Should I get an oxygen monitor

[CorgiWalker]

I have been using my APAP 2 years. I averaged around 3.5 AHI's. Mid-November, my AHI's started averaging 7.9 with a high of 14.1 and a low of 3.4. Several things changed. 1. I started intermittent fasting. 2. I started a healthy, low carb, low-inflammation, keto diet. 3. My right shoulder (the side on which I normally sleep) is painful, so I am sleeping more on my left (which triggers my AFIB more). OSCAR shows that many of the AHI episodes are during periodic breathing. I contacted both my pulmonologist NP and my cardiologist. Neither seems concerned. The NP did up the pressure Min from 8 to 10 and max from 12 to 15. I don't see a change, yet. My concern is that it seems a long time in which I might not be getting sufficient oxygen. Would you advise getting a 24 hr monitoring device, and if so, which one? Thanks! OSCAR charts are attached for the worst night. Thank You!

[Pugsy]

Any chance you were awake during the clustering of CAs/Centrals?
I was looking at 12/9 at 3:36 and there's a cluster and it ends with the machine being turned off. Were you awake for a period of time before you turned the machine off?
Do you ever spend much time awake with the mask and machine on?

Try turning off Flex exhale relief and see what happens.

If you still get a large number of CAs/centrals and you were for sure asleep, then yes...I think if it were me I would invest in an overnight recording pulse oximeter.

[palerider]

The contec CMS50F and CMS50i are wrist mounted oximeters that record overnight, the F only records one session, the I will record multiple sessions, as well as the perfusion index. They're both supported by Oscar, so you can sync the time on the oximeter, then import the data into Oscar to display along with your cpap data.

[KatieW]

This is the one I got, from Amazon.com
https://www.amazon.com/gp/product/B0796 ... UTF8&psc=1

I have a Mac, so their software doesn't work, but it syncs just fine with Oscar and is included in the daily report.

[CorgiWalker]

Thanks, so much, ya'll. I will put a pen and paper by the bed and write down when I am awake. I will also look at more recent nights to help determine, if I was awake. I think that the episodes and AFIB woke me, but I will check this out. I will also try the setting change. Then, if I am asleep, I will pursue one of these O2 monitors. Again, THANK YOU!

[CorgiWalker]

Pugsy,
You are definitely on to something. I turned the flex off. I know that I need many samples to be significantly different, but I am definitely encouraged. Prior to turning the flex off: AHI-9.15, PB-14.52, CA-4.90, Obs-1.29, HA-2.96, RERA-1.16. After turning off the flex: AHI-3.37, PB-5.39%, CA-0.15, Obs-2.30, HA-0.92, RERA-4.14. It looks like I am very susceptible to the pressure changes. And, I was awake during many of the events. One series of events looks like it may have precipitated waking. I recorded that at 3:38, I woke and my heart was fluttery (or I was jittery). Last night was a terrible night for sleep, so the chart is very deceptive. We walked yesterday, so I could not get comfortable to go to sleep and did not drift off till sometime after 02:30. At 3:38, I awoke. Again, at 5:59, I awoke. But the AHI and periodic breathing while I was asleep are much better. I listened to a YouTube that LankyLefty had on the EPR/FLEX, and I think that my pressure ranges may need to be narrowed as well. THANK YOU, THANK YOU, THANK YOU!

[Pugsy]

Sometimes easy peasy works....let's see how you do on a night where you know your sleep quality was better and you slept more soundly.
There's probably some false positive awake events getting flagged last night.
They muddy up the evaluation process.

Sometimes when people use exhale relief it creates a bilevel situation which can trigger centrals in numbers that are alarming.
It creates an unstable breathing pattern that perpetuates itself. It's not extremely common but it can happen.
Turning off exhale relief (or sometimes just reducing it) seems to keep that unstable breathing from ever starting or feeding itself.

Need more nights where you sleep more soundly to see for sure.

[palerider]

It looks like I am very susceptible to the pressure changes.

What you're susceptible to is the extra ventilation that flex causes, which drives down your CO2 levels, which depresses your respiration.

NOT the pressure changes, of which there are many, that reduce your obstructive breathing events.

[CorgiWalker]

Thank you! I didn’t state that well. By pressure changes, I meant the reduce by 3 from the inhale to the exhale. I will go awhile and then feedback.

[palerider]

Thank you! I didn’t state that well. By pressure changes, I meant the reduce by 3 from the inhale to the exhale. I will go awhile and then feedback.

Aflex doesn't reduce by 3... those setting numbers have no direct relation to the amount of exhale relief.

I correct these misinterpretations to prevent others from getting the wrong idea.

A small percentage of people are sensitive to the extra ventilation and end up with central apneas... you're apparently one of that small group.

[CorgiWalker]

Thanks! Must be an algorithm to some change.

[Mogy]

Hi CorgiWalker,
One of the things about intermittent fasting and a keto diet is that it's difficult to get enough potassium. Some of the foods that are highest in potassium are cut out of your diet.
I had some palpitations before I started with keto, and they only got worse. One of the reasons I was going keto was to help my heart. I thought I was getting enough potassium, but I wasn't. I was supplementing, but the largest dose you can buy is 100mg. The RDA is 4700mg. That is a lot.
There are many videos on YouTube about keto and potassium.
Also, here is a link to a study about AFIB and potassium.
Cheers!
https://www.ncbi.nlm.nih.gov/pubmed/24012173

[m421]

This is the one I got, from Amazon.com
https://www.amazon.com/gp/product/B0796 ... UTF8&psc=1

I have a Mac, so their software doesn't work, but it syncs just fine with Oscar and is included in the daily report.

I'm sure I found this info somewhere on this forum, but I found Mac software compatible with the CMS50F here:

http://torontek.com/product/torontek-b400/

The last time I tried OSCAR it wasn't yet compatible with newer CMS50F firmware, maybe it is now.

[CorgiWalker]

Thanks! I supplement potassium, but no where near this amount. I will rearch.

And, although my phone and tablet are iOS, my computer is Windows, so I can use OSCAR.

I told my allergist about OSCAR this week. He is a hose head and was very interested in it. He said that if he gets a 90%, he wanted to see what and when it was happening. I told him that this would show all the charts through the night.