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General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Re: Does a O2 level of 87 at high altitude really require CPAP?

Postby Guest on Mon May 15, 2017 8:42 pm

Arizona JC wrote:Not enough sleep recorded to allow split.
That is a reference to a "Split Night" study. This when a diagnosis is the first part of the nite and if/when certain criteria is met (and the doc has ordered it) they can then go into the part where a mask is put on and they try to eliminate all events (if possible) by adjusting pressures - this is known as the "Titration" which may or may not be accurate given the time constraints.

Which btw is normally an early exit but not often that early.

fwiw - Medicare requires a minimum of 2hrs for diagnosis. That means the patient must sleep for at least 2 hrs. So now I am wondering since she didn't sleep 2hrs IF the billing code used was for something else and that is why
the cost (it ended up being fully covered by insurances) for this was $1249.84
See if you can find out what code was used and just maybe she can get yet another PSG= Sleep Study at home or elsewhere if needed.

Arizona JC
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Re: Does a O2 level of 87 at high altitude really require CPAP?

Postby Arizona JC on Thu May 18, 2017 3:29 pm

Sorry I (original poster) have been absent from this thread; I managed to hurt my hand (just bruised, nothing serious) so can't type much today, and couldn't at all until now. (for those unaware, it's preferable to close your car door after, not before, moving your hand out of the way.. oops.).

I've read every post in this thread, and all I can say is THANK YOU ALL, so much. Having this interaction has been a rock in what, for me, was a very stressful and uncertain time. I'll reply as I can, which is hopefully soon (my hand is healing).

So, now the update on Mom. She's doing pretty well getting used to CPAP. Also, I have noticed she doesn't doze while watching TV anymore (she did occasionally before CPAP).
I also did a series of oximeter spot checks on her during a hike. She was pretty steady at 92 (approx... a point either way deviation) until we got to the uphill section a couple of miles in. It's a small climb, about 100 ft elevation gain at a 10% grade. Hiking uphill usually bothers her, and it did this time too. At the top, she was severely out of breath (she insisted on not taking it easier or pausing) and her 02 was 79, but came up very fast.
The elevation we were at was about 5700 feet.

I still find the sleep study she had to be dubious (not saying she doesn't need CPAP, just that I don't trust the sleep study). I've previously reported that the study report shows (in print, but not in the graph) that her heart BPM hit 255, which is incredibly dubious IMHO. I've now uncovered another discrepancy, this one certain; her AHI. It's not in the printed report, just in handwriting on the front (same is true for her hypoxia level) and is 87. BUT, on the CPAP provider's paperwork, Mom's AHI is 18, and further a "moderate" AHI, with range, is circled on their paperwork. Seeing as how 87 is not 18, somebody goofed. And, I want to know exactly where the CPAP provider got that AHI of 18 number, because it's not anywhere in the records I've been given, and I've been told I now have all of them.

My current plan is to ask a heck of a lot of questions next week, when I take Mom to the CPAP provider for her followup. I'm also still getting a logging oximeter to get more data.


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Re: Does a O2 level of 87 at high altitude really require CPAP?

Postby Julie on Thu May 18, 2017 4:12 pm

Just a thought from here... I think if I was 88 regardless of anything much - OSA or not - I might cut back on uphills at high elevations (or even low ones!) because it may not be the best thing all around at that age... maybe even for ex-olympic athletes!

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Re: Does a O2 level of 87 at high altitude really require CPAP?

Postby raisedfist on Fri May 19, 2017 12:04 pm

It sounds like she should be using supplemental oxygen while awake and moving around, especially during strenuous activity. According to the sleep study her baseline oxygen saturation while awake, on room air, just sitting/laying around, was 89%, which is low. Then, you say during a hike her oxygen saturation went as low as 79%, which is very low. IMO she should be making a doctor's appointment and getting checked out by a cardiologist as clearly she has more problems than sleep apnea and being old.

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ResMed S9 VPAP ST-A with iVAPS
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