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oxygen desaturation and heart rate
#1
Hi everyone,

Sometimes when we are having a long apnea event we experience oxygen desaturation. I'm thinking this should affect the heart rate. So i'm thinking when a desaturation happens the heart rate must raise to try to compensate.

I'm i interpreting this correctly?

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#2
Generally true. Blood Pressure also rises to increase flow.
The increased workload on the heart is one very good reason apnea must be treated -- lest on have cardiomegaly, left ventricular hypertrophy, and leaky aortic and mitral valves.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
(08-25-2014, 10:05 AM)justMongo Wrote: Generally true. Blood Pressure also rises to increase flow.
The increased workload on the heart is one very good reason apnea must be treated -- lest on have cardiomegaly, left ventricular hypertrophy, and leaky aortic and mitral valves.


Thanks for the confirmation airman Mongo Cool

Yesterday i had a 0.8 AHI night. No apneas at all. Dancing
Only small hypopneas

I slept with a heart monitor.
Minimal HR 47
MaximaL HR 87 (most likely while going to bed)
average HR 57

I'll try to monitor that for a couple of days. To see what happens when i get a big apnea event.

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#4
(08-25-2014, 07:46 AM)Ghandi Wrote: Sometimes when having a long apnea event we experience oxygen desaturation. I'm thinking this should affect the heart rate. So i'm thinking when a desaturation happens the heart rate must raise to try to compensate.
I'm i interpreting this correctly?
Science and logic would tend to agree with your interpretation, but I have found that it's inconsistent. Mostly the BPM trace mirrors the SPO2 trace, but not in every apnoic event. Here is a grab from a nights monitoring . The heart rate is the lower trace. It can be seen, in my case at least, it doesn't always hold true.
[Image: signature.png]Keep on breathin'
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#5
(08-25-2014, 09:06 PM)woozie38 Wrote:
(08-25-2014, 07:46 AM)Ghandi Wrote: Sometimes when having a long apnea event we experience oxygen desaturation. I'm thinking this should affect the heart rate. So i'm thinking when a desaturation happens the heart rate must raise to try to compensate.
I'm i interpreting this correctly?
Science and logic would tend to agree with your interpretation, but I have found that it's inconsistent. Mostly the BPM trace mirrors the SPO2 trace, but not in every apnoic event. Here is a grab from a nights monitoring . The heart rate is the lower trace. It can be seen, in my case at least, it doesn't always hold true.


That's interesting. Your heart rate stayed steady during the desaturation. Thx for sharing

I wore my hr monitor last night. And i cant find a correlation between apnea events and hr raising. It was at an average of 57 during the night.

At some point it peaked in the 80's but it seems to be when i was moving around. No events occured when the hr raised.

Last night was horrible. 3.0 ahi with events lasting for 40 seconds. This morning i feel so tired. Dont-know

Maybe i'm incubating a flu. My wife and the kid are sick Thinking-about

I,m Going to see the family doctor today. I will ask him to raise pressure at 8. Dont know if he will want to step in the pneumologist sandbox.


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#6
But, what is not recorded is blood pressure. A little increase in rate is not an issue unless above 100 BPM which is classified as Tachycardia.
Tachycardia puts a person at risk for abnormal beats -- generally not an issue in the healthy heart.

An increase in pressure is more damaging to the heart as the heart muscle is working harder which thickens it.
The left ventricle becomes stiff; and does no create a suction during diastole. The ejection fraction is lowered. The aortic valve starts to leak; the mitral valve prolapses... This is, of course, a long term process. The heart compensates over a range known as the Frank-Starling Law... until, it falls off the curve; and the end result is heart failure.

Sleep Apnea -- diagnose it early; treat it; and you'll live longer.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
(08-26-2014, 10:35 AM)justMongo Wrote: But, what is not recorded is blood pressure. A little increase in rate is not an issue unless above 100 BPM which is classified as Tachycardia.
Tachycardia puts a person at risk for abnormal beats -- generally not an issue in the healthy heart.

An increase in pressure is more damaging to the heart as the heart muscle is working harder which thickens it.
The left ventricle becomes stiff; and does no create a suction during diastole. The ejection fraction is lowered. The aortic valve starts to leak; the mitral valve prolapses... This is, of course, a long term process. The heart compensates over a range known as the Frank-Starling Law... until, it falls off the curve; and the end result is heart failure.

Sleep Apnea -- diagnose it early; treat it; and you'll live longer.

Mongo, is there anyway to monitor that?
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#8
(08-26-2014, 10:54 AM)Ghandi Wrote: Mongo, is there anyway to monitor that?
They have not come up with a way to measure BP on a continuous basis.
In hospitals and ERs, a BP cuff is put on the patient's arm; and it is periodically inflated and it listens to the Korotkoff sounds. This periodic measurement is automated; but not continuous. Catching the BP during an apnea event is difficult.

It's when one gets into deep desaturation that the adrenal glands on the kidneys release epinephrine and norepinephrine -- which in turn stimulates the heart to crank it up...
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#9
I can speak to this from over 15 yrs of experience dealing with uncontrolled BP, Afib, a botched ablation surgery, 3 Bp meds day min, soaring heart rates, and slow heart rates. Left Ventrical thickening etc etc etc. All before being diagnosed with Apena 2 weeks ago. Though the wife has been yelling I had it for 20 yrs.

Normally if you stop breathing on purpose or not your heart rate will slow. And speed up with you breathe. Totally normal.
There is a point though during an obstructive Apena where you are struggling to breathe as if fighting someone choking you to death your body dumps adrenaline which will speed up your heat rate dramatically.

Apena does put a heavy strain on your heart though. My O2 was dropping to 64 as I have mild COPD also so just a few OA would cause it to plummet. It has over the years kept my BP uncontrolled, LV wall to thicken though not enough to affect it ability to pump thank goodness. Though the chamber is smaller due to the thickening.

I was also losing my memory and had got to the point I couldnt concentrate on anything much at all.

Good news is that after only four days on a PR system one 560 auto, my AHi is down to 2.4, my heart rate is regular, running about 50 when I get up then coming into the 60s withing a little bit of moving around. BP is lowered and stabilized at the borderline of hypertension while being on only one med instead of three. My 02 stays at normal levels at night on the machine.

My memory is returning, It doesnt take me 2 hours to make it out of bed after I wake up now either. I just wake up and get up like a normal person.

My only concern for a bit was the lowered pulse rate into the 40s on first waking but it comes up to a normal rate in 15 to 20 min so I guess my ticker is getting the rest it needs at night instead of hammering away all night.

Stick with it. If four nights worth of therapy can level out all this mess ive dealt with for 20 yrs to the extent it has and make a night and day difference in the way I feel its worth it.


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#10
(08-26-2014, 12:40 PM)justMongo Wrote:
(08-26-2014, 10:54 AM)Ghandi Wrote: Mongo, is there anyway to monitor that?
They have not come up with a way to measure BP on a continuous basis.
In hospitals and ERs, a BP cuff is put on the patient's arm; and it is periodically inflated and it listens to the Korotkoff sounds. This periodic measurement is automated; but not continuous. Catching the BP during an apnea event is difficult.

It's when one gets into deep desaturation that the adrenal glands on the kidneys release epinephrine and norepinephrine -- which in turn stimulates the heart to crank it up...

For the moment i guess we have to rely on the oximetry data, which implies bp increase.

My doctor though the cpap was used to provide oxygen. He did't even know that apnea caused desaturation.

So i'll have to wait to see the pneumonolgist to adress this.

I called to be on the waiting list but ....Otherwise i have an appointment in november.
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