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How do I get my Sp02 down, yes, down? - Printable Version

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How do I get my Sp02 down, yes, down? - Rcgop - 02-21-2017

Or, looking for the science behind this.

I am using this title to attract experienced and knowledgeable users. I hope it works.

My AHI is all clear airway apneas (well almost) and I believe they are harmless, BUT, I feel I should be able to eliminate them. Here’s why.
I got a recording oximeter and finally got a good synchronization for the last half of the night. Upon close examination it appears the clear airway apneas occur at high oxygen levels (95% and above) and higher oxygen occurs at higher pressure. That is why I believe they are harmless. In addition, I am getting enough sleep as I have eliminated my afternoon naps and cannot stay in bed more than 8 hours.

HOWEVER:

For the entire month of December, my average AHI was 1.08 and so far this month it ranges from 3 to 4.

I have 3 screen shots to demonstrate this –

1. Is the full night with oximeter readings for the last 4 hours. This is a typical day in February.
2. A small section of that same night.
3. And a typical day in December.

http://imgur.com/a/XJifT

Here are MY thoughts on why my AHI has suddenly taken a jump.

I have allergies to Bayberry. It is a seasonal problem that occurs January to March each year, causing my nasal passages to become restricted. This might cause my flow limitations to increase my pressure greater than needed to eliminate any OA’s thus the higher SP02 levels.
Here are MY thoughts on how to eliminate the clear airway apneas.

1. Switch from a large pillow to a medium to reduce the flow.
2. Increase my EPR from 1 to 2 (or even 3). EPR of 2 is the most comfortable followed by 2.
3. Decrease humidity from 6 to 5 or even less. I live in Florida and even on a dry day, the humidity is 40% or greater.
4. Lower my maximum pressure to the point I just start to get obstructive apneas. My 90% pressure has been a very constant 8 cm for the last 11 months.

Please feel free to “Correct me if I am wrong”.

Any other suggestions will be appreciated.

RE: How do I get my Sp02 down, yes, down? - Crimson Nape - 02-21-2017

Actually increasing your EPR may result in increased CO2 washout thus causing more CA's .

RE: How do I get my Sp02 down, yes, down? - E.W. - 02-21-2017

Here  is an off the wall thought how is your hemoglobin could
it be a tad high ?  You might try donating a pint of blood besides
there are some studies showing that in men who donate at least
twice a year there risk of a heart attack is substantially lower.

RE: How do I get my Sp02 down, yes, down? - justMongo - 02-21-2017

mmmm.... SpO2 is the percent of oxygenated hemoglobin.

RE: How do I get my Sp02 down, yes, down? - Cranberry Ray - 02-21-2017

Notice that your respiratory rate is higher lately when you are getting the higher AHI readings. Not sure if that is a cause or effect? With more breathes would that mean taking in more oxygen?

RE: How do I get my Sp02 down, yes, down? - Sleeprider - 02-21-2017

Let's put this where we can see it. 

[Image: 8nHeXfT.png]

And the answer is, turn EPR off, set minimum CPAP pressure to 6.6 and maximum CPAP pressure to 6.6 or use CPAP mode. 

With regard to your question, EPAP is what holds the airway patent, and prevents obstruction. EPAP is also where oxygenation occurs. IPAP is for ventilation, and as noted earlier, with pressure support more CO2 is blown off, and for most of us, this can affect respiratory drive. So your problem is not oxygenation, that is a good thing, the lack of drive and consequential CA is from over-ventilation. The solution above proposed to deal with all of this. I would not expect to see this effect with only EPR of 1, so I think holding pressure stable may be a good move as well. If this works, you can experiment with EPR and see if it triggers more CA. If we see more OA, we will gradually increase maximum pressure.

RE: How do I get my Sp02 down, yes, down? - Rcgop - 02-21-2017

http://imgur.com/a/q8VDr

I do not know why the link did not work properly.  This should get all three graphs.

Very interesting responses.
In my college days, I did donate blood.  One time I was not allowed to donate due to low hemoglobin. I think that was because poor diet and too much partying.

I have tried EPR "off". It was some better but not much. I probably need to try that again.

I think my respiration does go up and I think that might be part of the cause.

I think lowering my max pressure might be key.

Thanks for the responses.

RE: How do I get my Sp02 down, yes, down? - Rcgop - 02-22-2017

(02-21-2017, 01:20 PM)Sleeprider Wrote: And the answer is, turn EPR off, set minimum CPAP pressure to 6.6 and maximum CPAP pressure to 6.6 or use CPAP mode. 

This is the result of these changes.
I left the ramp to auto starting at 5 cm. and min at 6.0 cm.

Here are the results.

http://imgur.com/a/Krfx4

I am not sure what happened to the SP02 graph. I stopped recording shortly after 3:00

I have had good results in the past so I cannot say this is fixed but it is the first time my CAs were less than my Hs.

Also, I was much more comfortable during the night.

I think we are going in a good direction.

Thanks Sleeprider for the suggestion.

RE: How do I get my Sp02 down, yes, down? - Sleeprider - 02-22-2017

Winner winner, chicken dinner....I'd keep that.

RE: How do I get my Sp02 down, yes, down? - Rcgop - 02-24-2017

(02-22-2017, 11:59 AM)Sleeprider Wrote: Winner winner, chicken dinner....I'd keep that.

May have spoke too soon. Last 2 nights going up to 2 to 3 range. But still less CAs, more Hs. And good sleep. 

Will post more when I have more data.