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.

[Honeyhoney]

If anyone is interested, this is what my oxygen variation looked like BEFORE

 

l was diagnosed with severe complex sleep disordered breathing. When these were recorded l was having 50 events per hour, ie a lot of central apnea and hypoxia , as well as obstructive apnea, and l had cheyne-stokes breathing 80% of the night.  These are the worst looking ones, but l also had plenty that were well down in the green.  I have been having cpap therapy for a couple of.months now but my fitbit sleep stages graphs don't  look much different, even though my apnea events have gone from 50 per hour to around 5 per hour. The number of wakes are the same, l just get a bit more deep sleep time, which is good.   The oxygen variation  still gets occasional peaks over the line, but does look better .  In general, l don't  think that fitbit provides much useful information that could point to a suspicion of sleep apnea.  I can't  see that anything screams severe sleep apnea on my fitbit history.

[AngryChef]

It is outrageous that this so called graph has no bearing on actual oxygen levels. WHAT O2 LEVELS ARE THE DOTTED LINES FOR PETES SAKE. The implication to the layman is that a high spike is bad and a low spike is bad but actually a high spike MAY BE an oxygen level well OVER 95 and not a problem. My sleep doctor also had no clue what the graph meant. But what it DOES MEAN is that folks like me are scared into EXPENSIVE SLEEP STUDIES that are totally unnecessary.  Crap data is crap. Period.

[RandySue]

I don't understand this information at all. My graph is all over the place and I have a CPAP 

 

[mkohn]

Why not simply show/display the average O2 levels.  Unless, of course, the data is inaccurate, in which case why show the continuously questioned "variation" of something without a basis or reference or any axis?

[Honeyhoney]

I agree. I have always just presumed that the green part was low variation
meaning steady and ok, and the spikes into the orange zone meant levels
were varying highly, ie lower oxygen. Green for ok and orange for alarm.
But with no indication of what the actual levels are, it's pretty useless,
and now that fitbit in its wisdom have changed the graphs and there are no
more colors it's even more ambiguous.

[jamesbenz72]

A single spike every few nights might not be a cause for concern, but it’s best to discuss it with your doctor. They can give you a more personalized assessment based on your overall health and symptoms.

[Jimichan]

One big problem that has received hardly any attention is that the EOV graph has no information at all as to what the x and y axes are.  We have to assume that the x axis is time, which would be reasonable, but what exactly does the y axis represent?  

Another, perhaps more troubling, problem is that we have to rely on a public forum to get support.  

[Fishb]

You started/stopped snoring or you lay on your stomach. 

Only worry if it happens every night 

[Spirithawk]

Let me try to shed light upon what this useless graph is actually telling us. What we are looking at is what the people that Fitbit describe as variations. But what does variation really tell us, they tell us absolutely nothing, it's data only!

Shall I digress

First of all they are not distinguishing between spo2 levels that are low but have variations or spo2 levels that are high and have variations. So this graph is worthless. 

For an example if you have an spo2 of approximately 98 and your oxygen levels drop to 96% 94 %while you're sleeping it'll show it as a high variation but those oxygen levels are actually very good they're nothing to be alarmed about. 

Let's say you have an average oxygen level of around 94 but while you're sleeping your oxygen   levels drop into the 80s this can be cause for alarm especially if they stay that low for at least 5 minutes. Let me explain further.

If you do end up getting a sleep study one of the studies would involve your spo2 levels. Throughout the evening you wear this device on your finger such as the same device that you often get when you  walk into a doctor's office.

That device is checking your spo2 levels at this moment. There is a device you can buy online on Amazon the prices vary and you can wear it throughout the night it looks like a watch that is worn on the wrist but a wire comes off of the watch to a rubber device that fits over your finger and projects a red light through your nail bed. This device is measuring spo2, and the graph that it produces throughout your sleep will show high levels are low levels. And you can determine whether or not your spo2 levels are too low and if you are alarmed by that you don't necessarily have to feel tired during the day to be experiencing actuals sleep apnea. Tiredness during the day is not the only tall tale sign of sleep apnea. 

In fact you might not experience this at all. 

Using myself as an example I was concerned with the spikes on the graph produced by my Fitbit. I spoke to my heart specialist and they suggested a sleep study. My sleep study determine that I had mild sleep apnea 15 AHI events during the evenings I believe this meant I was having difficulty breathing 15 times per hour but this was still considered mild, but it is in fact sleep apnea 

Anything between the numbers of 5 and 15 AHI is mild

With five or below being of no concern. 

Besides the one sign everybody alludes to , tiredness during the day. As I said earlier this could be non-existent. Other concerns you may have are foggy-ness throughout the day, difficulty with memory, fatigue, easily agitated, but these too could be many different symptoms of many different disorders I believe the spo2 is the gold standard ,

So is this oxygen variation graph telling you anything? Yes! But it's definitely not telling you if you have sleep apnea once again it's just telling you if you had a variation that variation can be high which is ridiculous to even have to concern yourself with higher oxygen is a good levels for your brain the only thing you really have to concern you with is variations in low especially for long periods of time ,and this

graph is not telling you that.

[mkohn]

Well said!!!

[Spirithawk]

This is a sleep study at home adorable! 

[Fujisan54]

I get a couple of spikes into the high zone most nights, and sometimes really quite high. I know snore quite loudly and decided to get a sleep test done. I was surprised to find that my disruptions and low oxygen moments were very few. 1 time per hour.

My Fitbit shows I wake up a lot during the night. I also tend to be low on REM and sleep graphs are more Rocky Mountain than hammocks. However, I get a lot of deep sleep - way more than the average for people my age and my oxygen levels tend to show an average of 96% or so. My sleep test showed a 97% average and Fitbit showed 96%. All I can guess from all this is that even with spikes into high zone, if your average oxygen stays quite high you might well be okay. Sleep study did show a drop to 90, which would be a bigger than 3% drop but isn’t particularly worrying. Obviously, bigger and more consistent drops or longer periods of hypopnea would bring the average down so I am wondering if rather than spikes, it might be better looking at the average oxygen percentage. After all, you could have long periods of hypopnea but low variation and therefore few spikes.  Do people who have diagnosed sleep apnea usually have comparatively low average of oxygen levels?