Sleep Apnea Screenings:

[momsworry]

These are being done to determine the need for a sleep study as I understand it. Can anyone share if these are worth while? I am a cpap user and doing fine with it. My wife I suspect might have sleep apnea and I'm wondering if one of the screenings might be a good first step. Thanks.

[montana user]

We use a screener called ApneaLink by Resmed. It only monitors the airflow, and we have had huge success with it! They make other ones with pulse ox, and belts etc, but I think the screeners do a good job. I have had several men tell me this stuff is a hoax, then look at their screener results and make appointments. In fact, we just had a guy this week who had a trip to Arizona planned for next week,take the ApneaLink home. We showed him the results- He cancelled his trip and is coming to see me instead. So my answer is yes they are worth the time! We offer ours for free, but I have a feeling we are on a very short list of people who do that. Insurance covers them as far as I know.

[Slinky]

Montana User, where is the ApneaLink all that much different than an overnight oximetry?

[montana user]

As you know the pulse ox measures the O2 in the blood. Heres the problem we found with itl. It breaks down the results like this-

96% of the night the O2 was between 100-90%
4% of the night the O2 was betweeen 89%-70%
0%of the night the O2 was Below 70% (These are just numbers I'm throwing out there)

So we look for a 4% decrease in the O2 to count it as an "event" So O2 can go from 100% to 96% and its an "event" But we cant tell from the overnight pulse ox because it groups it together. Yeah the above looks good! 96% in the 90-100% range. Thats great! or is it? How many times in that 96% did it drop 4%? We don't know. So the average person turns in the above the numbers and the doctor says, looks good! no need for a sleep study.

We do studies on people ALL the time and there oxygen never drops below 90%, but they have apnea. So it does work on the people who have O2 sats that drop way down for most of the night. So it does work, but it misses people as well.

Now the airflow is different. Technically there should never be a decrease or flatting of the airflow. So if we see there is more than 5 flatting or decreases in the airflow an hour, then the chances are very good there is apnea.

So pulse ox , O2 sats are grouped and not sepereated into how many times it dropped 4% or more. Airflow is measured by every individual breath.


I hope that made some sort of sense. If not please let me know! Thanks for the great question!!

[Slinky]

It makes sense - except - the pulse ox reports that I've seen why my DME provider sends me home for an overnight oximetry on occasion every desat is listed .... I'll see if I can find one and scan it to post here. BRB.

[Slinky]

Heck, I don't know how to post it from my scanner!!!! Grrrr.

But, whilst the first page is the "summary" additional pages consist of:

The number of events * The start time of each event * The end time of each event * The duration of each event * Saturation: onset - low * Pulse range: low - high

The last pages consist of 2 hour segment "squiggly line" graphs of the entire night.

I can e-mail a pdf if someone knows how to post it. I can send just one page each type (3), no need to send the entire 10 pages.

Even our "inexpensive" home recordng oximeters such as the SPO 700 and the Contec CMS 50 D Plus which come w/their own software produce the pages of the type of information you are interested in. At least the SP0 7500 does. And I think I saw a printout from a CMS 50 D+ that shows the same type of page and info right here in the cpaptalk forum.

[montana user]

these must be a newe ones, which is awsome! The ones we send home with people ( this DME and the other one I worked with) grouoped the numbers like I mentioned earlier. There are other disorders that you can have with your breathing that has nothing to do with oxygen also. So we were missing people with those issues too. Oxygen saturation is very important, and I prefer the screeners that have both the O2 sensor AND the airflow sensor.

[Slinky]

Not all that new, Montana User. That report I used as an example was from 2006, EARLY 2006. By late 2006 I purchased the SP0 7500 wrist recording oximeter and its software prints out a similar report. Your company NEEDS to update its equipment, it working in the dark ages!

[montana user]

So if I understand correctly the dme sends you home with a POX and it shows every single desaturation? Id love to see this chart so i can get our DME to get them.

But back to one of my other posts just the overnight POX can miss a group of people who have breathing disorder that does not effect the O2 saturations. Some screeners come with 2 effort belts, airflow sensor and the POX. These are pretty nice ones, but requires the user to put more things on in their home, vs. just a nasal cannual with the one we use. So each lab has their favorite screener just as people have different types of CPAP machines they like.

[rested gal]

Here's Slinky's 2006 oximetry report:

[Slinky]

And here is the other page I mentioned:

[snnnark]

From my PSG:
_______
The average event duration was 26 seconds, and the maximum duration was 62 seconds.

The average baseline for oxygen desaturations was 98% and the minimum Sa02 during a desaturation event was 94%.

Conclusion: Abnormal polysomnogram with an apnea/hypopnea index of 30 events per hour of sleep. Events were not associated with significant desaturation but arousals were prominent and snoring was evident throughout the polysomnogram recording. The findings would support a diagnosis of obstructive sleep apnea.
__________

So even though I have borderline severe sleep apnea, an overnight pulse ox would not have shown a problem!
If anyone does the pulse ox and doesn't show significant desaturations, it can be regarded as a false negative and further testing can be done.

[montana user]

Thanks for the chart, I will look into this!