Opinions please on my oximeter readings good, bad, ok ?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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ChicagoGranny
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Re: Opinions please on my oximeter readings good, bad, ok ?

Post by ChicagoGranny » Fri Nov 27, 2015 11:08 am

Mike1234 wrote:Here is the trace zoomed in I can't see a break :

https://flic.kr/p/ABMQph
Look at three of the four deepest drops in the ox line - drop 1, 2 and 4. Just before each of these drops, you see a drop in pulse measurement. When you are TRULY having an apnea, your pulse will go up, not down. Your pulse measurement is probably dropping due to a loss in contact as Pugsy explained. Then immediately following, the ox measurement catches up and records a drop.

I am not a fan of patient analyzed pulse-ox reports for two reasons. One, you get this kind of confusion and fretting because the patient does not know how to read the report. Two, a good pulse-ox report does not mean the patient is cleared of having a very unhealthy sleep-disordered breathing (SDB) condition ---->
Pugsy wrote: pulse oximetry reports aren't alarming but that doesn't mean that there's no sleep apnea or no sleep disordered breathing. All it means is that the oxygen levels aren't alarming. We can still have sleep breathing problems or arousals that can cause problems without there being any alarming drop in oxygen levels.
One of those situations where a negative pulse ox report doesn't mean no problems...just means the oxygen levels aren't alarming...and further evaluation in other areas possibly needs to be done.

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49er
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Re: Opinions please on my oximeter readings good, bad, ok ?

Post by 49er » Fri Nov 27, 2015 11:36 am

Pugsy wrote:Your images are hard to evaluate due to sizing issues but you don't appear to be spending much time below 90%. Those sudden spikes downward are mostly likely loss of contact artifacts and not alarming.

It's normal to have a little drop in O2 levels when we go to sleep and I think you can see that easily enough with the slight drop initially.

So your pulse oximetry reports aren't alarming but that doesn't mean that there's no sleep apnea or no sleep disordered breathing. All it means is that the oxygen levels aren't alarming. We can still have sleep breathing problems or arousals that can cause problems without there being any alarming drop in oxygen levels.
One of those situations where a negative pulse ox report doesn't mean no problems...just means the oxygen levels aren't alarming...and further evaluation in other areas possibly needs to be done.
I am a perfect example. On my most recent sleep study, the lowest O2 level I went down to was 91% and only for a few seconds before going back up to the mid/high 90s. My AHI was 25 which may be underreported due to my sleeping only 3 hours.

Agree with all the advice to see a sleep doctor immediately and not depend on an O2 report.

tiredandscared
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Re: Opinions please on my oximeter readings good, bad, ok ?

Post by tiredandscared » Fri Nov 27, 2015 4:22 pm

I had something similar happen. And I know they probably weren't reliable readings. Buy a roll of medical tape and fasten the oximeter so it doesn't move. See if you still get these extreme oxygen desaturations. And pugsy is right. Desaturations are gradual. I've seen mine go down from 90 to 86-87. But gradually ,you have to stop breathing for 20-30 seconds to drop that fast.
Last edited by tiredandscared on Sun Nov 29, 2015 12:39 pm, edited 1 time in total.

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Re: Opinions please on my oximeter readings good, bad, ok ?

Post by HoseCrusher » Fri Nov 27, 2015 4:43 pm

Mike, while your data doesn't look absolutely awful, it isn't good or "picture perfect." Ideally you don't want excursions below 90% and you don't want spikes in your pulse rate.

Look at the data again but go to a 10 minute time frame (or a 1 minute time frame) and see if there is any indication of a loss of signal. One cause for these weird signals is if you happen to wiggle your finger inside the oximeter. In these cases you almost loose contact but not quite. It throws the data off.

You can also review your summary report and see what you have for % Artifacts.

I would suggest you record a few more nights of data. Perhaps take a night or two off then try it again. This will give your finger a break and it may seem that the oximeter is a little more comfortable.

Hold on to this data. It represents what is going on before you start on your journey to determine if you have sleep breathing issues. If it turns out that you do have some issues and start on an XPAP machine, you can then compare your results while using the machine with your initial observations to see what the difference is.

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brain_cloud
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Re: Opinions please on my oximeter readings good, bad, ok ?

Post by brain_cloud » Sat Nov 28, 2015 2:01 am

Mike1234 wrote:Hi guys,

I'm new to the forum, I have been feeling tired for a long time so I bought a oximeter to check my results I have posted them below for 3 nights what do you think ?


https://www.flickr.com/photos/138077675 ... res/Fb92i2
https://www.flickr.com/photos/138077675 ... res/fS783f
https://www.flickr.com/photos/138077675 ... res/hgx2Ju

Thanks Mike
Hi Mike,

These look pretty bad. I've collected data like this on 4 people who have OSA, and 7 people who do not. And the oximetry charts coming from the people who do not have OSA all look the same, and look nothing like yours. People are getting hung up on the issue of how low do your O2 levels go, and are there artifacts, etc., etc. Doesn't matter. It's the entire night of data that is abnormal, both the choppy nature of the O2 levels, even when it stays above 90%, and the choppy nature of the heart rate. Tomorrow I'll post some oximetry data from "normals". It looks nothing like yours or mine (pre therapy, that is).

