Apnea alarm devices for adults

[sim62]

CPAP machines and other devices usually help us but often they can not eliminate the incidents altogether. In such cases apnea monitors with alarm functionality could be useful. However, I could not find anything suitable for me. My monitor can give an alarm when SpO2 or PR go beyond the preset limits. Unfortunately, both indicators proved hardly useful.

When I intentionally hold my breath I begin suffering well before the SpO2 readings start dropping. If I was sleeping I would wake up before the alarm, and the incident would be harmful for my health. The delay reflects the time needed for blood to reach the finger, so we can do nothing about it. Concerning the PR monitor/alarm, I could not find a setting that would give a signal only at apnea and not when I am changing the position or maybe dreaming in sleep. If I set the limit higher I will wake up with bad feelings before the alarm. We need a monitor for the cause (breathing disturbance) and not for consequenses. 

There exist monitors of breath airflow but they can not be used with a mask. As to CPAP machines, I've had a hard time to find any specific model that would give an alarm signal (though AI says they exist). Such machine could be inferior to mine in other respects or its price could exceed my budget. At the time I am not prepared to change my machine but would be grateful for any specific information.

Finally, there are many models of breath monitors with apnea alarm functionality for babies. They are equipped with optical, pressure or acceleration sensors that react to movements of the user's chest or abdomen. This type of device seems to be most interesting but none of them AFAIK is intended for use by adults. I tried one and found it too sensitive (which is logical) and not enough selective (it would take my heartbeat for breathing though these movements have quite different frequency and spatial characteristics). Any experience or ideas?

P.S. Snoring acoustic/vibration detectors - maybe better than nothing?

[StevesSp]

I recently bought the Wellue O2 Ring in order to investigate some cardiac issues I was experiencing. I found it to be very useful in solving a problem I'd been having for some years, where I would be awakened periodically, gasping for breath and with a thudding heart. At first, I assumed these were apneas, but strangely, they never showed up on Oscar except perhaps as accelerated breathing.

Well the O2 ring somewhat resolved the puzzle. I was having episodes of very low SPO2, often as low as 88%. I found this out by setting the alarm function to 90%, only to have the thing go off rather often. This was good insofar as it explained the awakenings, though of course it didn't explain WHY my O2 was dropping.

Incidentally, I began taking Quercetin as I had read it offers benefits for heart health. According to the O2 ring, it worked immediately. In the two weeks I have been taking the Quercetin I have not had a single episode of low oxygen. I wasn't expecting that!

So although I still don't know what was going on, it now appears to be that those low oxygen episodes were in fact heart related, not apneas nor a lung problem. I did experience a single, three-day episode of atrial fibrillation a few weeks ago, further suggesting that I have some sort of rythym issue. If that's the case, I've had it for around ten years, possibly longer. It might even be the case that the problem was actually caused or exacerbated by CPAP, because the low SPO2 episodes coincide with me starting therapy.

So for me, those little oximeters do indeed work and they CAN provide diagnostic data.

[sim62]

StevesSp,  I am interested in the alarm functionality. Also my symphtoms are different from yours. Oscar indicates short (less than 20 s) CAs that often follow the obstructive palatal prolapse pattern which itself is usually not registered as AI. However, my SpO2 is never lower than 92. If I hold breath for 20-30 s when awake, the monitor does not show any SpO2 drop despite I feel the symptoms. Such events at night cause me anxiety and hypertension.

The finely tuned SpO2 and/or PR alarm likely can prevent the worse but it is still better to arouse in advance. The only way I see is direct detection of apnea/hypopnea incidents.

[SarcasticDave94]

I myself would think any intentional breath hold to simulate an Apnea would probably give questionable data. Just myself, I would not rely heavily on simulated events. Do you know for certain for yourself at least that you can mimic every aspect of Apnea to give data worth acting on?

Not intending to be belligerent or contrary, but just asking if it really can be reliable.

Anyway, eliminating all events with CPAP is not really necessary. Getting most controlled with decent or better comfort is a better goal. An AHI under 5 definitely, but most users reach less than 3 reasonably easily.

What does your OSCAR chart look like? There might be something shown to get it better.

