Oximeter Results Help? Newbie

[desaturator]

Sustained low night-time oxygen saturation -- and its corollaries -- can certainly cause cardiac problems. However, sleep apnea can cause cardiac problems quite apart from the effect on oxygenation. There are many mechanisms for this, and some are poorly understood.

At the same time, many people suffer from palpitations of one sort or another for a slew of reasons having nothing to do with apnea. Palpitations in the form of ectopic beats, and sinus (normal rhythm) tachycardias are pretty common, in people with sleep-disordered breathing and without. Doctors don't usually take these very seriously unless the are totally ruining your life -- often they result from stress or exhaustion, and clear up on their own in due course. Sometimes they result from poor sleep quality for reasons that have nothing to do with apnea -- being repeatedly woken up by a baby, for example. Heart rhythm disturbances of all kinds can be a symptom of infections in and around the heart and these, too, nearly always disappear without trace when the infection does.

Then there's all kinds of electrolyte disorders, diabetes, hormone disturbances (particularly thyroid), weird oddities of the adrenal and pituitary glands, etc, etc. These can also come and go, according to the underlying disturbance.

Occasional tachycardias originating from the oddities of the atria or SA node are also pretty common and, again, they don't usually raise a cardiologists eyebrow very far unless they are really troublesome. Ventricular tachycardias of any kind usually get a full work-up, because they can sometimes be nasty.

My point is that a sleep study of any kind won't do much towards diagnosing a cardiac problem. In addition, in my experience (which, I admit, is not recent), cardiac problems do not normally present with oddities in oxygen saturation (whether real or artefactual). Usually patients turn up with pain, breathlessness, palpitations, or poor exercise tolerance. There can be disturbances in oxygen saturation in cardiac disease, but that's rarely the first thing the patient notices.

My gut feeling is that you need a sleep study. If you think you have cardiac problems, then my gut feeling is that you need a proper work-up specific for those problems.

Best wishes, DS

[Ratchick]

Yeah, I'm gonna agree here - your dips aren't big and may just be noise, but a sleep study will show if there's any underlying sleep disorder that might be causing that. The fact that the drops only seem to be happening around the time you fall asleep though probably suggests you're okay.

If you're worried about your heart though, you need to talk to your doctor. Did you get any testing done like a Holter monitor or ECG etc after the previous palpitations? There are loads of causes including just anxiety, not all of them are serious. But this isn't the way to diagnose them.

[Geer1]

Talk to your doctor.

The daytime stuff isn't really my realm of knowledge and I am not sure if the drops are artifacts (oximetry readings are affected by motion) or real. If real I don't know what would cause intermittent drops like that (other than say holding your breath). I imagine you would need to ask for a referral to a cardiologist (since you think heart may be involved) and maybe a pulmonologist if your doctor and cardiologist don't satisfy your questions. Your SPO2 stays within a good level so not sure if it will worry doctors but it looks odd enough to me it doesn't hurt to ask doctor for their opinion.

The night data you posted may support an apnea diagnosis. Your SPO2 stays decent but there are enough desaturations that may be being caused by apnea and that could explain the "furry" look mentioned by desaturator. Should be pretty easy to get a home sleep study through your doctor.

[desaturator]

The daytime stuff isn't really my realm of knowledge and I am not sure if the drops are artifacts (oximetry readings are affected by motion) or real. If real I don't know what would cause intermittent drops like that (other than say holding your breath). 

I note that the precipitous drops in the daytime are roughly aligned with higher heart-rate, which suggests a motion artefact to me. The alternative would be a huge, sudden desaturation on the slightest exercise. Right now, a common explanation for that kind behaviour is Covid. In any event, I think if you were experiencing those kinds of desaturations, and they were real, you'd be obviously ill.
But diagnosing heart problems -- if there even is one -- from SpO2 is unlikely to be productive. I'd be surprised if any doctor would give the daytime SpO2 chart a second look, to be honest.
Best wishes, DS

[Ratchick]

Right now, a common explanation for that kind behaviour is Covid. In any event, I think if you were experiencing those kinds of desaturations, and they were real, you'd be obviously ill.

Normally I would agree, but the occurrence of silent hypoxia in otherwise well people with Covid (symptomatic or otherwise) is a known issue. 

Honestly, my sats bounce around all the time when I'm awake but then, I have dysautonomia and secondary problems from so long without therapy. 

In reality, I would agree that movement artefacts would seem the most likely cause, in the absence of any other symptoms occurring at the same time. And of course, it wouldn't hurt to do a Covid test if you are worried you might have contracted it.

[desaturator]

Normally I would agree, but the occurrence of silent hypoxia in otherwise well people with Covid (symptomatic or otherwise) is a known issue.

Sure. But the OP has a waking SpO2 generally ~97%, so he isn't generally hypoxic -- not even silently. People can be hypoxic with Covid and generally feel well, and they can be normally-saturated and feel like hell. In both cases, exercise desaturation is a feature of Covid, and can be seen in both well-feeling and sick-feeling people. So far as I can see, nothing in the OP's comments rules out Covid -- some people have no symptoms at all. Can a person have no symptoms at all, have normal resting SpO2, and still desaturate furiously on exercise? That I don't know.

Sorry -- this is purely an academic discussion, I think. I only mentioned Covid because it's a potential explanation for significant desaturation on exercise, not because I think the OP has Covid. Of course, the only reasons not to have Covid this week is that you had it last week, or you're getting it next week

BW, DS

[SarcasticDave94]

The SpO2 chart you've stated was sleeping was 11 hours it appears. Below 90% was 0.9% of 11 hours. And they were just small, short duration spikes. No SpO2 problem here.

Ditto the daytime SpO2 is not an issue, if these are normal representatives.

Perspective, my low level COPD influenced daytime SpO2 might be at 92% for hours at a time, with some spikes lower like mid 80's for a few minutes. According to what I was told, the 6 minute walk test would have needed my SpO2 to drop to 89 or less to get supplemental oxygen. My last result, 94%.

So I don't think there's an issue to worry about. But if you want to be sure, check in with your doctor's office.