Low & Fluctuating spO2

[r4robin]

BACKSTORY (YOU CAN SKIP TO MAIN PART)

I always feel so exhausted when I wake up, and just throughout the night I feel awful.

I did an at home sleep test (still waiting for lab, im in Canada so it’s been a year).

Anyways, it showed very borderline mild (5), and high RDI. Doc said it probably won’t make a huge difference but I could try.

I tried both APAP / Bilevel for months, neither helped a lot. Regardless of pressure settings / tweaking, which I also worked with a professional with. 

It shows <0.5ahi constantly and with Bilevel also not a lot of flow limitation, so when I present to my sleep specialist (not a doc) they say it looks good and I should just continue (which I have for months, no results).

MAIN PART

Anyways, recently I decided to try a spO2 ring, to check my o2 levels at night, and the levels look concerning.

I’ve attached the readings, if anyone has experience reading this let me know what you think. 

Keep in mind this is the monitoring while using APAP, so I suspect it would be even worse without…

HERE IS THE MONITOR DATA:
https://imgur.com/a/W2DuVcx

[G. Szabo]

It would be best to post your OSCAR and your oxygen saturation. Please look up how to organize your charts on Wikipedia so we can see all the details.

[Crimson Nape]

Three questions. Are you diabetic? Are you on any medications? Have you had a complete cardio profile workup recently?
- Red

[r4robin]

Not diabetic, no medication, and recently saw a cardiologist (after 6 month referral), did a holter monitor test, heart ultrasound, and EKG. EKG was abnormal (RBBB & LAFB), Ultrasound showed some minor valve issue (like loose or something). Anyways, I brought up to him that it could be causing my issues, and he said it doesn’t cause issue in 90% of people. Yeah, so the question would be, maybe I’m in the 10% right? Well, he just booked a follow up for January 2025 (Thank you Canadian healthcare!). According to him though he doesn’t believe my sleep issues are caused by my heart. I am 23 years old and otherwise healthy, so he doesn’t really take me too serious…

[Crimson Nape]

OK! What is your typical sleeping position(s)? Have you tried sleeping with your upper body inclined?
- Red

[LuminousOne]

While you are waiting for the follow-up can they do labwork: complete blood count, thyroid panel, etc.?
I'm so sorry that you have to wait so long. Labwork is easy and can be reviewed quickly so maybe they will entertain this step while you are waiting for a follow up visit.
Have they considered an Ear, Nose, and Throat specialist referral to see if you have any structural issues that need correction? 
Would your healthcare system allow for a second opinion?

Wishing you the best. I hope you get answers and assistance soon.

[r4robin]

I have done a lot of tests to rule out other medical issues, I even went to the ER in hopes to get further testing quicker.

And also I’ve seen an ENT as well.

All my blood work is normal, I‘ve done A LOT. Hormones, Vitamins,  CBC, Blood Sugars, Cholesterol, Kidney, etc.

Also at the hospital they did further blood tests for some autoimmune markers, and other diseases nothing came up.

I’ve also done chest xray, echocardiogram, ecg, gastroscopy (to rule out gerd), nasal endoscopy (ENT) I’ve seen TMJ sleep dentist, etc - all normal. 

I’ve been advocating for myself and pushing so hard for testing and just help in general, but the Canadian healthcare system is so messy, especially when you are young and have normal blood levels they don’t seem to care for further testings.

[r4robin]

I typically sleep on my stomach / side. I use an incline since it helps a little.

[LuminousOne]

You've been a smart and proactive advocate for yourself. I'm so sorry you aren't getting help in a reasonable and timely manner. Hopefully the in lab study will hold the key to the problem.
Not that this will make you feel better, but here in the US there is a delay in getting treatment and follow up, even in urban areas. I was told that I would need to wait months to schedule a titration study they were so busy. I called the next day to make sure I heard this correctly and the person I spoke to asked if I would accept an appointment that had just been cancelled for two days later (Sunday night). Spoiler: I said YES. Would this be an option for you to try to get the test done sooner?  
Anyways, best of luck.

[Crimson Nape]

If it doesn't involve any investment or major adjustments, try sleeping supine (on your back) and inclined.  Try an elevation that is as comfortable for you.  You may find rolling up a bath towel and placing under your knees will help with the position.

Let us know if this helps or not.
- Red