Apneas and Oximeter

[Dolpp]

I might be having trouble with central apneas but i'm not sure if my machine is reporting them properly and so I purchased and oximeter, should be here in a few days. My question is, If my machine tells me I am having centrals but the oximeter doesn't show a drop in o2 sat. is that a good indication that it is reporting it wrong? I guess I'm looking for some information on o2 sats., apneas, periodic breathing and daytime fatigue and how they correlate. Do the apneas cause the daytime fatigue and affect your quality of sleep more or do the o2 sats, or can you not have one without the other. I apologize if this doesn't make sense, I know what I'm trying to ask just having trouble wording it. Basically, I just want to see how I should incorporate the oximeter into my arsenal and interpret its data in correlation with my biPaP data.

[LoQ]

I think I understand what you are asking, because I've pondered this myself.

In my limited experience, I can have both high O2 sats and low AHI for a night and still be tired the next day. There are so many factors in alertness that just those two things don't begin to cover it.

I've seen similar or slightly worse nights and yet felt pretty good the following day.

My experiences suggests that until you know all of the factors causing your fatigue, you can't really look at just O2 sats and AHI and draw conclusions about what kind of day it's going to be.

Some people appear to be affected mainly by their PAP therapy. Good night=good day and vice versa. I wish I were one of them, but unfortunately, I have other factors, so what kind of sleep I get at night is only part of the solution. If you are lucky, all of your problems will be solved by BiPAP. If you are not, you'll have to look at other issues, possibly unrelated to sleep.

[Dolpp]

I got my pulse oximeter today, how exactly do I go about using it? I guess I should have looked into a little more before i blew $130. I mean I know how to use I can read directions, but is it going to tell me anything useful? And how do I interpret what it tells me?

[LoQ]

I got my pulse oximeter today, how exactly do I go about using it? I guess I should have looked into a little more before i blew $130. I mean I know how to use I can read directions, but is it going to tell me anything useful? And how do I interpret what it tells me?

Well we don't know what kind of pulseox you have, if you are asking for directions about it specifically.

Otherwise, you wear the thing at night, download the data in the morning, then look at the generated reports. Higher oxygen sats are better than lower ones. Anything below 90% possibly represents a serious problem, but my sats can stay above 91% and I might still feel lousy. After many nights of using my pulseox and studying the data, I've discovered that my O2 needs to stay 96% to 97% for most of the night in order for me to feel good. I can't really spend too much time below that without feeling lousy.

How to fix the problem is a whole 'nother tomato.

[Dolpp]

Ok, so this might sound stupid, but I was trying it out and I had it on a held my breath as long as I could and my sats. never changed. Should they? Or am I looking at this wrong? does it have to be more prolonged?

I'm more concerned about the centrals I'm having to see if they are actually centrals or if my machine is flagging them wrong, my plan was to see the correlation between when my machine said there was a central and my o2 sats at the same time. But if it doesn't change when I hold my breath I don't think this is going to work. Any thoughts?

[echo]

Many of us have tried the holding our breath while awake while wearing a pulseox, and yes the durn thing never changes. I don't have a good technical explanation why this is NOT the case when we're asleep, but remember that the body is in a very different state when asleep and it won't react in the same way.

I think you're so focused on the many number of things that *could possibly go wrong* or be false negatives/positives... but first why don't you just use the pulse ox and see what the results are? A flagged CA accompanied by a drop in SP02 is worth investigating further, but look at the leak rate at that time point too. Normally if you're prone to CAs those will show up during your titration. Were any centrals noticed during your titration? At which pressures? Do you have a copy of your titration study? What's your current pressure (range) ?

[Dolpp]

I do have a tendency to over-think things a little bit. I am analytical and type-A to a fault. It just seems like I've been going in circles for the past two years and would really like to be able to live my life again. I'm missing out on so much because I would rather be sleeping than doing anything. I'm willing to try anything.

I did get a copy of my sleep study. I was titrated with a BiPaP. This was my 4th sleep study the only one with the bipap and the only one with any centrals. The centrals started at a pressure of 12/8 which is the pressure he put me at. Because that was when the hypopneas and obstructions went down to just about 0, and the doctor felt that the centrals would go away when I got used to the BiPaP, but according to my software they didn't. My doctor doesn't believe in the software and just wants me to "stay the course" so I'm trying to learn as much as I can to figure all this out on my own. According to my titration, I was at 3.2/hr at 12/8. Then 1/hr at 14/8. Then 1.6/hr. at 16/10. Nothing before that.

I've been using a pressure of straight 8 and been getting real good numbers but still am tired all day.

[echo]

OK, I can understand that, and your concerns about the CAs do seem warranted. I haven't followed any of your other threads, so I can't really comment much on your therapy... but I would say definitely use the pulseox and see what it says first. I have the same tendencies, I like to think about all the possible scenarios and what they could possibly mean before I take any action. Sometimes that can create paralysis, I've found, so now I take my BF's approach and try to think less (easier said than done).

It's worth noting, if your pulse ox is good, and your numbers are good, then there many just be other factors at play. Once my OSA was treated, I struggled for another 2+ years. I was sleeping much better of course, and definitely felt the positive effects of CPAP, but I was still dead tired most days. Only after I started treatment for hypothyroidism did the rest of my symptoms of fatigue and excessive sleep disappear.... so while we all focus on the xPAP therapy as the solution to all our problems, it could just as easily be diabetes, anemia, low B vitamins, or any number of other health issues too... Just my 2 cents!

Good luck and let us know your pulseox results!