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More on the benefit of Oximeters
#1
More on the benefit of Oximeters
Hi Guys,
 
The following “case study” demonstrates the benefit of using Oximeters for evaluating our treatment.
 
File A (attached) shows a CMS 50F Oximetry report of last night. As you can see, I spent about 7 minutes with saturation level below 88% (which is bad!). When I looked at the CPAP report, I found out that between 2:30 and 3 o’clock, I removed unintentionally the mask, so no CPAP treatment.
 
File B (attached) shows the same report but with excluding the time without mask from the data. Now only 0.1 minute below 88%! This is a different story.
 
Personal conclusions:
 
1.      CPAP treatment works and it is essential for our health.
2.      We should be very active in evaluating our treatment, trying to optimize it in every possible way. Cannot trust the healthcare system to do this for us.
 
A word on CMS 50F: although I’m not sure that the saturation readings are accurate (I suspect a bias of few percent below the correct reading) the relative results are correct and consistent and the excellent software that comes with the  product is very useful.
 
 I’ll publish a full report on my journey to the “promised land” (AHI=0) soon.
 
Arik
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#2
RE: More on the benefit of Oximeters
The chart shows a significant period of desaturation around 2:30, I would suggest you put some charts up, It more than likely you need to raise your min pressure, to see if this resolves it.
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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#3
RE: More on the benefit of Oximeters
Arik,

You are 100% correct in your theory about oximetry.  Apnea is one thing, but the resulting desaturation is what does the damage.  I have fine tuned my equipment to the point of having an AHI of 0.00 most of the time, but without wearing a sleep O2 monitor, I would not have known that I was still having periods of desaturation.

So, here is the problem;  I have tried several of the sleep O2 monitors, and in my opinion, they are all junk, probably from the same factory in China.  I am currently trying out the Innovo CMS 50F.  The advantage I have is that I have a known accurate finger oximeter that I tested against three of my doctor's oximeters.  Come to find out, one of my doctor's units was bad. LOL

That said, you are also correct in your speculation that the CMS 50F is inaccurate.  Mine consistantly reads 3-4% (usually 4%) lower than actual.  It is not a huge problem, but I do have to factor that in when considering where to set my low O2 alarm.  For me, my action point is 88%, so I set the monitor alarm at 84%.  This is by no means a perfect world scenario, but it is the best I have been able to achieve with the junk that is available on the market.

I agree, the SpO2 Assistant software is a good analytical tool!

HP
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#4
RE: More on the benefit of Oximeters
I agree. Two additional notes:

1. I have tried a Nonin Oximeter ($800 cost) and it was disappointing as well. So unless you want to spend on a clinical grade Oximeter for few thousands, they are all about the same. Nevertheless, we can still use them knowing their limitations.

2. Disaturation is one problem we have to deal with. The other one is that all these arousals we have are interfering with the brain activities during sleep which are essential for our health.

Best regards,
Arik
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#5
RE: More on the benefit of Oximeters
Arik,

You are 100% correct in your theory about oximetry.  Apnea is one thing, but the resulting desaturation is what does the damage.Arik,



This thread has me worried.

I recently had a sleep test, AHI 47. The sleep doc recommenced I use a CPAP machine, thats seems to be now working ok and events are well down.

What wasnt discussed was the sleep o2 levels from the test.
Average O2 desaturation was 85%
Time spent below 90% was 85 minutes or 17.4%
Lowest SaO2 was 75%

According to Doctor Google Im into a coma at 65%

Should I be worried?
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#6
RE: More on the benefit of Oximeters
Absolutely! you should consult a doctor ASAP, providing that the disaturation results are correct.

Arik
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#7
RE: More on the benefit of Oximeters
(06-23-2019, 01:28 AM)wesozzzz Wrote: This thread has me worried.

I recently had a sleep test, AHI 47. The sleep doc recommenced I use a CPAP machine, thats seems to be now working ok and events are well down.

What wasnt discussed was the sleep o2 levels from the test.
Average O2 desaturation was 85%
Time spent below 90% was 85 minutes or 17.4%
Lowest SaO2 was 75%

According to Doctor Google Im into a coma at 65%

Should I be worried?

I wouldn't think so, untreated under 90% down to 75% isn't that unusual. It would be classed in the severe range. The cpap should be resolving your apnea and o2. Why don't you start a thread and put some charts up. To get some opinions. I wouldn't buy a cms50f recording SPO2 for $80 yet.
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: Update on the Innovo CMS 50F
Last night was my second night on the CMS 50F.  At 2:00 a.m. and also around 6:00 a.m. the device alarmed, indicating that my o2 sat had dropped below the 84% treshold.  I checked my o2 level with my finger oximeter and found that my saturation was actually at 94%.  Sleepyhead reported no events at those times.   If I had been relying on the CMS 50F, I would have gone on supplimental oxygen needlessly.  The only reason I even wear one of these sleep monitors is to alert me if my o2 level drops to a point where I might need supplimental o2, but in the case of the Innovo CMS 50F, I am wasting my time.  It is a $170 piece of junk. Surprisingly, the finger oximeter I have is a $39 unit from Rite Aid, and it has proven to be as accurate as the equipment my doctor uses, and much more accurate than the more expensive units I have been trying to use.  That said, I know at least some of the oximeters can work accurately, I guess its just a matter of finding the right one.  I will keep searching, and post a notice if I find one that is something more that a toy.

FWIW, it appears to me that frequent and repeated periods of desaturation over time are what do the most damage.  My father had sleep apnea and refused treatment, (tough guy syndrome).  It wasn't long before he experienced his first early morning heart attack.  Due to his untreated apnea, his health continued to deterioriate over time, with lung and kidney problems.  He made it a couple of more years before experiencing another early morning (fatal) heart attack. 
Im my opinion, desaturations are nothing to screw around with.
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#9
RE: More on the benefit of Oximeters
You may wish to try another (new) probe on the 50F.  I've found they seem to degrade with age. I haven't determined whether it is the laser or the sensor that degrades.  I have improved readings (2%) by cleaning the sensor with a Q-tip and lens cleaning solution.
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
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#10
RE: More on the benefit of Oximeters
Still looking for an accurate reliable Oximeter. Few I had tried sort-of worked but not that great.
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