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SP02 During Sleep Study
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me50 Offline

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Post: #11
RE: SP02 During Sleep Study
(10-23-2013 08:50 PM)archangle Wrote:  
(10-23-2013 06:29 PM)me50 Wrote:  My question is this: If I have better SPO2 at lower pressures, why would CPAP therapy at a higher pressure drop my O2 to 85%?

I agree to not panic, but talk to your doctor.

Speculation: Higher pressure may reduce the urge to breathe. Partly this is because of deeper breathing lowering your CO2 level. CO2 in the blood is the main impetus to make you breathe. There are also some neurological effects from stretching out your lung tissues when your lungs get filled more deeply with air.

These are part of the explanations of why some people develop central apnea on higher pressure.

Maybe these effects will lower your O2 saturation without causing central apneas due to you breathing less.

You may also be having central apenas. That probably needs to be fixed.

I agree to not panic too much over the 85%. Talk to your doctor. It may be that 85% is not too much of a problem if there's an explanation for why that happens. It might also correct itself as your body adjusts to CPAP.

You might want to get a recording pulseox and do your own testing at home. Be sure to get one of the recording pulseoxen like the CMS-50D+. (Note the plus). A non-recording pulseox doesn't do much for sleep apnea testing.

I will make it a point to get a script for the pulseox from my doc next Monday. I have been on pap therapy since April 2011 (S9 elite) and began using S9 auto on Sept 10. I would have hoped by now I had adjusted to therapy lol

Thank you all for your comments. I am still nervous about the O2 because I have not felt rested on cpap yet. I did have centrals at pressure 15 so that concerns me a little bit since I just changed my settings from 12 to 20 to 15 to 20 but since I have, according to the reports, been at 19.9% 95% of the night, I won't worry as much. I just wish during the sleep study (the 2nd one) they would have checked me at the higher pressures to see what kind of apneas, if any, I had. AND, even more than that, I wish they would have tried me in the BIPAP like I was promised and therefore, I feel as though the sleep study was a waste of time and money. I could have just rocked along with the 12 to 20 pressure without spending money on a 2nd sleep study. The doc called me today and he was looking at my records from my oct appt. and it was like a light bulb went off in his head that I was not in need of a set pressure since I had an auto pap
10-23-2013 09:02 PM
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me50 Offline

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Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
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Post: #12
RE: SP02 During Sleep Study
You might want to get a recording pulseox and do your own testing at home. Be sure to get one of the recording pulseoxen like the CMS-50D+.

I will read up on this when I get a minute or 2. In the meantime, do you use this all night, every night, while sleeping?
10-23-2013 09:25 PM
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Peter_C Offline

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Post: #13
RE: SP02 During Sleep Study
(10-23-2013 06:19 PM)justMongo Wrote:  
(10-23-2013 01:58 AM)me50 Wrote:  I am concerned because my SP02 was low all during my sleep study and it dropped to 88% at pressure 14; 85% at pressure 15 and 16. It was 92% at 12 and 13. Is this a reason for concern or am I panicking over nothing.

I'm jealous of your O2 stats. Really, you have nothing to be concerned with even at 85%.

Hehe - as am I. I bounce around like that during the day. Prior to getting my machine, I was often entering the smurf zone often when sleeping.

*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
10-24-2013 12:19 PM
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Peter_C Offline

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Machine: System One DS960HS
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Other Comments: Severe obstructive sleep apnea 1999/Just got an ASV machine

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Location: Akron, Ohio USA

Post: #14
RE: SP02 During Sleep Study
Me50? Just a couple of thoughts off the cuff? All I've seen are your posts, so I could be way off base here, and I apologize in advance if I am wrong, but I do wonder at times if you might be better served to just be a 'user' for a while, and let your machine just do it's thing? Sometimes we get so wrapped up in numbers that we start stressing over them, and the goal becomes chasing the numbers instead of a good night's sleep?

