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Intermittent desaturations during sleep
#51
RE: Intermittent desaturations during sleep
If you will just post a screenshot in the manner we recommend, we can make a lot more sense of your data than a scrolling GIF image http://www.apneaboard.com/wiki/index.php...ganization I actually find the GIF frustrating because I want to study a part of the screen, but the damn thing keeps moving away from what I need to see. Imgur is fine for hosting, but please give me clear, stationary screenshots. To show more information, do you have the ability to put your monitor in portrait mode for the screenshot?

Have you tried opening up your machine and using it in Vauto mode? I would like you to try these settings to see if we can work on the desaturation events. We certainly want more ventilation by increasing pressure support, we also will probably want a higher EPAP pressure as that normally increases O2 saturation. We will start with a low setting like you currently use, and probably change these settings to see your response.
Mode: Vauto
EPAP min: 7.0
PS: 3.0
IPAP max: 12.0
Trigger Sensitivity: high
Cycle Sensitivity: Medium
Ti Min 0.3
Ti Max 2.0
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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#52
RE: Intermittent desaturations during sleep
As Sleeprider states a simple screenshot would be easier to interpret. For this level of investigation you need to move the SPO2 graph up directly below the flow rate graph so you can see how the desaturations are associated with your breathing. I have attached an example of the level of investigation required, you can see how my first hypopnea barely affects SPO2 then the two following hypopnea both have desaturations associated with them. 

   

Your SPO2 data needs to be accurately synced for this level of analysis. I sync mine by holding my breath and pulling oximeter off at the same time at the beginning of the night (so flow rate chart reads 0 flow and SPO2 signal is gone) and I do that twice. I then import oximetry data, determine if an offset is required, purge and re-import with adjusted time in order to make sure both are synced. If your oximetry data is even 20 seconds out of sync it will make it tough to understand/interpret properly. Below is an example showing how I know my data is perfectly synced before I start to try and interpret what is causing the desaturations. 

   
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#53
RE: Intermittent desaturations during sleep
I have chronic desat issues and I am on O2 at night.  I just responded to another desat thread and will not repeat that post.  I have been using a Wellue SleepU (using Viatom software) for a month.  What seems to be most important to me is the time below 90% which I believe is the only % on the standard Viatom report. The Viatom 10 point scoring system is not as valuable and I believe can provide erroneous information.  As best I can tell, it lowers your score for every "drop" of 4% in a short period of time. I have had scores as low as 3/10 with 52 "drops" in 6 hours while only going below 90% for 4 minutes.  What you should be concerned with (and what you need to tell your doctor) is the time below 90%.  Alternatively, it could be that 4% drops do indicate a sort of "instability".  I am reading more about that and will discuss it with my doc.  My understanding is that most insurance companies use 3% to qualify for reimbursement, but medicare uses 4%.  My Viatom report uses 4% drops, but I am not certain it is being reported correctly.  From what  I remember about my sleep study, it was more like dropping below 90% for a certain amount of time?

If you do need an Rx for O2, it is not that difficult unless you travel a lot by air.  Do note that too much oxygen can be harmful, so do not add O2 without a prescription.  I use a Philips Simply Go O2 concentrator for travel, mostly for driving vacations. Flying can be an issue with desaturations.  I am interested in the great info provided in this thread.  Good luck!
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#54
RE: Intermittent desaturations during sleep
New observation:

Sp02 levels greatly improved due to atmospheric changes.

Visiting family for the holidays:
~640' elevation and 61% humidity resulted in higher Sp02 levels (96% avg) throughout sleep + 0 seconds of <90% time
vs. my home at ~3000' elevation and 29% humidity which gives me ~94% avg Sp02 + 1-5 minutes + of <90% time.

I've observed this on two separate occasions. I would conclude that the higher elevation and lower humidity is contributing to mild-moderate hypoxia.

I also have better digestion and am less stressed when waking.

Has anyone else noticed a similar phenomena?

t would seem unfortunate to have to resort to adding a 02 concentrator because of living at a higher altitude.
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