Need help... Brain fog and constantly tired

[pulseoximeter]

I'm always tired no matter how much time I spend in bed. I did an at-home sleep study through Lofta and got the following results: "REM related and Positional Obstructive Sleep Apnea (G47.33) - Mild based on a REM pRDI=9.7, supine pAHI=5.2, supine pRDI=6.1 and O2 nadir of 92%". My overall AHI was 1.5. The recommendation was to use a CPAP machine, but before purchasing, I bought a Wellue O2 ring to monitor my sleep some more. 


Here is the O2 ring data in OSCAR for a night I slept for a while but felt groggy and brain-foggy all day. Over the week I've been using the O2 ring I notice dips to 88-90% SpO2, but they are just very momentary and spike back up, so I'm not sure if they are just artifact of the device or if they are truly desaturation events. What's more concerning to me is pulse rate, I always notice large spikes in pulse rate. I'm otherwise healthy and exercise a lot, so I'm surprised to see such pulse rate go above 100 during sleep.

Is there anything concerning about my data? Should I go ahead with CPAP even with the really mild AHI (1.5). Is Lofta just trying to sell me a CPAP machine? Thanks

[BoxcarPete]

This is cause to go in for a PSG in my opinion, if your insurance will cover it. There's not a clear diagnosis of either OSA or UARS, but there's definitely some smoke there, and a full polysomnography will be able to tell for sure what positions and sleep states cause problems for you, as well as any other problems that are potential contributors. Once you get a proper in-lab sleep study, your needs should become more clear.

The pulse rate spikes are probably your body's response to breathing problems, waking yourself up from a deeper sleep state to resolve it. Your biggest "humps" of HR spikes occur right where a robust sleep architecture would put the first two segments of REM. A PSG will be able to confirm all this, but I would not be at all surprised if your home test is underestimating your problem just because of the limited types of data it can collect.

The biggest reason not to do a PSG is that the most likely result is just a prescription for a CPAP anyway. If it was me though, I'd want the extra data if it could be done in a timely fashion and at reasonable cost out of pocket.

[xaid]

I suffer from the same issues. May I know what PSG is?

[BoxcarPete]

Polysomnography. It's a big long compound word that mixes greek and latin roots, and means "many sleep writing" but more importantly for you, it is a test where the patient is monitored in a lab with visual cameras, often a full EKG, and EEG brain wave sensors in addition to airflow measuring equipment. This is the most accurate type of sleep test and it can detect much more than a home sleep test which only has an airflow sensor, chest band, and a pulse oximiter.

[pulseoximeter]

Thanks for the reply BoxcarPete. I'll checkout my options for a PSG. If its too expensive/takes a long time to get it, then I think I might just buy the Resmed AirSense 10 for like 500 bucks, since I already have the prescription from Lofta.