Pulse Rate events WHY? importance?

[gomer]

A newbie here trying to understand some pulse-oximeter testing.

I bought a CMS 50h after my multiple sclerosis doc ordered a sleep test. It came with software, Spo2 assistant. I had a sleep test (no results yet) but will have a follow-up apt w/sleep doc coming up soon.

I understand the Spo2 event stuff, but not the WHY or reason/ significance /importance of the pulse rate events test results. I read quite a bit on here about o2 events but not about pulse rate events. IF pulse rate events are a relative non-issue, then WHY does the software report on them in detail similar to O2 events.

Does anyone here understand pulse-rate events and could enlighten me on this aspect.
The reason I ask is I get many times the PR/heart rate events than I get O2 events.

Thanks for any enlightenment you can give into this.....

[archangle]

I understand the Spo2 event stuff, but not the WHY or reason/ significance /importance of the pulse rate events test results. I read quite a bit on here about o2 events but not about pulse rate events. IF pulse rate events are a relative non-issue, then WHY does the software report on them in detail similar to O2 events.

If you have a pulse rate event at the same time as an SpO2 event, it adds some confirmation that the O2 event was real.

Not all apneas cause an SpO2 event. You sometimes wake up enough to start breathing before SpO2 drops. I wonder if these will show up as pulse rate events.

[lazer]

I'm a little curious as to this also as with the limited usage of my pulse oximeter, I've noticed many more pulse rate events as opposed to O2 events.

[gomer]

I must say I am surprised at the lack of responses, so far, considering I thought there were quite a few apnea-geeks or at least semi apnea-geeks with charts and data galore.

I guess there is little interest in this question.........

[shaunas]

I am curious about this also. Although I don't have an oximeter, Sleepyhead tells me I have lots of pulse events. What do they mean?

[gomer]

Well.... bumping this back up the line, in hopes someone who knows more, will see and respond


There are several of us wanting to know, so I am not alone with this question.

[tetragon]

I am curious about this also. Although I don't have an oximeter, Sleepyhead tells me I have lots of pulse events. What do they mean?

Do you mean to say pressure pulses, and not pulse events? Two entirely different pulses. The oximiter measures your pulse rate. Sleepyhead displays your machine's logged pressure pulses.

Your machine will briefly increase the pressure when it wants to guess at whether a potential apnea it sees is obstructive or clear airway. This gets logged, and SleepyHead displays it.

[gomer]

I posted my question here as I thought (what I get for thinking) the knowledge base was quite extensive. I still think it is but my Q about "Pulse Rate" is drawing others w/same question but not answers. Is there a better web source for the information I am seeking? I tried Googling the subject and not found much useful information.

Still hoping...

[Pugsy]

Try a Google search for "Pulse rates and oxygen desats"
https://www.google.com/search?q=pulse%2 ... channel=np

Pulse rates will vary through the night...different stages of sleep...bad dream....a real big oxygen drop....maybe some sort of heart issue unrelated to sleep apnea drops.
Small changes I wouldn't worry about. Number of small changes in pulse rate I wouldn't worry about because some change is a normal occurrence. Now a lot of changes or large changes then I would probably be talking to my doctor about them.

Normally we look at pulse rates at the time of oxygen desat as a way of confirming that an apnea likely caused both the desat and change in pulse rate.

If you are seeing a lot of changes and no desats then maybe it would be something to talk over with your doctor.

Not everyone on this forum uses an overnight pulse oximeter and so not everyone even bothers with pulse rates.
Pulse rates and correlation with anything just hasn't been discussed all that much on this forum...or at least from what I have seen on this forum. Main thing I have seen is just what archangle said....we just use the pulse rate for verification that the desat was likely real.

[gomer]

Thanks Pugsy......

I was not using the term "desats" in my searches.

I had a sleep study a couple weeks ago, will know more later this week when I see the doc.
After my Multiple Sclerosis doc (neurologist) wanted a sleep study, I got curious and bought a CMS-50h.

This whole sleep issue may be put to sleep (puntended) after I see the sleep doc. I had no complaints or no known Sx of OSA and fatigue is common with MS. I do awaken frequently during the night for no know cause but did not mention to any of my docs. Having hypertension and diabetes just puts me in a high risk category.

I am on heart meds to keep my heart/pulse rate down to preserve my valves (3 valves with mild-moderate stenosis I am told is due to rheumatic fever) My oxymeter does show o2 events but not severe or too many per hr. My testing did show many pulse-rate events like dozens per hr (with and without o2 events) ..so that is WHY I was curious

Thanx again Pugsy... (no pug nose on those deer?)

