Low Oxygen Saturation

[dan_76]

I had a sleep apnea test done at home. I haven't got the feedback yet from my doctor, but I noticed already when I wore the equipment at night that the pulse oximeter showed saturation levels around 92-94% when I was still up. After going to bed the figures went down to at least 88% before I fell asleep. I do not know what it showed during the night. Upon waking up the figures were again between 92-94%.

I have understood that those figures are not within a normal range. I have wondering what may be the cause... I have had several health issues and symptoms during past 3 years including lightheadedness and heart dysrhythmias. I don't feel like I would have any pulmonary disease since I am not feeling out of breath. I have high hemoglobin levels 165-175 g/l which I have started to think may be caused by the low saturation (?).

Can sleep apnea cause daytime hypoxemia/hypoxia? What are other possible causes? I am trying to get my bearings right before meeting my doctor, so I could ask the right questions...

[sac727]

By the way, magnesium is amazing for muscle twitching at night (caused by a deficiency).

And yes dan_76, your oxygen readings are too low. Ask your doctor, and if he/she doesn't know, don't be afraid to find a new one. Good luck!

[Jerry_NJ]

I'm behind here, but on your question about a O2 sat of 90%, that is low (95% and up are more normal), but not dangerous...but if dizzy, then too low.  

I have avoided using a CPAP for night/sleep by losing weight, as already stated.  The 10% loss in body weight was the "silver bullet" for me.  

My sleep study did show me to be busy at night with almost continuous leg twitching, but not strong enough to keep my wife awake, and that means it is very slight indeed.  The doctor was not worried about that and said I was recorded in the low normal range for (what is it called, stage?) deep sleep and so a CPAP would not make any dramatic improvement in my awake hours, that is I am not sleepy during the day, and I'm an old guy too.  Yes, I can fall asleep watching TV, but...

[dan_76]

I had an appointment at the sleep clinic and I am being queued for the CPAP treatment. Just need to wait until May to get that...

In addition to that they took arterial blood gas sample and it was otherwise normal, except my pO2 was only 9,0 kPa (67 mmHg). Could this be a result of sleep apnea or something else? I am waiting to go to measurement of diffusion capacity and spirometry.

I have to say that for me hypoxia would sound very logical explanation for most of my symptoms... but on the other hand the cause of hypoxia seems difficult to understand since I don't have any other lung symptoms.. like cough.

[jmayuiers]

I currently have a friend who has Hypoxia, and has severe sleep apnea. She has a CPAP / with oxygen and her O2 levels are ridiculously low. Low 80's. She is obese and refuses to lose weight. She was taking opiates for months that ultimately caused her apnea.she is also averaging 58 apneas an hour. She woke the other night gasping for air. I have said to her so many times...execise, lose weight and eat better...this should make her start feeling better right??

[dan_76]

Thanks for your insights...

Based on the overnight polygraphy I was diagnosed with medium obstructive sleep apnea... but as you, I am not sleepy during the days, so there was no immediate indication to go for CPAP.

What I could not get a response from my GP was that if the lowish saturation during day time ~90% could be causing my lightheadedness.

Well, now it seems my GP is going to try to get me to pulmonologist any way, so hopefully i get my answer from there.

[Jerry_NJ]

I will give a slightly different spin based on personal experience, I am not a medical doctor.

I believe the recording oximeter is the best first step to decide if OSA is a possibility.  A saturation level of 88% isn't good but you may have simply not been breathing properly when the reading occurred.  I think a saturation of 95% or better is considered "normal", but 90% or over is not bad.

I have forgotten my readings, but I asked for the test when I found myself waking up feeling like I was suffocating.  Best I can do without looking up my study records is that I had readings in the low 80% range during the overnight test.  This led to a overnight sleep study done in my local hospital under observation and lots of attached sensors...everything from oxygen to heart rate to leg motion... to sleep phases.  This resulted in a diagnosis of mild sleep apnea.  I was not tired during the day.

My overseeing Pulmonary doctor said if I loss some weight my condition could improve.   I weighed about 240 pounds and am 6 foot 6 inches tall, well maybe closer to 5 inches as wear of age is making me shorter.  He also said a CPAP would not likely make much difference in how I felt during the day - I had no day tiredness complaints.  

I am down to about 225 and no longer wake up with any sense of suffocation  The doctor's plan is to do a follow up overnight oximeter test at home to confirm if the weight loss was effective.  I have not called him back to the follow up test even though the Sleep Study was done last April.  .  

[Bhupinder Kaur, MD]

Hello,
Sleep apnea is a chronic condition characterized by upper airway collapse during sleep which may cause recurrent drops in oxyhemoglobin saturation. Daytime hypoxemia has been reported to develop in patients with obstructive sleep apnea (OSA). You should consult a sleep specialist and take the result of sleep studies to him. If you are diagnosed with obstructive sleep apnea then it needs treatment.

The most common treatment and arguably the most consistently effective treatment for sleep apnea is the use of a continuous positive airway pressure (CPAP) device. In addition to CPAP, a dentist specializing in sleep disorders can prescribe Oral Appliance Therapy (OAT).

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.