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Hi Dr. Sorkin!
Here is Dr. Patel's response!
"Yes night by night variability can explain the findings. If you have a Type 3 testing unit that has more channels you can get to see more then just one signal of oxygen."
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Hi Dr. Patel,
After subjective symptoms of OSA have resolved (ie, feeling well rested in am, snoring cessation,etc), I typically send the patient home with a pulse oximeter (Virtuox Ultra Wrist)for screening purposes only. I was taught that we want % time SpO2 below 90 to be 1% or less and the ODI (3 % events/hr) to be less than 5. Lately, I have been getting back results that have been worsening as I titrate the device forward and have seen wild fluctuations in the time below 90%. For example, the most recent patient used the pulse ox for 4 nights and was 17.5%, 10.5%,18.4%,and 53.7%. That was his second time being titrated forward. The first time, his % below 90 was 5.4% and 38.2%. Obviously, his ODI was nowhere near 5. Do you commonly see these fluctuations? I understand that other factors like position and alcohol use play a role but I was hoping to get consistent results before sending them for a follow-up HST or PSG.
Any thoughts or advice would be greatly appreciated.
Thanks,
Andrew
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