What is the flat line? Is he not breathing? CMS50D+ report

[ejackson1200]

Last night he kept waking up and waking up. Glanced at the report and said HUM how odd it looks like the best night ever based on the SPO2 index of 2.4, however the average duration is 50.4 seconds, and is it possible that the 2L of O2 is keeping the number of events down as he doesn't desat 4%?. Then I paged through the strips and now I"m wondering if the long straight line is where he is declining to breathe for a few minutes at a time?

He's def. not rested, in bed "sleeping" about 10 hours at night but not refreshed or ready to get up and then back in bed for 1-2 hours later in the day.

Here is the enlarged report link.

http://s1201.photobucket.com/albums/bb3 ... strips.jpg

Thanks

[archangle]

Does an SPO2 "event" really mean anything if the SPO2 level is over 90% or so?

By "flat line", do you mean like around 1:45? It looks a little strange because it's varying so little that the machine doesn't see the changes. As long as the level isn't too low, that's probably a good thing.

I would think actual apneas would have a lot of variation in SPO2 levels. There might be some other kinds of breathing problems that would cause a low SPO2 level without a lot of variation. His SPO2 doesn't look that low, though.

[ejackson1200]

Yes, I do mean around then. I'm wondering what is causing it as he's so tired and almost lethargic and waking so often at night. Last night he was "snorting" maybe around the lips as he was retrying his Swift FX instead of his Quattro. I'm wondering if just the pressure and the 2 liters of oxygen can maintain a certain level.

[Lizistired]

I think it samples every 6 seconds... or reports an average every 6 seconds. You won't see a breath by breath report like from a cpap. HIs O2 is staying above 90 so that's good. It's really all the oximeter can tell you. What you may be seeing is different sleep stages, or lack there of, which result in different breathing patterns. Is he on medications that might interfere with sleep stages?

[ejackson1200]

Meds include Tramadol, Lyrica, warfarin, Elavil, Amlodipine, Doxasozin and Zoloft. We do suspect meds and pain are major issues.

[Lizistired]

Meds include Tramadol, Lyrica, warfarin, Elavil, Amlodipine, Doxasozin and Zoloft. We do suspect meds and pain are major issues.

If his apneas are under control and his O2 is "acceptable", with all the meds, I don't think you can expect much else on the sleep side. If the meds interfere with his sleep stages, it's understandable that he wouldn't feel rested.
You have to pick your battles. His O2 graphs look like he's breathing steady. I have drops in my O2 with events less than 10 seconds(aren't flagged), so I was suprised when you said he stops breathing and his graphs are that steady. I don't know, it may be his body's/brain's way of balancing it all.

[sleepdeprivedemt]

Well the SpO2 reading is pretty good for someone one respiratory depressants. Anything 94% and above is normal, 90%-93.9% is moderate hypoxia, the cpap combined with the o2 is allowing gas exchange to take place without a full respiration.

I don't trust SpO2 100%, so many factors can cause an inaccurate reading, such as COPD, smoking, and even cold extremities. I would rather see this combined with an End Tidal CO2 reading, but you aren't going to get that at home, another study would have to be done and I think ETCO2 has to be specially requested.