RE: SpO2 drop without any apnea?
(06-04-2019, 07:30 PM)ajack Wrote: The machine saw something that it raised the epap on. It also caused an o2 desaturation. So yes, In this one, I would follow the machines advice, that more epap is needed. Even if the AHI was 0.0. A lab may increase PS as well. The forum sticks to PS 4, I haven't seen many times when a higher PS is suggested.
As I see it. You have a choice of a lower epap and choke to raise the pressure, or raise the pressure first and don't choke on anything that would happen under that pressure. There is a reason the techs send you home with fixed pressure on a titration, even on a vauto.
The "forum" doesn't have a policy on PS, however, 4-cm is a good starting point for most, and consistent with the titration guides. I have personally recommended both higher and lower depending on what we have see. I think I commonly suggest 5-6, but not much higher except under extraordinary circumstances where CA remains low and respiration is affected by COPD or similar restrictive disorder.
As far as EPAP goes, for individuals using a recording oximeter like this, a higher EPAP (PEEP) does recruit lung volume and increase SpO2. This principle applies to both mechanical and non-invasive ventilation. From what I see here, a higher EPAP would be helpful, but I don't see a need for higher pressure support.
07-21-2019, 10:41 AM
(This post was last modified: 07-21-2019, 10:43 AM by MyronH.)
RE: SpO2 drop without any apnea?
(07-21-2019, 10:23 AM)Sleeprider Wrote: The "forum" doesn't have a policy on PS, however, 4-cm is a good starting point for most, and consistent with the titration guides. I have personally recommended both higher and lower depending on what we have see. I think I commonly suggest 5-6, but not much higher except under extraordinary circumstances where CA remains low and respiration is affected by COPD or similar restrictive disorder.
As far as EPAP goes, for individuals using a recording oximeter like this, a higher EPAP (PEEP) does recruit lung volume and increase SpO2. This principle applies to both mechanical and non-invasive ventilation. From what I see here, a higher EPAP would be helpful, but I don't see a need for higher pressure support.
Yeah I don't need higher PS. One time I tried going down to PS3, and that made things worse. But anything higher then PS4 I don't need either.
Here is last night when I woke up with arms/hands slightly numb and warm. Felt a little lack of oxygen and SpO2 was 86% HR100. Confirmed with both the Contec, and another fingertip sensor. The event was 10sec Hyponea, but really 40sec if you look at chart of irregular airflow. My body woke me up and then things returned normal. This has happened numerous times in past especially when laying on my back. Doctor is not concerned and had no recommendations.
[attachment=13728][attachment=13729][attachment=13730]
ResMed AirCurve 10 vAuto
Pressure EPAP min 4.4, IPAP 8.4, IPAP Max 18, PS 4.
RE: SpO2 drop without any apnea?
(07-21-2019, 10:23 AM)Sleeprider Wrote: ajackThe machine saw something that it raised the epap on. It also caused an o2 desaturation. So yes, In this one, I would follow the machines advice, that more epap is needed. Even if the AHI was 0.0. A lab may increase PS as well. The forum sticks to PS 4, I haven't seen many times when a higher PS is suggested.
As I see it. You have a choice of a lower epap and choke to raise the pressure, or raise the pressure first and don't choke on anything that would happen under that pressure. There is a reason the techs send you home with fixed pressure on a titration, even on a vauto.
The "forum" doesn't have a policy on PS, however, 4-cm is a good starting point for most, and consistent with the titration guides. I have personally recommended both higher and lower depending on what we have see. I think I commonly suggest 5-6, but not much higher except under extraordinary circumstances where CA remains low and respiration is affected by COPD or similar restrictive disorder.
As far as EPAP goes, for individuals using a recording oximeter like this, a higher EPAP (PEEP) does recruit lung volume and increase SpO2. This principle applies to both mechanical and non-invasive ventilation. From what I see here, a higher EPAP would be helpful, but I don't see a need for higher pressure support.
I raised my EPAP to 5 and been trying that out. My SpO2 when sleeping is usually still reading 92-94%. Daytime SpO2 is no more than 95%, never above.
This morning at 6:03am, was laying on my back, my Contec alarm was set to 84% SpO2, woke me up. Immediately checked with finger-tip oximeter and same reading. As you can see, I had two OA's, 14sec and 16sec near each other.
