Decreased oxygenation while lying down

[Katijanae]

Hi,
I'm a 51 yo female with Asthma and Decreased oxygenation while sleeping due to dysautonomia.  I have been experiencing a lot of pain in my feet the past few days after being exposed to the cold temperatures while shopping.  I have also experienced a loss of sensation in my toes, and can no longer move them well.  Since sitting up makes my pain worse, I have been lying down.  I am on  oxygen at night, but I have noticed in these past few days I become sleepy while lying down, so I put my O2 on to take a nap.  The increased O2 wakes me up, and I feel fine, no longer sleepy.  It makes sense to me that lying down is causing me the same problems I was having only during sleep.  I have had some mild asthma symptoms, so have been using the nebulizer too, but that doesn't seem to help this constant sleepiness.   Does that make sense to you?  Can a lack of oxygen cause the problems with my toes?  I know that sounds corny, but I've learned to ask everyone all of my questions because I never know what is causing what anymore. Do I need medical help now, or can I wait a couple of weeks until I can get in with my pulmonologist?

[National Jewish Health]

Dysautonomia is a disease of the autonomic nervous system.  The features of this disorder include orthostatic intolerance, erectile dysfunction, bowel hypomotility, urinary incontinence and respiratory disturbances, such as sleep apnea and laryngeal stridor.

You may have non-obstructive, central, sleep apnea, resulting in decreased blood oxygen levels.  Sleep apnea can cause a great variety of neurological symptoms, so that pain and loss of sensation could be related to the apnea.  That supplemental oxygen improves your alertness, making you not sleepy, could be that it compensates for your under-ventilation.  Many of the neurological symptoms that can occur with apneic states may be caused by a rise in blood carbon dioxide levels, rather than by hypoxia alone.

What you describe does not suggest the need to see your pulmonologist on an urgent basis.

Good luck.

[Katijanae]

I appreciate your answer, but it sounds like you think I am not aware of the symptoms of dysautonomia.  I have all of the above problems you mentioned above, and deal with them daily, with the execption of errectile dysfunction.  I don't have a penis. I do however also have temperature intolerance, which you did not mention.   I had a sleep study done that showed my blood oxygen levels to be at 80% when I steep, which is why I use oxygen at night. It did not show any significant sleep apnea.   I think now, looking back, that the problems with my toes had to do with getting too cold in a store, and my body's reaction to that.  I have a spinal injury resulting in severe stenosis and Peripheral neuropathy.  The latter can cause more problems when I get too cold, or maybe the temperature intolerance makes the pain and numbness from that worse,  I took your advice and didn't scurry off to the doctor.  When my asthma symptoms cleared up, so did the "need" for suplemental oxygen.  Btw, I live in Colorado, and am familiar with National Jewish and all the good you all do there.  Thanks for taking the time to answer questions on this board.  I have finally found a neuromuscular specialist in Denver, who can hopefully help me deal with this stuff on an ongoing basis.  It's easy to get information on what the symptoms are, but hard to get anything on what to do about them.  Thanks for you help.  
Katijanae

[Katijanae]

I have been having some unexplained short tern memory loss.  It comes and goes though.  I went to the doctor's office today to see if i could get some input.  He wasn't there, but his assistant told me that they would have to do a study to see if I am needing more oxygen when I'm exerting myself.  I have this permanent relationship with an electric  wheelchair.  That didn't seem to resolve anything in her mind though.  I wonder what Kind of exertion she had in mind...?
Thanks for your input.  
Katijanae

[Rob2008]

I was curious if you were ever having any problems with your thinking, or some type of anxiety due to your oxygen deprivation?

[Katijanae]

I forgot to mention that I have been coughing up a plug of yellow mucus every time I wake up, which is sometimes several times a day lately, since lying down is part of the way I manage my pain from Peripheral Neuropathy.  Even when sitting up I have been feeling very tired.    
Katijanae