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Shortness of Breath - Low Oxygen level - Sandyelle - 07-16-2023
I have tried for years to us a CPAP and have not been successful. Now I have low Oxygen levels during the day and night.
Here is a brief recent history.
May 2022: I had Sepsis and spent 9 days in the hospital. Unknown cause however, I no longer have a gallbladder, which was not the cause of the Sepsis. They were able to tell me this after looking at my gallbladder, once it was removed. The source may have been a UTI however lab testing did not confirm this. I had a lung CT that showed nodules and said to repeat in 6 months.
Several months ago I noticed that I had shortness of breath, difficulty going up starts. I do a water fitness class multiple times a week and also swim a couple of laps. I noticed that I am constantly huffing and puffing. I started check my O2 level on my apple watch and O2 had numbers were often in the the low 90's and would drop into the 80's.
I have seen 2 pulmonologists recently. (there was a long wait to see the 1st doctor) The only testing that showed anything as the 6 minute walking test, with numbers into the low 80', which was repeated on 2 different visits.
Doctor A concentrated on sleep apena and wanted to me to go back to using my CPAP. They have a program to help with adjustment. However I’m not sure that the CPAP will have an impact on my daytime O2 levels.
Dr B repeated my CT, without contrast, which was previously done 1 year earlier when I had Sepsis and showed 2 small nodules which had then disappeared and were thought to be inflammation. All of my lung testing was fine and doctor was saying that he did not think my issues were
pulmonology related until I did the 6 minute walking test. As soon as we started my O2 dropped to the low 80’s and doctor had me do it again with my other hand with same results.
He said that I needed Oxygen at night, since my oxygen could drop while I was sleeping and I would not be aware.
He ordered a test for blood clots, which was negative. On my follow up visit the doctor actually walked with me as I repeated the test. We walked at a very brisk walk part of the time with the same results. I have been sleeping with Oxygen for the past few months.
I was also taking a trip and needed a POC for travel. Doctor told that I would need Oxygen on the plane, which I laughed at, as I never needed Oxygen before. Surprise, the doctor was correct and my Oxygen fell into the low 80's again. I did not have access to my POC and had to use breathing techniques to get it up. (My friend next to me was a paramedic, which made me feel better) Doctor B said told me that he would see me in 3 months (meaning he was done with no answers but did call me back to follow up with my cardiologist)
I had started with the Cardiologist when I firsts thought I had a problem. He referred to to the Pulmonologist who is now sending me back to the cardiologist. I told the Cardio that they were both playing “Not It” and that one of them had to be “It” He ordered a TEE ultrasound and I see the Cardio on Tuesday for the results.
Pulmonologist A wanted me to use my CPAP
Pulmonologist B suggested I see a dentist that he works with for an Oral Appliance. I told him that my DDS said most fail with the Oral Appliance. He works with this this dentist has very good success.
I made an appointment with them for a few weeks however, it is pricey and may not be covered by insurance. They do lots of follow up, with repeat sleep studies.
I am trying to get a copy of my older sleep study that was done more than 5 years ago.
I have Brachycardi aand my heart rate drops below 50 multiple times a night.
I had Covid in 2021 was very sick, and spent a week in the hospital however, I did not need a ventilator. I remember a nurse telling me how she watch my heart rate at night that dropped into the 30’s, and was very concerned.
Sorry for the long history. I am looking for thoughts on my low Oxygen levels. Is it related to my Sleep Apnea. My prior sleep report indicates that I spent 69 minutes at Oxygen saturation less then 79%.
Any thoughts or suggestions? I am 62 years old feel exhausted. I am having difficulties at work and trouble remembering things.
11/21 sleep study info attached. as a PDF.
show Apnea's total 183 events, 162 Hypopneas, 21 Apneas,
REI 60
Mean O2 92%
56.9 minutes below 79%.
LInk to my 2017 entry with compliance results: Link to my 2017 info https://www.apneaboard.com/forums/Thread-Newbe-with-Chipmunk-Cheeks?highlight=sandyelle
RE: Shortness of Breath - Low Oxygen level - Sleeprider - 07-16-2023
A CPAP is not going to correct hypoxia from routine daily activities and a dental device is certainly not going to help, but it will resolve the hypoonea and apnea your 2021 test revealed. You may need to fire pulmonologist B and add a cardiologist to your medical team and wear a Holter monitor or monitor your SpO2 and blood tests like PaCO2 to measure arterial blood gasses under a doctor's supervision to qualify for supplemental oxygen. Also a complete heart workup including echocardiogram to determine left ventricular ejection fraction should be considered. We deal with CPAP to resolve diagnosed obstructive sleep apnea all the time on this forum, but the conditions you are describing go far beyond that scope. Treating sleep apnea can improve your health and reduce or eliminate hypoxia and hypercapnea from sleep disordered breathing, but it is not going to increase your oxygen while climbing stairs or conducting routine daily activity.
We can help you to optimize your CPAP therapy, but I suspect you need to address the conditions you described by resolving the health conditions that are affecting your heart and respiration rate or provide a high fraction of inspired oxygen via supplemental oxygen. In any event, combining a recording pulse oximeter with your CPAP therapy can document your AHI, respiration rate and volume and SpO2 to help justify these treatments.
RE: Shortness of Breath - Low Oxygen level - Sandyelle - 07-16-2023
Thanks for the input. I seem to be spinning around in circles. I knew my issues were not solely caused by sleep apnea, as one pulmonologist seemed to think. There so many people on this site, with a vast amount of knowledge and I was hopped to find something that has been missed.
I knew that the oral device probably would not work for me.
I did the Holter monitor and echo some time back, and last week I had a transesophageal ultrasound which I get the results of on Tuesday.
What type of pulse ox works in conjunction with CPAP? I have a Resmed air sense 10, which I assume I can use my oxygen with with an attachment. Using oxygen in conjunction with the CPAP may make it easier to acclimate to.
Thanks again for your response.
RE: Shortness of Breath - Low Oxygen level - Sleeprider - 07-17-2023
Your profile shows you are using Resscan software, so I recommend you add the much easier to use OSCAR to be able to share your charts on this forum to let us better help you to optimize results and to see your respiratory statistics to evaluate whether there is anything further we can help with. There are a number of pulse oximeters that are compatible with your Resmed machine and with OSCAR software. These are discussed in the Oscar Help here https://www.apneaboard.com/wiki/index.php?title=OSCAR_supported_machines#Pulse_Oximeters If you decide to get one, there are some members that are very good at getting you setup with integrating the pulse and SpO2 graphs into Oscar.
If anything was "missed" on the CPAP therapy side, we can quickly spot it in your CPAP data. Read the Organize your Oscar Charts wiki and you will have an idea of what information is available. http://www.apneaboard.com/wiki/index.php?title=OSCAR_Chart_Organization Oscar tracks events as well as your breath rate, tidal volume, minute vent and much more. Posting a chart is the best way to let us help you or interpret the efficacy of your current therapy and where it might be improved.