I tend to look at it this way, my current numbers are far and away much better than my numbers without the machine, and while my numbers are not perfect, and I would like to get them closer to the ideal, the fact that my life is no longer 'at risk' whenever I go to sleep is a real boon to me.

By all means, be knowledgeable, and work towards great numbers, but do not stress or worry over them, as sometimes hiccups will happen, but simply knowing that you are doing so much better on your machine than before is a real plus. Does this make sense?

*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
10-24-2013 12:26 PM
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me50 Offline

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Post: #15
RE: SP02 During Sleep Study
(10-24-2013 12:26 PM)Peter_C Wrote:  Me50? Just a couple of thoughts off the cuff? All I've seen are your posts, so I could be way off base here, and I apologize in advance if I am wrong, but I do wonder at times if you might be better served to just be a 'user' for a while, and let your machine just do it's thing? Sometimes we get so wrapped up in numbers that we start stressing over them, and the goal becomes chasing the numbers instead of a good night's sleep?

I have been a CPAP user for almost 3 years and I should have been getting good sleep quality by now but have not. Part of the issue was the wrong mask size which I finally got corrected. Still sleep quality was not what it should be so I got an Auto Set which shows that I am at the maximum pressure this machine will go. Doc ordered a new sleep study which shows my O2 at 85% which concerns me. As most of us agree, it is up to us to ask questions and I think that there are 2 issues with my sleep quality: 1 being pressure setting at maximum and perhaps I would benefit from a bipap or another machine type that the pressure goes higher in case it is needed. There is only a small window of opportunity to get the proper machine so I have no choice but to make sure I have the correct machine to give me the correct therapy. O2 pressure can affect everyone differently. Some may do just fine with 85% pressure. With me, my sleep quality is not good and I do NOT feel refreshed in the morning when I wake up. Secondly, if I am not getting enough O2 FOR ME and my body, then that is an issue that needs to be addressed. If I am not feeling better with CPAP therapy after almost 3 years, then I believe I have given it a very good chance and I need to do something to improve my quality of sleep and the quality of my life. Nobody is going to do it for me, especially if I don't tell the doc how it is affecting me. After my 2nd sleep study that I had this month, I felt so lousy that I slept most of Saturday and Sunday.

I tend to look at it this way, my current numbers are far and away much better than my numbers without the machine, and while my numbers are not perfect, and I would like to get them closer to the ideal, the fact that my life is no longer 'at risk' whenever I go to sleep is a real boon to me. I am not stressing over them but I want a doc to listen to me, review the data and do what needs to be done so I can have the best sleep quality and have a life where I can function close to normal....what is normal for me!! Does this make sense?


By all means, be knowledgeable, and work towards great numbers, but do not stress or worry over them, as sometimes hiccups will happen, but simply knowing that you are doing so much better on your machine than before is a real plus. Does this make sense?
10-24-2013 01:27 PM
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Peter_C Offline

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Other Comments: Severe obstructive sleep apnea 1999/Just got an ASV machine

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Post: #16
RE: SP02 During Sleep Study
I do understand what you are saying, and perhaps I am too easily satisfied personally. I've never been a 'morning person', and usually wake up tired and wanting for sleep, regardless of how long I have slept. I *am* much better than I was 10-12yrs ago, and yes, I would like to be better still - which is why I too am here.

*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
10-24-2013 01:55 PM
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DocWils Offline

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Post: #17
RE: SP02 During Sleep Study
I guess the big question is - are you still sleepy during the day, or nodding off at 4 p.m. (assuming you get up around 7 a.m. or so)? If so, it ain't working for you - on the other hand, a lot of people feel dragged out in the morning, no matter how "healthy" their sleep is. These are often factors that a PAP device can't fix, because other factors are involved, ranging from blood sugar to sleep hygiene to thyroid to, well, a whole laundry list of other factors.

