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[Symptoms] New. No CPAP yet. Oximeter results inside.
#1
Hello everyone. Just found this board today.

A little background:

I snore. (My wife sleeps in another room)
I sometimes wake up gasping for air.
Two nights ago I woke up panting very hard, and my heart racing. But wasn't dreaming. Took a while to catch my breath, like I'd just finished a sprint.

I'm still tired after sleeping. Except on the weekends if I can get 10 hours then it's not too bad.

The worst symptoms started probably 5 years ago, maybe a little more. (54 now)

A couple of years ago I lost 20 lbs and it was better. (190 down to 170)
Have gained 10 lbs of that back. But still about the same waist size (34"). 180 at 6' height is not exactly obese... 170 was too slim. So getting skinnier is probably not a reasonable option for me to alleviate my symptoms.

Testosterone therapy has helped a lot with mood and energy, started about 2 years ago. But still a lot more tired than I should be.

The past year my heart rate has been climbing up. Blood pressure is good (magnesium supplements helped me a lot there). Resting rate of 80's is usual, sometimes low 90's.

Got an oximeter yesterday. OMS 50D+. Wore it last night. My o2's were mainly in the 90's, but were up and down a lot. My heart rate was up and down a lot too, often in the 100's.

Last night was a pretty good night, one of my better ones, as far as how I feel this morning. I'm curious how a bad night would look.

I have a pair of dental retainers left from braces 24 years ago. I still wear them at night. My top teeth shift after a few weeks if I don't. I have found in the past couple of months, if I leave the bottom retainer out, and use the top retainer, it pushes my lower jaw forward which seems to help a lot (but not completely). If I forget the top retainer, my sleep quality is much worse.

I've resisted getting a sleep study. Probably mainly because I have been resistant to needing to wear a CPAP. But I know it did wonders for a co-worker who was so bad off he would nearly nod off in the middle of a conversation with you.

I'm tired of being tired. And the elevated heart rate has me concerned. So I think I'm about to overcome my resistance... Smile



Here's my oximeter chart from last night.

I'm curious how it would look if I slept badly (i.e. without my top retainer) but not curious enough to take on the fatigue the next day. Especially at the moment, because I'm in the last few days of studying for a tough certification exam in one week, and need to be on my game as best I can.

I've tried holding my breath as long as I can, to see how low I can get my o2%, but can't hold it past 95%, which makes me think that the low 90's are low "for me".

Just had some blood work done and my red blood cell counts were high compared to 6 months ago, so there is probably some compensation going on there.



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#2
Oh one more thing. (wasn't there enough in the first post...) Smile

I tried a chin strap a few days ago. That was worse. The way my teeth align, the more pressure there is on closing my mouth, the further back my lower jaw is pressed, which just closed the airway even more.

I need the lower teeth to match the top teeth (the front teeth that is), or even better is if the lower teeth go in front of the top teeth, but I can't hold that position during sleep. With the lowers behind, the lower jaw just gets wedged further back the more I close. Having two top teeth removed back during the braces days, wearing headgear, and shifting the top teeth back to close the gap for the removed teeth probably contributes to that effect.

Might try a moldable appliance sometime, but then I wouldn't be able to wear the upper dental retainer and my teeth will shift out of position. Maybe an appliance can be a backup device though, if it works.


And sleeping on my side helps, but doesn't solve the problem. Putting pillows beside me to help encourage me to stay on my side helps but doesn't eliminate the problem. I still end up on my back. Sometimes I've found I've ended up laying on my stomach too the past few weeks, which is new for me.



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#3
Hi worn_out_in_lebanon, and welcome to the forum!

From viewing your O2 and BP graph, I don't think there is any doubt that you can benefit from cpap therapy.

That said, I can also tell you that I use a dental device called SnoreRX (mandibular displacement device) for times when my nose needs a rest from the mask. It works medium well but I can't use it over a week or so without it causing me to feel like my teeth are being moved too much.

