New Diagnosis and living at high elevation

[Fedman]

Good day all!  I'm writing on behalf of a friend who just this week received her home study results.  The catalyst for her obtaining a home study was me talking about my own experience with apnea and her symptoms.  It wasn't much of a surprise that she was diagnosed with severe apnea via the home study.

I have insisted that she educate herself by way of this forum and she is doing so but is also feeling very overwhelmed at the moment.  I obtained her permission to post her sleep report for comments. 


Total Apnea-Hypopnea Index: 43.6
Total Apneas: 85
Total obstructive Apneas: 75
Total Hypopneas: 99
Total Central Apneas: 9

Impression/Diagnosis: Findings are consistent with Severe Obstructive Sleep Apnea

Recommend Auto Pap with pressure ranges 5-20 cmH2O with download or facility based PAP titration

Oxygen desaturation index: 45.9

Patient qualifies for O2 with an SaO2 89% for 5 mins or greater

Heart Rate Min-Max 64-100

Severe Hypoxemia was noted

She is seeing her Dr. on Monday.  The reason I wanted to post her results was the reference to severe Hypoxemia.  She lives at an elevation of 7200 feet.  I'm interested in other members experience living at high elevation and Hypoxemia.  I've already told my friend to make sure the Dr rules out other conditions which could be contributing to the Hypoxemia.  But I'm curious.  Have other members living at high elevation had such high O2 desaturations caused solely by apnea?  Any insight would be greatly appreciated.

[Sleeprider]

Fedman, I would encourage your friend to start with the auto CPAP first, and monitor SpO2 using a recording oximeter to determine if the oxygen desaturation persists or not. It is likely she will have much better oxygen levels using the APAP once it is tuned in to her needs. What I notice right away is that the ODI of 45.9 matches the AHI, so there may be a causal relationship as you should expect. Anyway, keep therapy simple and then add oxygen if warranted.

As usual, I strongly prefer a Resmed Airsense 10 Autoset for Her for individuals that are self-titrating. It is a more responsive machine, and is more likely to intercept apnea and hypopnea than the Philips when not starting at optimized pressure.

[Fedman]

Thank you Sleeprider.  Your insight is always appreciated.

[Mogy]

Hi Fedman,
I don't live at a high altitude but my oxygen levels were quite low when first diagnosed. During the first sleep test my oxygen was below 90% for basically the whole test. I would encourage your friend to get an Oximeter and see how her levels are with the APAP and without.
I lost a bunch of weight and now my oxygen is much better, both with machine and without.
I wrote a more detailed explanation with some graphs at this link, starting at post #3:
https://www.sleepapneagroup.com/threads/...meter.210/

[PaulaO2]

If she lives at that height, and has for a while, then it is not attributing to the hypoximea (sp?). Her body has gotten used to it.