At the microphone of Alice Moitié in the podcast Alice Underground broadcast this September 23, Melha Bedia candidly addressed her anxiety attacks and her hypochondria.
Blood tests, meditation, psychoanalysis… The comedian on tour in 2027 is doing everything he can to reassure himself. In a pharmacy setting – a place she describes as reassuring – she confessed to a somewhat disturbing nocturnal habit. “I have an oximeter before I sleep to see if my heartbeat and oxygen saturation are okay.” she confides.
This anxiety disorder is characterized by an irrational fear of illness. Even if the pathologies are not real, the psychological suffering is. To allay their fears, the affected person carries out more check-ups. “As soon as I know that I have nothing it reassures me“, admits the actress, while recognizing that this relief is fleeting.
What is a pulse oximeter and how does it work?
Sold freely in pharmacies and on the Internet, the pulse oximeter (or oximeter) is a small self-measurement device. Placed on the tip of the finger, it evaluates two key parameters: heart rate and blood oxygen saturation (SpO2). Oxygen is carried by red blood cells to supply organs; this rapid test allows you to check the correct distribution.
There are two methods to evaluate this saturation:
- Gasometry: carried out in the hospital via a blood test in the radial artery, it measures SaO2. It is “extremely reliable” but “not systematic because it is invasive and sometimes painful”, explains Dr Gérald Kierzek, emergency doctor;
- Saturometry: non-invasive, it assesses SpO2. The box placed on the finger uses infrared to evaluate “almost the entire body’s oxygenation,” explains the doctor.
Oxygen saturation: what are the standards?
The saturation rate is expressed as a percentage. The medical benchmarks are established as follows:
- Between 95% and 100%: saturation is considered normal (between 94% and 98% in the elderly);
- Below 95%: this is hypoxemia (decrease in oxygenation);
- Below 90%: the situation involves desaturation and constitutes a medical emergency.
Dr Kierzek, however, qualifies these figures. “Some people, such as people with respiratory failure or simply smokers, have a chronic lack of oxygen. The important thing is not so much the rate itself as its evolution: if we see a drop of more than 3 or 4%, we should be worried.
Decreases in oxygen can result from pulmonary or cardiac pathologies, infections or septic syndromes. They result in shortness of breath, tachycardia, disorientation or bluish discoloration of the extremities (cyanosis). Conversely, too high a level under oxygen therapy (hyperoxemia) also presents harmful risks.
Should you measure your saturation at home?
As part of medical monitoring, home measurement is useful for patients suffering from heart or respiratory failure. “It is a reliable and reproducible parameter.”adds Dr. Kierzek. “The term ‘reproducibility’ is important, because not everyone has the same saturation rate. So you just need to know your basic saturation and monitor it.”
This monitoring was also supervised by the High Authority of Health (HAS) during the Covid-19 epidemic in people at risk, in order to identify “silent hypoxemia” without apparent symptoms at rest. In this specific context, the device can be prescribed and covered 100% by Health Insurance.
In the event of a proven decline, management is based on oxygen therapy and treatment of the underlying cause (sleep apnea, COPD, etc.). “As soon as we observe low saturation and very infected lungs on the CT scan, we must provide the patient with very rapid oxygen supply before the whole inflammatory cascade and the vicious circle begin.“, insists the emergency doctor.
How to deal with hypochondria on a daily basis?
While using an oximeter provides temporary comfort, it does not treat underlying anxiety. For Professor Antoine Pelissolo, psychiatrist at the Pitié-Salpêtrière hospital, hypochondria is a “real illness” which is based on fear of anticipation. “The signs of a panic attack can be frightening, but they are absolutely not dangerous. Contrary to popular belief, you never die of fear!“, recalls the specialist.
To escape this vicious circle, he recommends several approaches:
- Psychotherapies: cognitive and behavioral therapies (CBT) and psychoanalytic approaches help to rationalize fear and understand its origins;
- Meditation and relaxation: Mindfulness allows you to tame your physical sensations without overinterpreting them.
- Alternative medicines: herbal medicine (valerian, hawthorn, passionflower) helps to soothe the anxious environment;
- Lifestyle: practicing regular physical activity and avoiding compulsive searches for symptoms on the Internet (cyberchondria) promote better anchoring.
If anxiolytics can calm an acute attack on an occasional basis, Professor Pelissolo emphasizes that it is a “transitory solution” which does not replace global therapeutic care.