Oximeter prescription

hecate · Post by **hecate** » Tue Apr 04, 2006 1:38 pm

Hi,

My doctor gave me a prescription for an overnight oximeter use. My reason for wanting this was because I was concerned about my congestion causeing lower oxygen levels. My desturations line up perfectly with my events from the Encore Pro printout. Unfortunately or more properly I only had two OAs and 4 Hs to check this against.

I did find some unexplained desaturations, one of them went down to 83%. Do you think this does show that my congestion is causing me problems or could there be another cause for this? I can post images (of the report) later if needed to assist with this question.

I have the oximeter for 1 more night for my doctors sake. He swears that I would love the F&P Oracle that he wants me to try it. He is so sure I will like it that if after a month I am unconvinced he will buy it back from me.

I'll let you know how the oximeter readings compare with that.

NightHawkeye · Post by **NightHawkeye** » Tue Apr 04, 2006 3:04 pm

Liz, charts are useful. A picture's worth a thousand words . . .

The length of the desaturations is important too. Apnea desaturations occurr slowly. Quick deep desats are caused by other factors.

Regards,
Bill

two · Post by **two** » Tue Apr 04, 2006 4:39 pm

What are the other causes of sudden desaturations? I experience several of those many nights, down to 85% or lower. Thanks for any insight or suggestions.

hecate · Post by **hecate** » Tue Apr 04, 2006 5:42 pm

Here are my charts. Sorry, but the oximeter print out is ugly, but detailed.

Thanks in advance for any comments.

NightHawkeye · Post by **NightHawkeye** » Tue Apr 04, 2006 10:01 pm

Liz, some of your desaturations look exactly like what I see in my own oximeter data when I have apnea events. Specifically, the desaturations at 23:17, 04:08, and maybe 04:30, all look similar to the desaturations I see when I have apnea events. Apnea seems to cause these sort of long, slow desaturations. I suppose the reason is that oxygen depletes from the lungs slowly.

Your deeper desaturations, such as at 01:48, 01:52, 05:26, and 05:38, occur much more quickly, and I'd only be speculating about the cause. I do see somewhat similar quick deep desaturations in my own oximeter data sometimes and have wondered about the cause. I kinda think in my case, some are cardiac related, as I've experienced A-fib and mitral issues in the past. For me, such quick desaturations aren't associated with any obvious physical issues at the moment, and so I haven't really paid much attention to them. The ones that cause me grief are the long slow desaturations.

Hope this helps.

Regards,
Bill

rested gal · Post by **rested gal** » Wed Apr 05, 2006 5:56 am

Might want to consider that just because tick marks for "events" don't appear along with some desats, it doesn't mean that something apneic wasn't going on. After all, these machines are supposed to prevent "events" (apneas and hypopneas) and for the most part they do that job very well. When they prevent things from getting bad enough to warrant a tick mark, nothing's going to appear on the chart. Sometimes I see slight increases of pressure without anything "ticked". I figure the machine was doing its job and kept an impending event from escalating enough to sneak through and be marked.

The events that are marked on charts are ones that sneaked through despite the machine's preventive actions. Or they might be events that happened too suddenly for the machine to ward them off proactively.

Then, too...there's this to consider:

-SWS once wrote: "Perhaps the biggest fallacy I have seen repeatedly mentioned on these message boards is that when a patient's AutoPAP cannot successfully treat their SDB [sleep disordered breathing] events, then at least their overnight data is going to be accurate. Nothing could really be further from the truth."

NightHawkeye · Post by **NightHawkeye** » Wed Apr 05, 2006 6:37 am

Good points, RG. Every measurement method has its limitations. In PSG sleep studies, they measure six major variables related to sleep; airflow, snoring, oxygen saturation, cardiac function, brain waves, and chest movement. With our xPAP monitoring software we measure only the first two, although not with the same precision as done in a PSG. By adding an oximeter, four of the six variables can be measured, but again not with the same depth of function.

