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[Symptoms] First night with O2 meter - low of 78
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mdh235 Offline

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Machine: ResMed S9 Autoset
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Sex: Male
Location: West Coast U.S.

Post: #11
RE: First night with O2 meter - low of 78
I'm amazed you and so many others here can get good readings at all during the night. When I use a cheapo finger non-recording O2 meter I get good readings for as long as I wear it.

When I try using a recording O2 meter - a CMS60D, say - I'm lucky if I can get the device to give me a reading at all, and when it does it's all over the place compared to the cheapo.

It doesn't seem to matter which finger I use. I'll always end up with a "finger out" message within a few minutes. Before that happens, it's not unusual for me to get pulse rate readings of 140 with an O2 level of 50%. Since I'm checking this with the non-recording meter I know the CMS60D readings are crap.

When I've had a "pro" model from the DME for an overnight home study everything works fine and my numbers are ok.

I guess the point of my rant is I wouldn't always trust the readings from these inexpensive Chinese meters. Maybe I've just been unlucky, but if I just went by the readings I was getting from my recorder, I would have put myself into the ER.
10-27-2013 12:36 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

Sex: Male
Location: Akron, Ohio USA

Post: #12
RE: First night with O2 meter - low of 78
I also have a non-recording pulse oximeter, and I believe these numbers to be correct within the scope of the stated accuracy level of +/- 2 points. Sadly, due to my father in-law having passed of COPD, O2 issues, etc is something I am used to dealing with. I do know that some folks have issues with getting accurate readings due to various issues like circulation, and so on - but I am not one of those.

*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."
10-27-2013 01:34 PM
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DocWils Offline

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Machine: Philips Remstar series 60
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CPAP Pressure: 5-15
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Sex: Male
Location: Switzerland

Post: #13
RE: First night with O2 meter - low of 78
Peter,

The odd part is that each severe desat is only for a second or two, and does not trigger an event marking - I am guessing that what you might be seeing there is actually noise, but without seeing it combined in the sleepyhead data to compare it to apnoea events, it is difficult to be 100% sure. If you shift and the device is not secured with tape, you will generate noise (actually, you will anyway, trust me). (hint - take surgical tape, the stretchy kind (we use Leukotape here) and tape the bottom of the device to your finger, and run it up the side, being careful not to make it tight. The fingerling doesn't need it, it holds the finger at the right pressure - you just want to keep if from shifting or coming out and are using the tape as an anchor). Another possibility is that these are isolated breathing events, where you go long pause before the next intake, and that one a shallow one, and this will also show a big desat, usually this is happening when you are shifting between sleep phases. That you are still having long segments at 89% and such is a bit more problematic. Like it or not, if this continues you need to see the doc and have the pressure adjusted.

Your heart rate is all over the place, but since you only provide one page of the strip chart, again it is difficult to get a good read on this.
10-27-2013 01:38 PM
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Peter_C Offline

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Machine: System One DS960HS
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro "MED"
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CPAP Pressure: Auto mode-script is:15/3/3
CPAP Software: EncoreBasic Other Software

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

Sex: Male
Location: Akron, Ohio USA

Post: #14
RE: First night with O2 meter - low of 78
I hear you, and understand about 'noise'. My big concern isn't the actual big drops, it's that from bout 7AM on I am dropping often into the mid to low 80s.

If desired, I can upload or email the entire night's report. My heart isn't the best, at one point I was having weekly heart DR APPTs due to my at rest heartrate at/greater than 122. Which is how we found the OSA, and after a heart cath (#1) that I had self-bypassed an artery, and in my past had had a heart attack of some type. Fast-forward to now, I see my PCP every 6 months, and am on 20mg of Bystolic, and 40mg of Crestor, but no longer need to see the heart Doc unless I have a new issue. I've had multiple stress, multiple caths, and some other tests in the past, and am slowly changing habits, weight, etc..

*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."
10-27-2013 05:12 PM
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DocWils Offline

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Machine: Philips Remstar series 60
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Sex: Male
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Post: #15
RE: First night with O2 meter - low of 78
Peter, your early morning drops could be due to your changing to lighter sleep, or a half waking phase, which can coincide with altered breathing patterns that may lower you blood oxygenation. Have a look at your sleepyhead chart and match it up to the O2 chart - if you see there is a change in the sleep phase (your heart rate will start to rise a bit, you may have clusters of apnoea events as you move up out of the deep sleep phase, due to the alteration of your breathing patterns, especially RRA events). If that is confirmed, then you have the culprit, Otherwise, you may have to do a bit more careful observation. Remember, the data, if you wish to match it to sleepyhead, must be imported to the most recent download of the sleepyhead data - they have to match by date and time, or it won't attach to the right date.

