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Re: Re: Re: Re: Re: Diagnosis after Oximetry test

Posted by writermd on May 18, 2002 at 18:49:20:

In Reply to: Re: Re: Re: Re: Diagnosis after Oximetry test posted by Engineer on May 18, 2002 at 16:53:53:

I'm not an expert, but I'll tell what I think to be correct:

>1. Looking at an oximetry record, what constitues evidene of an apnea, is it a spike that drops several points of saturation ie(96 - 92) followed my an increase of heart rate from 50 to 110? I guess what I am asking is how can you recognise an apnea from an oximetry test?

I think the usual definition of *obstructive* apnea is cessation of airflow in the presence of persistent (or increased) muscular effort by the respiratory muscles (especially diaphragm and to some extent thoracic muscles).

>2. In response to your earlier question , I was down around 82% 02 for three periods during the night, for round 20-25 minutes each time ( I have the graph in front of me)?

I don't know enough to answer with assurance, but sustained periods of hypoxia (low oxygen levels) like that sound unusual to me, and of concern. I think the typical pattern is to have short periods (a minute, mabe) of low oxygen during the apnea, and that when the apnea ends, oxygen returns towards (or to?) normal. It sounds like you have some kind of sustained periods of low ventilation, maybe a sustained hypopnea (low breathing as oppsed to cessation,which defines apnea) or perhaps some central event (reduced ventilatory signals coming from the brain). You surely should have a full polysomnography at a recognized center and an evaluation by a fully qualified sleep specialist. Definitely do *not* rely on the judgment of a regular doc (e.g., internist, family doc, whatever), no matter how well informed they seem. My experience is that doctors are often wrong, and that if you have a specialized problem, you should take full advantage of people with specialized knowledge. Find a good doctor, with good credentials; then be informed and assertive and an active partner in your care; and with luck you'll get decent care.

>3. I am still confused about the relevance of the heart rate, all I know is that mine was going nuts for most of the night.

I don't know enough about this subject to answer with any assurance. But for consideration, the heart rate may increase when oxygen levels are low, trying to pump more blood to the body to make up for the fact that the blood has less-than-normal levels of oxygen. The heart rate changes may be a compensatory response to the hypoxia, but there may be other explanations as well, which may be more correct. (Or maybe my interpretation is simply wrong.) Don't delay, see a good sleep doc, and get studied ASAP--push, cajole, beg, cry, threaten (carefully), switch doctors, cry uncle, or whatever else it takes. Once you find a doc you're comfortable with, try to stay on good terms, but don't sacrifice good care or legitimate concerns for the sake of that relationship. There are many doctors out there, and if you have to switch 10 times to get what you need, do it.

Good luck!

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