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[CPAP] Oxygen sensing and recording
#1
I am using Philips Respironics (I have to use a full face mask, Quattro, because if I use nasal pillow, air comes out my mouth. I wish I knew how some people avoid that!.)
CPAP (has been disappointing to me. I never had any trouble falling asleep, but I wake up four times a night to urinate. So I went to a sleep clinic and was diagnosed with OSA but not when I sleep on my back. I have been using CPAP for about a year, but it is not helping. I also tried Zzoma ,which is a device that prevents you from sleeping on your back, and it did not help either. Now, I understand that the purpose of CPAP is to keep your blood oxygen level from dropping while you sleep. So if I can measure my blood oxygen while I sleep, using CPAP, Zzoma, both, or neither, I will find out which of these arrangements (if any) is effective at maintaining my blood oxygen. This is important to me, because if it turns out that my blood oxygen is not dropping during the night (no O2 desaturation), then CPAP can't help -- it's not treating the cause of my waking!

So I have two questions :

Has anyone else been dissatsfied with CPAP? If so, what did you do?

Can anyone recommend a blood oxygen monitor that will record to my computer overnight (or to a memory card) so I can find out how effective the CPAP is at maintaining my O2 level? Do I need a prescription?

Thank you! I am hoping to benefit from the experience of others.
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#2
Hi, shnorrer,
Welcome to Apnea Board! I'm sorry you haven't been very satisfied with CPAP treatment, but I'm glad you are sticking with it and trying to find out more about your treatment. Supplier #19 (just click on the "Supplier List" at the tope of this page) sells recording pulse oximeters. I use the CMS-50D Plus and like it a lot.
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#3
I use a Contec CMS50EW pulse oximeter. It has a rechargeable lithium polymer battery and will record all night. I then put the graph of the SpO2 (blood oxygen) below the graphs from ResScan and stretch it so that the timelines are as close as possible to one another so I can see if any desats are comparable to events. I have to go on supplemental O2 at night infused into my airflow in order to keep my SpO2 above 90% and prevent awakenings or arousals due to low SpO2 or more specifically, increased CO2 in my blood. Worked like a charm. As of late my tests have shown that I remain above 90% on my own (as my lungs regenerate and heal, long story) so I have ceased using my Everflo Q oxygen concentrator. To answer your question? A sleep study should show desats but mine did not as mine were intermittent and associated with shallow breathing. I am VERY happy with my treatment although after buying my own APAP (S9 Auto) and adjusting my pressures, etc., to almost perfection, my sleep doc suggested that he was going to prescribe APAP machines to anyone he was able to and he thanked ME for showing his the benefits!

You MUST be aware of your condition and educate yourself. Never be afraid to ask questions. Never believe what you are told. But read and learn and digest and work on it. In the end you will be pleased with the results. If a 20+ year sleep doc and highly respected (sic) DME gave me bum information - you can be sure that you want to take anything you hear, including THIS information, with a grain of salt.

One thing. Stick with it. I will NOT sleep a single night without my OSA gear. I am fortunate in not having centrals so mine is a relatively simple resolution. My wife has just gone onto XPAP treatment and went from a sky high AHI to under 5 simply by going to my spare S9 Auto and a well fitting mask. Nuff said.
----------------------------------------------------------------------------
Educate, Advocate, Contemplate.
Herein lies personal opinion, no professional advice, which ALL are well advised to seek.



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#4
(10-04-2014, 12:01 AM)shnorrer Wrote: Can anyone recommend a blood oxygen monitor that will record to my computer overnight (or to a memory card) so I can find out how effective the CPAP is at maintaining my O2 level? Do I need a prescription?

For an expensive medical grade instrument, you may need an Rx.
However, you can get a CMS50F from supplier 19.
(see link to "Supplier List" at top of page)
It will record and can be readout via simple Windows based software.

PSaO2 is not the entire story to sleep apnea. You can have many short or hypo apneas that cause arousal -- prevent you from achieving the deeper stages of sleep -- without desat.

