• O2 sensor discrepancies

    Posted by brenda-denzler on December 2, 2022 at 12:10 pm

    Hey, folks. I got a question.

    I’ve been evaluated for apnea and found I’m on the very low, low end of “moderate sleep apnea.”

    They want me to get a CPAP with mask. I’m weighing options.

    One of the ways I’m weighing is by checking my O2 saturations overnight, as I sleep. I have three different O2 sensors, and they seem to say slightly different things.

    Original O2 sensor is a ReliOn fingertip sensor. It doesn’t save data , but it does tell you moment-by-moment what your O2 and HR are.

    The second one is an Emay fingertip sensor. It *does* save data that it collects at frequent intervals, and it can transmit that data via bluetooth to an app on my phone, where it is displayed in both graph form and as a report with graphs.

    The third one is a Wellue O2 ring sensor that also saves data that it collects at frequent intervals, and it transmits the data via bluetooth or wired link-up to an app on my phone or on my laptop, where it appears in report form.

    I am wearing the last two sensors at night. I collect the data the next morning. When I compare the data, I note that they don’t always agree in what they are saying. Examples:

    The fingertip sensor says I’ve had no O2 sat drops during the night, while the ring sensor says I had 15 drops.

    The fingertip sensor says my lowest reading was 87%, while the ring sensor says my lowest reading was 88% or 89%.

    I don’t quite know what to make of this. I realize the differences are not large, WRT the O2.

    When it comes to the question of whether I had any O2 sat drops of siginficance, however, there is a pretty large discrepancy.

    Any words of advice or wisdom gained from experience that y’all can share with me as I try to make sense of these disparate readings?

     

    brenda-denzler replied 1 year, 11 months ago 4 Members · 7 Replies
  • 7 Replies
  • brenda-denzler

    Member
    December 2, 2022 at 12:14 pm

    BTW, I also have a diagnosis of mild PH, but I’m assuming that it is not directly relevant to the apnea diagnosis.

  • jen-cueva

    Member
    December 6, 2022 at 1:13 pm

    Hi @brendad53, I know you may not want to hear this. However, I suggest having overnight oximetry done at a sleep lab. They use different things that are more accurate and would help you have some clarity about this.

    I do find the discrepancies in if your oxygen drops relatively high. Either way, your oxygen saturation is below 90, it seems many times. That suggests that oxygen at night could help boost those levels and offer you some relief. Again, I’m not a doctor, just my opinion.

    You certainly do have the tech gadgets, young lady!

    • brenda-denzler

      Member
      December 6, 2022 at 1:46 pm

      I’ve already had a proper sleep study done. Last June. Home-based, not in the hospital. I gather they only do in-hospital studies when it comes to fitting you for a CPAP.

      So what I’m trying to do here is simply figure out how to understand the variations in device readings. (I’ve collected these devices over the last 11 years or so…not all at once!)

      The problem with a sleep oximetry in the hospital is, when my O2 drops, they will NOT fit me with O2, because that’s not “standard of care” for sleep apnea. They will wake me up to fit me with a mask and a CPAP machine. I will say, “No. I have already talked to the doctor about this. I want to try supplemental O2.”

      They will say they can’t do that, and that being fitted with a CPAP is the standard of care.

      I will say, “I understand that. But I am highly uncomfortable with a mask and CPAP and prefer to try less psychologically traumatic methods of addressing this first.”

      They will say, “Well, insurance won’t let us do that. They will only pay for a CPAP.”

      I will say, “Then we have reached an impasse. Please let me go back to sleep.”

      And in my medical record, I will be noted as having refused treatment. Which is not true. I have refused the ONLY treatment they want to offer me. But that fact will not be reflected in my medical record–the fact that I have a reasoned plan for approaching treatment that is evidence-based and simultaneously honors my mPTSD. THAT will not be noted in the record. The only thing that will be noted is that I have refused treatment.

      So I am reluctant to go.

