O2 drop with CPAP

[NewToSleepApnea]

Awesome! Didn’t know that. I will do that tomorrow thank you! If you don’t mind me asking a How often does your O2 drop during sleep with the CPAP? And how low? Still trying to get a grasp on normalcy.

[NewToSleepApnea]

I can’t believe no one else on this whole forum has the same problem as me. And Drs are dismissing it. This is like a bad dream. It’s 1250am right now. Here’s my O2 chart trying to go to sleep from 11:21 - 12:38.

I woke up 4 times with my chest hurting, not breathing and obv O2 levels were down. All 4 times I woke up before it vibrated to tell me my levels were down. I was barely asleep for each wakeup. Wtf.

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[Norma45]

Ok, I just joined, saw your post, and yup, I get those drops also.
I have also wondered it if was something off in the Oximeter - I have one similar to yours and I have heard the wire can wiggle.
I have not tried to make them happen by not breathing/wiggling my finger or hand around.

When I look at the drops in Oscar, they can last a minute or two. Not necessarily related to apneas (sometime yes, sometimes definitely not).

My Dr thinks it is REM sleep but I am not confident in her (new Dr, I am just starting this route).
I can sleep through them.

I also have some concerns and would like to figure out what is going on, I am still figuring out this whole Xpap thing, so those funny dips is just part of the whole picture .

Like you, I think I have some unusual breathing patterns. I think I pause my breathing wide awake - sitting up. My O2 is 95 or above sitting up so I have not worried about it. I took a lung test many years ago (simple one you blew into a tube if I remember right) and I was told I was just on the edge of the value they were looking for (signed up to help with emergencies at work and they wanted to make sure you could squat, pick things up, and checked breath also).
I have noticed that I seem to sit between breaths (after an out-breath) for a longer period at times (3-5 seconds) before taking an in-breath and I can also breath shallow when wide awake if I am sitting/ laying quiet.
I have a friend who lays down and even while wide awake, as he starts to relax he starts having hypoapneas.
So like others have said, we all have our quirks and need to figure them out. And like you, I have not yet found a good Dr. The one I am seeing was using the myair reports (which gave nothing of value and showed smiley faces when Oscar was showing serious issues, luckily in this time of telemedicine she did pay attention when I showed her oscar reports - had heard of the software but I bet she never looks at it).
You need to drive the discussions and upgrade your Dr if you are not getting good results.

Also, I know you are getting better sleep with the pills, but I personally am very cautious about using any kind of sleeping pill when I know I have issues going on. It just means I could sleep thru problems but the problems are still there. I heard back when that someone had died because they had a couple of drinks and fell asleep without their cpap - slept right thru the fact they were not getting enough O2. That person had severe apnea and I don't have that severe of apnea, but that scenario would still concern me. That said, you gotta do what works for you.

Keep us updated on what you learn about yourself - as I get my machine use worked out if I figure anything out I will come back and post. And I will try to do some experiments to see if I can make that O2 drop happen.

[NewToSleepApnea]

Thanks for the post. Mine definitely do not happen in REM. But hopefully will figure this stuff out sooner rather than later. Your post helps a lot, I think it may be about breathing patterns as well. Shallow breath etc.

[NewToSleepApnea]

Screenshot of today with O2 now in, thanks grounded

First one is all night. The second one is when my O2 dropped the lowest. You can see from the flow rate that my breathing goes way down but the machine didn't even register an AHI.

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[raisedfist]

Those do not look like real O2 drops...O2 does not drop and recover that sharply. I would purchase a Contec device as they are of reasonable expense, and I find the recordings to be quite reliable. I got mine on Amazon but they are also on Ebay and aliexpress if you want to save a few bucks by ordering from China.

[NewToSleepApnea]

Thanks for the response Raisedfirst but It recovers because I wake up.

I wake up from the O2 dropping. And then I breath until it goes back up.

That is the whole problem. It wakes me up. Literally the only problem I have ever had with this sleep apnea thing since the day it started.
I have tried 3 different oximeters. All have ONLY dropped at the same exact time that the Flow looks like that and when I wake up.
If the oximeters happen to be falsely showing a drop reading at the exact times i wake up, multiple times a night for 3 weeks - the odds must be astronomical. Can't even fathom those odds. This is basically what every doctor has told me.
"This doesnt make sense, your pulse oximeter must be wrong".

