Low O2 and Snoring

[Bigdonpaul]

Here are the screenshots I took from OSCAR for a 3 minute span:

           

[Bigdonpaul]

Anything else I need to tell the doctor tomorrow or any summary I should give him?

[Sleeprider]

Your pressure on CPAP is maxed out and you are not achieving an appropriate air volume for a man of your height. You have persistent flow limitation and RERA, both of which would respond to BiPAP. There is no question you qualify for a bilevel positive air pressure therapy, which would facilitate improved respiratory volume, shorten inspiration time, reduce RERA, and if indicated by other tests, reduce CO2 and improve oxygen. The obvious choice is a Resmed Aircurve 10 Vauto because you have good spontaneous respiration, and just need the higher pressure and pressure support of bilevel, not a ventilator.

Out of this concern for low tidal and respiratory volume, you might ask for a simple pulmonary function test (PFT) which is an easy spirometry evaluation performed at the doctor's office. This will allow your doctor to evaluate your lung function and diagnose COPD or asthma if applicable. This will also help you to better target an appropriate respiration volume. Another test that may be appropriate is arterial blood gas PaCO2 and PaO2. These fairly simple tests can help to identify problems and design a better treatment plan. You have made good progress in losing weight, but at some point a bariatric procedure may be appropriate, and that is a worthwhile discussion.

All of these are an important discussion to move you towards a better plan to improve your health. Try not to overwhelm your doctor with data. Simple examples that show how you base your concerns, and that show the problems with CPAP therapy should be good enough. Bilevel therapy will make a huge difference, but the other metabolic tests can help you and your doctor plan a recovery course and will establish a baseline that can be used to measure your progress.

[Bigdonpaul]

For now, I'm doing the following:

Blood drawn today to check my thyroid levels

Blood draw tomorrow for Arterial Blood Gas

O2 study overnight while wearing my CPAP for hopefully later this week

[Bigdonpaul]

Thank you everyone for your help and advice. After all the testing, I'm getting a BiPAP titration study done at a lab in the near future. They'll determine if I also need additional O2 with it.