fan]

Slow down! It doesn't start till 7.30!

Hey! Brummie Jon

It is your choice of approach, of course, but before lodging an appeal and probably bogging your license in an ocean of red tape, I recommend reading the various threads on the topic of DVLA and driving with OSA.

The quickest way of getting your license back, I suggest, is to prove to the DVLA that your are CPAP compliant and that you are no longer sleepy during the day. To my way of thinking, the issue is how quickly you can get yourself a machine, NHS or private, and start CPAP therapy. You then make a statement to DVLA and they give you your license back - it can be quite quick.

Tigers Fan

[Cat Mando]

my levels, when diagnosed

Hi, the night i was tested i had a worse than normal nights sleep. The fact that i had tubes and wires everywhere didnt help so i dont know how acurate these rates will be.

65 hyponoea events per hour of sleep
average 39 secs stop breathing event
one event of 219 seconds
spO2 average 84%
spO2 lowest 48%
1279 snoring events/ 155 per hour

I guess it explains why my wife was often moaning about my snoring and is soooo happy now.

[Tigers Fan]

Not that there is a competition, but ......

Your stats have to be a record, Cat! 219 seconds without breathing?!?!?!?!!

My 'results' in Southampton were that I snored at 70 decibels for 2.5 hours. The test for success on CPAP here? Do you still snore?

Tigers Fan

[Cat Mando]

no snoring anymore, wife is over the moon. no idea how i went over 3 and half minutes without a breath, can hardly manage 30 seconds while conscious. So glad to be diagnosed and get on with the rest of my life. Thank goodness my wife insisted i get checked out, although i had been to the docs on a few times before with other complaints and mentioned the snoring, only to be told if i lose a little weight it will all be fine.
I had presumed i was more tired than usual because of the birth of our son (now 3 years old) and changed sleep patterns.

Happy to have found this place and thanks for such helpful info. It is appreciated.

Cat

[threewheelweave]

Check You Tube Film of OSA - Scary!

Hi
That is amazing Cat Mando; there is a guy filmed on You Tube that stops breathing for just over a minute and the nurse filming him thinks he has died and then suddenly the great gasp and the cycle starts all over again but your stop rate is incredible - it is a wonder you were able to function at all!

Like you my wife encouraged me to get it sorted, after having seven chest invections leading to Tietze Syndrome (inflamed chest cartiledge pain like a massive heart attack! ) together with HBP - it is simply great to know what was the underlying cause of it all - OSA.

The treatment is simple and it really makes a difference - no snoring anymore for me too.

Welcome back to the land of the living rather than the living dead!

As Tiger said you may hold a record for an OSA event - check with the Guinness Book of Records - fame at last!

Anyway - take care of yourself and keep smiling - Cheers

TWW
UK