Software v. Pulse Oximetry for Analysis of xPAP

oneantonee · Post by **oneantonee** » Thu Apr 13, 2006 12:15 am

I've been reading a lot about the software and it sounds like the $200 for the Encore Pro and SmartCard reader is well worth the investment, and I will definitely make it once I am set with the Remstar Auto with C-Flex. Then I will also take a more proactive stance in analyzing my sleep and making changes to the machine settings as indicated.

However, in the meantime, it sounds like PO gives a better indication of treatment efficacy, whereas the software analysis is better for making treatment setting decisions. Is this correct?

If so, rather than investing in a PO at this point, should I ask the DME to rent me one for the first month or so?

Thank you all.

Antonio

dsm · Post by **dsm** » Thu Apr 13, 2006 4:16 am

The main issue re using a PO is having to attach a wire to your finger all night (or your ear, or elsewhere )

Most people using one only needs to do so to learn what it is that might cause a desat. That can be from more than just OSA events.

I still believe the ideal would be a mask hose with a wire running along its side & a built in probe fitted in the mask in some way, that eliminates the complexity of other approaches & allows the cable to be plugged in to the xPAP machine & that the recorded data can include the SpO2 levels.

That would be very very helpful.

Cheers

DSM

oneantonee · Post by **oneantonee** » Thu Apr 13, 2006 12:22 pm

I don't really have a problem with a wire going from my finger all night. If I did, I certainly don't think I could even conceive of tolerating xPAP!

Should I get a PO from the DME for the first month to make sure my pressures are achieving the proper therapeutic level?

Thanks for an informative reply.

Take good care,

Antonio

oneantonee · Post by **oneantonee** » Thu Apr 13, 2006 12:23 pm

What I meant was, thanks for the reply, but I would appreciate it if someone could actually answer my question.

Thanks anyway.

Antonio

NightHawkeye · Post by **NightHawkeye** » Thu Apr 13, 2006 12:38 pm

oneantonee wrote: . . but I would appreciate it if someone could actually answer my question.

OK, I'll bite, Antonio.

Actually, only you can decide whether or not you want to buy an oximeter. I'll say though that I find the data from it at least as valuable as the data I get from my Remstar. An oximeter is just another tool though that can help with xPAP therapy. The data from it somewhat overlaps the data you get from an xPAP.

In your case though, since you've had some bad experiences with xPAP, it seems likely that an oximeter could help you identify if the treatment is effective, regardless of what the xPAP data might be showing.

Hope this helps. Did I fully answer your question?

Regards,
Bill

Wulfman · Post by **Wulfman** » Thu Apr 13, 2006 12:45 pm

oneantonee wrote:Should I get a PO from the DME for the first month to make sure my pressures are achieving the proper therapeutic level?

Thanks for an informative reply.

Take good care,

Antonio

That would be my suggestion. The DME will probably require a prescription from your doctor.....which shouldn't be hard to get. There should be NO CHARGE for it. I went that route last summer and got two pulse oximeters from a local DME and did mine over a weekend (recording one night on each one).....took them back in on Monday afternoon and they downloaded the info and gave me a copy and sent the other to my sleep doc. A lot cheaper than buying one.

Best wishes,

Den

oneantonee · Post by **oneantonee** » Thu Apr 13, 2006 1:02 pm

Bill,

Yes, that did answer my question. THANK YOU!!!
___________________________________________________________________

Den,

That clarified Bill's reply. YES, I was going to "rent" one from the DME. I'll TRY to get it at no charge, but in this market, (Los Angeles), things might be different than where you are at.

I will follow your example and get it over a weekend, or any other 2-3 day period once I am using CPAP regularly. This will then tell if the treatment is working, as well as by my partner's ability to tolerate me in the same bed.

Then, if I keep the Remstar Auto with C-Flex, I will make the investment in the software and card reader for better analysis and management of the machine settings and understanding my sleep patterns.

Many thanks.
___________________________________________________________________

WHEW!

I'm glad I'm starting to get some of this figured out. It's nice to be on top of my therapy and not letting the doctors dictate what THEY want. I'm on an insulin pump and I take a proactive role in managing that as well.

Everyone here is so great that I will stay active even when I'm not asking questions.

Best regards to everyone!

Antonio

Wulfman · Post by **Wulfman** » Thu Apr 13, 2006 1:39 pm

oneantonee,

"All things being equal"......they should NOT be able to charge you because there are no "billing codes" for those particular devices. On the other hand, considering where you live.....all bets are off.

Good luck.