Additionally, all these major variables have many subvariables which are not measured, not even with an in-lab sleep study PSG. That's why the bottom line is how a person feels. If the measured data says everything is OK, then physicians often discount the patient's feelings. As individuals, we don't have that luxury, because we have to live with the symptoms, even if the measured data says things are just fine.

Just my perspective.

Regards,
Bill

hecate · Post by **hecate** » Wed Apr 05, 2006 1:05 pm

I'm sorry I should have posted my respronics print out as well for you to look at.

Guest · Post by **Guest** » Wed Apr 05, 2006 1:11 pm

AHI of 0.7? Now I'm really jealous. For oxygen desats, is the magic number that it has to be above in order not to be considered a problem 85%?

Roger... · Post by **Roger...** » Wed Apr 05, 2006 3:59 pm

I've been able to get the Nellcor N-395 Oximeter to record a few desaturation spikes of 73% by simply moving the finger probe when it was clamped on the finger. Another time without trying, a quick movement of the hand where the probe was connected caused the disconnect alarm to sound.

I suspect the quick spikes are more probe related than physical changes. Right now I'm following what Bill mentions above to look only at the areas where the desaturations cover a block of time instead of a brief spike change.

Guest · Post by **Guest** » Wed Apr 05, 2006 8:01 pm

Using a BCI 3303, I often have nights where I see sharp spikes down to <85% on the printout--not too much definition, as the printout is approximately 1 hr/inch. They are not caused by movement or the probe, as when I wake up to the alarm, I can get the alarm to shut off by breathing deeply for a bit. If I get several of these areas in a night, I usually feel bad the next day. These spikes are pretty much straight lines down. I'm trying to figure out what it could be, as the spikes don't correlate that well with the apneic events (the recorded ones, anyway).

I have experienced probe/movement-related problems when I taped the probe on tightly. The alarm would go off (a different pattern then for desats), waking me up, and I would find the readout flashing without data. I tried flexing my finger while awake, and got the same result. It's possible my probe is defective; but, I've found that I don't experience this problem if I only tape the top part of the probe to my finger, with only the probe's spring pressing the bottom part against the finger.

NightHawkeye · Post by **NightHawkeye** » Wed Apr 05, 2006 8:55 pm

Guest wrote:These spikes are pretty much straight lines down. I'm trying to figure out what it could be, as the spikes don't correlate that well with the apneic events (the recorded ones, anyway).

Yeah, I'd like to know, too. For me, some are like Roger has described, but I think maybe some aren't. In the past I've been diagnosed with thoracic outlet syndrome, which means circulation to the arms can be restricted at times. That kinda makes sense to me since the time I'm most likely to see these sharp spikes is shortly after going to bed at night when I'm still moving my arms around some. I tend not to move around much after going to sleep, so I don't see any spikes later during the night.

Given that we all see these sharp spikes, even with different instruments, I'd venture to say the instruments are measuring a real phenomenon rather than a probe phenomenon. The best answer I can come up with is that these desaturations are related to momentary circulatory restrictions from whatever source, and since they occur much faster than oxygen is depleted in the lungs, they're not necessarily apnea related. (Does that make sense?)

Regards,
Bill

meister · Post by **meister** » Thu Apr 06, 2006 9:53 am

It was very helpful to me to see your data. Thanks for sharing. Your
data look really good. You may even be able to get relief without a
PAP machine by wearing a Dental Device like the Silent Night. Your
eagerness to help others indicates that you would be a good candidate
for a Help Desk job at the University of Idaho.

P.S. Your apnea may be mild enough that the Pillar procedure could
be of some value to you. http://www.pillarprocedure.com

hecate · Post by **hecate** » Thu Apr 06, 2006 10:02 am

meister wrote:It was very helpful to me to see your data. Thanks for sharing. Your
data look really good. You may even be able to get relief without a
PAP machine by wearing a Dental Device like the Silent Night. Your
eagerness to help others indicates that you would be a good candidate
for a Help Desk job at the University of Idaho.

Okay, do I know you? I did actually work at the help desk, not for University of Idaho, but for Idaho State University!

Oximeter prescription

Oximeter prescription

Thanks for sharing!

Re: Thanks for sharing!