AHI OK, resting pulse rate odd

The table below shows My AHI and my average overnight pulse rate since I started BiPAP therapy. I think I have self-titrated fairly well, and I am happy with my overall AHI score for the past week.

I switched from a full face mask to nasal pillow mask on the 21NOV.

I am concerned about my average resting pulse rate as recorded my pulse oximeter. It is all over the map. The low is 58, and the high is 86.6.
These are average rates taken over 4-8 hours.

I am going to talk to my doctor about this, but has anyone ever seen anything like this or have any theories as to what it means?

AHI Date Average Pulse Rate
8.8 5-Nov-14 67.2
3.62 6-Nov-14 70.4
6.59 7-Nov-14 75.1
3.17 8-Nov-14 73.2
5.19 9-Nov-14 76.5
4.91 10-Nov-14 68.7
5.86 11-Nov-14 66.1
2.67 12-Nov-14 71.2
3.26 13-Nov-14 60.7
6.75 14-Nov-14 70.8
4.66 15-Nov-14 71.1
7.19 16-Nov-14 77.7
8.42 17-Nov-14 67.2
3.77 18-Nov-14 58.9
6.39 19-Nov-14 57.5
10.1 20-Nov-14 65.6
1.11 21-Nov-14
2.87 22-Nov-14 86.6
1.88 23-Nov-14 73.9
1.97 24-Nov-14 67.9
1.54 25-Nov-14 68
0.57 26-Nov-14 67.5
2.27 27-Nov-14 66.9
0.67 28-Nov-14 67.3
0.25 29-Nov-14 78

It looks like you are oscillating around 70. Good nights and less than good nights...?

Heart rates vary greatly to provide what we need when we need it. I didn't really see anything that seems abnormal as long as your O2 sats were ok. The normal pulse rate is 60 - 100 with a little less and a little more ok sometimes for short periods. Pulse rate always has to be evaluated with blood pressure and regularity. Also with the sat monitors good circulation is required to read correctly so cold hands and position can affect reading. Some medications also affect heart rate. I would ask your doctor if this rate at night is normal for you especially if you have underlying heart disease.

cnaumann wrote:I am concerned about my average resting pulse rate as recorded my pulse oximeter. It is all over the map. The low is 58, and the high is 86.6.
These are average rates taken over 4-8 hours.

There are many things that affect heart rate. You do know the heart rate always varies depending on many different things.

Age & physical condition are two variables and I don't know yours but your numbers seem to be within the normal window.

By all means do discuss it with your doc.

I have been tracking meds, alcohol and caffeine intake. I have not found any real correlation. There does not seem to be any correlation between AHI and pulse rate either. Most of these have been pretty good nights sleep wise.

Before I started bipap therapy, I was having a huge number of moderatly long apneas (45 seconds was typical) and would have constant strings of desats going from 95% to low 80%, sometimes a little lower. I could kind of understand a high resting heart rate then. I have seen a huge drop in my overnight heart rate since I started therapy.

Based on my age, health and fitness level, around 70 is understandable. But I just don't understand the high 80's and I certainly do not understand why it varies so much night to night. I had my best AHI score to date last night, I had very few desats. Most of the desats I had were yawns or something were my spO2 level went up quickly and then came down to the average line. And yet my average pulse rate was 78.

I think the pulse ox data is right, I don't see large gaps, discontinuities or long periods of unchanging data. It just seems odd to me.

cnaumann wrote:I have seen a huge drop in my overnight heart rate since I started therapy.

That is a good thing and what is expected.

IF you are not seeing desats that coincide with the changes in heart rate then I have to ask if you are securely taping the O2 sensor in place so it does not move? And where is it you are placing the O2 sensor? Are you moving a lot in your sleep?

Here's my thinking. If your therapy has decreased your apneas and desats, your heart is not having to work as hard to get the oxygen out to your cells. Hope that helps. If there is something other than that I wouldn't know from what I can see. Let us know what your doctor says tomorrow.

Did your sleep study show leg movements? If you didn't have a PSG & titration leg movements could very well be the reason for the changes you are seeing? Altho they do like to wait for your therapy to stabilize before they get excited about leg movements.

IF you are not seeing desats that coincide with the changes in heart rate then I have to ask if you are securely taping the O2 sensor in place so it does not move? And where is it you are placing the O2 sensor? Are you moving a lot in your sleep?

To answer the question, I am not taping the sensor down. I place it on my pinkie finger, same one every night. It really does not seem to move very much. If I wake up in the night, I usually take it off and put it back on to mark the place where I woke up. I do not move around much in my sleep, I usually wake up to change positions and change positions 4-5 times in the night. I do not have any sign of RLS.

I did see changes in heart rate coinciding with desats before I started therapy. Back then, things were a total mess. Here is a typical one hour sample. You can clearly see my heart rate going up with the deeper desats:



This is from last night during the time when my spO2 level was changing the most (During first REM?) Things are dramatically improved. The desats seem pretty insignificant, and do not really correspond to increases in heart rate. My heart rate is jumping around, I think that is due to REM, and is nothing to worry about. However, my average heart rate seems a bit high for sleeping. There are other parts of the night where spO2 levels are very constant, my heart rate is constant, but still kind of high. I could accept the higher rate as 'normal for me', but I really don't understand why it is so much lower other nights.

Hi - there really doesn't seem to be anything at all wrong or abnormal about your graphs... seen much, much worse. You can keep obsessing about it all, but you'll make yourself nuts and stressed, which will not help anything of course. Just relax and go with things for a while, a few weeks or so and then get some kind of true consensus about things - that does not mean pulling out the odd 'worst' nights for examination, just taking an overview of the whole thing. If something is truly not right, you'll get help with it, but for now... get some sleep!

Oximeters are usually not placed on pinky fingers. Pointer or middle fingers are best.

Your graphs look fine. Heart rate is going to vary depending on sleep stage and what is going on in your dreams also.

I'm afraid that you may have developed too much backlash in your gears and slip in your clutches...

that and the fact that the human body isn't a precision machine with carefully defined, and tightly associated inputs and outputs.