Nocturnal Hypoxemia Without Sleep Apnea

Sly Saint

Sly Saint

Senior Member (Voting Rights)
I've recently been having a better look at reports of my garmin vivosmart watch, specifically the ones during sleep as I've only fairly recently been wearing it overnight.

I found that it also regularly monitors spO2 during the night and the readings are a bit concerning as my levels drop considerably when asleep and on many occasions take very low dips. AFAIK I don't have sleep apnoea.

Found this on Nocturnal Hypoxemia Without Sleep Apnea
among the causes are COPD and other lung diseases, obesity and cardiovascular disease but also

Neuromuscular disorders, which affect the muscles and nerves responsible for breathing, can also lead to nocturnal hypoxemia without sleep apnea. Conditions such as muscular dystrophy or amyotrophic lateral sclerosis (ALS) can weaken the respiratory muscles, making it challenging to maintain adequate ventilation during sleep. This can result in a gradual decrease in oxygen levels throughout the night.
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Symptoms include:
daytime fatigue. When your body doesn’t receive adequate oxygen during sleep, it can lead to poor sleep quality and leave you feeling exhausted and lethargic during the day. This fatigue can be persistent and may not improve even with seemingly sufficient sleep duration.

Morning headaches are another telltale sign of nocturnal hypoxemia. As oxygen levels drop during the night, blood vessels in the brain may dilate, leading to headaches that are typically most severe upon waking. These headaches often improve as the day progresses and oxygen levels normalize.

Cognitive impairment is a concerning symptom of nocturnal hypoxemia that can significantly impact daily functioning. Reduced oxygen levels during sleep can affect brain function, leading to difficulties with concentration, memory, and decision-making. Over time, chronic nocturnal hypoxemia may even contribute to more severe cognitive decline.

Mood changes and irritability are common in individuals experiencing nocturnal hypoxemia. The combination of poor sleep quality and reduced oxygen levels can take a toll on emotional well-being, leading to increased irritability, mood swings, and even symptoms of depression or anxiety.

Nocturnal restlessness and frequent awakenings are often reported by those suffering from nocturnal hypoxemia without sleep apnea. While these individuals may not experience the characteristic gasping or choking associated with sleep apnea, they may find themselves tossing and turning throughout the night or waking up frequently without a clear reason.
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Nocturnal Hypoxemia Without Sleep Apnea: Causes, Symptoms, and Treatment Options

I know that Dr Bateman was keen on using oura rings to monitor pwME, and more recent research on LC using wearables is ongoing. But has there been any research done on ME patients?

It would be a relatively 'cheap' and uncomplicated trial, just x number of patients/controls wearing an oura or whatever, for say a month and analysing the results.

Has anyone else monitored their nocturnal spO2?

 
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Sly Saint said:
Has anyone else monitored their nocturnal spO2?
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Yep, looks completely normal on me. (I use an older fitbit so if measures are accurate is another question, but they seem to match those on my Pulse Oximeter when awake).

I get in the range from 94-99%.

I get lower end in crashes, middle end when normal, and higher end when Adrenalined/Wired.

I’m going to be honest and say I think that it isn’t common to have low spo2 at night with ME. Perhaps a little more common than the general population due to confounding factors, but tons of pwME have bought smartwatches and stuff so if it was a stark contrast we would have known by now.
 
Utsikt said:
The doc said it was normal in all people.
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what was normal in all people?

According to my readings they go way below 90% sometimes over night, last night there was one drop down to just under 80%, that's not normal.
Having said that I have read that if I'm moving a lot in bed then the accuracy can be quite off with these wearables.


At the very least should this not be part of the work up for an ME diagnosis?
By that I mean something to be checked to be ruled out/excluded.
 
Sly Saint said:
According to my readings they go way below 90% sometimes over night, last night there was one drop down to just under 80%, that's not normal.
Having said that I have read that if I'm moving a lot in bed then the accuracy can be quite off with these wearables.
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I kept record with my Vivoactive few years ago but stopped because it ate too much of the battery. I also had quite often dips to less than 80% but I suspect that it was because I couldn't keep the watch tightly on my wrist all the time with my swelling and shrinking wrists! I wouldn't trust the readings too much for spO2.

I also have been diagnosed with mild sleep apnoea before, although that seems to have cleared off. I used a CPAP for about 6 months without any help on symptoms. The data of that almost never showed as low readings as the wearable did.

ETA. I might remember wrong things here.. I have a feeling that just using CPAP doesn't record oxygen levels.. But remember it from the sleep study.
 
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Sly Saint said:
what was normal in all people?

According to my readings they go way below 90% sometimes over night, last night there was one drop down to just under 80%, that's not normal.
Having said that I have read that if I'm moving a lot in bed then the accuracy can be quite off with these wearables.


At the very least should this not be part of the work up for an ME diagnosis?
By that I mean something to be checked to be ruled out/excluded.
Click to expand...
I think so.

This is the sort of thing that could have been happening back in the 80’s and 90’s when you could still get non emergency hospital admissions for diagnostic evaluations in the UK.

I wonder if this was done for some ME patients back then in sleep clinics or something…?
 
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I have an Apple Ultra 2 that monitors Sp02. It also monitors respiratory rate whilst asleep. My lowest blood oxygen was 78%, but my normal range is about 90-100% with a few below in the mid 80's. Body position sleeping can lower your levels (sleeping on one's back) so I am presuming that is causing this. (As well as my history of smoking, though have been a nonsmoker for 15 years I probably have some lung damage).

Also certain medications can lower blood oxygen while asleep eg. opiates and a few others, none that I am on. Also obesity can cause sleep apnoea but not applicable either.

I recently got a notification through the Apple Health app that I might have mild sleep apnoea and suggested I talk to my doctor which I am going to do.

I agree, it should be part of the ME work-up. Any problems sleeping with excessive fatigue needs to be investigated and treated.
 
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