  • Mendo Bruce

    Member
    December 6, 2022 at 2:44 pm

    There really isn’t any discrepancy as oximeters are only accurate +/- 2% and all your readings are within 2 %

    BTW, I agree that supplemental oxygen at night is more appropriate than a CPAP. Talk to your pulmonologist or cardiologist (whichever is treating your PH.)

    • brenda-denzler

      Member
      December 6, 2022 at 3:52 pm

      Re: no discrepancy…thank you! I hadn’t quite thought of it that way. Thanks.

      Re: Agree with supplemental O2 at night…bless you! My pulmonologist IS ordering it for me. The sleep lab fellow and attending (and the PA) were adamant that ONLY a CPAP would be possible. I found medical journal articles validating an O2 approach and shared those with them, to no avail. When the “but it’s the standard of care” approach didn’t work with me, they moved to the “insurance won’t let us” approach. Idiots. My guess is they graduated in the unimaginative lowest 10th of their classes. They are able to rote memorize rules and procedures, but not think critically and creatively.

  • Colleen

    Member
    December 6, 2022 at 6:33 pm

    @brendad53 @mendo-bruce I can speak in regard to the sleep apnea but for what it’s worth, when my son was diagnosed his PH was critical but still managed for about 2 years using O2 just at night. Bedtime seemed to be when he struggle with his breathing the most. His heart was so enlarged and his lungs working so hard that lying down made breathing that much more difficult. The O2 at night helped lighten those episodes a bit. When his PH worsened he eventually had to transition to O2 24/7.

    He was never placed on CPAP but also never got around to having a sleep study. Every time they scheduled one he would have a crisis or decline and the study would get placed on the back burner. I never thought it was necessary anyway. I do know PH patients can also have sleep apnea but I believe Cullen’s issues were predominantly PH related in which case he would benefit more from pure O2 instead of pressurized air…but I’m no doctor.

    • brenda-denzler

      Member
      December 6, 2022 at 7:09 pm

      THanks, Colleen. I have had two sleep studies. One in 2012 and another this last summer, which would be 10 years later. There is a clear difference in the results. And it is clear that I have brief periods when I stop breathing. However….

      I have never (knock on wood) had general anesthesia. It requires them to paralyze you so you can’t breathe on your own, then they put a tube down your throat and into your lungs and pump pressurized air in. Sounds like fun, huh? (NOT!)

      I had a major breakdown when in the hospital for neutropenia (chemo-related) in 2009 when a thoughtless resident asked me in passing how I felt about being intubated. I was facing a mastectomy, which is “usually” done under general anesthesia, and I was beyond terrified. But I was trying to put that issue on the back burner for a while, as I adjusted to the chemo and all of the issues THAT brought up. Dr. Idiot Resident asked me how I felt about being intubated, as she had her hand on the doorhandles and was preparing to leave the room. All hades broke loose inside me. And outside me. I was curled up in a sobbing fetal position for a couple of hours, trying to calm myself.

      A CPAP straps a mask over the breathing parts of your face and forces air into your airway, just like a ventilator does when you’re under general anesthesia.

      See where I’m going with this?

      As a result, I am committed to trying supplemental O2 first, even though there’s no overt reason to believe that it will help those short bursts of not breathing. But no one can say with 100% certainty that it won’t. And maybe it will help things just enough to make moving on to a CPAP unnecessary.

      But of course, the wonderfully clever and erudite physicians who are managing the sleep lab can only imagine one response to sleep apnea: a CPAP. Any other considerations for why a CPAP might not work are irrelevant to them. Idiots.

      Anyway, I’m in full rant mode, I guess.

      I do appreciate hearing about folks with breathing issues who do not have to have a CPAP! It makes me feel like my plan to start “small” with supplemental O2 at night, and then work our way up the scale of “not desired” things until we reach all the way to the dreaded/hated CPAP— Well, that plan is not totally crazy. I appreciate the support.

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