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What are signs you need supplemental oxygen?
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Post: #11
RE: What are signs you need supplemental oxygen?
You may have low oxygen saturation while awake as well. If so, that part is not caused by apnea. But, your doc should already have noted that condition (such as COPD, asthma, emphysema).

Generally, low oxygen saturation levels during sleep are caused by hypoxia due to either hypopnea or apnea. Those are corrected by effective treatment (often by positive airway pressure).

QAL

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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.
07-12-2015 11:01 AM
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Enhander Offline

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Post: #12
RE: What are signs you need supplemental oxygen?
(07-12-2015 11:01 AM)quiescence at last Wrote:  You may have low oxygen saturation while awake as well. If so, that part is not caused by apnea. But, your doc should already have noted that condition (such as COPD, asthma, emphysema).

Generally, low oxygen saturation levels during sleep are caused by hypoxia due to either hypopnea or apnea. Those are corrected by effective treatment (often by positive airway pressure).

QAL

If you wake up with the hypoxic headache slightly, even with the right pressure, does that mean treatment isn't working?
07-13-2015 02:11 AM
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quiescence at last Offline

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Machine: REMstar System One with Autoflex
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Mask Make & Model: Quattro AirFit F10
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CPAP Software: SleepyHead EncoreBasic

Other Comments: CMS-50F Plus oximeter /w SPO2 Assistant software. Avowed mouth-breather switching to nose-breathing

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Post: #13
RE: What are signs you need supplemental oxygen?
It means that treatment for apnea may not be the only treatment you need. you should talk to the doctor and request an overnight pulse oximetry test. that can also indicate clearly that oxygen levels (are, are not) being resolved.

you may be having some residual brain thawing - where the brain hasn't figured out yet that you are not going to keep strangling yourself all night. sometimes various body part need some long term convincing that the "new normal" is "i get oxygen all the time."

QAL

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.
07-13-2015 07:58 AM
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me50 Offline

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Post: #14
RE: What are signs you need supplemental oxygen?
(07-13-2015 02:11 AM)Enhander Wrote:  
(07-12-2015 11:01 AM)quiescence at last Wrote:  You may have low oxygen saturation while awake as well. If so, that part is not caused by apnea. But, your doc should already have noted that condition (such as COPD, asthma, emphysema).

Generally, low oxygen saturation levels during sleep are caused by hypoxia due to either hypopnea or apnea. Those are corrected by effective treatment (often by positive airway pressure).

QAL

If you wake up with the hypoxic headache slightly, even with the right pressure, does that mean treatment isn't working?

is it possible that you may need a little higher pressure?
07-13-2015 11:19 AM
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Mosquitobait Online

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Post: #15
RE: What are signs you need supplemental oxygen?
(07-13-2015 02:11 AM)Enhander Wrote:  If you wake up with the hypoxic headache slightly, even with the right pressure, does that mean treatment isn't working?

Your treatment should eliminate those headaches within a couple of weeks unless something else is present or your pressure simply isn't high enough. I have trouble with RLS (Restless Leg Syndrome). So, even though the therapy works, I don't get enough sleep because I keep waking up due to the RLS. I'm taking iron, magnesium and zinc and the problem is gradually going away (again).

I also found that the Resmed algorithm works a lot better for me. I don't know why. I'm using a loaner Respironics 560 and I had to switch to cpap mode because I just felt terrible with the Apap. I had no problems with the S9 (the machine failed). Since my AHI was similar on both machines, I expect the Resmed algorithm handles RERAs better.
07-13-2015 03:26 PM
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Post: #16
RE: What are signs you need supplemental oxygen?
(07-13-2015 03:26 PM)Mosquitobait Wrote:  
(07-13-2015 02:11 AM)Enhander Wrote:  If you wake up with the hypoxic headache slightly, even with the right pressure, does that mean treatment isn't working?

Your treatment should eliminate those headaches within a couple of weeks unless something else is present or your pressure simply isn't high enough. I have trouble with RLS (Restless Leg Syndrome). So, even though the therapy works, I don't get enough sleep because I keep waking up due to the RLS. I'm taking iron, magnesium and zinc and the problem is gradually going away (again).

I also found that the Resmed algorithm works a lot better for me. I don't know why. I'm using a loaner Respironics 560 and I had to switch to cpap mode because I just felt terrible with the Apap. I had no problems with the S9 (the machine failed). Since my AHI was similar on both machines, I expect the Resmed algorithm handles RERAs better.



Oh okay. I thought that the headaches were supposed to go away right away. yes, they reduced the first night I wore the machine, but I was still tired.

You know what I'm talking about right? The headaches are not migraines or regular headaches. They are pressure headaches. They happen when you wake up.