Den

RestInSeattle · Post by **RestInSeattle** » Thu Apr 13, 2006 1:51 pm

Sounds like you already had your question answered, but due to XPAP therapy designed to primarily resolve a significant problem, being blood/oxygen levels. I think that the oximeter is a great idea to ensure that your compliance to XPAP is actually effective in it's treatment.

It's not just the lack of sleep that is important to resolve, although this is extremely important and goes directly in hand with poor Blood/Oxygen levels. Many have their levels drop low enough, untreated, that it is at the level that hospitals recognize as potentially causing organ damage and other issues. This is why all surgical patients have an oximeter in the recovery rooms at hospitals, as a good ratio of oxygen is vital to speedy recovery.

While current models of Respironics gear don't have an input port for an oximeter, they may in time. The competition (ResMed) has an optional reader that can be installed onto the XPAP system for combined monitoring. Primarily they market it as a system physicians can send home for outpatient sleep studies, but it's still a great idea. This way your readings are all combined into one report.

Here's the link: https://www.cpap.com/productpage/resmed ... ystem.html Yowtch! Pricy! This may be why you haven't seen much mention of this item as I don't think most insurance plans would cover it anyways.

A separate oximeter still provides you great data, but the real value is when it's combined so that you can directly compare it to the AHI data throughout the evening.

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CPAPopedia Keywords Contained In This Post (Click For Definition): respironics, AHI

oneantonee · Post by **oneantonee** » Thu Apr 13, 2006 2:06 pm

Yeah, back in 1998 I was diagnosed with OSA and subsequently had 2 other sleep studies over the next several years. Then, a couple of years ago, I just wanted to make sure I was still having OSA and I didn't have a sleeping partner, so I asked my sleep doc for a PO to have at home over a 3 day period to check so I wouldn't need another PSG. This was no problem for the DME, nor my insurance.

However, now I have different insurance (Medicare/Medi-Cal) and my GP is coordinating the OSA treatment. Luckily, HE is pretty easy going, so I should have no problem getting the Rx for the PO. Getting the DME to go along with it is another matter that I'll have to figure out. Since I usually get what I want, medically speaking, I will finagle it somehow.

Best,

Antonio

RestInSeattle · Post by **RestInSeattle** » Thu Apr 13, 2006 2:06 pm

dsm wrote:The main issue re using a PO is having to attach a wire to your finger all night (or your ear, or elsewhere )

Actually, the implied location from the smilie wouldn't necessarily be a good location. Both in Women and Men the amount of blood in this area changes through out the night as part of the Circadian rythm. This would provide changing results without the impact of XPAP on top of it.

Not to mention the interruptions to the sleep process everytime one rolled and the cord was trapped. Have enough problems with OSA without addition sleep disruptions from the oximeter.

Of course this may be for fun before dosing off for the night.

dsm · Post by **dsm** » Thu Apr 13, 2006 6:28 pm

I have some DS25 PO probes (stick on probes) and am always intrigued that the best reading I get is if I place it on my forehead. It will typically be 99% vs say 95/96% if I use a DS100A probe on my finger.

I didn't think there was enough flesh on my forehead for the pulse part of the probe to work. If it does provide accurate info then the idea of embedding similar probes in the rims of masks is not so silly as it sounds.

The Ultra Mirage F/F mask I use has a replaceable face seal. One of these seals fitted with a DS25 style probe does seem all that difficult to do.

Food for though.

Cheers

DSM

(PS I did tell myself that a 99% SpO2 reading on my head may at least tell me that my brain should be in top condition even if my body isn't )

NightHawkeye · Post by **NightHawkeye** » Thu Apr 13, 2006 6:43 pm

dsm wrote:I have some DS25 PO probes (stick on probes) and am always intrigued that the best reading I get is if I place it on my forehead. It will typically be 99% vs say 95/96% if I use a DS100A probe on my finger.

Thanks, DSM. One of the things I've wondered about is whether oxygen saturation varies between upper and lower extremities. Could I get quite different readings if I attached a probe to my big toe for instance rather than my finger. I haven't yet tested this out, because it's not quite as convenient to attach a probe to one of my toes as it is to just slip the DS-100 onto my finger.

My guess though is yes under some circumstance, for instance if one's circulation in the leg is compromised. For you it sounds like saturation rises to the top. .

Regards,
Bill

dsm · Post by **dsm** » Fri Apr 14, 2006 1:47 am

Bill,

An interesting point. "Is it possible/probable, that SpO2 levels vary in different parts of the body"

I think is is possible but am just partly guessing. However based on playing around with my Nellcor P.O., I get different readings from different fingers. Plus using another type of probe (a strap on one) can get other readings from my arms & legs.

I think we have some very smart medical people here at cpaptalk who can clarify this point.

Cheers

DSM

Software v. Pulse Oximetry for Analysis of xPAP