For reference I'll show you my O2 and BP graphs before and after I started cpap therapy. It was very reassuring for me to see that the cpap was indeed limiting my wide excursions of O2 saturation and heart beat rate. As you can see, mine isn't great since it shows that I wake up a few times but it's so much better than the before version that I am sure it will get even better as I keep using the cpap. I've only been at it approx. 6 months and things are still evolving and generally improving.

[Image: a450yo.jpg]

[Image: 2u93imp.jpg]

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#4
here is mine, early in therapy, WITHOUT CPAP:

you will notice that the heart rate does not have to go up when you are having apneas.

And the characteristic of SAW TOOTH is indicative of halts in the flow of oxygen (apnea or hypopnea). I had 14 events in 20 minutes, for an AHI of 42 for that period.

[Image: 1KReSEU.png]

Your chart definitely has some saw tooth to it, but doesn't look quite as bad as mine. Widen the window a bit, and count the teeth in a 20 minute swath.

And, go and get the sleep study and diagnosis.

While you are waiting for this, do some more checks on SpO2 sleeping only on your side, left is usually better, but both are better than the back. Sleeping on my sides gave me better attention span for next day.
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#5
From a cursory look at your readings, you do not have anything that qualifies as severe apnoea. At no time does your sO2sat plunge below 88% although it certainly comes close on a few occasions. however, looking at your chart a bit more closely I see a great deal of noise that muddies the data considerably, for instance you have several sustained peaks of 100% oxygenation, which I hold as highly unlikely, even when awake. Each of the dips to below 90% immediately follow a high oxygenation incident. This to me seems to be noise from the device not being correctly secured on the finger. From this chart I would say something else is going on here, as there is no clear evidence of apnoea, however, only a proper sleep test, home or in clinic, will give a clear enough picture in that regard, so , no, CPAP will not be of benefit based on the one read out you have published. Your high sO2sats are accompanied by high heart rates (if you are sleeping with this heart rate, something is definitely wrong), plunges in sO2satas happen as the heart rate slows from a high, which is to be expected, but there is simply too much noise in this printout to be certain. I would advise correctly securing the fingerling (use some surgical tape, or even masking tape, on the sides of the fingerling to keep it from shifting as you move about, make sure the fingerling is not too tight and the sensor is correctly placed over the middle of the fingernail, closer to the bulb than the root, and try the middle or third finger of the left hand, perhaps), take a few night's readings, and bring the short and extended reports to your doctor. Given that you are on testosterone, this may be part of the problem. In addition, I would examine other possible causes. Rule of thumb for obstructive apnoea - your neck must be 40 cm around or more. Below that, the possibility of severe obstructive apnoea decreases, unless there are other physical causes. However, at no point in the read out you posted, did you show a desat to the point of apnoea, and again, your high hear rates preceded your mild desats, which is backwards of apnoea events. I would take the high heart rate seriously and seek advice as soon as possible from your doctor. Not all snoring means apnoea, but such high resting heart rates indicates some other problem. Good luck.
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#6
Hi worn_out_in_lebanon,
WELCOME! to the forum.!
Hang in there for more responses to your post and much success to you.
trish6hundred
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#7
This segment in the 3 hour range may be more informative than 10 hours squished into one chart.
Again, this was a relatively good night, based on how I felt this morning when I got up.
Thanks again for all the input to this point.





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#8
yeah those are some wild spikes! you had almost the same score as I did, 14 in 20 minutes, but yours don't seem to have been as long. In addition, your desaturations compared to the heart rate increases are easier to see. And your desat's are faster than mine, but just barely stay over 88%. if I were a betting man, I'd say you are in need of some medical help, and that sleep test will confirm moderate sleep apnea. good work on the data posting so far.
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#9
I'm sorry, from this there is not enough to indicate clinical levels of apnoea, although it certainly indicates something is up, an a proper study will tell what is really happening here.
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#10
Worn_out_in_Lebanon,
I see you're using version 1.5 of SpO2 Assistant. The newest version that I'm aware of is version 2.7. If you can get a copy of it, see if your data is the same. Version 2.7 allows you to change the display limits of each parameter. This will allow you to constrain the upper and lower limits closer to the extreme values in your data. It also has several reports besides the strip chart. Check out the Oximetry report.
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