Sleep study review / O2 ring - Oxygen Desaturation

[SingleH]

Hi all,

Whilst reading up on this board to treat my Dad's apnea issues, I read there can be a hereditary element to sleep apnea. As I generally dont sleep well, I decided to do a home sleep study and was hoping to get some feedback on here.

The study reported that I have an AHI of 1.2 and does not support the diagnosis of OSA.

The study observed my mean O2 level at 94% with a minimum of 92.

I previously purchased a Viatom 02 ring, which typically reports my average O2% during sleep between 92 and 94% with my lowest figures between 86 and 89%. I read normal levels during sleep should be above 95%.

I have attached two screenshots of two nights use which I imported into Oscar, the Viatom software reported the following for those two nights.
29th <90% = 10mins
31st <90% = 5 min 32 secs

I have also attached a copy of my sleep study. My main questions are:

• Do I have a problem with my oxygen levels? 
  
• What is a normal number/percentages of desaturations per night. Lowest I have is 16 (1.02%) to more commonly 50-180 (15%) upto a couple of 100 (30-45%)
  
• I noticed that the graph for my pulse rate shows a significant increase and correlation to the graph that shows and increase in  snoring intensity. Is that normal?
  
• Whilst my study says I do not have OSA, is there anything to suggest I am "on the road" to OSA or potentially something else?
  

Thanks in advance.

           

[SingleH]

           

[Jay51]

IMO, everything looks ok. 
1. Not sure about question #1.  Usually 95 or so for a mean spo2 during the night is normal.  Drops in the low 90's are usually ok, but watch them.  When drops occur below 90, then they should be monitored more closely and followed up with the appropriate corrective action.  Medicare states that 5 total, cumulative minutes below 88% qualifies a person for supplemental oxygen (for reference).  There are some major discrepancies between your Viatom o2 ring and your sleep study.  I am assuming the sleep study is more accurate with your SPO2 levels (but the Viatom may be more accurate - in that case dips below 90 are more significant).  The 86 and 89 you got on your Viatom may be outliers or even positional apnea that brought SPO2 down to these levels.  Not sure.  
2.  AHI of 5 or less is considered normal by most.  So you could have 5 desaturations per hour (or 8 hours sleep X 5 per hours for a total of 40 total desaturations) and still considered in the "normal" range.  1 desaturation is kind of correlated with 1 AHI (loosely correlated).  Again, major discrepancy between your sleep study and the Viatom.  
3.  There could be a correlation here IMO.  Snoring can limit O2 intake a little bit, so an increase in heart rate is possibly a consequence.  
4.  Nothing looks bad IMO (from the sleep study), but the Viatom data looks suspicious.  You may want to keep an eye on the snoring, too.  

Great job being proactive SingleH and testing yourself.  If anyone sees anything else in SingleH's study or charts that look suspicious or look like they may develop into a problem in the future, please post.  Also anyone who an opinion as to which would be more accurate the sleep study or the Viatom, please post.  What sleep study did you do?  Was this the NightOwl?  Watchpat?

[BoxcarPete]

Your results don't point to a significant problem at the moment, but that can easily be age dependent. As we get older, muscle tone tends to decrease which leads to both a greater propensity to airway collapse and less ability to overcome that blockage with respiratory or arousal efforts. This is why UARS and OSA swap occurrence rates somewhere in the age 40-50 range. I don't know if your age or if your home sleep study rates arousals, but your viatom ring is reporting some restlessness which could be a minor problem now and become a bigger problem later. UARS is tricky because the normal OSA treatments aren't always effective. It's worth keeping an eye on at the very least, +1 on a good job for being proactive.

[SingleH]

Thanks for the feedback and explanation regarding the reference guideline on supplemental oxygen. So far from the small number of nights I have tested I dont meet that criteria. I am going to do an extended period of nightly testing and see how I get on.

Regarding snoring, I did download a snore recording app and on the majority of nights I tested over a week long period, I had no snoring, so it seems to be an occasional thing.

The sleep study was done using a Watchpat 300 device.

[SingleH]

Glad to know my results dont look too bad at this point. I'm 47 and I cant see any reference to arousals in my study. I am prone to getting blocked noses and did fracture my nose when I was a teenager resulting in one side tending to getting blocked. I had previously seen a radiofrequency treatment that can be done to reduce soft tissue blockages in the nose, but as you point out results seem to be mixed. I also had a throat infection a few years ago, that felt to me like my throat was more restricted after I recovered, although the doctor said they couldnt see any problem. Anyway I will continue with the Viatom device and do further testing. One thing I can say, is that I dont see any desaturation problems when I have worn it during the day.