I have a CMS50F; and I use it for spot checks (don't wear it every night.)
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#5
First , please tell us EXACTLY which Philips Resperonics machine you have, there are many different models. Remove the water tank and look at the label on the bottom. There will be an REF number like ref 260 or 460. Once we know what you have we can take you to the next step.
Supplier 19 offers a variety of SPO2 meters. I have the CMS 50i wrist mounted recording oximeter. It can record 7 nights of sleep.
But the oximeter will not tell the whole story. It's like only reading the pages on the left side of a book.
You will need to get software like Sleepyhead to see what is going on when you sleep, but it only works if your XPAP records what is happening while you sleep. Like recording a movie on an SD card it won't work unless you put it in a camera.
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#6
All the information you are getting is good and useful and should spur you on to google for more information yet. One thing you need to be aware of is this: SpO2 is critical, regardless of its cause or relation to OSA. SpO2 dropping to under merely 89% to a paramedic is considered RESPIRATORY DISTRESS and will get you a free ride, lights and siren, to the hospital with a green air bag at the ready and O2 running into a full face mask to keep your O2 above 90%, at which point they will turn off the lights and siren but get you priority service when you arrive based on triage at that moment.

WHY? Respiratory distress will bring on things like cardiac arrhythmias, etc. But more importantly, your body will react to it in different ways (from person to person) and you are very likely to find your blood pressure to skyrocket in your body's attempt to oxygenate vital organs. Further, other nasty things will start happening pretty quickly within your body, permitting non-essential organs to starve for oxygen. The sky high BP increases your risk of stroke and the proverbial "popped vein" exponentially. Pop a vein in your brain or have a stroke in the right place and you are very lucky indeed if you are on your way to the hospital in a hurry as you are going to need your problem identified and treated FAST, failing which you are destined for non-reversible damage or worse.

SO, the bottom line is that regardless of its relationship to sleep apnea, your SpO2 is a critical parameter that you should be aware of. We use the Contec CMS50EW which is recording, rechargeable, wireless and accurate. We also use a Datascope Accutor 4 Blood Pressure Monitor, which is hospital grade and recording to monitor and record blood pressure. Problem is that it is not condusive to sleep at all, so it is used on a regular basis to monitor BP but generally not while attempting to sleep. Both of the above items can be picked up online in the hundred dollar or so range (the Accutor being a used one of course).

I am in no way suggesting self medication - rather, self awareness. When you go in to see your MD you are always well advised to bring in a small binder with printouts/graphs. Makes you appear much more believable. And tends to reduce the GOD complex we all experience with various physicians.

One last thing.... we picked up a roll of blue painter's masking tape and use it to keep the oximeter solidly on our finger all night. Ditto with the Accutor BP meter on the rare occasion we try and sleep with it on and set to automatic.

For what it is worth.
----------------------------------------------------------------------------
Educate, Advocate, Contemplate.
Herein lies personal opinion, no professional advice, which ALL are well advised to seek.



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#7
To all who have replied: Thank you! I will follow up and post what I learn.
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#8
[quote='bwexler' pid='86141' dateline='1412443782']
First , please tell us EXACTLY which Philips Resperonics machine you have,

It is REF 560P.

Thank you!
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#9
Your 560 records full data. You should get the Sleepyhead software and look at your detailed data. Your SD card should retain the data from the first day you used the machine.
If you can learn to post the reports here, the experts will help you translate into terms you understand.
The next step would be to adjust your machine based on the reports to optimize your therapy.
If you also get the recording oximeter it will show up on the same reports and add information into the mix.
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#10
(Yesterday 10:01 PM)shnorrer Wrote:
Quote:Can anyone recommend a blood oxygen monitor that will record to my computer overnight (or to a memory card) so I can find out how effective the CPAP is at maintaining my O2 level?

Hi shnorrer,

The wrist-mounted ones with separate finger sensor are more comfortable to wear a full night.

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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