[sim62]

SarcasticDave94, if an apnea incident is a complete interruption of breathing then I can not see a difference with intentional hold. The real apnea pattern may be complex but again I do not see how it can alter my point concerning alarm. 

My AHI does not exceed 2.5, mostly it is in the range 0.7 - 1.2. Probably I am better than most patients but still not OK. Looking at numbers is a common practice but I think it is an oversimplification. And yes I pay much attention to sleeping comfort. 

BTW only recently I realized that my nasal congestion might be related to gastroesophageal reflux (diagnosed also not long ago). Now I am better with respect to UARS but palatal prolapse still affects my sleep. I can sleep even without CPAP but would like to have an alarm device working as described above. No idea why those baby-oriented devices are inappropriate for adults with some changes in settings. Maybe the manufacturers will read this thread?

[Jay51]

This is just a thought and a long shot.  

There is such a thing as V/Q mismatch.  Basically a lung problem with getting oxygen to the blood and cells (everything else can be normal, but if this is present, SPO2 levels could fall).  

Research it if you like.  Most likely it doesn't apply to your situation, but a few members here at ApneaBoard have presented with this problem (V/Q mismatch).

[sim62]

Jay51, it is unlikely V/Q mismatch since in everyday life I am OK even doing cycling with substantial loads. It is OA (palatal prolapse and maybe tongue muscles dystony in sleep) that likely provokes CA through disruption of normal breathing cycle. Perhaps I am sensitive to intervention - not only to breath interruption, but also to *help*. For example, EPR makes my exhalation deeper. After that I do not *want* to inhale until I have to because of beginning suffocation feeling. My breath ceases to be light and automatic. I observed this effect when awake. This is why I am not using ERP, BIPAP or ASV. Besides, ERP did not help me with respect to apnea.

[SarcasticDave94]

It may be possible there's something different wrong instead of Apnea. This isn't nitpicking, but while awake it's not Apnea, so if whatever it is goes on while awake it has to be based on something other.

I myself have sometimes large breath pauses while awake, and I have COPD and Asthma symptoms. Just an example is all.

[sim62]

SarcasticDave94, I am inclined to assume that it is Apnea. Why should we look for another cause if everything looks like Apnea? Given that, I would like to have an alarm device that would react to not breathing like those various baby monitors. After a discussion with Sider and more Internet search the mission seems impossible. Weird enough. May be I do not understand something? Have tried Snuza Hero, thinking to test Babysense 7. Very preferably the monitor should turn off the alarm when the breathing resumes. Snuza Hero operates this way (as well as Contec CMS50F that monitors SpO2 and PR), Babysense likely does not. Have one more idea how to fiddle with Snuza.

[StevesSp]

The Wellue O2 Ring connects to a smartphone via an app, wherein you can set alarm thresholds for both SPO2 and heart rate. The ring vibrates if either of these thresholds is exceeded and the strength of the vibration is set by the user. In my case I use only the SPO2 alarm as I have no concerns about BPM. It is set to 'Medium' and is strong enough to wake me. It will continue vibrating as long as the threshold is exceeded, but stops as soon as O2 returns above the threshold, which it always does once I'm awake.

One of the things I believe the O2 ring has revealed is that I have become, to some extent and perhaps temporarily, dependent on CPAP. A few nights ago, the ring alarmed soon after I lay down to sleep. This followed a week or more with no such events so I was disappointed, thinking the Quercetin wasn't working so well after all. Every single time I rolled over and tried to fall asleep, the alarm would go off. This went on for an hour or so, with multiple low SPO2 events. It was quite concerning, so I made to get up for a while. That's when I realised I hadn't turned the CPAP on ...

Whilst it was good to find the reason for all those low SPO2 events, it did highlight my utter dependence on CPAP nowadays. I believe my AHI without CPAP to be far, far worse then it was pre-therapy, even though I am in fact lighter than I was back then and drink less alcohol (two possible causes). I suspect therefore that years of CPAP use can 'train' the body to become more and more reliant on the machine to do some/most of the breathing for you. Maybe the lungs can lose 'condition'?

I have therefore ordered one of those lung exercising devices, the type that has a metal ball inside that 'vibrates' the lungs as well as strengthening them. Although I walk a fair bit, I never jog or cycle, so my lungs don't get much of a workout these days. Maybe that's something else I need to do?