LATEST OXIMETER FINDINGS

[mcs2014]

Was diagnosed with mild OSA (AHI of 12.5) in late 2012. I had also been diagnosed with a deviated septum since 2001 which in time I believe has worsened.

Here are my findings using a ChoiceMed W11SM pulse oximeter:

NO TREATMENT (external nasal strip only):
Avg Sp02 <88: 180
Avg event level: 84
Lowest level: 81
Other: morning hypertension

BIPAP+ external nasal strip :
Avg Sp02 <88: 56
Avg event level: 86
Lowest level: 84
Other: morning hypertension; chronic dry mouth following usage; mouth-breathing because could not breathe through nose

OASYS ORAL DEVICE (OSA mandibular advancement device) + external nasal strip:
Avg Sp02 <88: 389
Avg event level: 82
Lowest level: 80
Other: morning hypertension; transient intermittent TMJ/TMD after a few night usage

O2 CONCENTRATOR + external nasal strip :
Avg Sp02 <88: 16
Avg event level: 85
Lowest level: 78
Other: morning hypertension, but better

Conclusions:
1) Pulse rate spikes in the majority of desaturation events but not in all cases; can be immediate spike in PR or a gradual response to varying levels of desaturation or sometimes with no desaturation at all.

2) 02 + external nasal strip resulted in 12 out of 34 sessions with Sp02 of 88 or greater. There was a much higher average >95 Sp02 than with the other treatments. I suspect <88 Sp02 results are mostly due to transient nasal congestion.

3) By far, the 02 concentrator direct to the nostrils via cannula @ a 4-5+ setting with humidifier cup attachment + external nasal strip produces the best results and the least desaturation events <88 (most consistent 02 @ 98).

Although I have not had a followup polysomnography to confirm 100%, my preliminary findings would indicate that my intermittent nocturnal hypoxia/hyponeas stem from my nasal obstruction/constriction/congestion mainly due to the deviated septum and possible rhinosinusitis due to airborne allergens.

My ENT doc was right all along when all the other docs said a deviated septum/nasal congestion does not cause OSA. This goes to show that not all OSA is related to soft tissue/throat issues.

Would welcome any additional input.

[Julie]

Not only are many OSAs the result of anatomy (narrow airway and jaw, with crowded teeth), but there are others like 'central apneas' (or clear airway) resulting from your brain not telling you to breathe for some time, and aggravating factors like back sleeping, etc. Nasal blockages do not cause apnea, but certainly can worsen things.

[Guest]

Not only are many OSAs the result of anatomy (narrow airway and jaw, with crowded teeth), but there are others like 'central apneas' (or clear airway) resulting from your brain not telling you to breathe for some time, and aggravating factors like back sleeping, etc. Nasal blockages do not cause apnea, but certainly can worsen things.

Given the dramatic difference in my above results, it is clear that the main reason for at least my desaturation is due to nasal obstruction.

"Bottom line... Nasal obstruction doesn't directly cause sleep apnea, because the collapse of the airways does not occur in the nose. However, indirectly, there is a link between nasal septum deviation and sleep breathing disorders, including snoring and sleep apnea. So, clearing the obstruction of the nasal passages, will help you improve breathing during sleep and even prevent the collapse of the airway (sleep apnea).
Clearing the obstruction of the nasal passages, will help you improve breathing during sleep and even prevent the collapse of the airway (sleep apnea)."

I am therefore planning on having a septoplasty to restore my breathing through my sinuses. Hopefully that will fix the problem. PAP therapy did not improve my breathing, reduce my desaturation enough, and was impossible for me to sleep with too many reasons, so that is not no longer an option; the oral appliance seems to make everything worse since I cannot breathe through my mouth while wearing it, and certainly not through my nose, causing even more desat events. The 02 concentrator has given me the best results as I've demonstrated in my above post.

[mcs2015]

don't know why I showed as guest

[HoseCrusher]

While using your O2 concentrator did reduce the number of events <88%, the depth of the desaturation was deeper (78 versus 84) than when you were using BiPAP.

Another step is to evaluate the amount of time spent at these low saturation levels.

Pulse rate spikes are interesting. When caused by desaturation they seem to make sense. When recorded in isolation they may be connected to arousals rather than desaturations. You need to add an EEG channel to correlate that.

If you stick your fingers in your nose and keep your mouth shut you will experience desaturation. Nasal obstructions are best eliminated. However there may be more to sleep disordered breathing than nasal obstructions.

Keep monitoring. The goal is to have good health and that comes from restful and productive sleep.

[Too tall]

Not only are many OSAs the result of anatomy (narrow airway and jaw, with crowded teeth), but there are others like 'central apneas' (or clear airway) resulting from your brain not telling you to breathe for some time, and aggravating factors like back sleeping, etc. Nasal blockages do not cause apnea, but certainly can worsen things.

Given the dramatic difference in my above results, it is clear that the main reason for at least my desaturation is due to nasal obstruction.

"Bottom line... Nasal obstruction doesn't directly cause sleep apnea, because the collapse of the airways does not occur in the nose. However, indirectly, there is a link between nasal septum deviation and sleep breathing disorders, including snoring and sleep apnea. So, clearing the obstruction of the nasal passages, will help you improve breathing during sleep and even prevent the collapse of the airway (sleep apnea).
Clearing the obstruction of the nasal passages, will help you improve breathing during sleep and even prevent the collapse of the airway (sleep apnea)."

I am therefore planning on having a septoplasty to restore my breathing through my sinuses. Hopefully that will fix the problem. PAP therapy did not improve my breathing, reduce my desaturation enough, and was impossible for me to sleep with too many reasons, so that is not no longer an option; the oral appliance seems to make everything worse since I cannot breathe through my mouth while wearing it, and certainly not through my nose, causing even more desat events. The 02 concentrator has given me the best results as I've demonstrated in my above post.

Agree with you. I just had the nasal work you are planning and the UPPP and tongue radio frequency reduction. You will be very pleased with the nasal work. I'm in my 3rd week and sinus is starting to clear up but my nose is wide open. It's a no brainer. Go for it.

[bwexler]

You seemed to skip using the O2 concentrator with the BiPAP.
I have been using an O2 concentrator with CPAP/AsV for 5 years. Without the O2 I have desats below 88, with O2 I generally stay above 90%

[Guest]

You seemed to skip using the O2 concentrator with the BiPAP.
I have been using an O2 concentrator with CPAP/AsV for 5 years. Without the O2 I have desats below 88, with O2 I generally stay above 90%

Just tested using the 02 + the BIPAP + nasal strip. Adding the BIPAP caused a substantial increase in desats <88 (91 total; lowest was 83), caused a transient spike/arousal in my PR (250), completely dried out my sinuses, making breathing through my nose impossible despite using a heated humdifier, and was horribly uncomfortable as was always the case.

Thoughts?