OSCAR Data vs Lookee O2 Ring

[Sleeprider]

How does someone get supplemental O2 when their docs have no interest in looking into this or verifying the numbers?   I thought qualifications were rather stringent.  My new sleep doc immediately started commenting how hard it is to get O2 and never looked that much at the supporting info I tried providing. 

Oxygen is not hard to get approved. You clearly exceed the time of desaturation required for coverage.  The problem is you need a new doctor.  Your primary care doc can do this stuff. Why are you using worthless specialists? Change.

[Gideon]

A lot of talk about oxygen levels in this thread.

https://study.com/learn/lesson/blood-oxy...ation.html

Blood Oxygen Level (%) Description
95-100 Normal
91-95 Concerning
90 and below Low
80-85 Brain Affected by Low Level
67 Cyanosis

Medicare says 88% or lower for a cumulative 5 minutes qualifies for supplemental oxygen overnight.

A low value IMHO means to look deeper as a spike is meaningless long-term, but time at levels is significant.

[cmpman1974]

Oxygen is not hard to get approved. You clearly exceed the time of desaturation required for coverage.  The problem is you need a new doctor.  Your primary care doc can do this stuff. Why are you using worthless specialists? Change.

I am going to make one final push with my PCP for help.  I have tried so much with these physicians to get help, but every time PCPs defer to specialists on stuff like this and then specialists literally push you aside so it's a no win loop.  I have not had a single physician genuinely look at the O2 data presented or feel any need to investigate further.  The medical system is so broken.   I tried to get into the best sleep clinic in my state and found out the first appt is in August 2023.  Sad.   

A lot of talk about oxygen levels in this thread.

https://study.com/learn/lesson/blood-oxy...ation.html

Blood Oxygen Level (%) Description
95-100 Normal
91-95 Concerning
90 and below Low
80-85 Brain Affected by Low Level
67 Cyanosis

Medicare says 88% or lower for a cumulative 5 minutes qualifies for supplemental oxygen overnight.

A low value IMHO means to look deeper as a spike is meaningless long-term, but time at levels is significant.

Great info Gideon and consistent with what I have read recently.   Thanks for sharing.

[cmpman1974]

This is quite an interesting publication and explains some stuff relating to ST-A IVAPS issues possibly. If I'm understanding it right, my pressure ranges may be too low on my machine despite the decent AHI results every night. I think the piece that is missing is no one is following up to see if I'm achieving proper Co2/O2 balance even in the AM or at night. it seems like trying an idea was applied, but no investigation taken to see if I achieved the goal. This publication clearly states targets for Tidal Volume for specific health issues. While my tidal volume seems high around 650-700 mL as a median level, this now makes me wonder is it high enough to achieve what I need? According to this publication, my pressure support is inadequate at min 5, max 10. It's saying PS should be 20-25. I don't know if that's tolerable at all though.

https://journals.sagepub.com/doi/10.1177...2316674392

[cmpman1974]

Flow chart how to titrate/deal with OHS..   Looks like idea Tidal Volume is about 540-770 mL based on my height (7-10 mL/kG of Ideal Body Weight).  Seems like these are the figures I hit based on OSCAR.   The missing part is the 90-92% mean O2.

Another clip of info from a study:

Conclusion
Treatment of OHS with AVAPS targeting a VT ≥ 10 mL/kg IBW (larger than traditionally prescribed) is significantly associated with successful treatment of hypoventilation and resolution of hypoxemia. Prospective studies examining the outcome of OHS patients to determine optimal targets for hypoventilation should be of benefit.

This would mean my tidal volume again may be too low as it would mean the target median Tidal Volume was around 800 mL.

[cmpman1974]

I finally got a data cable today from Amazon for the Lookee O2 ring.  This was the magic piece i needed to import data into O2 Insights Pro.  Now the data appeared to be in binary format and importable into OSCAR!   These rings are horrendous due to signal drop over and over again in a given night.  I lost connection four times in 5-6 hrs therefore wasn't even able to capture a full night's data.  The manufacturer claims it is not typical.  Yeah sure that's why endless people post online about the exact same problem.  It did not happen when I had the Lookee wrist watch and silicone finger ring before. It just was an issue with the Lookee O2 ring.

It is only a 4-5 hr window where I could blend the SPO2 and PR data with the flow rate and other stuff.  From what I see, there is zero correlation between a SPO2 drop and apnea/hypopnea episode.  Unless I'm reading this wrong, Lookee's data seems highly suspect.   However if it is possible to have these O2 drops without a marked desaturation event for other reasons, then I could be the one who is wrong.   Also, no significant changes/increases in my pulse rate regardless of where my O2 goes. That seems suspect again.

I'm going to try to wear this ring one last night and then it's going back for a refund.  I'll look for a better option.  If not reliable, no reason to keep it.  Last night, I wore it on a better finger so it should be more accurate.  Lookee is not stating any unusual amount of movement either that could account for these big swings.   Based on previous polysomnogram findings, I certainly have reason to believe there are O2 issues though.  It is more important than ever to know the info is accurate to assess whether the ST-A machine is making a difference for me. It seems to be extremely difficult to get to the bottom of this.  The ring loses connection more than four times a night makes it absolutely useless when only able to store the four most recent sessions regardless of cumulative time recorded. It really is unexplainable.

https://www.thehealthyjournal.com/freque...e-sleeping

[Dormeo]

Please do talk to your PCP and get night-time O2. These results continue to be concerning. I'm baffled by the inanition of your specialist doctors.

[Jay51]

I am sorry to hear that your sleep specialist dropped you and you are scrambling like you are at the moment.  That may have been one of the best things that could have happened to you though.  

I recently purchased an approximately $400+ oxygen concentrator on ebay for $150.  I asked the RT at my DME to give me some brand names of oxygen concentrators she likes.  If you shop and can wait long enough, the deals are there.  I read an article about beta blockers and heart attack risk in hot weather.  To summarize it, the study found a 66% increase in heart attack risk in hot weather when taking a beta blocker (a word of caution to those on a beta blocker).  Surprised me it was that high.  Heart attack risk can increase with cold weather and a beta blocker also.  The mechanism is that the beta blocker inhibits the hearts ability to circulate blood around the body quickly to either cool or heat the body in extreme temperatures.  I plan to limit my time and exertion in both the heat and cold now.  I want to take a few 3, 4, or 5 minutes shots of 1 liter of 90% o2 to see if that gives me a boost.  It should act as a safety measure also (for beta blocker + hot or cold weather).  I don't need it at night.  

By all means exhaust every opportunity you have to get supplemental oxygen covered by your insurance before you even think about this option of paying out of pocket.   You will probably need an unlimited supply long term.

[cmpman1974]

I looked at my OSCAR report from last night.  I just don't understand it at all.  It shows an AHI of 0.11.  I am dead tired, headache and can barely think straight.   I took three snapshots of detail.  How are some of these not apneas, hypopneas, etc.  My flow rate stayed in the low 20s for 1+ minutes on the third chart.  Is this normal?

Don't have the Lookee ring data because the stupid thing dropped out 4 times in 2 hrs and lost all the earlier data for the night. Useless. It's back in the mail to be returned. I'm done with that particular product. On to a better one hopefully.

[cmpman1974]

This whole paper makes me wonder why a sleep doc chooses IVAPS over my VAuto for this suspected condition.  Nothing sounds encouraging based on this.