Normal Oxyhemoglobin Saturation During Sleep: How Low Does It Go?

doi:10.1378/chest.110.6.1489

Chest

Volume 110, Issue 6, December 1996, Pages 1489-1492

https://doi.org/10.1378/chest.110.6.1489 Get rights and content

Study objective

To determine oxyhemoglobin saturation (O₂ Sat) in healthy humans.

Design

Retrospective review of all-night pulse oximetry data, carefully examined to exclude periods of motion artifact. The lowest saturation recorded during the night (Low Sat), the median saturation (Sat 50), and the saturation below which the patient spent 10% of the time (Sat 10) were tabulated. These data were compared to the O₂ Sat in patients with obstructive sleep apnea (OSA) and patients with stable asthma.

Setting

Sleep laboratory in a tertiary care hospital.

Patients

Three hundred fifty people with normal results of overnight polysomnography. Patients with known craniofacial or neurologic abnormalities or any previously diagnosed pulmonary disease such as asthma or COPD were excluded. The healthy subjects ranged in age from 1 month to 85 years. There were 184 male and 166 female subjects. These were compared to 25 patients with OSA and 21 patients with asthma.

Results

For the healthy patients, the mean±SD Low Sat was 90.4%±3.1%. The mean Sat 10 was 94.7%±1.6%. The mean Sat 50 was 96.5%±1.5%. There was no relationship between any of the O₂ Sat measures and sex, race, or obesity as measured by body mass index. However, older subjects (>60 years of age) had lower Sat 10 (92.8±2.3) and Sat 50 (95.1±2.0) than did younger subjects. The O₂ Sat of the patients with asthma was not different from the healthy subjects, but the patients with OSA had a significantly lower Sat 50, Sat 10, and Low Sat.

Summary

We describe in detail O₂ Sat in a large group of healthy people. Older subjects without known cardiorespiratory disease have lower O₂ Sat than younger subjects.

Section snippets

Materials and Methods

All individuals who had all-night oximetry performed as part of polysomnography (PSG) in the sleep laboratory of Rainbow Babies and Childrens Hospital from 1990 through 1994 were considered for the study. PSG included six EEG leads (bilateral frontal, central, and occipital), bilateral electro-oculographic leads, and submental electromyographic leads. Motion of the chest wall and abdomen was measured by respiratory inductance plethysmography (Respitrace; Ambulatory Monitoring Inc; Ardsley, NY).

Results

A total of 1,996 individuals had overnight oximetry performed in the PSG laboratory from 1990 through 1994. Of these, 629 had an RDI less than 5. An additional 279 individuals were eliminated because of underlying cardiopulmonary disease, leaving a study population of 350. There were 184 male and 166 female subjects, with a broad range of age (1 month to 85 years), height (43.0 to 193.7 cm), weight (3.0 to 167 kg), and body mass index (BMI) (12.9 to 55.2 kg/m²). Two hundred six subjects were

Discussion

We describe O₂ Sat in a large number of subjects carefully monitored overnight in a sleep laboratory. Examining several points along the cumulative percent time curve (Low Sat, Sat 10, Sat 50) provides a more comprehensive picture of an individual's oxygenation than does any single measurement. Our large numbers and wide age range enabled us to establish normal values (presented for reference in Table 1), as well as make meaningful comparisons of O₂ Sat across age groups. A 2- to 3-s averaging

Acknowledgments

The authors thank Pamela B. Davis, MD, PhD, Robert C. Stern, MD, and Kingman P. Strohl, MD, for their helpful comments on the manuscript; Juliann M. DiFiore for assistance with the figures; and Sheri Foster and Linda Robinson for excellent secretarial support.

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: Supported by a Student Research Fellowship, Department of Pediatrics, Case Western Reserve University.

: revision accepted July 22.

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Chest

Clinical Investigations: SleepNormal Oxyhemoglobin Saturation During Sleep: How Low Does It Go?

Study objective

Design

Setting

Patients

Results

Summary

Section snippets

Materials and Methods

Results

Discussion

Acknowledgments

Chest

Normative values of oxygen saturation over time

J Amb Monit

Nocturnal desaturation and serum erythropoietin: a study in patients with chronic obstructive pulmonary disease and in normal subjects

Clin Sci

Transcutaneous monitoring of oxygenation: what is normal?

J Pediatr

Oxygen saturation and breathing patterns in infancy: I

Full term infants in the second month of life. Arch Dis Child

Noninvasive monitoring of oxygenation in infants and children: practical consideration and areas of concern

Pediatrics

Quantification of oxygen saturation during episodic hypoxemia

Am Rev Respir Dis

Clinical Investigations: Sleep
Normal Oxyhemoglobin Saturation During Sleep: How Low Does It Go?