Estimated oxygen variation graph: when to see a doctor

[GoodGuy5000HD]

I can understand why the FDA was hesitant to approve the Estimated oxygen variation (EOV) graph: with little guidance about what constitutes a "problem," it could/would create anxiety in a lot of people, and needlessly fill-up doctors' schedules as well as sleep labs (good for the sleep labs). If I bring it up with my doctor, I'm certain he'll take a "why not?" approach to a sleep study costing me thousands (even on forced socialized medicine).

Since my EOV graph has been activated, most days show a squiggly line in the low range. However, over the past 3 weeks, I seem to get a single spike past the "high" threshold once every 2-3 nights. Is this enough of a "problem" to schedule a sleep study?

Generally, what does the EOV look like for people who are eventually prescribed a CPAP machine (before and after the CPAP)? Or, have users seen some spikes, scheduled a one-night sleep study and were told that their sleep was normal?

Perhaps if Fitbit won't (or cannot because of the FDA) give guidance about what a problematic EOV graph looks like, we can crowd-source where that "see a doctor" threshold really is.

[Dominique]

Thanks for bringing my attention on EOV, I somehow had missed the announcement about the whole thing, and hadn’t noticed there was some more stuff after the "sleeping heart rate" graph. Unfortunately, I can’t answer your question, as I’ve never been involved with CPAP machines and my EOV graphs all seem to be pretty much flat in the low variation area. I would imagine a single spike now and then would not be of concern / would not warrant a sleep study.

[marynoz]

I agree!

I bought my fitbit earlier this week and have tracked my sleep for the past three nights. Every night has a short spike right above the treshold. I have no idea how serious/bad this could be.

[Bakebeans]

Hi mines causing me huge anxiety. Looking back through my graphs they’ve gone from all green to yellow showing 2/3 times a week. I emailed my dr and this was her response 

Looking online, it does appear that things like the way that the Fitbit is positioned on your wrist can affect the data on a given night. If you're having nights with all green on the graph, and others with yellow I'd think it's unlikely to be anything to worry about.

she did then go on to mention that if I noticed it was getting worse, I was extremely tired during the day  or my partner noticed me making any weird choking/ struggling noises in my sleep she would happily test me for sleep apnea.

this was last Monday and since then I’ve put my Fitbit on my other wrist each night and had all greens, last night was very close to a tiny spike but didn’t quite manage it. 

[VonAdd]

I have had quite a lot of spikes on the variations graph. I know my doctor though, and although I am worried, I also know that she will not take this seriously. 

I'm not quite sure of what do do, as it is a worry.

My health isn't great as it is and I am overweight, so I could easily have sleep apnoea.

Yvonne

[n8vz]

Thanks for this post.  Your doctor seems to put this in perspective.  I’ve noticed a correlation between orange spikes and vivid dreams during REM sleep.  Mostly all green nights, but once or twice a week a get a single orange spike during REM sleep, and often remember having a vivid, sometimes scary, dream at that time. 

[shipo]

@n8vz, while I don't remember having a scary dream in, geez, decades, your observed correlation between orange spikes and REM sleep applies to my graphs as well.  Too bad Fitbit doesn't superimpose the O2 Variation Graph on the sleep stages graph.

[Cathyf123]

I have had two recent sleep studies, one in November and one 2 weeks ago. Both nights I had my Fitbit on. The SpO2 desaturations that I had in the sleep study were seen by the Fitbit. Interestingly, the first study had one minor de-sat (to 92%), while the 2nd study had 3 serious de-sats down to 86%-88%. The desats in the second study didn't look more "serious" than the minor de-sat did -- they all 4 bumped the same distance over the line into "high".

So, yeah, the chart is kind of vague compared to what the PSG shows.

[n8vz]

Could you post the Fitbit graphs in question? That would be very helpful. Thanks for considering it. — Carl

Sent from my iPhone
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Moderator edit: personal info removed

[Cathyf123]

This is impossible to align exactly because fitbit refuses to put a proper x-axis on these graphs, and my psg doesn't display data very intelligently either, but you can get the idea.

