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SpO2 drop without any apnea?
#1
SpO2 drop without any apnea?
I had an SpO2 drop last night that woke me up with my heart racing a little bit. I had no apneas during this time, just some minor flow rate fluctuation. Since the Contec sensor doesnt update fast enough i took out my fingertip oximeter and it showed same SpO2 with over 100bpm+. Also I'm wearing a heart monitor prescribed by my cardiologist, so I pushed the button to record whatever happened at that time.

How can SpO2 drop with no apnea nor real issue with breathing?



   
ResMed AirCurve 10 vAuto
Pressure EPAP min 4.4, IPAP 8.4, IPAP Max 18, PS 4.

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#2
RE: SpO2 drop without any apnea?
According to some people, you SPO2 drop is not for up to 5 minutes straight so possibly it can just be an artifact with the contec oximeter. Your SPO2 drop lasted less than 30 seconds. I'm not too sure about the heart racing part though as I am not a doctor.
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#3
RE: SpO2 drop without any apnea?
MY SP02 drops usually with some type of an event.  Sometimes I do not see an event close and I get drops lower than yours.  I do see that you had a min of 3 for your SP02.  You may have lost connectivity.    Your ODI looks low as well.  My ODI runs from 15-20 on average.  I am not sure if the Contec is giving me good results or my SP02 levels are that bad.
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#4
RE: SpO2 drop without any apnea?
There is a time lag from the oxygen deficit, to when it reaches your finger. The machine saw an event and afterwards, raised the epap.
If it was my chart, I'd raise the epap. I might have mentioned that o2 is on epap or APAP min pressure.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#5
RE: SpO2 drop without any apnea?
(06-04-2019, 08:09 AM)ajack Wrote: There is a time lag from the oxygen deficit, to when it reaches your finger. The machine saw an event and afterwards, raised the epap.
If it was my chart, I'd raise the epap. I might have mentioned that o2 is on epap or APAP min pressure.

You would raise EPAP even with Obstructive apneas at 0 per hour? Doesn't this mean EPAP pressure is optimal if it is keeping the airway open to register 0 apneas?
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#6
RE: SpO2 drop without any apnea?
(06-04-2019, 11:16 AM)Michaely6 Wrote:
(06-04-2019, 08:09 AM)ajack Wrote: There is a time lag from the oxygen deficit, to when it reaches your finger. The machine saw an event and afterwards, raised the epap.
If it was my chart, I'd raise the epap. I might have mentioned that o2 is on epap or APAP min pressure.

You would raise EPAP even with Obstructive apneas at 0 per hour? Doesn't this mean EPAP pressure is optimal if it is keeping the airway open to register 0 apneas?

If the ventilation data appears to be normal, which it does, then yes EPAP is a valid tool to address oxygen desaturation. You would only raise EPAP just enough to keep the desaturations from occurring. If desaturation is due to hypoventilation, you would see it in the ventilation statistics, and for that you would raise IPAP to increase the tidal volume.

But first you have to make sure the oxygen desaturation is real and not just an artifact or loss of contact due to the probe slipping on the finger, or changing sleeping positions, etc,. I would post a chart of the SpO2 assistant software for an entire night, and we can see whether there are artifacts during the desats or not.
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#7
RE: SpO2 drop without any apnea?
Your heart was racing (should be not much higher than 65-ish in most people sleeping, except maybe when dreaming), and your equipment says you were desatted.  You have a cardiologist on board who is also keen to monitor you.  Would that be because you have a heart condition, ongoing or newly developing?  How about AFib or tachycardia?  Those cause elevated heartbeat indications, but the former will leave you somewhat lower in saturation because of inefficiency.  They also can arouse you with anxiety which, itself, will produce epinephrine and get the heart racing...pounding even, although the AFib would probably mask it.

We haven't discussed hypopnea, or you don't give any indication that they factor in any way.  They might, maybe just not showing up for some reason.
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#8
RE: SpO2 drop without any apnea?
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.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#9
Increased CA's
(06-04-2019, 08:09 AM)ajack Wrote: There is a time lag from the oxygen deficit, to when it reaches your finger. The machine saw an event and afterwards, raised the epap.
If it was my chart, I'd raise the epap. I might have mentioned that o2 is on epap or APAP min pressure.

I have not raised EPAP yet, since recently I've been noticing more CA's. Last couple of nights had 7 CA's. If you look at them, they are caused by me taking a deep breath right before them. I always notice this deep breath on my charts and this occurs every 20-30min or so. I don't know why I take a deep breath like this all night long.

I had my Echocardiogram Stress Test last week, and all was normal. They got my HR up to right above my maximum 176bpm, and they used an oximeter which always showed 95-98%.

But when my heart rate is lower at resting and during the night, my oximeters show 93-94% usually. Sometimes lower. I went out and bought another oximeter and that reads one percentage higher, so they are not far off.

Not sure why after a long time on BILEVEL, I'm now noticing more CA's.
   


   
ResMed AirCurve 10 vAuto
Pressure EPAP min 4.4, IPAP 8.4, IPAP Max 18, PS 4.

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#10
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.

Yeah I believe I need to raise EPAP to at least 5 or 6. Early in the morning, I rolled on my back around 6am. Woke up 7am with feeling of lack of oxygen, and my arms/hands felt slightly numb. When I checked my SpO2 it was 86% and heart rate over 100bpm. The machine only recorded a 10sec Hyponea , but looking at the flow rate suggests that I had about 40sec event, with random breaths in-between, so those weren't marked as apneas. Tidal Volume flucuated down to 170 or so and back to 500 up and down repeatedly.
ResMed AirCurve 10 vAuto
Pressure EPAP min 4.4, IPAP 8.4, IPAP Max 18, PS 4.

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