Need Help Interpreting Sp02

[CPAPLuv]

Tried out my Oximeter last night with these results. It looks to me like I am still experiencing desaturations (my sleep study said I had severe desaturations). If this is correct what should I do? Should I try upping my pressure? How would I go about doing that? My AHI has been consistently below 1.0 as of late. I know the graph portion is a mess and I am still trying to work that out.

I might also add that I have been having some days where I feel absolutely great and some that I am feeling groggy/foggy. I am wondering if this could be because of desaturations?

Any thoughts/advice you might have would be greatly appreciated!

[Geer1]

Is there a graph for spo2? If so posting it will help.

[jnk...]

Use of ramp and use of a minimum pressure on an APAP below 6 cmH2O or so can both sometimes have a negative impact on saturation, for some.

But if an APAP is keeping your airway open and stable enough to prevent obstructive apneas and obstructive hypopneas, APAP adjustment is not generally what is looked at for improvements in overall sustained saturation, other than switching to true bilevel to address obesity-related hypoventilation or adding O2, when protocols call for such things for reasons beyond simple OSA.

[CPAPLuv]

I will take a look later today when I have my home computer available. Meanwhile, should I be concerned by the 192 desaturations?

[jnk...]

. . . should I be concerned by the 192 desaturations?

Depends on what you define as a "desaturation," and it looks like your threshold is set up to flag anything below 96%--useful, perhaps, for establishing an OSA diagnosis, but maybe not so useful for evaluating overall O2 saturation, especially in situations in which accuracy of measurement may be called into question. Waking saturation is more useful for evaluations of overall circulation/respiration health.

As for sleep in general:

Although there are no generally accepted classifications for severity of oxygen desaturation, reductions to not less than 90% usually are considered mild.--http://healthysleep.med.harvard.edu/sle ... ng-results

[Pugsy]

I would want to see the software report from the pulse ox itself and not so much OSCAR in this situation.
I would want to see the SpO2 (or whatever it is called) software report.
Some of those desats might well be loss of contact artifacts.
There's more detail available on the real software reports than what OSCAR will give you.

[CPAPLuv]

I would want to see the software report from the pulse ox itself and not so much OSCAR in this situation.
I would want to see the SpO2 (or whatever it is called) software report.
Some of those desats might well be loss of contact artifacts.
There's more detail available on the real software reports than what OSCAR will give you.

Ok, that is good to know! I will take a look at that as well.

[palerider]

Oxygenation happens at the epap pressure, for most of your night, that's 4, 8d bump your min pressure to 8, or 9, and see what that does.

[CPAPLuv]

. . . should I be concerned by the 192 desaturations?

Depends on what you define as a "desaturation," and it looks like your threshold is set up to flag anything below 96%--useful, perhaps, for establishing an OSA diagnosis, but maybe not so useful for evaluating overall O2 saturation, especially in situations in which accuracy of measurement may be called into question. Waking saturation is more useful for evaluations of overall circulation/respiration health.

Thanks this is interesting and confusing. I am just going on what the chart said and it looks like 192 is the total number of desaturations which seems high to me.

As for sleep in general:

Although there are no generally accepted classifications for severity of oxygen desaturation, reductions to not less than 90% usually are considered mild.--http://healthysleep.med.harvard.edu/sle ... ng-results

So, according to this my desaturation of 89% is moderate?

[CPAPLuv]

Oxygenation happens at the epap pressure, for most of your night, that's 4, 8d bump your min pressure to 8, or 9, and see what that does.

Thanks, I will try bumping up (in the clinical menu?). Maybe a little bit at a time.

[slowriter]

Oxygenation happens at the epap pressure, for most of your night, that's 4, 8d bump your min pressure to 8, or 9, and see what that does.

Thanks, I will try bumping up (in the clinical menu?). Maybe a little bit at a time.

Why is your pressure so low? Aside from not being very effective, a lot of people find that setting too low, so that they feel starved for air.

Plus, at that level, you get no benefit from EPR.

I guess I'm saying I wouldn't be too conservative with a bump.

[jnk...]

. . . my desaturation of 89% is moderate?

A brief desat is different from sustained desats for long periods of time.

My two points are (1) that home monitors need to be well-positioned on the finger at all times to be accurate and (2) that the oxygenation of sleep-breathing usually gets fixed long before events are sufficiently controlled. In other words, rarely is O2 saturation the best method to use for optimizing APAP treatment pressures. That is why APAPs monitor breathing events for reporting efficacy data instead of all coming with built-in spO2 sensors. In other, other words, breathing-event detection is more useful for knowing status of airway during sleep than any O2 sensor, as far as dialing in the best PAP settings.

Once PAP pressures are optimized based on home-machine-reported events, then, and only then, should any residual sustained O2 issues be addressed, separately, as a separate health concern that may need to be evaluated and dealt with using something other than mere manipulations of APAP min/max pressures. For the vast majority, anyway.

In my opinion as a nobody.

Home pulse-ox monitors aren't even reliable for finding OSA, let alone useful for figuring out any specifics of how best to treat it for any given OSA sufferer.

[Pugsy]

The 89% could be a loss of contact number.
Maybe very brief. Happens all the time.
This is why more details than just what you see in OSCAR is needed.

[CPAPLuv]

Appreciate all of the input.

I also found this:

https://www.ncbi.nlm.nih.gov/pubmed/3382042

I had on dark blue nail polish so that could have skewed the reading...

[Geer1]

Does Oscar not graph the SpO2 results?

You can see the last two lines in Oscar events are pulse changes and desaturations, I imagine graphs are available if you scroll down.

For the first ~4.5 hrs it appears you had no issues. Then you had two smaller groups of desaturations that coincided with pressure increases which makes sense since the pressures increase when breathing difficulties start. These were likely real desats but I wouldn’t trust these basic desat stats until you know what they represent(likely a 3% or 4% drop etc). You also need to review graph as momentary drops in SPO2 are not uncommon, longer drops cause more issues. 88-90% is considered an issue so you touching 89% probably isn’t much of an issue.

What becomes more clear is that you shouldn’t have turned cpap off. After doing so you had the biggest group of desats and this is likely when your O2 hit 89%.

I am taking a bit of a leap due to lack of information/graphs but I think your apnea is worse with rem sleep and that is why it got progressively worse later in the night/morning. Turning off your cpap had a clearly negative effect as one would expect. Your minimum should probably be raised a bit to avoid some of the breathing issues/desats.