If your O2 is still dropping regularly to 85% for more than a second or three while on auto PAP and removing mask leaks and other such factors, there is definitely a problem still that needs to be explored - if you are on fixed pressures, it may be a problem with the pressure adjustment. That said, the odd drop every night is within the norms, and should not be overly stressed about. The big picture needs to be looked at, and the little details are there to pinpoint problems that are making the big picture not so good If your overall AHI per night is good, and your O2 sats only occasionally dropping, then you are in a safe area.

One question is mask fit and type - if you are a mouth breather or on a high pressure, then a full face mask is advisable, but if not, and your are mostly a nose breather, then nasal pillows might be a better solution, because a full face mask will be of little benefit to you if you are a nose breather and your nasal walls collapse when you breath, as so many do. Only air forced directly up the nose can deal with that. And if you do both nose and mouth, but still primarily use your nose, then a hybrid mask like the Mirage Liberty might be for you (although I couldn't get one to fit me - too small a distance between nose and lip). So that is something to consider.
10-24-2013 05:18 PM
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me50 Offline

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Post: #18
RE: SP02 During Sleep Study
(10-24-2013 05:18 PM)DocWils Wrote:  I guess the big question is - are you still sleepy during the day, or nodding off at 4 p.m. (assuming you get up around 7 a.m. or so)? If so, it ain't working for you - on the other hand, a lot of people feel dragged out in the morning, no matter how "healthy" their sleep is. These are often factors that a PAP device can't fix, because other factors are involved, ranging from blood sugar to sleep hygiene to thyroid to, well, a whole laundry list of other factors.

If your O2 is still dropping regularly to 85% for more than a second or three while on auto PAP and removing mask leaks and other such factors, there is definitely a problem still that needs to be explored - if you are on fixed pressures, it may be a problem with the pressure adjustment. That said, the odd drop every night is within the norms, and should not be overly stressed about. The big picture needs to be looked at, and the little details are there to pinpoint problems that are making the big picture not so good If your overall AHI per night is good, and your O2 sats only occasionally dropping, then you are in a safe area.

One question is mask fit and type - if you are a mouth breather or on a high pressure, then a full face mask is advisable, but if not, and your are mostly a nose breather, then nasal pillows might be a better solution, because a full face mask will be of little benefit to you if you are a nose breather and your nasal walls collapse when you breath, as so many do. Only air forced directly up the nose can deal with that. And if you do both nose and mouth, but still primarily use your nose, then a hybrid mask like the Mirage Liberty might be for you (although I couldn't get one to fit me - too small a distance between nose and lip). So that is something to consider.

I use a Quattro fx right now. I am a mouth breather when my nose is stopped up so I opted for a ffm. I am waiting for my Amara gel to arrive. Thanks so much for all your good advice to me. I do appreciate it DocWils. I am hoping that all of this will get worked out with the proper machine and proper mask. I am currently using s9 auto set and am not on a fixed pressure. Most of the time, I am at 20. I think if I get a good mask, the right machine then I hope my sleep gets better. It has been almost 3 years so I am looking forward to it. Yes, my AHI's and leaks are great. I just don't sleep long at a time and wake every 2 hours with the exception of last night and I slept for 5.5 hours but then I could not go back to sleep. I had changed my pressure to 15 to 20 last night. I keep trying and NEVER sleep without my machine.
10-24-2013 05:35 PM
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DocWils Offline

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Post: #19
RE: SP02 During Sleep Study
Well, good luck. Sometimes the magic doesn't work at once, but if there are no other extenuating factors, eventually with tweaking things should work out. If there has been a good examination of your throat and nose, and there is no anatomical problem that is exacerbating the problem, then the correct mask and pressure should be all you need.
10-24-2013 06:09 PM
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Bobshouse Offline

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Post: #20
RE: SP02 During Sleep Study
I have to agree with me. What did I just say?

Seriously, todays medical care sucks. Your not a "Patient" your a person sitting in a little room where the doctor, who is treating 1 person every 15 minutes, will eventually get around to. If you don't research and make an attempt to diagnose yourself, and advise the doctor of "what you think" is going on it could be missed and cause bigger problems down the line.
10-24-2013 06:46 PM
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