Sleep Apnea without Oxygen Desaturation?

[Inspire]

Hi all,
Is it possible to officially have obstructive sleep apnea without decreased oxygen sats?

In case you want the details, I had a portable sleep study done at home (the proper ones have a 2 year wait list, which I'm on), and got the results today:

REM (Norm: 20-25%) 14,8%
S1 (Norm: 5%) 1,6%
S2 (Norm: 45-50%) 36,4%
S3 (Norm: 5-15%) 16%
S4 (Norm: 10-15%) 18.1%

This part was apparently not so abnormal. BUT I had 302 obstructive apneas in 520 minutes of sleep time (Index: 33.7)! This sounds as if it could be part of the reason why I'm always so exhausted, however my oxygen sats were 95% on average, and 90% at the lowest. I was sent the test results, and the result is (in translation): "Normal sleep structure, High number of apneas, but no decrease in oxygen saturation."
Have any of you had similar results, or know what this means? Can you officially have obsructive sleep apnea without decreased oxygen sats? Due to other medical issues, I can only sleep on my back. I always sleep with my head to the side (as far as is possible, without causing neck problems) because I otherwise feel my airway collapsing. I also did this during the test.

Thoughts? Advice?! Would CPAP treatment still help?
Thanks in advance!

[PoolQ]

yep, I had an AHI of 29 and never dropped below 94% O2

[justMongo]

Would CPAP treatment still help?

Generally, yes. It's more than the effects on O₂ saturation. Each apnea event either prevents one from reaching deep stages of sleep; or arouses one from deep sleep stages. The disturbance of sleep architecture is a cause of tiredness during the day.

I do not understand how one can have, "302 obstructive apneas in 520 minutes," and still have "Normal sleep structure."

[0rangebear]

Inspire

I also had no evidence of desaturations at anytime. Two sleep tests, 4 days in ICU followed by 3 days in hospital with 24 hr monitoring.
I then wore monitoring device for a month. Results 0 desats. O2 range 91-99.

I had no daytime sleepiness, no headaches. I felt like I felt find and believed I slept fine. Nevertheless every doctor I had met for several years wanted to get me on CPAP therapy.

I gave in to the pressure in 20151115 and started therapy 20151229.

I have now been on therapy for 111 days and would recommend giving the therapy a try. The pathway through therapy is often crooked and broken, and the signs are unclear resulting in confusion.

Nevertheless, the adventure has rewards that are unique to each individual who accepts the challenge. Think of it as a Quest.

The forum is here to help you negotiate through the difficult choices you will have to make, to be successful.

I was not a believer when I started down this path, it took me around 13 weeks to see any benefits to the therapy.

I am still learning and I hope to hear more from you inside the forum.

To answer you question: You will find in the forum several different definitions of OSA because it is an international forum quoting many compliance organization and schools of thought.
The most conservative view I have seen from a creditable source is anything > 4 should be treated.

The most liberal interpretation would exclude people who do not have any 02 desaturation as high as <16

All of them recommend treatment if AHI>15 regardless of 02 readings
in some jurisdictions someone with the test result you received would not be allowed to drive without treatment.

Stay tuned for some great advice form the forum

[Crimson Nape]

Hi Inspire,

Is it possible to officially have obstructive sleep apnea without decreased oxygen sats?

Yes; An apnea event is any stoppage or significant reduction in breathing for a period longer than 10 seconds. If your events are closer to the minimum time threshold then your desaturation would probably be minimal. Apnea seems to prevent (more or less) the deeper sleep stages with SpO2 levels coming into play with a more acute case (prolonged times and apnea types) of apnea.

The above is just my opinion, so please don't take it as fact.

My initial sleep test resulted in an AHI of 89. All recorded apneas were of a short time frame. It was enough to prevent any deep sleep but my SpO2 level remained at 95% or better.

Did your report break down the apnea types? (e.g.: CA, OA, or Hyp.)

[green wings]

Another comment about your sleep stage results. Shouldn't the percentages add up to 100?

S1 & S2 are your light sleep stages, right, and S3 & S4 are deeper sleep?

So you had slightly less light sleep than normal & slightly more deep sleep than normal? Seems odd if you had a lot of obstructive apneas going on.

Did they send you any graphical results or just a summary? I was wondering how your apneas were distributed, sleep stage-wise.

Also, did the study measure respiratory effort related arousals?

So what's your next step if you want to try an xPAP machine?

Hi all,
Is it possible to officially have obstructive sleep apnea without decreased oxygen sats?

In case you want the details, I had a portable sleep study done at home (the proper ones have a 2 year wait list, which I'm on), and got the results today:

REM (Norm: 20-25%) 14,8%
S1 (Norm: 5%) 1,6%
S2 (Norm: 45-50%) 36,4%
S3 (Norm: 5-15%) 16%
S4 (Norm: 10-15%) 18.1%

This part was apparently not so abnormal. BUT I had 302 obstructive apneas in 520 minutes of sleep time (Index: 33.7)! This sounds as if it could be part of the reason why I'm always so exhausted, however my oxygen sats were 95% on average, and 90% at the lowest. I was sent the test results, and the result is (in translation): "Normal sleep structure, High number of apneas, but no decrease in oxygen saturation."
Have any of you had similar results, or know what this means? Can you officially have obsructive sleep apnea without decreased oxygen sats? Due to other medical issues, I can only sleep on my back. I always sleep with my head to the side (as far as is possible, without causing neck problems) because I otherwise feel my airway collapsing. I also did this during the test.

Thoughts? Advice?! Would CPAP treatment still help?
Thanks in advance!

[trish6hundred]

Hi Inspire,
WELCOME! to the forum.!

Hang in there for more responses to your post.

[Inspire]

First of all, thank you SO much for all your replies. I'm so glad I found this forum...Amazing!

A couple of you asked if I got more info than I posted: nope...It was just the summary that I posted. I also think it's strange that I had a relatively large amount of deep sleep, despite having so many apneas. I don't know what this means. All I know is that I'm always exhausted. I have been dragging myself around for decades. I never thought about it before I got these results, but I believe my fatigue increased dramatically around the same time when I could no longer sleep on my belly, and then even more when sleeping on my side also became impossible. Maybe I always had OSA, but it only really started to cause problems when I was forced to sleep on my back!
That's what I'm desperately hoping, because that might mean that I have a chance at significant improvement! I have read so many success stories here. I called the sleep clinic and have been told that I've been moved up on the urgency list. So instead of waiting the 2 years until my appointment for the in hospital testing, I should be called in last-minute within the next 3 months...Really happy with that, although - now that I know what might help - I'm desperate to start therapy TODAY! I'm not actually sure why they're bothering with further testing at all. Based on what all of you have said, I should be a candidate for CPAP treatment anyway. Maybe they'll be using the more detailed analysis to see if something else is going on as well?

JustMongo: I also "do not understand how one can have, "302 obstructive apneas in 520 minutes," and still have "Normal sleep structure."" I guess they meant that the percentages of deep sleep, etc. weren't so far off normal...It must have worried them enough to push up my appointment by 18 months?

Green wings: It did add up to 100%. I only left out the few percent for which I was awake ;-)

Thanks again so much for your help! I'm going to push for treatment, regardless of what comes out of my in-hospital testing. Can't do much harm to try, and I might get my life back...I'm afraid to even hope!