[WilsonFitbit]

Hello everyone. Thanks for participating in the community forums. 

I'd like to let you know that Small variations in your estimated oxygen saturation levels are typical (source). Frequent big variations may indicate that you experience breathing disturbances during sleep. Breathing disturbances can lead to higher than expected variations in blood oxygen levels, which can indicate that your body is not getting enough oxygen while you sleep. If you frequently see big variations on your graph, consider talking to your doctor, particularly if you experience symptoms such as excessive tiredness, loud snoring, or gasping during sleep.

Other factors, including your arm position and certain physical characteristics, can affect your estimated oxygen variation readings, making them appear to be more variable. Make sure your Fitbit device is snug and secure on your wrist. For more information, see How do I wear my Fitbit device?

Note that your Fitbit device is not intended for medical purposes. Consult your health care professional about any questions or health issues you may have.

See you around. 

[Toolman907]

Wow did you just copy that response from the more info tab in the app

[shipo]

@Toolman907, to whom are you responding?

[BellyoftheBeast]

Why provide medical information if it is not intended to be useful?

[Peggy9970]

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@GoodGuy5000HD wrote:

I can understand why the FDA was hesitant to approve the Estimated oxygen variation (EOV) graph: with little guidance about what constitutes a "problem,"

Why would the FDA be hesitant to allow a graph of O2 saturation versus time when they have no issue with the Pulse Rate versus time? If the FDA doesn't allow O2 data to be recorded and graphed, why would the FDA permit the 02 data to be displayed on the clock face?  Puzzle.

For sometime now I've been trying to get someone at Fitbit to explain what the Y-axis (on the left hand side) of the EOV graph represents. The latest explanation is that the Y-axis is actually 02 readings with the bottom of the scale at 92% O2 and the top of the scale at 98% 02 and the dividing line between "high" and "low" at 95%. 

(In red, I've inserted the suggestion made by the Fitbit rep).

But that explanation doesn't make sense when combined with the statement directly below that says:

I had originally expected that the Y-axis label to be CHANGE in O2 with a scale of (say) 0 to 10%, that would make some degree of sense. But then what do you do with negative changes (for example the observed 02 changes from 95% to 92%..... that would be a  -3% change).

I wish that I could get someone at Fitbit (or in the community @ this forum) to clarify what the scale on this graphic is supposed to represent. This question has been asked over and over again over the past 3 years without an adequate response.  

Even my doctor can't interpret this graph, so does it provide some value.

[HDWorker]

but how does one explain many spikes into the high zone during the night?  How to talk to my doctor intelligently about the spikes?

[mkohn]

Attached is screen shot of my oxygen variation from FitBit Charge 5.  What is it - per FitBit's suggestion - that I tell my cardiologist this is? Am I well? Do I have a problem? I'd rather know nothing than wonder what this may be indicative of.

Please advise.

[Strobaugh]

I have mild sleep apnea. This is mine without a cpap. 

Having 1 or 2 spikes that don't stay in the high for long, wouldn't be super concerning. Everyone has some sleep episodes. It's when there are many episodes, every night. If your worried ask your partner if they notice that you struggle to breathe during sleep or make gaging noises. 

 

[mkohn]

Isn't anyone from FitBit - or anywhere - able to explain what the variations in the O2 Oxygen Variation Screen differ from? And what is nomad relative to each of our statistics? If not, why bother have this?

[Dgreener]

I was having a lot of extra heart beats and getting Palpitations in my chest and turns out I have PVC pre ventricular contractions.  After testing it was revealed I have a slightly enlarged heart and doctor sent me to sleep clinic where I was told I have sleep apnea and need CPAP even though I don't snore. Of course he never showed or sent me the data. I'm just supposed to accept whatever the deity says but my graph from fitbit does seem to confirm there's a lot of variation in blood oxygen. Anyon3 else care to paste their pics to compare. Mine has lots of spikes.