Oxygen and AHI events

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
sonnichs
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Oxygen and AHI events

Post by sonnichs » Mon Oct 12, 2015 3:42 pm

I am presently investigating an oxygen sensor.

Recently I see increased AHI events on my log. I am assuming that this should not matter as long as the CPAP addresses the event. However it brings to mind-what is the ultimate test of the results of using a CPAP? Is this to be found in watching the blood oxygen levels? It would seem that all else doesn't really matter as long as the oxygen levels are maintained.

Fritz

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jdr999
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Re: Oxygen and AHI events

Post by jdr999 » Mon Oct 12, 2015 11:11 pm

sonnichs wrote:However it brings to mind-what is the ultimate test of the results of using a CPAP? Is this to be found in watching the blood oxygen levels? It would seem that all else doesn't really matter as long as the oxygen levels are maintained.
That's not entirely true.

The ultimate benchmark is your health.

For that to improve a few things must happen:

You need to get restful, restorative uninterrupted sleep
You need to make sure your body is maintaining proper oxygen levels
You need to prevent those damaging flight-or-fight responses during the night when your body dumps adrenaline and other hormones into your system when it senses things going downhill fast.

#1 is just as important as the rest....

But I agree that an oximeter will give you a better understanding of what's happening during those events. Leak rate, flow limitations, AHI, pulse, and SPO2 all help you see the bigger picture. Some consider a pulse oximeter overkill while others use one for peace of mind.

I use one, but it's not the ultimate test for your xpap therapy. It's just another tool....

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The Choker
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Re: Oxygen and AHI events

Post by The Choker » Tue Oct 13, 2015 5:26 am

sonnichs wrote:Recently I see increased AHI events on my log. I am assuming that this should not matter as long as the CPAP addresses the event.
Bad assumption. If your data shows breathing events, then you are having events that are not treated by CPAP.

But they most likely can be treated if you have the proper machine settings, and you don't have large leaks in your CPAP circuit.

Fill out your equipment profile, state your machine settings and some details about the events. Ideally, you will post a night's details (graphic) from Sleepyhead.
sonnichs wrote:I am presently investigating an oxygen sensor.
Quit worrying about an oximeter. Your first priority is to optimize your CPAP process, and this can be done with tools already available.
T.C.

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49er
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Re: Oxygen and AHI events

Post by 49er » Tue Oct 13, 2015 6:24 am

Agree with the previous posts as one who never got below a 90% O2 level on two sleep study tests and only very briefly but yet had moderate apnea. An oximetry test for screening sleep apnea would have been totally worthless in my case.

sonnichs
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Re: Oxygen and AHI events

Post by sonnichs » Tue Oct 13, 2015 7:04 am

Ok and thanks.

I find revealing, the comment "If your data shows breathing events, then you are having events that are not treated by CPAP."

This was not entirely clear to me (the documentation with the device is useless) and I was trying to determine exactly what the machine defines as an "event". The nurse noted that I was still having over 10 events per hour and increased the pressure. I wasn't clear if the CPAP prevents the events or just addresses them when the occur. Recently I have seen and a climb from about 5 to 17 events. Not sure if this is physiological of something going on with the machine.

cheers
fs

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Pugsy
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Re: Oxygen and AHI events

Post by Pugsy » Tue Oct 13, 2015 7:27 am

The flagged events that you see are the ones that slipped past the machine's defenses.
The machine can't fix them after they happen. At best it can only hope to prevent more from happening.
We have no way to know how many airway collapses (events) may have occurred.
sonnichs wrote: I wasn't clear if the CPAP prevents the events or just addresses them when the occur.
It's supposed to prevent...can't fix them after they happen or during when they happen...won't increase the pressure during the apnea event to "blow the airway open". That's not the way it works.
sonnichs wrote:Recently I have seen and a climb from about 5 to 17 events. Not sure if this is physiological of something going on with the machine.
Is this 5 to 17 per hour or over the entire night? If it is per hour then you need to be using the software and see exactly what kind of events are happening...then decide best course of action.

The goal is to have the AHI (which is a per hour average) less than 5.0. Yours isn't and that's why they increased the pressure.
You really need to use the software available because leaks might be a factor or maybe centrals are a factor (and more pressure won't prevent centrals)....there's just so much more that needs to be evaluated.
See here for software options.
https://sleep.tnet.com/equipment

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Pugsy
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Re: Oxygen and AHI events

Post by Pugsy » Tue Oct 13, 2015 7:33 am

Oh...another thing. It's not all about oxygen only...it's about sleep quality in general.
You don't have to have significant oxygen drops to have a major sleep apnea problem.
Oxygen levels are important but not the only important item.

Example: I come over to your house and stick you with a pin and cause you to wake up every 2 minutes (that would be like AHI of 30). You wake up briefly but go back to sleep until I stick you with a pin again in 2 minutes. I do this all night long. How good do you think you will feel? Your oxygen levels won't drop with the pin sticking but you wake up all night long and never really get good quality sleep or the normal sleep cycles.

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sonnichs
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Re: Oxygen and AHI events

Post by sonnichs » Tue Oct 13, 2015 11:55 am

Thanks for the further information. I have been using the SleepyHead software. And I do see leaks-I am trying to get a handle on whether this is a problem and also whether it leads to false reporting. I keep the full mask on very tight and it seems to have no leaks most of the time that i am aware of when full pressure (15") is developed. I am not sure what it takes to report a leak. I pull the mask away momentarily when I cough for example-don't know if the system catches this and reports it as a leak.

I am waiting to hear back from the resp. therapist on leaks in general and the reason for the climb to 17 AHI/hour.

thanks
fs

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Julie
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Re: Oxygen and AHI events

Post by Julie » Tue Oct 13, 2015 11:59 am

That may be the problem - you should not tighten the mask like that - it won't allow the silicone to inflate and seal properly, and it must be uncomfortable. If you can't get a good seal without overtightening, you may need a different mask, or better fitting of yours, diff. size, etc. but overtightening is counterproductive and can even create new micro leaks in new places. You might want to look into Padacheek.com liners that help seal masks.

sickwithapnea17
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Re: Oxygen and AHI events

Post by sickwithapnea17 » Tue Oct 13, 2015 1:42 pm

if you think about it you can die from hypoxia and having low O2 for 3 minutes so what does 10 seconds or more of hypoxia do to your brain? I feel like a good portion of my brain is braindead now from the hypoxia and I'm really suffering.
18/14 bipap st

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Re: Oxygen and AHI events

Post by SewTired » Tue Oct 13, 2015 1:54 pm

The oxygen sensor isn't useful until you resolve the other issues such as leaks and apnea. The oxygen sensor is useful after you've resolved the major issues and still are having problems. You aren't there yet.

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sonnichs
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Re: Oxygen and AHI events

Post by sonnichs » Tue Oct 13, 2015 7:21 pm

Thanks,
Yes-over tightening warps the mask at some point creating leaks. However having it somewhat loser it starts to leak at the gasket around 12" pressure. I will talk to the vendor when they get in this week to try other masks.

My O2 was below 85% in the sleep tests and I am just curious to see if it improves with the CPAP. I feel somewhat better when I use the CPAP but no remarkable results here so i want to experiment some more.

fs