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Should I be alarmed that oxygen drops very low while sleeping?
#11
RE: Should I be alarmed that oxygen drops very low while sleeping?
(11-28-2013, 06:45 PM)zonk Wrote:
(11-28-2013, 06:33 PM)Airstream Wrote: Today, Zonk, I hereby make you an honorary American. Smile
Thanks. Great honor bestowed on me
[Image: 220px-ChurchillsUSPassport.png]
Where the heck did you find that Zonk? (lol)

To err is human, but to really mess things up, you need a computer.
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#12
RE: Should I be alarmed that oxygen drops very low while sleeping?
(11-28-2013, 03:33 PM)Emilo Wrote: Hi everyone,

I'm new here and would really love some help. I've been using a CPAP for over a year and still have a terrible time with it (waking up constantly from a FF mask moving, waking up with my nose stuffy and not breathing well while wearing the nasal mask). I am housebound and lost my job due to sudden ill health and would do anything to feel better. Every morning I feel as if I smoked a pack of cigarettes (tight chest, sore throat, headache) and got beat up by big men with baseball bats. My brain doesn't work like it used to.

I bought an Oximeter (CMS50D+) and wore it for the first time last night. I had three episodes where my oxygen plummeted (60s and 50s - 57% was the lowest) and my heart rate jumped up (the highest was 120 from a norm of 55bpm). These episodes lasted minutes, not seconds. Two of them happened while wearing my mask and the last one happened after I had taken it off and gone back to sleep.

My husband was really alarmed by the 57% oxygen drop after he read 55% is unconsciousness. Has anyone else had this happen? Are three big drops in oxygen not that many compared to other people? Could this be contributing to why I feel so horrific? Should I go see my sleep doctor? I've only seen him twice and he never seems to think anything is a big deal.

Thank you so much for your help!! (And happy Thanksgiving to you American users Smile)

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#13
RE: Should I be alarmed that oxygen drops very low while sleeping?
I think a pulmologist is only warranted if the O2 is dipping that low while awake. Or if the waking O2 is lower than norm.

What is probably happening is you, Emilio, are having either really long events or a cluster of events based on position.

Your profile says you have an auto but you have it set to a single pressure of 7. Why aren't you using it in the autoPAP mode?

One suggestion is to download SleepyHead and view your data. You can download it from this site.
http://www.apneaboard.com/forums/Thread-...e-software

Viewing the machine's data would tell you what is going on at the same time as the O2 drops.

In the meantime, it is time to see your sleep doc. It is not uncommon for us to need our pressure adjusted after the first few months or year.
PaulaO

Take a deep breath and count to zen.




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#14
RE: Should I be alarmed that oxygen drops very low while sleeping?
(11-28-2013, 07:05 PM)Airstream Wrote: I 3rd the vote for seeing a pulmonologist.

Before you take the time and expense to see a pulmonologist, you should explore the avenues I suggested - check with your sleep doctor on how your mask is or isn't fitting, the pressure settings, etc and see if your oxymeter is actually producing noise rather than hard data - if you don't tape it (described elsewhere in the forum) correctly, it will shift and produce noise and data drops. I agree that tying it to sleepyhead would be a very good idea, since then you can correlate the O2 drops to SA events, and thereby eliminate the noise issue.

I am intrigued by why you have a fixed pressure on an auto device, and for that matter why such a low fixed pressure, and I suspect that the real problem lies there and in mask fittings. Unless you are seeing massive drops in O2sats during the day, I don't think a lung-thumper is the first type of doctor for you to see. You really should go back to your prescribing doctor first and present the problem to him.

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#15
RE: Should I be alarmed that oxygen drops very low while sleeping?
(11-28-2013, 05:34 PM)zonk Wrote: Was the O2 drop while using nasal mask or full face mask? Full face mask allows you to breathe through nose or mouth so if nose get stuffy, you can still breathe breathe through the mouth and get some treatment

If you find nasal mask is more comfortable, add a chinstrap, chinstrap helps minimize mouth leaks but leaks in general whether mouth or mask leak reduces the effectiveness of the therapy. Washing the mask every day to remove facial oil and washing face before bed improve mask seal

Whats AHI breakdown (obstructive, clear airway evnts), leak shown on SleepyHead

If most of apnea events are central, pressure increase would not helps but might helps in case of obstructive events.