The problem I have is I can't sleep. The machine actually wakes me up after 2 to 3 hours. The CPAP has made the sleep much worse. I tried high settings and low settings. It wakes me and it's harder to get to sleep with the machine. My sleep wasn't good to BEGIN with but the CpAP has made it seemingly impossible and inconceivable. Will getting my OFFICIAL mask change things.

Thank you for your time.
07-13-2015 06:28 PM
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Mosquitobait Online

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Post: #17
RE: What are signs you need supplemental oxygen?
Getting a mask that works for you certainly helps.

I don't know what to tell you. May be others will pipe in here. Before I got my cpap, I slept like the dead for 8 or 9 hours and was groggy all day. I wake up more often, which is the pits, but am no longer driven to take 2 naps a day. I think once I'm back on the Resmed algorithm AND solve this RLS, I will be able to get through the night with only one wake-up call to the bathroom.
07-13-2015 07:19 PM
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Post: #18
RE: What are signs you need supplemental oxygen?
(07-13-2015 07:19 PM)Mosquitobait Wrote:  Getting a mask that works for you certainly helps.

I don't know what to tell you. May be others will pipe in here. Before I got my cpap, I slept like the dead for 8 or 9 hours and was groggy all day. I wake up more often, which is the pits, but am no longer driven to take 2 naps a day. I think once I'm back on the Resmed algorithm AND solve this RLS, I will be able to get through the night with only one wake-up call to the bathroom.



Is it possible for some people that CPAP causes you to wake up too soon no matter what? Even with the right mask?
07-13-2015 07:21 PM
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TyroneShoes Offline

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Post: #19
RE: What are signs you need supplemental oxygen?
I think it is a mistake to assume a 1-to-1 relationship between how you feel and how effective xPAP therapy is.

While AHI is a dumbed-down simplified inaccurate indicator, it has great value in one thing, which is in determining how many events you are having. Its an event counter, after all. So that means it is also a pretty accurate indicator of how effective the therapy is. If your AHI is low, therapy is effective. If your AHI is high, therapy is not effective. Completely separate from and regardless of how you feel. It doesn't get any simpler than that. And no one here has ever been able to predict what the xPAP says their AHI was the night before based on how they feel that next morning.

How you feel is in turn not at all an accurate indicator of how effective the therapy is, because there are lots of things that can affect how you feel. If I were sleeping on top of some rocks and gravel I brought in from the street, I probably would not sleep well and would probably not feel wonderful when I got up, but my first question as to why would not be "gee, I wonder if my xPAP therapy isn't working?" I would be looking elsewhere for that answer. This doesn't mean that xPAP doesn't often has a positive effect on how you might feel. Of course it can. It just is not a causally linked relationship in many cases.

It is also easier to understand if you consider that there are two things going on here. The first is that OSA restricts how much air can get into your lungs when you breathe. The second thing is how efficient your lungs are in extracting 02 from whatever air you do get into your lungs. So there are two systems here to address.

XPAP addresses the first issue, by removing the obstructions. It is a direct fix. Sup 02 does not address either issue directly, but it is a nice workaround if you have the second issue of inefficient 02 extraction. If there is simply more 02 in the mix, you will get more 02 in your bloodstream, regardless if you have a problem with extracting 02 or not. That means that when you do have an event, which you will if your AHI is not zero every night, there is less likelihood of desat. And what is really great is that an xPAP can be used as a perfect delivery system for sup 02.

So unlike xPAP, sup 02 is not a direct fix, it is more like a crutch. Still, both are good and effective tools. Unfortunately, there is not much that can be done to improve lung efficiency directly, other than preventative measures prior to having this issue.
(This post was last modified: 07-13-2015 08:43 PM by TyroneShoes.)
07-13-2015 08:39 PM
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Post: #20
RE: What are signs you need supplemental oxygen?
(07-13-2015 07:21 PM)Enhander Wrote:  
(07-13-2015 07:19 PM)Mosquitobait Wrote:  Getting a mask that works for you certainly helps.

I don't know what to tell you. May be others will pipe in here. Before I got my cpap, I slept like the dead for 8 or 9 hours and was groggy all day. I wake up more often, which is the pits, but am no longer driven to take 2 naps a day. I think once I'm back on the Resmed algorithm AND solve this RLS, I will be able to get through the night with only one wake-up call to the bathroom.


Is it possible for some people that CPAP causes you to wake up too soon no matter what? Even with the right mask?


It may be accurate for some that the CPAP therapy causes a shift from [many many awakenings none distinct] to [blissful sleep for 100s more minutes with noticed distinct awakenings.]

Most of my wakings now appear to be at the end of a REM sleep period. I wake at least 5 times a night. At one point in most nights I wake thinking I just can't get back to sleep. Mostly due to discomfort.

I walk around, sip some fluids, do some light thinking, and then go back to bed when I feel tired is starting again.

QAL

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.
07-13-2015 11:38 PM
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