Every time you saw that steep dropped. I fully woke up and sat up until it went back to normal. I do not choose to. I gasp and it happens.

[raisedfist]

Well that is certainly odd then, appreciate the additional information as I kind of just briefly skimmed through this thread. When you zoom in on your therapy during these times, are you breathing at all?

I wonder if it would be worthwhile to trial a bi-level machine with a backup rate, such as an ST or ASV. The advantage being it will show you the "spontaneous trigger" percentage as part of your therapy statistics, and you can see if it's initiating a backup breath during those times. Or, you could also trial the VAuto, which although it is a bi-level without a backup rate, you'd then have the ability to make the "trigger" more sensitive to see if that helps.

In reading more of this thread, it seems you have some O2 problems while awake and lying down. I'd probably start with your primary care physician then and have your overall health examined, and then go from there. It could be something as simple as a heart arrhythmia that causes these brief issues. Maybe ask your PCP for some basic blood work, check your vitals, and do an EKG. Sometimes a bit of information is helpful in determining next steps.

[NewToSleepApnea]

Thanks! I’m on the same page as you. Gotten blood work, EKG, lung X-ray, echocardiogram, all of it.

But Monday = in lab sleep test! So hopefully that will give some answers!

All I really need is 1 doctor to be like, “okay your O2 sharply drops when you are falling asleep and wakes you up, even with CPAP. Lets figure out why”

[Norma45]

Raisedfist - I use a Contec CMS50FW (older one from about 7 years ago, got it from a friend, but put a new finger piece on it as that apparently wore out from years of non-use .

I get those weird drops also, for just a minute or two. They don't wake me up. First night with a bipap and the oximeter and only 1 o2 drop that also included a lost signal, so might have been a roll over wiggle device and not a real drop. I like the bipap much better - works better with my breathing, but it is early on and still a lot of things to figure out.

I did, with my Contect, try to emulate getting the O2 to drop. I could get it to go from 97 to 94 by holding my breath or by doing shallow breathing, but not lower than that. (sitting up, I didn't try laying down and I should try that).
When wiggeling it around, by sqeezing it on the finger probe (pretty hard, harder than would happen at night sleeping), I could get my pulse to show with crazy patterns - very fast, wild patterns, even flat line - but the O2 keep showing good readings.

[NewToSleepApnea]

This is from the first two hours of me sleeping. I woke up every time which is why it goes back up. This is with the CPAP. The rest of the night - nothing below 89%. Saw the Oscar data and it mostly doesn’t register as an event but the flow shows an obvious lack of breathing. Sometimes up to 3 mins.

Got a sleep lab tomorrow night. But worried it won’t show anything or something. It’s been a month of waking up like this not breathing. I really don’t know how much more of this I can take.

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[HoseCrusher]

Try this...

When you get up in the morning put your oximeter on and wear it to your appointment. See what happens during a "normal" day of wearing it.

If you can find a destination that is roughly 30 minutes away and doesn't involve heavy traffic, go for a drive. I can breathe shallow and drop my O2 levels while driving relaxed. It take a little time but they do drop to around 85%. As a result of this testing I make it a practice to frequently take a deep breath while driving to keep my levels up.

So far I don't see any large issues with the data you have presented. It would be nice if our bodies did what we want them to, but...

Keep in mind that Covid patients are presenting with O2 levels of around 75% and are totally fully functional. I figure if your level is 95% on average you are not in immediate trouble.

[NewToSleepApnea]

Okay great. That is helpful. It’s just so frustrating waking up every time I fall asleep for the first few hours.

You are the first person I’ve heard from that can actually drop their O2 levels like I can, same way. Shallow breathing relaxed. Makes me feel alittle better! Thank you!

[Norma45]

Newtosleepapnea, well an O2 drop did show up on the bipap 2nd night of usage. Not as bad as with cpap, but happened.
I read about the ASV machine and it talked about a condition where the throat spasms (or something like that - I read this a couple days ago). But the condition it treats is correlated with doing better lower pressure (you do 10-20). Just something to consider when you do the Sleep Study/talk to the Dr.

[SleepGeek]

Google 'Silent hypoxia' see if that fits your symptoms