[Treatment] May be Too Late for Me Too

[Tubaman]

Thank you Dude2 and Sleeprider!
Yes, all the pressure graphs are displayed normally (as well as all the other graphs).

I tried reloading it first from the SH backup file on my hard drive and then by using my backup USB jump drive (which I copy all the memory chip's data to daily). I got 4 blank spaces after doing the SH reload and 3 blank spaces after the USB jump drive reload. I tried the jump drive 2ce and still got 3 spaces, however the one group of 2 spaces shifted to the left one space.

Oh well, we'll see what happens tomorrow. No biggie.

By the way Dude2, I had a good laugh when I first saw your picture of a tight budget variable pressure PAP apparatus. Kind of felt good to laugh, I don't seem to do that much anymore.
Carl

[Tubaman]

I've been reading some of the postings by other CPAP users. Apparently some people seem to take a long time before seeing results from CPAP therapy. Looks like I may be one of them. However, occasionally I get decent AHI (in the mid 1s to mid 2s) but what I get has no correlation with my SpO2% oximeter results. I can get a good AHI (1.5 for instance) not so good and erratic SpO2% (89% - 90% average with some dips down to the low 80% to mid 70%).

I get no help from my Sleep (ENT) doctor other than his sleep therapy technician who has been somewhat helpful in giving me advice but no diagnoses nor prescription (I've seen neither of them yet and I've requested them several times). As a result I've been trying to tweak my machine to improve my SpO2% results (I want my SpO2% results to get better, I don't care about my AHI since it doesn't correlate very well with changes in my SpO2% levels).

I realize that my SpO2% levels are considered marginal and should not concern me (much) at this time even though I'm on 2L oxygen support. I am concerned that my SpO2% values seem to be on a slow slide lower as time goes on and I don't know what to do at this point. In fact, the last 2 or 3 oximetry reports are beginning to look much like reports I generated back in November 2014.

I guess I could try raising my oxygen flow rate from its current 2L to maybe 2.5L for starters and leave everything else the same.

If any of you folks have other ideas, recommendations, etc., please help me. I'm getting kind of disappointed and disillusioned with everything because nothing seems to work for very long. I make a change and things get better for a while and then they start deteriorating. Please let me know if I should post any more SleepyHead or oximetry charts and I will try to do that.

Thank you for all your help. I would not have had any idea what to do if not for this forum
Tubaman (Carl)

[Tubaman]

    Last night when I went to bed I put my mask on with the 3Lpm oxygen running. I forgot to turn on my auto CPAP machine (I didn't notice -- too tired). When I got up for my 1st sandbox run, I noticed the CPAP machine was not running so I started it. That was slightly after 0430. From then on everything went normally -- or so I thought. When I awoke / got up for the day, I immediately grabbed the memory chip and looked at the new sleep data (SleepyHead). It was the worst it has been since July (before I started oxygen assist). AHI = 5.56.

I then looked at my %SpO2 data and was kind of surprised. My best %SpO2 I've had (when sleeping) before I started the CPAP machine (see chart). After I started the CPAP machine, my %SpO2 level gradually went back to the level I've been getting lately. Please note: My %SpO2 level always jumps when I awaken for a bathroom trip and then goes back to a lower level once I fall asleep. I don't know if that happens for everybody since I haven't looked at anybody else's chart.

I'm uncertain what to think of this experience...? I did not post the SH charts but I will (if anybody wants to see them) when I get a chance later today.

I see the pulmonologist tomorrow afternoon. I still have not received any of my sleep and pulmonology test data. Monday the clinic records person told me it was "in the mail" (it's now Thursday and the mail doesn't arrive until 1400 - 1500, sometimes later).

Thank you for your help and patience.
Tubaman

[Sleeprider]

I'm sure when you run the CPAP any oxygen added to the circuit is highly diluted and rapidly exhausted from the mask vent. Without the flow from the CPAP it would have been much more concentrated in the mask, and probably enough so that rebreathing was not an issue. Interesting stuff for sure.