Your machine is PRS1 Auto and set on fixed mode at 7, at this setting the machine deliver 7 all night long (except Ramp time). On the other hand if set on auto mode with a range (minimum and maximum), the machine adjust pressure (between setting range) breath by breath as needed during the night

Nasal stuffiness can be related to humidity setting, turn down if on the higher end or turn up if on lower end and toss a coin if in the middle

At times, I wake up with a stuffy nose in the early hours of the morning, usually get up and prepare Saline sinus rinse (squeezey bottle) and drink cup of tea while browsing the forum for a while and go back to bed as soon as my nose cleared up somewhat

Thanksgiving to you all from non-American but feel like one, after been hanging around here for 3 years and counting Coffee

Zonk, I was wearing the Wisp nasal mask with tape over my mouth (chinstrap did nothing but make me more uncomfortable and air still went out my mouth). I had a lot of luck with tape and nasal pillows/nasal mask because I can sleep so much better than with the FF mask. In the past few months, I've been waking with one nostril plugged and I take my mask off and continue to sleep without it. Honestly, it may sound stupid, but I always assumed I would wake if I couldn't breathe well, not have huge dips in oxygen and HR spikes but NOT WAKE UP!

Regarding Sleepyhead, I just uploaded all my data for the first time ~ over a year ~ and I'm not sure how to read the information. This is what it said last night while wearing a FULL FACE mask:
Date Sleep Wake Hours
11/28/2013 22:13 05:26 07:13:13
AHIApnea / Hypopnea Index 4.85
HypopneaHypopnea 2.22
ObstructiveObstructive Apnea 2.22
Clear AirwayClear Airway Apnea 0.42
RERAResp. Effort Related Arousal 1.11
VSnore2Vibratory Snore #2 0.00
PB/CSRPeriodic Breathing 0.45%

I just looked and it seems my machine is fixed at 5.5 (not the 7 I thought) ~ should this be increased? Should this be auto? Mu humidity is at 3, but the air feels dry. However, when I wake up with stuffy sinuses, there is usually "dew" on my nose, as if the water collected on the tip of my nose because it couldn't get through the stuffiness. I don't know! Thank you again for your help, any help reading this info is appreciated!
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#16
RE: Should I be alarmed that oxygen drops very low while sleeping?
(11-28-2013, 04:45 PM)DocWils Wrote: It would help if you published the charts here, as it would be easier to see what is going on - your description does not give enough information to tell if you are seeing noise or something real, but from all your descriptions of your troubles with your mask, et al, my first thought is to say you need to have a look at what is happening with your mask and CPAP, together with professional guidance, and address the sO2sats in relation to that. Nonetheless, post your current charts here, so if it IS noise, it can be eliminated from the other concerns.

Thanks, DocWils! The oximeter software is so rudimentary that I couldn't figure out how to save the file to post here ~ any ideas?
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#17
RE: Should I be alarmed that oxygen drops very low while sleeping?
(11-28-2013, 06:34 PM)mdh235 Wrote:
(11-28-2013, 03:33 PM)Emilo Wrote: Hi everyone,

I'm new here and would really love some help. I've been using a CPAP for over a year and still have a terrible time with it (waking up constantly from a FF mask moving, waking up with my nose stuffy and not breathing well while wearing the nasal mask). I am housebound and lost my job due to sudden ill health and would do anything to feel better. Every morning I feel as if I smoked a pack of cigarettes (tight chest, sore throat, headache) and got beat up by big men with baseball bats. My brain doesn't work like it used to.

I bought an Oximeter (CMS50D+) and wore it for the first time last night. I had three episodes where my oxygen plummeted (60s and 50s - 57% was the lowest) and my heart rate jumped up (the highest was 120 from a norm of 55bpm). These episodes lasted minutes, not seconds. Two of them happened while wearing my mask and the last one happened after I had taken it off and gone back to sleep.

