Supplemental O2 ?

[russjpaul]

Could anyone give me a couple of pointers interpreting my Sleepyhead output. I live at 7200 feet and while my o2 stats are good at sea level, I'm noticing significant drops in spo2 while at home. Could anyone tell me how to arrange my Sleepyhead report so one of you knowledgeable folks might be able to give me some advice.

[russjpaul]

Sorry for not reading the introductory instructions. .

Attached is Sleepyhead with Spo2 reading. do you folks think a small amount of supplemental o2 will help ? I'm 56, 5'11 & 190 lbs and live in Park City, Utah. 7200 feet elevation.

[raisedfist]

Have you tried raising your min pressure a bit to see if that helps? EPAP/CPAP helps keeps the airways open so that proper gas exchange can occur.

What kind of pulse oximeter do you use to record? It may be helpful to use their software to upload the screenshots on here because it will show the % of movement artifact and a bit more data than importing into SleepyHead/OSCAR will.

It does appear from the rough chart that you do have a few sustained clusters of desaturations below 88%, leading me to guess that they aren't artifacts, but it's just a guess. I don't see anything in your data that screams an obvious culprit.

The general rule/advice is to optimize PAP therapy to the best ability first, and then if the issue persists, consider taking further steps.

My amateur plan would be to raise your min pressure until the remaining events are knocked away, including any snoring and flow limitations. Get those charts looking beautiful, and then test the O2 levels overnight.

Do wait until smarter people than I comment

[russjpaul]

Hi raisedfist !

Thanks so much for your insight.

I'm going to increase the low pressure setting by a couple of inches tonight and run the pulse ox too and see what we get tomorrow.

The pulse-ox I have is a CMS50FW and it uses Spo2 Assistant.

Attached is the graphic summary and oximetry it generated. If you can use a different report let me know and see if it will generate what you need.

It didnt dawn on me that the issue occurs at low pressure.

Thanks again!

Russ

[palerider]

Sorry for not reading the introductory instructions. .

Attached is Sleepyhead with Spo2 reading. do you folks think a small amount of supplemental o2 will help ? I'm 56, 5'11 & 190 lbs and live in Park City, Utah. 7200 feet elevation.

Please read the instructions on how to format charts. the AHI chart is *completely* useless.
http://cpaptalk.com/wiki/index.php/Oscar:organize

your SpO2 isn't bad for most of the night, a little more pressure would probably take care of it.

[raisedfist]

Basal SpO2 of 90ish is low but perhaps understandable due to the altitude. I think it’s similar to a pressurized cabin. Not harmful in itself but I would indeed try to improve that with EPAP. Below 88% can be harmful if repetitive or sustained but 12 mins below 88% should be able to be cleaned up with more pressure.

[russjpaul]

Increased Min Press.to 10.6. AHI index went down but spo2 actually dropped a tiny bit. Maybe increase min pressure to 11.5 ?

Thanks folks - appreciate the help.

R.

[raisedfist]

Hmm well your respiratory statistics look more or less normal...in terms of respiratory rate, minute ventilation and tidal volume. An adequate amount of air seems to be coming in and going out. Tidal volume *could be* a bit low depending on your height. No periodic breathing either from the altitude. I don't see any glaring issues. You could perhaps increase EPR to 3 full time just to see what effect it has if anything, to see what a bit of extra ventilation does, but I don't think that will yield much going from 2 to 3.

What are your oxygen levels while awake at altitude? Have you brought this issue up to your doctor?

Do you have an established life where it is necessary to stay in the town you live in? If there were nearby towns at lower elevation, and it wouldn't change your life/routine much, maybe consider moving depending on if you have any symptoms related to the lower oxygen levels.

An oxygen concentrator isn't a big deal to have and connect to a PAP device, but it does of course cost money, increase noise levels and electricity costs of course

[russjpaul]

I'll adjust the Min up to 11 and change the EPR to 3 just out of interest - watch it for a couple of days and see....my headgear was in a terrible state so I replaced that and the seal cushion too so leakage should go down.

My o2 stats are normal when up and about; 96 - 98 most of the time....admittedly I've never worn the PulseOx during the day and let it record.

I have a very established life in a great little ski town, we own and run a bed & breakfast so moving into the pollution of Salt Lake City wouldn't be my first choice.

I found a concentrator for $350 on Amazon, 1 liter/min at 93% o2, 2l/min at 73% and 5l/min at 35%. I've already got a climateline with an o2 port on it so its a breeze to connect the CPAP.

see how we do without o2......

R.

[palerider]

Increased Min Press.to 10.6. AHI index went down but spo2 actually dropped a tiny bit. Maybe increase min pressure to 11.5 ?

Thanks folks - appreciate the help.

R.

I'd say min of 12.

[raisedfist]

No need to record o2 during the day unless you had obvious symptoms while awake.

More min pressure like Palerider said is worth a shot. It won't cause any harm.

[Thumper68]

Why are you restricting your max pressure to 14.8? I think that your machine wants to increase above that at times to fight something.

[zonker]

Why are you restricting your max pressure to 14.8? I think that your machine wants to increase above that at times to fight something.

i don't see it trying to raise above 14.8 on the charts he's shown.

[Thumper68]

Why are you restricting your max pressure to 14.8? I think that your machine wants to increase above that at times to fight something.

i don't see it trying to raise above 14.8 on the charts he's shown.

On 1-9 it went to 14.6 and on the next one 1-15 it did max at 14.8. He may have a valid reason to limit it but I prefer to set the max to max!

[zonker]

Why are you restricting your max pressure to 14.8? I think that your machine wants to increase above that at times to fight something.

i don't see it trying to raise above 14.8 on the charts he's shown.

On 1-9 it went to 14.6 and on the next one 1-15 it did max at 14.8. He may have a valid reason to limit it but I prefer to set the max to max!

you've got better eyes than mine! good catch. and i agree with setting max to max. otherwise, it's not max!