[Pugsy]

(no pug nose on those deer?)

No pug nose on the deer. The deer picture is one I took a couple of summers ago when the twins were babies. I watched them grow up from tiny babies till they lost their spots and moved on in the fall. They were quite used to me so I could get real close. Not long ago I had a little buck standing out in my yard by my truck. I went outside and stood about 20 feet from him for about 10 minutes while he looked and me and snorted and stomped his foot.....just like one of the babies did 2 years ago. I like to think he was one of the twins who came back for a visit because that was what one of the twins used to do when they saw me. The twins were a doe and a buck.

Pugsy goes with my Pug dog. Love the little buggers. Not the sharpest breed out there but they totally are devoted to their owners.

[gomer]

Never had a pug dog, but I am partial to them.

I have sort of a pug nose due to it being broken once upon a time and no problems with it or ever fixed.

Gomer

[JDS74]

Hi Gomer:

The pulse-oximeter is recording pulse rate as part of the data collection. It measures the change in light intensity through the finger and derives the sPO2 value from that. It also can calculate the heart rate (pulse rate) from the same data.

It is a little like a single lead EKG device so you can look at the heart cycle if you watch the displayed graph.

I know of two reasons for "pulse rate" events being seen by the oximeter.

1) AFIB - this is a condition in which the atria part of the heart contracts at a much higher than normal rate. It can be a serious condition.

2) Tachycardia - this is a condition in which the overall heart rate is much higher. Again, a serious condition.

That being said, the pulse-oximeter is a very poor device for detecting and / or measuring either of these conditions.
In your sleep study, the technicians will have recorded your heart rate and a continuous EKG for the entire period of the test. When you get a copy of the study ( and you should insist on getting one ), there should be mention of any heart rate events that occurred. At that point, you should have a serious discussion with your doc as to what, if anything, such events means.
If it only one or two, its likely that nothing important is going on especially if they are correlated with drops in sPO2 levels below 80% or so. Increasing the heart rate is one way your body reacts to the oxygen loss that accompanies a longer apnea (more than 20 seconds or so would be needed to significantly drop the sPO2).

It is typical for the heart rate at night to be quite low. In my case, the average rate is below 60 bpm. If you are seeing on the sleep study, jumps from 60 or so to above 130 over a period of a few seconds, this is a good thing to discuss with the sleep doc. He / she may want to refer you to a cardiologist for evaluation.

If you continue to have concerns, Oregon Scientific makes a recording heart rate monitor that operates directly off of the electrical impulses of the heat and then can be use to produce a 24 hour report. There is a strap that goes around your chest and a wrist recorder that collects the data. If you have it done professionally, the device is called a Holter Monitor and it does very much the same thing but the charge for one night's recording will equal or exceed the purchase cost to the Oregon Scientific device.

It is common to discount sPO2 pulse data as being artifacts especially if they are of short duration and attribute them to body movements. That's why I purchased a recorder to verify my own data. My cardiologist considered the data to be useful.

Hope this helps.

Remember, it is most likely that your pulse events are a result of the apneas and NOT an indication of underlying coronary disease.

[gomer]

YES JDS... it does help.

I have not had A-fibs that I know of in recent years. My cardiologist has me on 2 meds to preserve my valves. (a little regurgitation/stenosis in my mitral, tricuspid & aortic but stable) One keeps my heart rate down so I would not expect wild swings.

A-fibs alone are a stroke risk, so normally I would be on baby aspirin as well, but I had surgery last month and not yet cleared to resume baby aspirin. I had an EKG last month in prep for my surgery and not problem noted. So I doubt I am having A-fibs, but my cardiologist considers everything stable and no need for a holter and no need for color doppler checks in the past couple years.

My Spo2 assistant software typically shows two to three dozen pulse events per hour, not sure why?

Maybe I will learn more about the sleep study later this week when I see the sleep doc.

Gomer

[deltadave]

What parameters are you using for Pulse Rate Event analysis?

I must say I am surprised at the lack of responses, so far, considering I thought there were quite a few apnea-geeks or at least semi apnea-geeks with charts and data galore.

Good idea. Post the graph.

Try a Google search for "Pulse rates and oxygen desats"
https://www.google.com/search?q=pulse%2 ... channel=np

Try Heart Rate Variability instead (assuming this isn't a lot of SWJ)(or mostly WJ)(or just plain ol' J).