My husband was really alarmed by the 57% oxygen drop after he read 55% is unconsciousness. Has anyone else had this happen? Are three big drops in oxygen not that many compared to other people? Could this be contributing to why I feel so horrific? Should I go see my sleep doctor? I've only seen him twice and he never seems to think anything is a big deal.

Thank you so much for your help!! (And happy Thanksgiving to you American users Smile)

I second the idea of seeing a pulmonologist. Your first appointment will probably be a lung function test. You may also be referred for a chest X-ray, an echo cardiogram, then a home O2 test with a pro-grade oximiter from the DME.

After all that, your pulmonologist will discuss your results and options with you. It could just be that the CMS5D is giving you bad readings. Both of the consumer grade O2 recorders I've tired did that with me, with large swings in BP and O2 similar to yours, but the pro grade one from the DME showed things were ok.

Since you're feeling badly you do need to start off by seeing a doc. It may not be as bad as you think.

Thanks for the reply. Honestly, I don't think it is a bad reading. Based on how I feel, it makes sense. And the times that I dipped very low make sense in terms of when I woke up. Also, last night, with the full face mask, I didn't go below 90%. Mind you, I was up most of the night because I think I had some paranoia about the oxygen dip. I can't win with this apnea! The mask keeps me awake, the apnea keeps me awake, the paranoia keeps me awake! Sad
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#18
RE: Should I be alarmed that oxygen drops very low while sleeping?
(11-28-2013, 08:24 PM)PaulaO2 Wrote: I think a pulmologist is only warranted if the O2 is dipping that low while awake. Or if the waking O2 is lower than norm.

What is probably happening is you, Emilio, are having either really long events or a cluster of events based on position.

Your profile says you have an auto but you have it set to a single pressure of 7. Why aren't you using it in the autoPAP mode?
Viewing the machine's data would tell you what is going on at the same time as the O2 drops.

In the meantime, it is time to see your sleep doc. It is not uncommon for us to need our pressure adjusted after the first few months or year.

Thanks, Paula! I think my machine is set to 5.5 fixed ~ should I adjust it myself before I see the sleep doc? I put all my date on Sleepyhead, I'm just not sure how to interpret what is happening to me from the graphs. Anything in particular I should look for. Any time I've seen a sleep doc, the only thing they say is "Your AHI isn't bad" and nothing else gets done. Sad
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#19
RE: Should I be alarmed that oxygen drops very low while sleeping?
Emilo

What pressure was decided during your sleep study?
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#20
RE: Should I be alarmed that oxygen drops very low while sleeping?
(11-29-2013, 07:12 AM)DocWils Wrote:
(11-28-2013, 07:05 PM)Airstream Wrote: I 3rd the vote for seeing a pulmonologist.

Before you take the time and expense to see a pulmonologist, you should explore the avenues I suggested - check with your sleep doctor on how your mask is or isn't fitting, the pressure settings, etc and see if your oxymeter is actually producing noise rather than hard data - if you don't tape it (described elsewhere in the forum) correctly, it will shift and produce noise and data drops. I agree that tying it to sleepyhead would be a very good idea, since then you can correlate the O2 drops to SA events, and thereby eliminate the noise issue.

I am intrigued by why you have a fixed pressure on an auto device, and for that matter why such a low fixed pressure, and I suspect that the real problem lies there and in mask fittings. Unless you are seeing massive drops in O2sats during the day, I don't think a lung-thumper is the first type of doctor for you to see. You really should go back to your prescribing doctor first and present the problem to him.

The first major drop in oxygen corresponds on Sleepyhead with a spike in insp. and exp. volume, the second drop corresponds with a huge spike in tidal volume and minute vent. and AHI, as well as being the same time I took my mask off... so I assume it's not noise?
(11-29-2013, 03:15 PM)me50 Wrote: Emilo

What pressure was decided during your sleep study?

I don't know! They didn't tell me anything ~ I thought they said 7, but not sure. I hate doctors. Sad
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