[rkl122]

........Please note: My %SpO2 level always jumps when I awaken for a bathroom trip and then goes back to a lower level once I fall asleep. I don't know if that happens for everybody since I haven't looked at anybody else's chart.....

Hi Tubaman. FWIW, my sleep doc told me just two days ago that it's normal for SpO2 to drop 2-3% when sleeping. I notice the same thing as you, and my range is similar, but the doc swears that (at our age) SpO2 > 90% is ok. I pointed out that the sleep study he himself ordered reported "mild hypoxia", but he maintained additional treatment is unnecessary.

Hang in for responses to your other concerns. Hopefully the doc will prove helpful too.

-Ron

[Tubaman]

Question:
Since my auto CPAP AHI levels continue to be erratic, but usually below 5 (not always) and my average %SpO2 levels are usually just barely acceptable in the 90.5% to 91.5% range (with APAP running), I wonder why I can't just use the 3L oxygen through my face mask without the auto CPAP running?

I accidentally (unintentionally) did this for a few hours one night (I started the oxygen generator but forgot to start the CPAP machine). My sleep %SpO2 level stayed in the 96% - 97% range for the 2 or 3 hours I slept before I realized the CPAP machine was turned off. After I turned the CPAP machine on my %SpO2 levels quickly fell back to their usual 91% and stayed there. Whether the higher %SpO2 levels would have continued for the remaining sleep time, I don't know but I'm now curious to find out.

Can anybody tell me what health problems arise with the %SpO2 levels high and allowing the apnea events to occur as they will (no CPAP)? In my case, my low %SpO2 levels were one of the main reasons I was placed on auto CPAP with oxygen assist. It appears the CPAP is actually bringing my %SpO2 levels down from where they could be. Please note: My CPAP + oxygen assist levels are consistently somewhat better than before I started CPAP therapy but still occasionally dive into the low 80% area with 5 to 10 minutes below 88%. I had one at 48 minutes below 88% with a 2.87 AHI and 3 Lpm oxygen the same night (Sept. 19).

FYI: I saw the Pulmonologist Sept. 16 and had two CT scans (lying on my back and on my stomach) Sept. 21. I also had an echocardiogram done Sept. 21. I don't know the results yet. So far, nothing has turned up (I finally obtained my other test results, sleep tests, pulmonary tests, %SpO2 levels). Other than the low %SpO2 results and elevated apnea rate, everything is normal. My lungs are smaller (shorter) than usual but they seem OK otherwise.

Anyway, I plan to sleep a few more hours with just the oxygen feeding through my mask to see if my %SpO2 levels stay higher and repeat what I previously obtained by accident.

Thank you for all your help. I have learned many more things about sleep apnea from you folks than my medical "team" has told me (they've told me very little to date).

Tubaman

[Sleeprider]

If you're going to run just oxygen rather than pressure, you might as well use a canula. It's more comfortable, and would deliver the same effect. I just don't see the point of a CPAP mask if you're intention is merely to deliver O2 from a generator. I think you should consult your doctor on this. Logically the point of CPAP is to avoid oxygen denaturations from obstructive apnea. There is a certain amount of stress that occurs from the breathing effort when the airway is blocked, so you need to deal with that if you accept OA events, but if you're not seeing SpO2 below 90%, then it seems to at least satisfy the aerobic needs of your body. You're kind of going outside of the arena of conventional CPAP treatment with this question.

One study I found suggests that CPAP without oxygen results in less risk/ blood pressure in patients, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172401/ "On average, the 24-hour mean arterial pressure at 12 weeks was lower in the group receiving CPAP than in the control group (−2.4 mm Hg; 95% confidence interval [CI], −4.7 to −0.1; P = 0.04) or the group receiving supplemental oxygen (−2.8 mm Hg; 95% CI, −5.1 to −0.5; P = 0.02). There was no significant difference in the 24-hour mean arterial pressure between the control group and the group receiving oxygen".

