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+--- Thread: Understanding sp02 levels and ahi with dental device (/Thread-Understanding-sp02-levels-and-ahi-with-dental-device)
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Understanding sp02 levels and ahi with dental device - blethered - 02-14-2019
Hello, I’m using a tap 3 dental device for my osa. I’ve been using it for many years since 2013 and through my own fault, I never did a follow up sleep study to actually see if I’ve been been compliant or not until last December 2018. I given a 3 day home sleep study and I did pretty bad. Now one of the main reasons main reasons I did bad was because the mouthpiece wasn’t staying in and was falling out. My sleep dentist fixed it and now that’s it’s staying in, i need to redo the test. I’ve been trying to self monitor myself the best I can and analyze my previous 3 night sleep study. I’ve been trying to prep myself for the sleep study again. I record myself sleeping on my iPhone both video and audio all night when I’m able to. It helps me to verify if snoring is still going on on my adjustments and I’m able to physically see myself sleeping setting up the iPhone on a bendable holder video mode all night. I’m also using an al night recording oximeter that I got to help me see how low I go etc.
I know I’m not going to be able to do much right now to figure out ahi using the dental device unless I have another sleep study but what I would like to know is does drops in sp02 under 90..88.. 80 etc able to give me any indication that this mouthpiece isn’t working? If I look at the drops sometimes there’s a similarity with the pulse rate going up. I’m assuming it’s probably an apnea I just had? Can anyone tell me what im looking here? I’m concerned about my desaturations I might have going on from what I’m seeing still some of the times. I guess it’s normal for people with sleep apnea to desat but by how much and by how long during the whole night does it become a concern? Thanks I hope someone can help me out a bit because unfortunately I’m not getting these questions answered by my sleep dentist or my pcp. All they want to do is do another test too see and if I have further questions my pcp told me to them schedule with a sleep specialist.
RE: Understanding sp02 levels and ahi with dental device - CB91710 - 02-14-2019
Under 90% is considered a flag for apnea in a sleep study.
Your pulse rate will increase following an apnea event because you are trying to reoxygenate your system, however there are other things (even dreams) that can cause your pulse to become elevated.
I think if you are desaturating to 80%, that is a major red flag that the mouthpiece is not doing the job and you may need to look into more effective therapies such as CPAP.
Are you recording snoring on your phone?
Generally, dental devices are occasionally effective for mild apnea only. More severe apnea is not effected.
Furthermore, Apnea is not something that treatment "cures".... Apnea may improve or worsen based on weight/body fat level, psychological condition, stress, or even position... but if nothing changes, treatment is simply treatment of the symptom. As we age, we tend to increase bodyfat, so apnea generally worsens, though effective treatment may be able to hold it at bay.
We've been on APAP for just over 2 years. The prompting was severe snoring... we would keep each other awake and it was always a race to see who could get to sleep first.
That is a thing of the past... but last weekend, we lost power for 15 hours. I could not sleep. I'd fall asleep, and would wake within 10 minutes gasping for air.
RE: Understanding sp02 levels and ahi with dental device - blethered - 02-14-2019
Yes I’m using an app called snore lab on my iPhone and sometimes I also setup my 250 gig iPhone to record myself all night close in hd. That’s how I actually found out the the top mouthpiece was popping right out and then subconsciously I would wake up and bit it back into place. So when you say red flag anything under 90 or big red flag if I see 80 doesn’t the time spent have a factor in it? Or is it bad regardless of the time? I still have room to adjust further out on the tap 3
RE: Understanding sp02 levels and ahi with dental device - Gideon - 02-15-2019
Medicare says if you are under 88% for 5 minutes per night you qualify for supplemental oxygen at night. Note that it normal to drop some at night from daytime values.
