My sleep apnea cured?

Too tall wrote:If I gave you guys the impression that an oximeter was a substitute for a CPAP, that was not my intent. Re-read my post and you'll see that I also said, "I've also worn my CPAP to see what the OSA's looked like. They were numerous a week after surgery but 3 weeks now they are down to under 1.". So, I'm trying to be as prudent about it as possible while recovering from the surgery, not trying to sell anyone an oximeter.

I appreciate your posts and thank you for sharing your experiences and observations on this board.

ChicagoGranny wrote: . . . visitors to this forum would not waste so much time, energy and money on home oximeters.

Thanks, Gran.

But don't make me feel like a hypocrite. I got two or three home oximeters lying around here somewhere myself. And years ago I found it very comforting to see for myself several nights in a row that I didn't have sustained desaturations, given how low and how long my O2 desats were in my diagnostic NPSG. (How's THAT for undermining my own arguments? )

I applaud people who take an active interest in their own health. Buying a pulse-ox may do more good than, or at least as much good as, buying the latest game box and upgrading to a 4K TV or whatever.

And I would never stop people from buying superfluous electronic gadgetry from China. What better use of disposable income could there possibly be for helping to prop up the international economy?

And if someone has COPD-like troubles or is on O2, it makes perfect sense to me for them to make regular use of a home oximeter. My only issues are (1) declaring someone OSA-free or (2) declaring someone's OSA treatment a success, based on the readings from one.

jnk... wrote:

ChicagoGranny wrote: . . . visitors to this forum would not waste so much time, energy and money on home oximeters.

Thanks, Gran.

But don't make me feel like a hypocrite. I got two or three home oximeters lying around here somewhere myself. And years ago I found it very comforting to see for myself several nights in a row that I didn't have sustained desaturations, given how low and how long my O2 desats were in my diagnostic NPSG. (How's THAT for undermining my own arguments? )

I applaud people who take an active interest in their own health. Buying a pulse-ox may do more good than, or at least as much good as, buying the latest game box and upgrading to a 4K TV or whatever.

And I would never stop people from buying superfluous electronic gadgetry from China. What better use of disposable income could there possibly be for helping to prop up the international economy?

And if someone has COPD-like troubles or is on O2, it makes perfect sense to me for them to make regular use of a home oximeter. My only issues are (1) declaring someone OSA-free or (2) declaring someone's OSA treatment a success, based on the readings from one.

I agree and like your clarification. You are obviously very knowledgeable on this subject, more so than I. For me O2 desaturations mean more because I've had AFIB. I never had issues with sleep quality, in fact, my sleep efficiency went down when I added the CPAP. (AHI = I had a catheter ablation to correct AFIB in 2013 and I've been cautious about both desaturations and OSAs because of the detrimental effects on the heart although, I think, O2 desaturations are more critical for organ/ heart damage than OSA however. (That's why I bought a $1000 Oximeter and software to give me more information along with my CPAP.). I feel it's paid off

There is a direct correlation between AHI and ODI (plenty of studies on this) so I slightly disagree with the notion that the oximeter is useless in predicting apnea severity, although the ODI / AHI relationship is probably more useful in categorizing the apnea in less than 5, >5<15 and >30 AHI. By definition, a desaturations is a drop of 4% O2 in less than 3 minutes. That's doesn't take much of an OSA. 98 to 94 in 3 minutes is a desaturation. So having 0 desaturations or an ODI of 0 has a very high probability of putting you in the less than 5 AHI category. A drop below 92 and then 88 get into the organ damaging environment. This doesn't mean that I throw my CPAP away, yet. But, with my cpap on minimum of 4 pressure and AHI under 1 and getting 0 or 2 desaturations per night max is a pretty safe indication that there ain't a whole lot of sleep apnea going on. You know what I mean.

Cool!

I may have some basic general knowledge. But when it comes to your condition, YOU and your docs will always have the edge.

A higher-quality oximeter is much more likely to catch transient desats, yes. But the question is, What can one do in a practical way with the information? An investment in data procurement is only worth the investment if it helps to point to a course of action. Documenting the short-length desat helps label some events as insurance-significant when making sleep-treatment decisions. But that doesn't make the short-term desat medically significant on its own. Apart from defining other events, short-term desats are meaningless, to the best of my knowledge. The damaging desats for the organism, apart from sleep definitions, are only the long-term desats. A quick desat shouldn't starve an organ or cause build up of waste gases, as far as I know.

I have no trouble, ever, with anyone thinking outside the box to collect night-to-night data that might balance the one-night snapshot of an NPSG. The thing is, though, patient-gathered data will never/rarely be accepted by docs who have to defend their decisions to the insurance bean-counters who presently rule the world. So other than a patient assuring himself, I see little benefit to home oximetry apart from tweaking O2 or monitoring lung-function unrelated to sleep.

That said, there are exceptions to every rule, and I am certainly no expert on AFIB or other cardiac comorbidities for which PAP can play a role apart from fixing sleep architecture.

PAP can help prevent the adrenaline surges that can come with a long-time blocked airway, so it all relates. But the problem with using PAP to check off-PAP breathing events is that there is no way to set the machine to zero cmH2O. Therefore, one can only check events that occur with pressure, which tells one nothing of what is happening when one is off PAP.

Anyway, PAP decisions for someone with heart irregularities are solidly in the realm of what should only be commented on by people with the education and experience to have a meaningful opinion, which counts me out. I think I understand some things about how some mechanical issues in the upper airway affect sleep, and I think I've read some things on the psychology of sleep that can be helpful to people with purely sleep issues. Other than that, my opinions are of little use to someone sorting out multiple health issues. My only semi-understanding is that the relationships between some forms of AFIB and some forms of sleep-breathing issues are mysterious and controversial and notoriously difficult to study.

I wish you the best with your conditions. And your toys!

An interesting aspect of this discussion is the focus on oxygen saturation...

A PULSE oximeter measures both O2 saturation and heart rate. If you don't experience desaturations but do have lots of arousals you will see evidence of this in the pulse rate channel.

Remember they are 2 channels on a pulse oximeter. Both provide valuable information once you learn how to interpret them.

And then there's always tea leaves and rolling some bones.

HoseCrusher wrote:If you don't experience desaturations but do have lots of arousals you will see evidence of this in the pulse rate channel.

But in this case, seeing an increase in the pulse should not be interpreted as an arousal due to a breathing event. If you are making this interpretation, you are misusing the data.

Having an increase in pulse rate should be checked out to determine what is causing the increase.

A breathing event is only one cause. Arousals are another. PVC's and Afib are another. Having the cat land on your face in the middle of the night is another...

HoseCrusher wrote:Having an increase in pulse rate should be checked out to determine what is causing the increase.

A breathing event is only one cause. Arousals are another. PVC's and Afib are another. Having the cat land on your face in the middle of the night is another...

My cat hit me in the head with the clock. I woke up startled and confused. Then found the clock next to my head and a cat on the desk looking at me.

NOT helpful.