So, yeah, you need a sleep study. I predict OSA with AHI in the 40-60 range.

Paul J.

gregzeng
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Re: Opinions please on my oximeter readings good, bad, ok ?

Post by gregzeng » Sat Nov 28, 2015 3:32 am

ChicagoGranny wrote:
Mike1234 wrote: I have been feeling tired for a long time
What led you to do an oximetry study? Do you have other symptoms? How old are you? What is your BMI? Do you have any other health problems? What is your diet like? Are you active? Have you had a medical physical recently? What drugs are you taking? How much alcohol do you consume?
Thank you for your ready response to newcomers issues here.

I am not sure what your advice in this one comment means, in regards to the original post. Another factor for oximetric readings are the reading situation at the time of reading. Is the situation a time of stress factors, such as unusual events before or soon to-be-expected after the reading time? Stress factors include examinations, deaths, birthdays, etc.

On the amount of alcohol, or other drugs: it is a matter of timing and tolerances also. My medical specialists have myself addicted to an ethanol substitute, http://www.drugs.com/baclofen.html - Baclofen. But that is another topic.

I would agree that your comments should be in the
"STICKIE - needed, to solve problems"

Perhaps you need to apologize to the newcomer for the extremely faulty design of this web site. Automatic details of experiences with CPAP should be easily, quickly included with the membership into this forum.

On your reply, suggesting visits to traditional therapists, this is not often easily possible, for very many reasons. End-user or self-help consumerism is usually better, cheaper, more convenient, and often safer than seeing authority figures, who are obligated to submit reports to insurance companies, legal authorities, etc.

Readers of Amazon's buyers feedback have many times shown that these authoritative experts can be very expensive, wrong and dangerous.

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ChicagoGranny
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Re: Opinions please on my oximeter readings good, bad, ok ?

Post by ChicagoGranny » Sat Nov 28, 2015 6:19 am

gregzeng wrote:Perhaps you need to apologize to the newcomer for the extremely faulty design of this web site.

Image

Guest

Re: Opinions please on my oximeter readings good, bad, ok ?

Post by Guest » Sun Nov 29, 2015 2:04 pm

Hi Mike,

These look pretty bad. I've collected data like this on 4 people who have OSA, and 7 people who do not. And the oximetry charts coming from the people who do not have OSA all look the same, and look nothing like yours. People are getting hung up on the issue of how low do your O2 levels go, and are there artifacts, etc., etc. Doesn't matter. It's the entire night of data that is abnormal, both the choppy nature of the O2 levels, even when it stays above 90%, and the choppy nature of the heart rate. Tomorrow I'll post some oximetry data from "normals". It looks nothing like yours or mine (pre therapy, that is).

So, yeah, you need a sleep study. I predict OSA with AHI in the 40-60 range.

Paul J.[/quote]
Thanks Paul for the advice and info. I really was not sure if the data was just chance. I'm trying to help myself as I have suffered from fatigue for years and really bad headaches, and the docs gave me blood pressure tablets. Which I now wonder if the high blood pressure was the secondary symptom I have taken the readings again with two oximeters on different hands and the data and time mirrors so I am more convinced by the results.( unless both meters are identically wrong which I'm guessing is unlikely) I am still waiting for my sleep study I hope it's soon thanks again. All the best Mike

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Re: Opinions please on my oximeter readings good, bad, ok ?

Post by brain_cloud » Sun Nov 29, 2015 3:19 pm

Guest wrote:
Hi Mike,

These look pretty bad. I've collected data like this on 4 people who have OSA, and 7 people who do not. And the oximetry charts coming from the people who do not have OSA all look the same, and look nothing like yours. People are getting hung up on the issue of how low do your O2 levels go, and are there artifacts, etc., etc. Doesn't matter. It's the entire night of data that is abnormal, both the choppy nature of the O2 levels, even when it stays above 90%, and the choppy nature of the heart rate. Tomorrow I'll post some oximetry data from "normals". It looks nothing like yours or mine (pre therapy, that is).

So, yeah, you need a sleep study. I predict OSA with AHI in the 40-60 range.

Paul J.
Thanks Paul for the advice and info. I really was not sure if the data was just chance. I'm trying to help myself as I have suffered from fatigue for years and really bad headaches, and the docs gave me blood pressure tablets. Which I now wonder if the high blood pressure was the secondary symptom I have taken the readings again with two oximeters on different hands and the data and time mirrors so I am more convinced by the results.( unless both meters are identically wrong which I'm guessing is unlikely) I am still waiting for my sleep study I hope it's soon thanks again. All the best Mike
Just remembered I said I would put up a couple sample charts from people that don't have OSA, for what it is worth.

Image

And number two:

Image


Now that I refresh my memory (I haven't looked at these in five years or so), these charts from the non-OSA people aren't quite as pacific as I remember. Top one is a woman, bottom is a man, both in the 40-45 year old range. Co-workers, always game for doing medical experiments. Engineers, you see.

Paul J.

tiredandscared
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Re: Opinions please on my oximeter readings good, bad, ok ?