Otherwise, you would have to be hooked up to a recording ECG for 24 hours to see if there is something going on with your heart, but I suspect the problem is more prosaic and related to your sleep patterns and pressure settings. And install sleepyhead, dammit, and do the stuff.
10-27-2013 05:25 PM
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Peter_C Offline

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Machine: System One DS960HS
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro "MED"
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CPAP Software: EncoreBasic Other Software

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

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Location: Akron, Ohio USA

Post: #16
RE: First night with O2 meter - low of 78
I really would if I could! My machine is an archaic one that only uses a proprietary connector and card reader that is no longer made or for sale. Some the only data I can pull is from the LED screen. So until I get on Medicare (July 2014), I am trying to work with what I have. At that point I plan to see my sleep doc, get a new study done, new machine, etc... At this point, unless life-threatening, there are no funds for a new machine or study, etc... As I learned late last week, there are no programs I am available for in the meantime.

My first plan, is simply to control the leaks, by going back to a FFM. At that point, I'll see what my O2 stats are like, and my AHI and AI - then go from there. If you compared the two different nights, you'll see that one (the first) looked much better than the second. To complicate matters I am also in Pain MGNT (long story there), so I suspect my pain meds aren't helping my numbers either...

*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."
10-27-2013 05:52 PM
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DocWils Offline

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Machine: Philips Remstar series 60
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CPAP Pressure: 5-15
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Sex: Male
Location: Switzerland

Post: #17
RE: First night with O2 meter - low of 78
Yeah, well that may well be the best clue - a lot of pain medication can cause shallow breathing and/or an elevated heart rate, which during the day is no biggie, but at night, if you have apnoea, can be a problem.

If that is the case, the real question will be the general quality of sleep and how many arousals you have (from sleep, NOT the other kind, although that is also a good indicator of health).

Leaks would not cause the drops you posted, so I think that can be ruled out.
10-28-2013 06:21 AM
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Peter_C Offline

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Machine: System One DS960HS
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro "MED"
Humidifier: Attached
CPAP Pressure: Auto mode-script is:15/3/3
CPAP Software: EncoreBasic Other Software

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

Sex: Male
Location: Akron, Ohio USA

Post: #18
RE: First night with O2 meter - low of 78
Here is a third night's report. More of the same, about 2hrs out of 7hrs below 88%.

Leak 0.68L/s
AHI 55.9
AI 20.6

The above was using 'nasal pillows'.

I am wondering how the lower O2 levels are affecting how tired I am when I awake? My AHI and AI are usually a lot lower, so am feeling a bit frustrated right now.

I have a new FFM on the way, and will recheck all these numbers after I get the new mask (thinking mouth-breathing perhaps). If that doesn't help then I punt.
[attachment=532]

*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."
10-28-2013 09:20 AM
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Peter_C Offline

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Machine: System One DS960HS
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro "MED"
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CPAP Software: EncoreBasic Other Software

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

Sex: Male
Location: Akron, Ohio USA

Post: #19
RE: First night with O2 meter - low of 78
(10-28-2013 06:21 AM)DocWils Wrote:  If that is the case, the real question will be the general quality of sleep and how many arousals you have (from sleep, NOT the other kind, although that is also a good indicator of health).

Gee? What are those? I don't remember getting either kind during the night <sigh>!!

*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."
10-28-2013 09:47 AM
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DocWils Offline

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Machine: Philips Remstar series 60
Mask Type: Nasal pillows
Mask Make & Model: ResMed P10
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CPAP Pressure: 5-15
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Switzerland

Post: #20
RE: First night with O2 meter - low of 78
Peter, what the heck is happening at 4:30? You have a great reading up until then, your heart rate indicates you have entered into a deep sleep, your O2sats are right on the money, and then you have an arousal, and from that point on, even though you go back into a relatively steady sleep, your O2sats drop. Do you pull of the mask? Do you start mouth breathing? When I look at this chart, those are my first questions - something has happened at that time that changes the entire pattern for pretty much the rest of the night, and I can only assume that it is an outside force, such as mask shifting or mouth breathing or sleeping on you back or something or other. Do your other charts reflect this same pattern? If so, then that is the point to investigate.

At any rate, if you have an AHI of 55 WITH the mask, you punt, because something is really not working right with the CPAP. The whole point is to have an AHI of 5 or less.
10-28-2013 05:02 PM
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