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AHI or SPO2
#1
AHI or SPO2
   
I have been on cpap for 6 or so years, mostly good. Three months ago i had surgery to correct severe deviated septum.  For the past month or two my AHI has been less than 1.    I started wondering if maybe i could get off cpap.  BUT then i remembered i have a recording oxymeter.  So last night i was on cpap as normal and had an AHI this morning of .4  I was happy with that but when i looked at spo2 it looked like the pic i am uploading.  Doesn't look so good.  So what would you conclude from great ahi and spo2 that looks like this?
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#2
RE: AHI or SPO2
AHI of 0.4 is an avarage. Meaning you could very well have ahi over 30 during eg. a 20 min period and then nothing for the rest of the night. Alternatively you could have seldom obstructive events through the night but serious enough to cause O2%sat drop to 80% . There's also the possibility that you can have many under <10s events, those don't get registered by default because you need to set a custom event marker in Oscar to also have them qualified.

I think the bolded option is your culprit. Post some charts.
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#3
RE: AHI or SPO2
   
I'm not  very adept at Sleepyhead, but i used it this time since it imports spo2.  I'm not sure how to get SH to show all the right graphs.  It shows my AHI is .13 but it is all hypopnea.  I usually have little or no obstructive apnea especially since my deviated septum surgery.  The sleephead chart coincides with the SPO2 chart i posted earlier.  Also i notice the spo2 graphs are not in line with the rest of the graphs.  I did something wrong when importing spo2.
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#4
RE: AHI or SPO2
Hi drgrimes, could you do a couple of things and then repost your chart so the experts can take a look? First, go into Preferences and turn off the pie chart. Then click the little triangle to turn off the calendar. Finally, show the following stacked on top of each other: events, flow rate, pressure, O2, flow limitations, snores. You may need to squish them a little to fit them in. You can do this by grabbing the gray horizontal line that separates one chart from another.
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#5
RE: AHI or SPO2
1am and 3am looks like it could use more min pressure. Sometimes there is a spike in the chart as the sensor moves on the finger. You really need the tidal volume and flow chart, to see if they correspond to an event. As suggested in wiki at the top of the page are suggestions on how to lay out the chart.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#6
RE: AHI or SPO2
   
Dormeo thanks for your response.  I switched from SleepyHead to Oscar, is that OK?  I got it arranged as per your instructions.  As you can see I did not get SPO2 in sync with the rest of the graphs.  Something confusing the way it is worded.

Ajack are you saying set min at 8 and max at 20?

How do i get the spo2 to align correctly with rest of charts? I'm confused about whether to set a time when it started or let it sync to a session. Obviously i clicked the wrong thing.
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#7
RE: AHI or SPO2
You have a few options, moving the min to 8 is one and probably a good start, till you get your head around things. At this stage there is no need to raise the max pressure, as long as it is set above the oscar max. My signature is just to get into the ballpark with settings.

Then I would check the nasal mask for leaks or mouth breathing. The tidal volume is a bit low.
Then I would consider increasing my epr from 1 to 3. This will give the easiest to breathe and perhaps increase the tidal volume a bit. You could also add 2 to the min pressure, to keep it even. Or make the adjustments to min pressure afterwards, going by the oscar charts.
For o2, you increase min pressure, sometimes you need to use the 95% pressure or above. So there is a lot of adjustments left you can make.

If you start recording when you start your apap, it makes it easier to sync. It's also not an issue using the contec chart.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#8
RE: AHI or SPO2
Good job on the charts, and Oscar is ideal. I hope the changes ajack is recommending will help you. Keep us posted.
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#9
RE: AHI or SPO2
Ajack, made your suggested changes.  Min=8, EPR=3.  What does EPR do?  As far as mask leaks, i have struggled with that for years.  I've learned to live with some amount of leak.  If i tighten to eliminate leaks, i wake with grooves in face and nose and very sore.  I guess for all of us, it's a degree of compromise.  I move about when i sleep and any movement of the hose makes leaks.  I am in the process of getting the new mask from Resmed which has the hose on top of the head.  Maybe that will be better.  I have tried almost every mask made.  I keep looking for the perfect one but have not found it

Pardon me for not just looking up "EPR". Ok now i know what it does, but does changing from 1 to 3 make it easier or harder to exhale?
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#10
RE: AHI or SPO2
EPR is expiratory pressure relief - it results in a lower pressure when you exhale, making it easier to get used to therapy. In other words, if the pressure was at 10 for inhale, you would only be exhaling against a pressure of 7.
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