Is it normal for a short OA of 16sec to drop SpO2 down into the low 80's?
I can hold my breath during the daytime for 30sec or longer, but don't see such a large drop.
[attachment=14015][attachment=14016]
ResMed AirCurve 10 vAuto
Pressure EPAP min 4.4, IPAP 8.4, IPAP Max 18, PS 4.
08-01-2019, 12:11 PM
(This post was last modified: 08-01-2019, 12:14 PM by ajack.)
RE: SpO2 drop without any apnea?
A spike desat at 6:03 with a recovery breath that you mentioned. Seems normal to me. Single events aren't a big issue. Even without the alarm, your would arouse, shift position and breathe. I don't use my alarm.
If your daytime is o2 is max 95% I would think anything above o2 90% is good, when asleep and would be normal range. Your o2 chart in general looks good, there seems to be no general periods of long desaturation below o2 90%. Just the sleep state 3-3:30 fluctuating, with increased pulse as well. Could be REM? Even then it is not a sustained period under o2 88%. It quickly goes back up to 95%+, to fall again.
If you showed that o2 chart to your doctor. I think he would be happy. You could continue to raise min epap to reduce obstructive events, try 6, then 7. Your tidal volume of 500 and breath rate of 15 falls in normal range and seems fine.
RE: SpO2 drop without any apnea?
Thanks for the explaining. Ever since my second DVT/PE last year, it has caused me to live in fear of another one happening. My hematologist never did another CT scan or VQ Scan of my chest afterwards so we don't know for sure how my lungs look now. They just told me I could have blood vessel changes which is why when I was on a plane my oxygen dropped to the 80s. That still concerns me since I plan another plane trip.
ResMed AirCurve 10 vAuto
Pressure EPAP min 4.4, IPAP 8.4, IPAP Max 18, PS 4.
08-01-2019, 08:49 PM
(This post was last modified: 08-01-2019, 08:50 PM by ajack.)
RE: SpO2 drop without any apnea?
I would be happy enough with your current o2 chart. I would raise my epap more, to see if it helps a few dips. You could also post the contex software chart next time. oscar is a bit hard to see. You could also change the Y-axis on the chart.
Have you had a google? My mum had asbestosis and used a concentrator in flight. It is normal to have some reduced o2 at altitude,(4%) lung issues make it worse.
You could ask your doctor about a portable o2 concentrator? Secondhand or craigs may be an option, depending on insurance.
https://www.webmd.com/heart-disease/news...anger-mark
https://www.europeanlung.org/en/lung-dis...fit-to-fly
08-06-2019, 09:26 AM
(This post was last modified: 08-06-2019, 09:27 AM by MyronH.)
RE: SpO2 drop without any apnea?
(08-01-2019, 08:49 PM)ajack Wrote: I would be happy enough with your current o2 chart. I would raise my epap more, to see if it helps a few dips. You could also post the contex software chart next time. oscar is a bit hard to see. You could also change the Y-axis on the chart.
Have you had a google? My mum had asbestosis and used a concentrator in flight. It is normal to have some reduced o2 at altitude,(4%) lung issues make it worse.
You could ask your doctor about a portable o2 concentrator? Secondhand or craigs may be an option, depending on insurance.
https://www.webmd.com/heart-disease/news...anger-mark
https://www.europeanlung.org/en/lung-dis...fit-to-fly
I'm 47yo, non-smoker. I don't think I'm there yet to lug around an O2 concentrator. I think something else is going on, since I have some O2 and HR drops without apnea events. See chart below. HR dropped to 48bpm, then moments after O2 dropped to 85%. Only lasted about a minute.
On another forum, someone mentioned Thoracic outlet syndrome, (TOS), that can cause wide range of symptoms.
Is it normal for HR to just drop from 60's to 48bpm with no apnea event? I've let my cardiologist/electrophysiologist know about this in the past, but they were not concerned. The big question is, why my O2 dropped to 85%?
[attachment=14204][attachment=14205]
ResMed AirCurve 10 vAuto
Pressure EPAP min 4.4, IPAP 8.4, IPAP Max 18, PS 4.
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