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Normal and Abnormal Blood Oxygen Levels During Sleep

Blood gas analysis, also called arterial blood gas analysis (ABG analysis), helps measure the concentration of oxygen and carbon dioxide in the blood. It also helps determine the pH of the blood, the levels of bicarbonate ions in the blood and the oxygen saturation of the blood. The normal range for blood gases are shown in the table. A healthy, normal blood oxygen level remains around 95 percent to 100 percent. You can monitor your blood oxygen level at home with a pulse oximeter. Values below 90 percent are considered low. When your body doesn’t receive enough oxygen and you have a low blood oxygen level, hypoxemia or hypoxia, cyanosis and other conditions may occur.

Low sleep apnea oxygen level is a sign that your treatment for sleep apnea is not effective.

Patients with breathing problems during sleep (sleep apnea, COPD) often have low oxygen levels in their blood.

Keep in mind that anything below 90% oxygen level is dangerous to your body and require intervention. Another thing to consider is that the brain can only survive 4 minutes once oxygen is completely cut off.

In this page you'll learn:

• What should your oxygen level be during sleep,
• How sleep apnea affects the oxygen levels in your blood,
• How oxygen levels affect your body,
• The link between pregnancy and low oxygen levels in obese women,
• How to monitor oxygen saturation levels,
• What is the best finger oximeter to monitor blood oxygen levels,
• How to treat sleep apnea oxygen level.

Oxygen Levels During Sleep Apnea

In sleep, the upper airway muscle tone of the patients with sleep apnea tends to narrow and collapses temporarily. When this happens, the breathing stops accompanied by a drop in blood oxygen levels and arousal from sleep.

The low oxygen levels during sleep can make you feel very tired in the morning and will contribute to more restless sleep.

Furthermore, when the oxygen levels start to drop, the carbon dioxide levels build up in your blood. This can lead to morning headaches, fatigue and sleepiness during the day.

Scientific Proofs - Oxygen Levels Decreases During Apneas

Even the most recent studies (2012) demonstrates the link between sleep apnea and oxygen desaturation. That's why the oximeter is an important tool in clinical assessment.

With a finger pulse oximeter you can monitor yourself to see how effective is CPAP (you'll learn how to do this bellow). The device can also be used to diagnose sleep apnea, but only if you use a quality product.

For more information on how to use an oximeter to diagnose sleep apnea, read the portable pulse oximeter article.

How Does Sleep Apnea Oxygen Level Affect the Body?

Any value of blood oxygen level bellow 92% is abnormal. However, the number of desaturations and the time spent with abnormal oxygen levels is important.

For example, if you only desaturated below 92% once or twice during a 7 hour sleep, and the desaturation level lasted only a couple of seconds, it's not a reason for worry.

Your body will be seriously affected when you'll have long term low oxygen levels. This can lead to:

• heart rhythm problems,
• increasing pressure on the right side of the heart,
• fluid build up in the body,
• heart failure,
• stroke.

Increasing the pressure on the right side of the heart

The right side of the heart has the role of pumping blood through the lungs, which requires a much lower pressure.

A higher pressure can lead to severe fluid buildup in the body that can cause life-threatening shortness of breath, heart failure and even death.

Please call your doctor urgently if you experience chest pain or shortness of breath that is not relieved by rest.

Monitoring Your Blood Oxygen Levels

If your doctor discovers that your blood oxygen level (oxygen saturation) is less than about 90% during the day (when you are resting), then your oxygen levels are probably dropping during the night. This means that you have sleep apnea, or other respiratory disorders, like UARS.

Your doctor may recommend overnight monitoring of your oxygen levels using am oximeter. In a sleep study, you usually have the oximeter attached on the finger.

You can use a portable oxygen saturation monitor or oximeter, a cool little device that can record your sleep apnea oxygen level and pulse rate during sleep. A medical approved oximeter is truly a great tool to see how well CPAP is working for you.

A tip before buying an oximeter: you would do well to invest in a recording oximeter with software. You can upload your data in a computer, and you can go to your sleep specialist with the results.

See an example in the followingvideo:

For more info about sleep study for sleep apnea, see sleep studies.

So, if you have a low blood oxygen level, follow up with the sleep study as soon as possible.

Continued drops in O2 levels will cause damage to cognitive function, short term memory, stroke and heart attack in your sleep, and a host of other problems.

Oxygen Levels in Pregnant Women

Overweight women who are pregnant or women who gain too much weight during pregnancy are at a higher risk of developing sleep apnea. This can cause a drop in blodd oxygen levels during sleep which can create complications for the baby.

So if you are overweight or gained a lot of weight during pregnancy, speak with your doctor to investigate if you have sleep apnea.

For more info about obesity, see sleep apnea and obesity.

Improving Sleep Apnea Oxygen Level

Patients with sleep apnea are usually treated with CPAP machines. If apnea episodes disappear, the oxygen levels will improve to normal levels.

How often should you use the CPAP?