Post by tiredandscared » Sun Nov 29, 2015 5:07 pm

brain_cloud wrote:
Guest wrote:
Hi Mike,

These look pretty bad. I've collected data like this on 4 people who have OSA, and 7 people who do not. And the oximetry charts coming from the people who do not have OSA all look the same, and look nothing like yours. People are getting hung up on the issue of how low do your O2 levels go, and are there artifacts, etc., etc. Doesn't matter. It's the entire night of data that is abnormal, both the choppy nature of the O2 levels, even when it stays above 90%, and the choppy nature of the heart rate. Tomorrow I'll post some oximetry data from "normals". It looks nothing like yours or mine (pre therapy, that is).

So, yeah, you need a sleep study. I predict OSA with AHI in the 40-60 range.

Paul J.
Thanks Paul for the advice and info. I really was not sure if the data was just chance. I'm trying to help myself as I have suffered from fatigue for years and really bad headaches, and the docs gave me blood pressure tablets. Which I now wonder if the high blood pressure was the secondary symptom I have taken the readings again with two oximeters on different hands and the data and time mirrors so I am more convinced by the results.( unless both meters are identically wrong which I'm guessing is unlikely) I am still waiting for my sleep study I hope it's soon thanks again. All the best Mike
Just remembered I said I would put up a couple sample charts from people that don't have OSA, for what it is worth.

Image

And number two:

Image


Now that I refresh my memory (I haven't looked at these in five years or so), these charts from the non-OSA people aren't quite as pacific as I remember. Top one is a woman, bottom is a man, both in the 40-45 year old range. Co-workers, always game for doing medical experiments. Engineers, you see.

Paul J.
My oxygen saturation looks like that the days I sleep fully on the side. Actually even better than this. They seem to spend a lot of time in 95-90%. Which is normal but suboptimal normal. As you need ro spend 90%+ in 99-96% oxygen saturation.

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Too tall
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Re: Opinions please on my oximeter readings good, bad, ok ?

Post by Too tall » Sun Nov 29, 2015 9:00 pm

There is a relationship between AHI and ODI. Oxygen Desaturation Index is the number of times per hour of sleep that the blood's oxygen level drops by 3 percent or more from baseline.

Your link is busted so I don't know if you posted the ODI or the number of Desats during the sleep period, but that is what you need. O2 can vary but still not be a recordable (meaningful) desaturation event. It takes software to break this stuff out and make sense of it.
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Re: Opinions please on my oximeter readings good, bad, ok ?

Post by brain_cloud » Sun Nov 29, 2015 9:46 pm

Too tall wrote:There is a relationship between AHI and ODI. Oxygen Desaturation Index is the number of times per hour of sleep that the blood's oxygen level drops by 3 percent or more from baseline.

Your link is busted so I don't know if you posted the ODI or the number of Desats during the sleep period, but that is what you need. O2 can vary but still not be a recordable (meaningful) desaturation event. It takes software to break this stuff out and make sense of it.
The oximeter software that the OP is using does not calculate the ODI unfortunately.

The AHI to ODI correlation is plausible. There are probably even better ways to calculate a reasonable approximation of AHI using oximetry signal that haven't been figured out yet. And since you also get heart rate as well, which gets perturbed during apneas, there are likely metrics out there yet to be discovered that would use the synchronized oximetry and heart rate signal to get a pretty robust AHI proxy. Hell, I wonder what might be possible using bare heart rate alone. Talk about your cheap home sleep studies.

Image below puts oximetry data overlaid on Resmed software Apnea events.

Image


Kinda makes me want to get busy crunching data and getting some patents going.

Paul J.

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Re: Opinions please on my oximeter readings good, bad, ok ?

Post by Too tall » Mon Nov 30, 2015 11:10 am

brain_cloud wrote:
Too tall wrote:There is a relationship between AHI and ODI. Oxygen Desaturation Index is the number of times per hour of sleep that the blood's oxygen level drops by 3 percent or more from baseline.

Your link is busted so I don't know if you posted the ODI or the number of Desats during the sleep period, but that is what you need. O2 can vary but still not be a recordable (meaningful) desaturation event. It takes software to break this stuff out and make sense of it.
The oximeter software that the OP is using does not calculate the ODI unfortunately.

The AHI to ODI correlation is plausible. There are probably even better ways to calculate a reasonable approximation of AHI using oximetry signal that haven't been figured out yet. And since you also get heart rate as well, which gets perturbed during apneas, there are likely metrics out there yet to be discovered that would use the synchronized oximetry and heart rate signal to get a pretty robust AHI proxy. Hell, I wonder what might be possible using bare heart rate alone. Talk about your cheap home sleep studies.

Image below puts oximetry data overlaid on Resmed software Apnea events.

Image


Kinda makes me want to get busy crunching data and getting some patents going.

Paul J.

Thanks for that, I'm a oximeter nut so I'm constantly trying to correlate my ODI to AHI. Here is a very short but interesting study on this study. They came up with a correlation that can somewhat be applied to ODI and AHI, more or less.

http://www.apneabuster.com/documents/Co ... vs_AHI.pdf
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