So on a very limited searc, it appears CPAP or oxygen supplementation are beneficial, but no significant difference was found between those two groups. Helpful?

[Tubaman]

Hello Sleeprider!
Confusion reigns supreme. I read the study you referenced (at least most of it) and it seems to indicate that CPAP results in lower arterial pressures -- and then it appears that there is no statistical significant difference between CPAP and oxygen assist (probably without CPAP -- not quite clear to me). In fact, are they talking about CPAP alone and then CPAP with oxygen assist? Or are they talking about oxygen alone? I'm unsure. But then, in my old age, my mind doesn't always comprehend things anymore.

Whatever. I will stick to auto CPAP + oxygen assist for now based on the information you researched for me (Thank you!). I shall be seeing my pulmonologist Oct. 7 so I hope he will have more information (he previously recommended I stay with oxygen @ 3Lpm which seems to help most of time).

Thank you again for giving me this information!
Tubaman

[eseedhouse]

One advantage of staying with the machine is that, assuming you have a modern one, it gives you data, which the oxygen machine doesn't do. On the other hand if you have a recording oxymeter on hand and sleep only on the oxygen for a few days and you get good sleep and the graph shows no desaturations perhaps you can do without the CPAP machine.

But I wouldn't do that without the approval of a doctor.

[Tubaman]

Hello -- It's been a while...

I've spent many hours studying the information on this web site, studying my SH & %SpO2 data ever since I started APAP last June. I had been making tweaks to my APAP and oxygen concentrater settings trying to find any positive trends / correlations or indications of anything that worked. Most of my past data seemed pretty random with no correlations of tweaks to AHI and/or %SpO2 levels. I finally found some of my data that seemed to have resulted in improvements and I set my APAP and oxygen lpm as best I could based on that data (wasn't much meaningful data but there seemed to be a little). After many more (small, incremental) tweaks to my APAP pressures and oxygen flow rates, I finally started to see some improvements -- ever so slight at first but then more significant as I found tweaks that had positive data responses. At the moment I'm seeing AHI levels between .13 and 3+, varying from night to night. My %SpO2 graphs have also improved so I'm almost always above the 90% saturation level with minimum time below the 88% level (maybe 0 to 2 minutes at most). Quite an improvement in the %SpO2 levels since before APAP (before this past June) I was getting time below 88% as much as over 400 minutes in one night with average %SpO2 levels around 87% to 89% with the occasional (rare) night at 90%+. I had started with my pulse oximeter back in October 2014 and had made many night time sleep sessions with my Oximeter on one of my fingers all night so I accumulated some history pre-APAP before I even understood what I was seeing. I showed some of my charts & data to my Primary and she said I should not expect anything better at my age (some help she was -- not).

I know I learned a great deal about sleep apnea and APAP + oxygen assist equipment / techniques from this forum. How the APAP + O2 system affects the body, etc., by searching and researching through the Sleep Apnea forum countless times in the past several months. This web site is a gold mine for information about sleep apnea and equipment to reduce it and improve lifetime health as a result. Thank you!

Anyway, change of subject (sort of). Can anybody tell me if someone has contacted any APAP equipment suppliers to get their inputs on using an ozone generator to sterilize APAP components? I read many negative postings on this web site listing odor & possible damage to the APAP machine from the ozone. I don't care about the odor problem but I am very concerned about any damage that the ozone gas passing through parts of the APAP machine on a regular basis that might result.

I did several searches and did not find any postings by anybody discussing the APAP machine's possible damage with a machine supplier. There's a very good chance I missed any existing postings (didn't find them with my searches). If nobody has addressed this problem with an APAP manufacturer, then I will contact my own APAP's supplier/manufacturer. No sense re-inventing the wheel if at all possible.

Thank you!
Tubaman (Carl)