If your doctor prescribed CPAP therapy, you should NEVER go a night EVER without a CPAP on or even take a nap without one.

More strategies to treat sleep apnea:

If your oxygen saturations drop significantly and persist during the night, you may benefit from overnight oxygen delivered by nasal masks or nasal prongs.

CPAP and Oxygen Levels During Sleep

You can have low oxygen levels during sleep even if you use the CPAP. This means that your CPAP doesn't have the desired effect.

That's why is important to monitor your oxygen and pulse rate.

To keep a better eye on your sleep apnea oxygen level you might consider purchasing a finger pulse oximeter.

Remember: don't use inferior equipment to measure your well-being and don't change anything without checking that information with a second opinion or proper equipment.

Clinical Contributors to this Story

Normal Blood Oxygen Level At High Altitude

Adrian Pristas, M.D. contributes to topics such as Sleep Medicine.

There has been a recent spike in sales for pulse oximeters, the small device used to measure the level of oxygen in your blood. Apple also just announced that the new Apple Watch Series 6 comes with a blood oxygen sensor and app. So, why is the spotlight on this health metric?

To get the inside scoop on blood oxygen levels and pulse oximeters and why there’s growing interest in both, we spoke to Adrian Pristas, M.D., pulmonologist and corporate medical director, Centers for Sleep Medicine at Hackensack Meridian Health.

Q: What does “blood oxygen level” mean?

Dr. Pristas: “Blood oxygen level” describes the amount of oxygen you have circulating in your blood. Our bodies need oxygen to function. Oxygen enters the body through the nose and mouth and passes through the lungs into the bloodstream. Once in the bloodstream, oxygen helps replace cells that wear out, provides energy for our bodies, supports the way our immune system functions and more. Low blood oxygen levels indicate that there may be an issue with your lungs or circulation.

Q: Why is there increased interest in blood oxygen levels?

Dr. Pristas: People started to buy pulse oximeters to measure blood oxygen levels at home when they learned that low levels could be a sign of COVID-19. Shortness of breath is a well-known symptom of COVID-19, but it’s not always easy to detect. Some thought this device could be a tool to help self-assess for signs and symptoms. There have also been reports of “silent hypoxia” where peoples’ oxygen levels are dangerously low, but they don’t necessarily experience shortness of breath.

Q: What’s a normal blood oxygen level, and when should I be concerned?

Dr. Pristas: If you’re using a pulse oximeter to measure your blood oxygen level, a normal reading is a Sp02 level that’s between 95 and 100 percent. However, this may vary for people with certain medical conditions, such as lung disease. Speak with your doctor to determine what ‘normal’ is for you and keep in mind that while these at home devises are handy and non-invasive, they are not always 100% accurate. In fact, Apple says its new blood oxygen feature should only be used for general fitness and wellness purposes and should not be used to diagnose, monitor or treat any medical conditions. Other tests, performed by health care providers, include blood draws or breathing tests to accurately measure blood oxygen levels. If your Sp02 is below 95% you should consult with your health care provider.

Q: Can a pulse oximeter detect COVID-19?

Dr. Pristas: A pulse oximeter cannot detect COVID-19, however, it can help you monitor for signs and symptoms associated with the virus. Having a low blood oxygen level could be a sign of COVID-19, but it can also be a sign of other health issues that need to be discussed with your health care provider. Either way, if you are monitoring your blood oxygen levels at home with a pulse oximeter, contact your health care provider if your Sp02 drops below 90-95%.

Q: How does a pulse oximeter work?

Dr. Pristas: Using a pulse oximeter is painless. The small device simply clips on to your finger, and beams of light measure the amount of oxygen in your blood, as well as your heart rate. The small beams of light analyze the color and movement of your blood cells. Dark red blood cells indicate a lack of oxygen, while bright red blood cells indicate the right amount of oxygen. If 95% of the blood cells are bright red, while 5% are dark red, your Sp02 would be 95%.

You can also attach a pulse oximeter to your toe, earlobe or nose, but it is commonly used on your finger. Once the Sp02 reading appears, you can remove it.

Q: Should I monitor my blood oxygen levels at home?

Dr. Pristas: There are some scenarios when your doctor might recommend you monitor your blood oxygen levels at home. If you have an underlying health condition, like heart or lung disease, or you are in the process of recovering from COVID-19, it could be helpful for you to keep an eye on your blood oxygen levels. However, if you do choose to monitor from home, talk to you doctor first about how to properly use the device, understand your reading and interpret the results. For example, if your hand is not steady during the reading you could see varying saturations from a faulty reading.

If you’re otherwise healthy, it’s not necessary to have a pulse oximeter or any other device to monitor your blood oxygen levels at home. If you’re unsure, ask your doctor for personal advice.

Next Steps & Resources:

• Meet our clinical contributor: Adrian Pristas, M.D.
• To make an appointment with Dr. Pristas or a doctor near you, call 800-822-8905.
• Looking for guidance on how to reopen safely? Learn more about our Reopening America program.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care

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