RE: Understanding sp02 levels and ahi with dental device - blethered - 02-15-2019
Yeah these drops that I see are maybe for a few seconds and very little in the totality but then it goes right back up to above 90 like right away and stays there for the most part. It’s like .1 percent total time under, but their are dips nonetheless. That’s why I want to know what is considered bad is it simply anything under 90 or doesn’t it take more then that to say someone’s has a breathing problem? I know the mouthpiece is providing some relief because this test I had is better then the one I had in 2012 with regards to ahi etc.
RE: Understanding sp02 levels and ahi with dental device - dmeRT - 02-15-2019
(02-15-2019, 09:09 AM)bonjour Wrote: Medicare says if you are under 88% for 5 minutes per night you qualify for supplemental oxygen at night. Note that it normal to drop some at night from daytime values.
If you have a diagnosis of OSA, it's harder to get O2. The OSA must be treated first (chronic stable state) before O2 need can be determined. Which usually means a sleep lab titration proving proper cpap settings. Then if SpO2 is low O2 is added.
Also, if you're trying to determine an apnea event using an oximeter, it's not how low the O2 goes. It is how many times it drops from your baseline. the drop only has to be 3-4% points. so you could drop from 97% to 94% then back up...that could have been due to an apnea event.
probably a home sleep study or in lab study using the dental device would be beneficial?
RE: Understanding sp02 levels and ahi with dental device - Sleeprider - 02-15-2019
Let's backup a bit here. Your profile shows you are using an Airsense 10 Autoset at 5 to 15 pressure. Are you using this with the Tap 3 device? If so, you probably did not achieve adequate efficacy with the CPAP alone. If so, there are some alternatives you should consider. Clustered obstructive apnea are usually a problem we associate with positional apnea. Your Tap 3 device is an expensive and poor solution to solving that compared to a soft cervical collar. Take a look at the Optimizing Therapy link in my signature, and go to the section on Positional Apnea. Take a look at the Sleepyhead charts there. If yours look like that, we can help you ditch the Tap and fix the problem.
RE: Understanding sp02 levels and ahi with dental device - blethered - 02-15-2019
I have a tap 3 tl device and also own an airsense 10 auto cpap full face f30 mask. There’s more to my very long story but let’s just say I’d rather use and detect compliance with the oral device and not use the cpap preferably. I know about sleepyhead and I’m able to get results. I could test the cpap with the mouthpiece on 4cm max to get a better baseline but it’s still 4cm treated. And I recently bought my own oximeter. My goal is to see if the mouthpiece alone will suffice or is cpap the only way. I wish there was there was a way easily to test out the mouthpiece.
(02-15-2019, 10:18 AM)Sleeprider Wrote: Let's backup a bit here. Your profile shows you are using an Airsense 10 Autoset at 5 to 15 pressure. Are you using this with the Tap 3 device? If so, you probably did not achieve adequate efficacy with the CPAP alone. If so, there are some alternatives you should consider. Clustered obstructive apnea are usually a problem we associate with positional apnea. Your Tap 3 device is an expensive and poor solution to solving that compared to a soft cervical collar. Take a look at the Optimizing Therapy link in my signature, and go to the section on Positional Apnea. Take a look at the Sleepyhead charts there. If yours look like that, we can help you ditch the Tap and fix the problem.
My first study from 2012 in lab 2 days did say there was sufficient positional portions to my apneas and most were on my back, but that was before I got the mouthpiece...
RE: Understanding sp02 levels and ahi with dental device - blethered - 02-15-2019
I don’t have time right now but I could post you the results from the first study back in 2012 with no device and cpap... and then the one from 2018 with the mouthpiece that was falling out during that study if that will help. Like I said I’m supposed to get another sleep study done in about a month with just the mouthpiece to get a better idea but I just want to see there’s a way to find out myself if I’m just wasting my time with the mouthpiece and wishful thinking it will work.
RE: Understanding sp02 levels and ahi with dental device - Sleeprider - 02-15-2019
Just post a Sleepyhead chart...no need for sleep test.