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Family Medicine  (Expert Forum)
 | 
Sleep Apnea
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.

Sleep Apnea

by twinkletwinklelittlestar292, Jan 20, 2006 12:00AM
I have a health question and was wondering if you'd know the answer. I went to sleep with a pulse oximeter on because I have been having forceful breathing episodes in my sleep through my nose, sometimes waking me up and I have concerns about sleep apnea as I found out that I have most of the symptoms. I had myself monitored during a short part of the time. The episodes seem to be averaging about 15 or so an hour with occurances of them sometimes 2 or 3 in a row. At the time right before the first episode, the oximeter read 93 (for the oxygen) / 75 (for the pulse) and as the breathing spell began, it went to reading 93 (oxygen) / 79 (pulse) to 92 (oxygen / 81 (pulse) going all the way up to 92 (oxygen / 112 (pulse) and then as the breathing spells stopped changing to 94 (oxygen / 111 (pulse) and going down to 94 (oxygen) / 81 (pulse) within a total of one minute. The lowest it went before another episode began was 93 (oxygen) / 71 (pulse). The second occurance began within 1 1/2 minutes after the first. This same rapid pulse readings occured after alot of the episodes I had with my pulse ranging from 60 to 70's before the event and my pulse going up past the 100 range during or right after the event. My question is what the oxygen level and pulse would drop to during sleep apnea / and if the rate of going from 95 or 94 down to 92 is low enough to be apnea. I do know that the rapid pulse could be indicative of the apnea but I do not know about the oxygen level. I am having surgery this Monday and am very concerned about doing so with this possible problem. I would like to know prior to the surgury, if possible. Thanks. ps.. I am also coughing, clearing my throat, and congested through my nose in my sleep waking up with headaches, not coughing through the day though and just have a mild stuffy nose. The problem seems to me to be within my nasal passage as the forceful breathing is also coming from my nose.

by Kevin Pho, MD, Jan 21, 2006 12:00AM
In sleep apnea, a signifant event in oximetry is a fall in SaO2 greater than or equal to 4 percent to a value less than or equal to 90 percent.

Thus, the readings you have given are not severe enough to suggest apnea.  

However, that being said, oximetry alone is not sensitive enough to diagnose apnea (only 56 percent).  I would consider a sleep study in a sleep study lab to give a more concrete diagnosis.

This option can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b
Member Comments (4)

by twinkletwinklelittlestar292, Jan 21, 2006 12:00AM
To: Dr Pho
Thank you so very much!

by elins, Jan 23, 2006 12:00AM
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by twinkletwinklelittlestar292, Jan 26, 2006 12:00AM
To: Dr. Kevin Pho (PLEASE READ) Not Breathing After Su
I had surgery this week and during the recovery period, they kept waking me up when I'd fall asleep because they said I wasn't wanting to breath. They did this 6 times before I managed to stay awake. Is that something that is normal or could I actually have sleep apnea? The oximeter turned out with negative results. And my doctor doesn't seem to want to do anything further about this. But I am really concerned here and I don't know what to do. I pray that you can help with this question.

by twinkletwinklelittlestar292, Jan 28, 2006 12:00AM
To: Everyone (got the answer I was looking for)
I talked to a neurologist (friend of mine) and he told me that this was not normal at all what happened to me in the hospital and thinks I have sleep apnea too.
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