Low Sp02 and some CA events

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
goodlife12
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Joined: Wed Jan 28, 2015 3:54 pm

Low Sp02 and some CA events

Post by goodlife12 » Fri Jan 30, 2015 9:01 am

Folks - Thanks for the excellent support on this forum. I have been a reader for a while - just posting this out of desperation.

I was diagnosed with Sleep Apnea 8 months back. AHI=12.4 (REM sleep AHI was 26). Put on Resmed S9 Autoset.
There were no centrals , only Obstructive events in my sleep study. Sleepyhead stats show hardly any centrals
for first 5 months.

After a recent turbinate reduction surgery, I am getting poor sleep for last month or so. Most nights I wakeup 2am-3am with a racing
heart. SpO2 levels seem to be dropping just before this happens. There are a few centrals after I wakeup. I talked
to my DME and they want to switch me to a BiPAP with ASV - suggesting a retitration. This is due to the few centrals (10-20 sec)
seens on some days (AHI 4-7 on 4-5 days last month).

I am getting by with just 2-3 hours sleep every night. The event is happening every night like clockwork.

What could be causing spO2 drop?. I see the drop happening before the heart races . The centrals appear after - when I am awake.

Could this be an issue with pressure or mask leakage ?. I do wake up with dry mouth some nights.

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Pugsy
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Re: Low Sp02 and some CA events

Post by Pugsy » Fri Jan 30, 2015 9:15 am

Can you include the leak graph please? We don't need insp or exp time graphs.

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goodlife12
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Joined: Wed Jan 28, 2015 3:54 pm

Re: Low Sp02 and some CA events

Post by goodlife12 » Fri Jan 30, 2015 9:27 am

Pugsy - here it is.
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Pugsy
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Re: Low Sp02 and some CA events

Post by Pugsy » Fri Jan 30, 2015 9:53 am

The report with AHI of 2.44 appears to have 2 different "blank" times where I assume you turned the machine off.
Are these the same reports...one appears to have the onset of the blank time around 4:45 and the other at around 3 AM...going by the flow rate graphs..So that has me confused a bit. While one appears to be more zoomed in version...the times shouldn't be different.

Some of your leaks are very large and when you see the leak line go over 30/35 then the S9 is going to have some difficulties sensing and treating the apnea events. Though to be honest I don't see a definite correlation going on with leak and pulse rate and O2 levels.

Your OSA is worse in REM stage sleep. That's already documented. What I suspect may be going on might be related, in part, to REM stage sleep. Normally we have more REM sleep in the wee hours of the morning..Typically the first stage happens around 90 minutes after sleep onset and as the night progresses REM time comes more frequently and lasts longer as the night progresses.

On the report that shows AHI of 2.44...and that awake time and high pulse rate that stays high while awake...I don't think that the one central was the problem...the problem started before the central got flagged. Something happened but I don't think we can see from these reports what it might have been. Something happened to increase the pulse rate significantly and caused it to stay up (probably adrenalin caused it to stay up) and the associated drop in oxygen...don't know which came first and is hard to tell.

I can't tell you why or what caused this....but the sudden increase in pulse rate and having it stay so elevated concerns me. I can't see anything to blame it on in terms of apnea stuff and since I can't explain it away...it really bugs me.
I think I would at least alert my doctor that this happened. It might be a fluke but it's a big change that I can't find anyway to explain it away and that would be a concern if it were me. When I can maybe explain things away I don't worry so much.

Your pulse should have return to more normal fairly quickly especially since you woke up...but it didn't and you continued to have problems while awake...that concerns me.

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Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

goodlife12
Posts: 4
Joined: Wed Jan 28, 2015 3:54 pm

Re: Low Sp02 and some CA events

Post by goodlife12 » Sun Feb 01, 2015 8:33 pm

Just in case anyone is having similar problems, I suspect that this is related to POTS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3700681/

This HR variability may not be related to CA or any OSA events.
I have a few other symptoms such as cold extremities, elevated heart rate when standing up or after food.

goodlife12
Posts: 4
Joined: Wed Jan 28, 2015 3:54 pm

Re: Low Sp02 and some CA events

Post by goodlife12 » Sun Feb 01, 2015 11:15 pm

Nigh time tachycardia is also linked to Anxiety , BetaBlockers are commonly prescribed
http://www.medhelp.org/posts/Heart-Dise ... how/250912